Bug Repellant for Kids - Is DEET safe? What about West Nile Virus?

I just asked our dermatologist (at Children's Memorial Hospital) about effective insect repellant for the spring/summer, and she recommended DEET in concentrations up to 10% for infants and young kids.  She also sent me a link to an IL public health statement on DEET which contains a link to public health info on West Nile Virus.

Flu Vaccination - if you are interested

I just got a memo from our pediatrican (Town & Country Pediatrics) about flu vaccinations for this season and I read some interesting things.  I thought I'd post them here while I investigate further:

1.  Patients have wondered why flu vaccine is readily available at retail outlets (Dominick's, Walgreens, etc.), but limited at Town and Country Pediatrics. The retail outlet flu vaccine is manufactured in multi-dose vials and contains a preservative (thimerosal). Historically, our patients have preferred a preservative free vaccine. This is the reason Town and Country Pediatrics special orders only flu vaccine without a preservative (thimerosal). There is a limited amount of vaccine without thimerosal and both the orders and shipments are controlled by the manufacturer. The manufacturer is aware of our need for the vaccine and is doing its best to supply us as quickly as possible.

2.  Please remember that the H1N1 flu vaccine is different from the seasonal flu vaccine. We are still waiting for a response from the Chicago Department of Public Health to find out whether we will receive the government-purchased H1N1 vaccine in our office for our patient population. Our application is currently pending. The FDA approved H1N1 vaccine from 4 manufacturers yesterday. Our information about the administration of this vaccine and when it may become available is taken directly from the website of the Centers for Disease Control.

3.  If we are able to administer the H1N1 flu vaccine in our office, we will follow the CDC mandated guidelines for administration to our patient population. The U.S. government will require Town and Country Pediatrics to document who is receiving H1N1 flu vaccine so we will follow tier guidelines that will be set up by the CDC.

Drug Expiration Dates - Usually No Big Deal?

I just read a piece in the Harvard Medical School Family Health Guide that suggests that most drugs are effective for years beyond their expiration dates. See what you think...

Drug Expiration Dates - Do They Mean Anything?

A Reply to Vaccine Post(s)

There is a very thoughtful and thought-provoking blogger post about NOT vaccinating at:

http://andothertimes.com/2009/04/11/vaccinations/

Some resources are listed. Check it out!

Safe Candy for Food Allergy Kids

As of 10/2008, this List contains popular safe candies with detail on what each candy does not contain.

As of 10/2008, this is a Short List of candies free of Top 8 Allergens, and gluten.

Report from the CDC, Recent Increase in Hib Disease in Children 0-5 yrs old

For families who have been following an alternative vaccination plan, this item might be of interest to you. I am not pushing any philosophy here - just providing info for families to consider. I received this notice from our pediatrician's office yesterday... [UPDATE: SEE REPLY TO VACCINE POST ON 4-12-09]

The U.S. Centers for Disease Control (CDC) announced that five cases of Haemophilus influenza type B (Hib) invasive disease were confirmed in 2008 in Minnesota. Of the 5 babies who contracted the disease, 3 patients had received no vaccinations due to parent deferral or refusal of vaccinations. One healthy infant who was unimmunized was 7 months old and died of Hib disease.

Hib disease is a severe bacterial infection, occurring primarily in infants and children under 5 years. It can be the cause of meningitis, pneumonia, sepsis, epiglotittis (a severe throat infection), skin infections, and arthritis. It can be serious in children under age 1, but there is little risk of getting the disease after age 5. Transmission is most likely through respiratory droplets (coughing and sneezing). http://www.cdc.gov/vaccines/vpd- vac/hib/default.htm

Hib meningitis can result in death in one out of 20 children, and permanent brain damage in 10% - 30% of the survivors.

Before widespread use of the Hib vaccine, Hib disease contributed to 20,000 deaths in small children/year in the U.S.

**************************************************
If your child has been receiving regular checkups and is following the recommended schedule of vaccination there is no need to worry. Hib vaccine is recommended for all infants and is provided as a 3 dose series in the form of Pentacel (combination vaccine of DTaP, Hib, and IPV) at 2, 4, and 6 months. A booster dose after 12 months is also recommended. http://www.townandcountrypeds.com/test_tips_wellExam. htm

Although Hib bacteria are present normally in the community, vaccines given to infants can significantly decrease its communicability.

*With decreasing rates of immunization due to parental refusal, we are currently experiencing resurgence of these bacteria in our community. This is also referred to as herd immunity.

