Category Archives: All ages

Georgetown Pediatrics: Your Patient-Centered Medical Home

Georgetown Pediatrics is proud to be your Patient-Centered Medical Home (PCMH). Just what is that, you may wonder? As defined by the National Committee for Quality Assurance, PCMH is a way of organizing primary care that emphasizes care coordination and communication to transform primary care into “what patients want it to be.”

Medical homes can lead to higher quality and lower costs, and can improve your child’s and your physician’s experience of care.

Essentially, with input from your family, a PCMH offers a patient-centered approach with our team of medical professionals and technology to provide the best possible care for your child.

In a PCMH like ours, your care team:

Is available 24/7 if you need them. You can communicate with your team by phone or email, and you can get an appointment quickly, even on the same day if needed.
Knows your child and remembers your health history. They know enough about your child’s personal or family history to suggest treatment options that make sense for your child.
Makes sure you understand your child’s condition(s) and how to take care of them. They help you sort through your options and make decisions about your child’s care.
Helps you coordinate your child’s healthcare—even if they are not giving the care themselves. They will help you find specialists, get appointments, and make sure those specialists have all the information they need. Your PCMH team will also be sure you know what the specialists say and what it means for your child.

Who is part of the PCMH team? The PCMH team will work like many athletic sports teams. There is the primary doctor (Head Coach), nurse (Assistant Coach), as well as other health care professionals who may assist in your child’s care, such as: pharmacists (Defensive Coordinators) and physical therapists (Offensive Coordinators). Your family caregivers are also included in your child’s team (fans). With a team approach and the input from your child’s “coaches” and “fans,” your child will feel like a “Star Player” of the team—with a championship level of care!

Be careful to give accurate dosage amounts to children

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A new study in Pediatrics, a publication of the American Academy of Pediatrics (AAP), shows that a surprisingly large percentage of adults give the wrong dosages of medications to children and infants.

Incorrect dosages can be harmful, even dangerous. When the pediatrician writes a prescription or recommends an over-the-counter drug, they take into account a child’s health, age, size and other factors, including other medications he may be taking. It’s important to be accurate when dispensing those meds.

The main problem, according to the study, has to do with measuring.

Adults who measured with teaspoons and tablespoons were twice as likely to make errors as those who used milliliters as their measuring standard.
Never just pull out a spoon from your flatware or plastic ware to measure medicine. These spoons can vary widely in the amount of liquid they hold.
Purchase a measuring instrument (dropper or spoon) in the pharmacy department of your discount or grocery store. Make sure it uses milliliters for measurement.
Measure accurately.
Keep a written record of when you’ve given a medication and how much. Many people unintentionally create problems when one person in the household dispenses a drug, not knowing that someone else has already given the medicine.

If you’re ever unsure about a dosage, call your pediatrician’s office. Safety with drugs, whether prescription or OTC, is essential.

Halloween Safety Tips

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Today’s entire blog below is quoted from the AAP, here. Have a great Halloween!

Halloween is an exciting time of year for kids. Here are some tips from the American Academy of Pediatrics (AAP) to help ensure they have a safe holiday.

All Dressed Up:

Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes.
When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
Obtain flashlights with fresh batteries for all children and their escorts.
Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.

Carving a Niche:

Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.

Home Safe Home:

To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
Parents should check outdoor lights and replace burned-out bulbs.
Wet leaves should be swept from sidewalks and steps.
Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

On the Trick-or-Treat Trail:

A parent or responsible adult should always accompany young children on their neighborhood rounds.
If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
Only go to homes with a porch light on and never enter a home or car for a treat.
Because pedestrian injuries are the most common injuries to children on Halloween, remind trick-or-treaters:
- Stay in a group and communicate where they will be going.
- Remember reflective tape for costumes and trick-or-treat bags.
- Carry a cell phone for quick communication.
- Remain on well-lit streets and always use the sidewalk.
- If no sidewalk is available, walk at the far edge of the roadway facing traffic.
- Never cut across yards or use alleys.
- Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
- Don’t assume the right of way. Motorists may have trouble seeing trick-or-treaters. Just because one car stops, doesn’t mean others will!
Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

Healthy Halloween:

A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
Try to ration treats for the days following Halloween.

