Recall of H1N1 vaccines

As many of you are probably aware, the CDC and Sanofi announced a recall of 800,000 doses of H1N1 vaccine yesterday. This was a non-safety related recall of 4 lots of the vaccine that were manufactured as pre-filled syringes intended for ages 6-36 months. As it turns out, testing done by the manufacturer after release showed lower potency levels than necessary to induce an immune response. Our patients will be happy to learn that TLC received no vaccines from the four lots that were recalled, so no further concern is necessary at this point in time.

Toy Safety

With the holidays fast approaching, many parents will find themselves in search of that perfect toy. Each year, hundreds of thousands of toys are recalled by the Consumer Product Safety Comission (CPSC) because of excess levels of lead or other harmful metals. However, many toys sneak below the radar and avoid recall despite higher than recommended levels of heavy metals or other chemicals. With so many toys on the market, where is a parent to turn? Luckily, the Ecology Center, a public interest group, reviews hundreds of toys each year and makes their results available to the public. Definitely a good site to check before you head out to the toy store:

http://www.healthystuff.org/departments/toys/

Flu slowing down, for now at least

Good news from the CDC today. For the fourth week in a row, the number of cases of H1N1 ("swine") flu decreased nationwide. In our area, we have seen a downward trend over the last 2 weeks or so. Also, it appears the vaccine supply may increase in the near future, which is good news as supplies are already dwindling in our area. Experts are unsure if there will be another surge of the flu in the coming months, but if people continue to get vaccinated, it will further decrease the number of susceptible individuals.

http://health.usnews.com/articles/health/healthday/2009/12/01/swine-flu-waning-but-could-return.html

H1N1 vaccine

We have begun to receive limited shipments of the H1N1 vaccine. Our office staff is in the process of calling parents of high risk children (asthma, diabetes, heart conditions, or other forms of chronic illness) to schedule the vaccine. If your child fits into this category and you do not have their name on our waiting list, please call the office to schedule an appointment for them. Once the high risk children are vaccinated, we will begin calling families who have placed their children on the waiting list. If you are interested in your child receiving this vaccine, please let the office know and we can add their name to the waiting list. The office is extremely busy because of the current flu pandemic, but we will do our best to give the vaccine out at quickly as possible.

Choosing the right thermometer

With the recent H1N1 flu pandemic, many children have been developing high fevers. One of the more common topics that we are asked about in the office is taking a child's temperature.

What kind of thermometer should I use?

There are many types of thermometers available these days, including rectal, axillary (under the arm), oral, tympanic (ear), and temporal (forehead). These methods all vary somewhat in their ability to truly measure core body temperature. Rectal thermometers are the most accurate and should be used as a first choice in children under 2 years. For older children, it seems as though the research supports the accuracy of oral or temporal thermometers over axillary or tympanic. With that being said, any of these methods may in fact underestimate the true body temperature by up to 2 degrees Fahrenheit. If you've spent some time at TLC, you know that for older children we tend to use the temporal artery thermometer, and for younger children (generally under 1 or 2 years), we prefer rectal measurements. There are many reasonably priced digital thermometers on the market today, many of which can give a reading in 10 seconds or less (fewer tears!). Mercury thermometers should never be used.

When is it considered a fever?

A temperature is considered a fever if it is greater than 100.4 degrees Fahrenheit.

When should I treat the fever?

A difficult question to answer as it varies depending on the age. If your child is under 6 months and develops a fever, you should let your child's physician know immediately, as it could be a sign of a more serious illness . Generally speaking, however, fever is a defense mechanism for the body. So, in fact, if the temperature is less than 101 degrees Fahrenheit, it may be okay to just observe. Once the temperature goes higher, it is prudent to treat with fever reducers as the child will likely start feeling the ill effects of the fever at that point. And remember, if your child's fever is extremely high (104 degrees Fahrenheit or higher), lasts more than 3 days, or your child is acting more sick than you would expect, call their physician right away.

For tips on using a thermometer, check out this link: http://aapnews.aappublications.org/cgi/content/full/30/11/29-d

Many US children Vitamin D deficient

A recent study suggests that as many as 6 million US children are deficient in Vitamin D, with darker skinned children especially at risk. Recent studies in adults point to Vitamin D deficiency as a potential risk factor for heart disease and certain cancers. Vitamin D is primarily produced in the skin by exposure to UV rays from sunlight, with just 10-15 minutes a day being necessary to maintain high levels of the vitamin. So, what's the big deal, right? The kids are always running around outside! There are two reasons why kids are at risk, sunscreen and our climate. How many of us have a daily ritual of lathering our children with sunscreen before going outside in the nice weather? Guilty as charged! Well, sunscreen blocks UV rays, thereby negating any chance of producing the beneficial vitamin. I'm not saying to can the sunscreen, but a few minutes (less than 15) can go a long way! The second problem is our climate here in the Northeast. Most research shows that the amount of sunlight we have is not enough to create a sufficient amount of Vitamin D between November and February (like we needed research to tell us that!).

So, what's a parent to do? Well, to start, I'll point out that the new recommendation by the American Academy of Pediatrics is for 400 I.U. (international units) daily. Most children's multi-vitamins contain that amount, so if you are giving your child a multivitamin, you're off to a good start. If your child is not taking a multi-vitamin, but is eating a well-balanced diet, he or she probably doesn't need a full multi-vitamin and you may be able to go with just a D supplement (or, if they will oblige, cod liver oil - yuck!). You don't have to stop there, though! There are some good food sources of Vitamin D, including salmon, canned tuna, egg yolks, and many dairy products. I should mention that the AAP recommends babies who are strictly breastfed should be supplemented with 400 I.U. daily as well. There are many products available for this purpose at your local pharmacy or health food store.

For some tips on optimizing Vitamin D intake, check out this article: http://health.usnews.com/blogs/on-parenting/2008/10/13/3-ways-to-make-sure-kids-get-their-vitamin-d.html. And, as always, please consult your child's physician if you have any questions.

Flu shot updates

As of today, we continue to wait for additional supplies of the seasonal flu as well as the H1N1 flu vaccines. If your child is on the waiting list, please be advised that our office will be contacting you as soon as supplies are made available. If your child is not on the list, but you would like them to receive either vaccine, please give our office a call. Please let the receptionist know if your child has asthma or any other chronic illness, as these children will be given priority.

Welcome to our blog!

This blog has been a long time coming. I've been wanting to start one for the past couple years, but never actually got around to it. I guess the craziness of the past few weeks, with all of the H1N1 flu going around, actually motivated me to do it. I thought it would be a great way to communicate with our families and friends on a more regular basis than the website allows us. Plus, with the ever changing nature of infectious disease and pediatric care, it will allow us to give regular updates on topics like vaccine supply and local disease patterns. I hope you enjoy it!