We understand that some parents are apprehensive about vaccinating their children. This is a timely and stern reminder for those hesitant about agreeing to follow the vaccination schedule published by the CDC.

Hib disease is nearly preventable with timely and complete vaccination.

If you have been following an alternative schedule, please take the time to think about fully vaccinating your infant or small child. Call the office for an immunization appointment today.

Halsted Office (312) 279-8900
Glenview Office (847) 998-8806
Lincoln Office (773) 478-1067

Town and Country Pediatrics, S.C.
email: jenniferh@townandcountrypeds.com
phone: 312-279-8900
web: http://www.townandcountrypeds.com

FEVER: DON'T ALTERNATE ACETAMINOPHEN AND IBUPROFEN

Fever may be the most common symptom why parents seek help from a health care provider. Even though fever is merely a symptom of an illness, its mere presence is enough to incite panic and fear for many parents. See our full explanation on fever and dosage charts.

Regimen for managing fever can include exposing a child to a lukewarm bath and/or administering anti-fever medications. Antifever medications may include acetaminophen (Tylenol or FeverAll suppositories), ibuprofen (Motrin or Advil). In recent times, it has become commonplace to administer these two medications in tandem alternating their use over a 3-4 hr period. For example, first a child may receive Tylenol and then 3-4 hours later receiving Motrin or Advil. This schedule for treating fever has been studied in only a few unsubstantiated clinical trials and the outcome of these trials is not enough to accept this as a safe method. The tandem use of these medications has not appeared in a few trials to lower fever more than the use of monotherapy (using acetaminophen or ibuprofen alone) anyway.

The science of using both of these medications is complex, however the medication and its broken down byproducts appear to concentrate in the kidneys. Of course for our littlest patients and for those with kidney compromise the synergistic use of these medications poses a major concern. Please refrain from alternating these medications in the future with your children.

Howard Rice, M.D.
Jennifer Hartman, CPNP
Town and Country Pediatrics
email: jenniferh@townandcountrypeds.com
phone: 773-929-2260
web: http://www.townandcountrypeds.com

Free/Affordable Vaccinations

If your insurance does not cover the cost of all vaccinations or only covers partial cost, please consider receiving your child's vaccinations at the Board of Health. These vaccinations will be given to your child free or at nominal cost. There are many clinics scattered across Chicagoland. Please call for the closest clinic to you. Chicago Board of Health 1-312-747-9884.

Is Organic Really Better?

Download a list of produce ranked by pesticide contamination at foodnews.org, an EWG website.

Decode "organic" food labels:
http://www.thedailygreen.com/healthy-eating/Food-Label-Decoder-451003

38 Non-Organic Ingredients Found in 'USDA Organic' Foods
http://www.thedailygreen.com/healthy-eating/eat-safe/3980

Nut Allergy Statements from Manufacturers

Click on the link if you are interested in seeing the catalogue of responses I have received from manufacturers when I ask, "Are your products free of any type of peanut or tree nut contamination?"

"My Stomach Hurts": Common Causes and Cures for Tummy Trouble

In any given month, 10 to 15 percent of kids ages 5 and up have abdominal pain. Although you can usually tell if your child's caught a stomach bug -- she'll have vomiting or diarrhea that lasts 24 to 48 hours -- you should know these other common causes of tummy trouble, and how you can help her feel better. Click on the title to this post to see details like: What it feels like; What's going on; and What to do for it and Alternative Home Remedies for the following ailments: Constipation and Gas / Gastroesophageal Reflux / Functional Abdominal Pain / Irritable Bowel Syndrome / Ulcers / Abdominal Migraines / Could It Be Appendicitis? 

Kids With Food Allergies - Safe Foods

My son is allergic to peanuts and treenuts. I am on a constant search for food items that can help him enjoy normal kids events without much disruption. These items I have found really help when I need "safe" versions of kids foods. Of course, always check the labeling before you consume, as recipes and ingredients can change. If anyone wants to share their food allergy solutions, please add your comments and identify your food allergy!
BIRTHDAY CAKE - nearly all commercially baked goods are off limits when you have nut allergies. However, Pepperidge Farm frozen cakes are presently NUT-FREE and not made on a shared mfg line. Available at your grocery freezer, they thaw in 20-60 mins... on the drive to the birthday party! Of course, we still must make sure the hands and eating surfaces are washed down.