Whether dressing up in costumes, trick-or-treating, or having parties with their friends, most kids love Halloween. But did you know that Halloween is also a time when more children than usual end up in the emergency room due to falls, traffic collisions and other injuries? All the sweets in the house (and at school) can also wreak havoc on a child’s teeth and healthy diet.

To help ensure your child’s Halloween is both safe and healthy, pediatrician Corinn Cross, MD, FAAP joins the Healthy Children show on RadioMD with some tips from the American Academy of Pediatrics. Listen here.

Stomach virus season

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Yes, we’re starting to see some fall/winter viruses that cause gastrointestinal (GI) problems. By the end of winter, Rotavirus will have been our most common offender, but now that kids are back in school, lots of viruses are happy. Families who get the viruses… not so much.

GI viruses like school, daycare and home settings because these places have children who haven’t always learned good hygiene practices. Prevention is always the best action against these diseases, so don’t forget to CLEAN door handles, toilet seats, other bathroom surfaces, television remotes. Also be sure to wash hands before cooking, serving and eating food.

Another way to hinder a virus is to keep your child home when she’s sick, preventing the spread to other children and adults. That may have been where she came into contact with the virus. Let’s not spread the “love.”

When can you send him back to school or daycare? Make sure he has been fever free for 24 hours (without a fever reducer), is able to tolerate small amounts of bland foods, has gone at least 12 hours since his last episode of vomiting and has had no more than 3 episodes of diarrhea in 8 hours.

Contact our office if diarrhea and vomiting don’t subside within three days or if diarrhea is bloody, if there’s been no urine output for 10 hours, or if the fever is high or doesn’t subside. We have a nurse available for advice on the phone, and we often can call in prescriptions for nausea for older children, unless we think they need to be seen in the office first.

More information? See our blog from last spring which includes a link to the American Academy of Pediatrics article on Rotavirus. Also, our blog regarding when to be concerned about a fever.

Stay healthy this winter!

Dangers of e-cigarettes for children and teens

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The American Academy of Pediatrics (AAP) has recently expressed their concerns about electronic cigarettes at a congressional hearing and on their website. In an article entitled “E-cigarettes: Dangerous, Available & Addicting,” the AAP warns parents about the problems with e-cigs, and those problems are many.

Many adults use e-cigs to try to end their smoking habit. E-cigs deliver nicotine through a battery operated device that resembles a cigarette, but without the tobacco or smoke. The e-cigs use water vapor to deliver the nicotine.

You may think that e-cigs are safer than tobacco cigarettes, but you should know that, according to the AAP, an e-cig “can have as much nicotine as a whole pack of cigarettes. In addition, the Food and Drug Administration (FDA) has found cancer-causing chemicals in electronic cigarettes.”

This presents a host of dangers.

Teens, apparently believing that e-cigs are safe, have doubled their use of these devices, bringing the usage to about 1 in 10 high school students. They may be avoiding tobacco, but nicotine is highly addictive.
The AAP is concerned about some e-cig flavors (e.g., vanilla, chocolate, peach schnapps and gummy bears). In the congressional hearing Dr. Suzanne Tanski answered “yes” when asked if she believed these flavors would be appealing to children.
Nicotine is a poison. The cartridges that contain nicotine are not childproof, and, says the AAP article, “Most cartridges have 20 milligrams of nicotine, and a dose of as little as 10 milligrams of nicotine can be fatal for a child. In addition, children can easily become hooked on the nicotine.”
E-cigs are widely available. Even though Kentucky law prohibits their sale to minors under the age of 18, they can be purchased online.

Keep your children away from electronic cigarettes and keep them safe from nicotine addiction or poisoning. If you are trying to quit smoking, nicotine patches or gum are safer alternatives.

Back in School, Part 4: Friends

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While you are worrying about your child’s academic year, he is probably more concerned about friends. Honestly, he has a point. While academic skills are an important part to future success and happiness, so are the social skills that help us make and keep friends.

Children at a very young age are usually too self-centered to have friends. This isn’t their fault; it is just a normal developmental stage. If you watch a couple of toddlers on a play date, they will usually engage in what is called “parallel play,” meaning they play side-by-side, but not really together. Even so, you can start to teach them to share, not to grab toys away, etc.

By school age, most children want friends, whether it is just one or many. Good social skills are learned from parents, teachers and peers. Here are some behaviors you can teach your kids that will serve them in school and throughout their lives.

Kindness. Use kind words and tones around the house. Don’t allow your children to be unkind to their siblings, to pets or to adults. Everyone responds positively to kindness, and no one likes a bully.
Politeness. (See our post on manners.)
Assertiveness. You don’t want your child to be aggressive toward others, but you want her to be able to assert her opinions and express her feelings without being overbearing. This takes practice, and it can be something you encourage through conversation, questions, and even role playing. For example, “What will you say if your friend wants to play kickball and you’d rather swing?” They can learn from you the give-and-take of good relationships.
Meeting and greeting. Teach your youngster to introduce himself and to ask questions about another person. They can learn to shake hands, make eye contact, smile.
Listening. Hearing what another person has to say is as important as expressing your opinion.

Here’s a really nice FREE online resource entitled 101 Ways to Teach Social Skills to Children. While the games and activities are designed for groups, many of them can be adapted for use within the family—a fun way to learn appropriate ways of behaving in different settings.

Every school in Scott County has a counselor who can observe behavioral issues both in and out of the classroom, and who can meet with your child and/or other students if needed.

A final word: pay attention to the friendships your child/teen is forming. Get to know his friends and their parents. Make sure their behavior isn’t out of line with what you expect from your own kids.

The friendships we form in childhood and adolescence may or may not last a lifetime. But they teach us skills and behaviors that are timeless.

Back in School, Part 1: Staying Healthy

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Now that your child is back in school, the sometimes easy-breezy days of summer have turned hectic with schedules, deadlines, homework, complex relationships. For the next few weeks we’ll be running a series about things to keep in mind during the school year ahead.

Today we start with how best to insure a healthy year at school.

You already know the best way to stay healthy, but it bears repeating: prevention is always the best medicine. Here are some pointers.

Checkups. Has your child had her annual well child checkup? If not, now is the time to schedule it. The doctor will look at health history, height and weight, and will discuss age-appropriate health topics with you and your child. If you have a specific concern (social behaviors, learning difficulties, chronic ear infections, etc.) to discuss, you’ll want to let the office know when you call for the appointment to make sure they schedule a longer visit for you.
Immunizations. Yes, we harp on this a lot, but it’s for good reason. Immunizations protect children, families, and even whole communities from dangerous diseases. The state requires that you keep certain ones up to date; we have others we recommend. Check with our office (or on the patient portal) for your records.
Exercise. Sitting all day at school, then coming home and sitting in front of the TV or at the computer and homework desk is not good for your kid. He needs to get moving. Don’t expect physical education classes to provide all the exercise he needs. Unstructured play is good for all children, and organized sports are a great way to learn things like discipline, teamwork and a sense of accomplishment.
Germs. Let’s be honest. There’s no way to avoid germs at school. Uncovered coughs and sneezes, shared desks and close quarters give viruses all sorts of opportunities to infect students. Some exposure is good to develop immunity, but keeping hands clean is a great way to stave off colds and flu. Send hand sanitizer to school in your children’s backpack, and remind them to clean their hands before eating and after they use the restroom. Every time. Don’t share drinks or eating utensils. And, while we’re at it, remind them not to share combs, brushes or hats, which is the most common way to spread head lice.
Sleep. A good night’s sleep is an essential ingredient in the learning process. Sleep also helps mood and strengthens the immune system. Set a regular bedtime and stick with it, making sure your child or teen has an age-appropriate amount of sleep.
Balanced diet. Eating right feeds both body and brain. This webpage at the American Academy of Pediatrics site lists several of their articles regarding diet. Don’t forget we have a dietician on staff who can help you come up with an action plan for your young athlete, picky eater, diabetic, or can help you plan easy lunches and snacks to pack for school.

Keep these things in mind throughout the school year and they will help your child have a successful and healthy school year.

Talking to your kids about alcohol and drugs

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Every parent worries about their child’s health, including whether or not that child will use drugs or alcohol.