PIZZA PARTY - most deluxe pizza places make something with pesto in their ovens. That makes most pizza off limits. What to do when your kid is going to a party where everyone is eating pizza? I go to Costco (only from the snack bar), Little Caesar, Papa John's, Domino's or bring Totino's, Lou Malnati's, or DiGiorno.  I no longer call Dominos.  I call one close to the party location, confirm they aren't baking any promo items with nuts, place an order for delivery (if they deliver) to the party address and let the host know. Again, we still make sure the hands and eating surfaces are washed down. ***Lately, Domino's has been unsafe after the introduction of baked sandwiches with sauce.  Domino's corporate office told me that they cannot represent the sauces are safe.

CRACKERS, CHIPS, PRETZELS, CEAREALS - what I can say here is that Snyders' products are NOT SAFE. However, most made for kids brands (e.g. Gerber) are nut-free, but always check the labels. Ritz Crackers, Pirate's Booty, Crispix, Cheese-Its, Goldfish, Ritz Originals, Sun Chips, Cape Cod Chips, Rolled Gold Pretzels, Back to Nature Original/Apple/Blueberry Granola are presently nut-free.

***Organic does not mean safe. Annie's brand are not nut-free. Amy's brand is generally not nut-free.  Barbara's brand may be peanut free but is not tree-nut free.
 

CANDY - this is a real danger zone for nut allergy sufferers. There's Vermont Nut Free Candies, but also, from most grocery or drug store candy aisles: Dum Dum Lollipops, Skittles, Lifesaver Gummies (not Gummy Bears!), Sweet Tarts, Trader Joe's Fruit Leathers are NUT-FREE. Chocolates, in general, are off limits because they are made on the same equipment as nut-containing foods.  I have found that regular sized, silver foil wrapped Hershey's Kisses are safe.

ICE CREAM - another danger zone for nut allergy sufferers. Opt for Popsicles brand when you can (I have found most are safe), and read the label first. Most frozen treat makers have a flavor with nuts in it that is made on the same line as the flavors/items without nuts. Even italian ice mfrs use nuts. I have found Breyers Vanilla is essentially NUT-FREE. Unilever told me that they break down their equipment and thoroughly wash and test it for traces of nuts between batches. That's as safe as I have found, in the mainstream, and its a big company that cannot afford to be sued for false labeling. Their labels do not include nuts in their allergy statement, thereby representing through silence that there are not traces of nuts in their vanilla ice cream or frozen yogurt. I am still very leery of even Breyers Vanilla ice cream though, and prefer to go with popsicles.  Also, Annette's Homemade Italian Ice (Armitage@Bissell) can dish up NUT-FREE, no cross-contamination servings. They have several regular customers with nut allergies and segregate their safe italian ices in a separate freezer, and use scoops that are specially identified for the non-nut containers.

Restaurants for Nut Allergy Sufferers

RJ Grunts, 2056 Lincoln Park West - will prepare your food in nut free area of kitchen with special attention by waiter and manager to avoid cross-contamination. They even have special hot-pink order tickets to flag your order to all who touch it. Actually, all of the Lettuce Entertain You restaurants take food allergies very seriously and can protect you while you dine there.

Pizzaria Due, 619 N. Wabash - Kitchen and menu are nut free. Pesto does not contain nuts. No desserts contain nuts.

Chef Dominique Tougne of Bistro 110, 110 E. Pearson - has 2 children with severe food allergies. He was recently profiled in Living Without magazine on this very subject. At Bistro 110, he says that they will accomodate food allergies and in fact, do this each day with increasing regularity.

Natural Cold Remedies

These recommendations are from a career herbalist. I'd like to check them out but if anyone has any experience with them, please comment!

"Some of my best cold/flu remedies to shorten the duration...
UMCKA (at Whole Foods, Merz Apothecary) - great for kids and adults
Zinc and Vitamin C lozenges - boost immunity
Hot ginger, cinnamon and honey tea
Oregano oil capsules (every few hours) - ADULTS ONLY"

Incidently, she has a book out called "Healing with Aromatherapy" available at major bookstores. Click on the title to this entry to go to the Amazon listing.

Kid's Health: How long is gastroenteritis contagious?

This from the nurse at Town & Country Pediatrics:

"The children are contagious about 2 days before they show symptoms and at least as slong as they have diarrhea symptoms at all... which is usually about 10 days after onset of symptoms. So about 12 - 14 days from start to finish to be sure your child is no longer contagious. This is an unreasonable length of time to keep them home but it is the CDC recommendation about rotavirus which is one of the most common causes of infectious diarrhea right now. Be careful and wash wash wash those hands!"