It’s a valid concern. According to the Centers for Disease Control and Prevention, several studies in 2011 showed that:

“among high school students, during the past 30 days

39% drank some amount of alcohol.
22% binge drank.
8% drove after drinking alcohol.
24% rode with a driver who had been drinking alcohol.”

In addition, 40% of high school students have used marijuana at least once, and 25% have been offered, sold or given illegal drugs on school property.

What can parents do to prevent drug and alcohol use and abuse with their own children?

There is no single answer, and some children and teens will use or abuse substances no matter how hard parents try to keep them safe, but here are some things that may help.

Start young. Teach them how to say “no” when they don’t want something. Show them how to be strong in the face of peer pressure. Make sure they know the dangers and consequences of drugs and alcohol use.
Educate yourself. Don’t hide from statistics, but learn from them.
Be firm. Set rules and stick to them.
Be an example. Don’t abuse alcohol or consume illegal substances. If you drink, be responsible and don’t EVER drive intoxicated. Keep alcohol and prescription drugs inaccessible to your youngster. Never offer alcohol to an underage person.

If you think your child or teen is drinking or taking drugs, talk to your pediatrician or school counselor. They can find you the right kind of help.

Measles

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You’ve been hearing about measles outbreaks in the news lately. Also called rubeola, measles is a respiratory disease caused by a virus. It causes a rash over the entire body, a fever and runny nose. According to the Centers for Disease Control and Prevention, “About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia.” Measles can also, rarely, be fatal. Between one and two children in 1000 who get the disease will die from it. The disease can also strike adults.

If you thought measles was a disease left in the past, think again. An outbreak this year in Ohio (374 cases in 4 months) has health departments all over the country concerned, because such an event can happen anywhere. The Ohio outbreak began when unvaccinated people traveled abroad to places where measles is more common because a larger percentage of the population is unvaccinated.

It’s no coincidence that we used the word “unvaccinated” twice in that last sentence. The reason measles is spreading again in the United States is because of a drop in MMR (Measles, Mumps and Rubella) vaccinations. Those who decide not to be vaccinated (or to have their children vaccinated) put themselves, their families and their communities at risk for dangerous diseases. As with most diseases, those at highest risk are the very young, the very old, and those with compromised immune systems.

The MMR vaccination is required for students in Scott County Schools, and HIGHLY recommended for all other children. The State of Kentucky requires two doses of the MMR vaccine before your child can enter school. If you have concerns about vaccinations, talk to your pediatrician.

Remember that the extremely rare risk of a reaction to a vaccination is much smaller than the risk of being unvaccinated against a dangerous illness.

Probiotics

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You’ve likely heard the term “probiotics”. Maybe you’ve also wondered what it means and what, if any, benefit probiotics could provide for your family’s health.

What are probiotics? According to the Centers for Disease Control and Prevention, “Probiotics are defined by the Food and Agriculture Organization of the World Health Organization as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” Sound appetizing?

Every human intestinal tract contains beneficial bacteria that helps break down food products into compounds that are more easily absorbed into the body. Sometimes the beneficial bacteria need a boost over the harmful bacteria that share the same space, or during or after a round of antibiotics that may kill the good bacteria along with the bad.

Probiotics contain the helpful bacteria. According to the American Academy of Pediatrics, giving probiotics early in the course of “acute viral gastroenteritis can reduce its duration by one day. Probiotics also have been found to be modestly effective in preventing antibiotic-associated diarrhea in otherwise healthy children, though there is no evidence probiotics are effective at treating this type of diarrhea.” [Italics ours.] Note the term “healthy children.” Probiotics don’t have any proven effects on treating chronic diarrhea, Crohn’s Disease or other chronic illnesses.

When a mother cannot breastfeed, special probiotics can be introduced to the formula that will help to replace the natural ones found in breast milk. Ask your pediatrician about this before trying these products.

Where do you get probiotics? They are available over the counter in drug stores and healthcare departments of grocery and discount stores. They come in foods or as supplements. Buy from a manufacturer you trust, remembering that probiotics are not regulated the same way prescription drugs are.

As always, eat a balanced diet, which is the best road to gastrointestinal health.