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March is Brain Injury Awareness Month

Want to learn more about the brain, especially the developing brain of children and adolescents, check out brainfacts.org. In this blog post, we’ll be talking about sport-related concussions, chronic traumatic encephalopathy, and what is all means for your young athletes.

Sport-related concussions have increasingly become a hot topic in the media and in medicine.

At Bee Well, we treat concussions weekly, sometimes daily, depending on the athletic season. Bee Well believes prevention is always the best medicine. We strive to give our patients the most up to date information to help guide decision making, including sports participation.

Not long ago, concussion was considered only a minor injury, if considered an injury at all.

But evidence from extensive research in recent years suggests that concussions pose a greater risk of potential long-term complications than previously thought.

Football gets most of the attention, because it has the highest incidence of concussion. According to sources cited by the American Academy of Pediatrics, football is also the most popular sport among male high school athletes, and also among those who play in youth leagues, ranging in age from 5 to 15.

Other sports with high rates of concussion are soccer, gymnastics, ice hockey, and lacrosse.

In this post, we offer a summary of facts and opinions on the subject, starting with a definition of concussion, its possible long-term effects, and proposed methods of prevention.

What is concussion?

The Boston University School of Medicine provides the following definition:

A concussion has occurred any time you have had a blow to the head that caused you to have symptoms for any amount of time. You do NOT need to have lost consciousness to have a concussion. These symptoms include blurred or double vision, seeing stars, sensitivity to light or noise, headache, dizziness or balance problems, nausea, vomiting, trouble sleeping, fatigue, confusion, difficulty remembering, difficulty concentrating, or loss of consciousness. A concussion has also occurred when a person gets a “ding” or gets their “bell rung.” Sometimes these symptoms might not be apparent right away. They may develop within the following 24-48 hours.

What is Chronic Traumatic Encephalopathy (CTE)?

We now know that a concussion is much more than just “getting your bell rung.”

In 2002, a breakthrough in the understanding of the long-term risk of concussion occurred when forensic pathologist Dr. Bennet Omalu performed an autopsy on the retired Pittsburgh Steeler, Mike Webster.

Webster won four Super Bowls in the 1970s as the Steelers’ starting center. After retiring, his mental health severely deteriorated, leading to an early death at age fifty.

When examining Webster’s brain, Dr. Omaulu discovered a previously unknown disorder that he named Chronic Traumatic Encephalopathy, or CTE.

The story is dramatized in the 2013 movie Concussion, starring Will Smith as Dr. Omalu.
The CTE Center at Boston University says:

We believe CTE is caused by repetitive brain trauma. This trauma includes both concussions that cause symptoms and subconcussive hits to the head that cause no symptoms. At this time the number or type of hits to the head needed to trigger degenerative changes of the brain is unknown. In addition, it is likely that other factors, such as genetics, may play a role in the development of CTE, as not everyone with a history of repeated brain trauma develops this disease. However, these other factors are not yet understood.

Concussion and the NFL

On July 25, 2017, the Journal of the American Medical Association published a study led by Dr. Ann McKee, director of the Boston University CTE Center. (The article is titled “Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football.”)

The study examined the brains of 111 former NFL players who donated their brains to the Center.

Of the 111 brains, 110 were diagnosed with CTE.

Andrew Hawkins, a 31-year-old wide receiver for the New England Patriots, announced his retirement the day the study was released.

Two days later, Baltimore Ravens offensive lineman John Urschel, 26, announced his retirement also. (He was already a doctoral candidate at MIT, and he decided to devote his brain to mathematics instead of football.)

In 2015, San Francisco 49ers hard-hitting linebacker Chris Borland retired at age 24, also citing concerns about CTE. “If there were no possibility of brain damage, I’d still be playing,” Borland told ESPN at the time.

The authors of the study acknowledge that the outcome is biased, because families have donated brains of those who were already displaying signs of CTE.

However, as Dr. McKee asserts, “the fact that we’ve been able to gather this high a number of cases in such a short period of time says that this disease is not uncommon … In fact, I think it’s much more common than we currently realize. And more importantly, this is a problem in football that we need to address and we need to address now in order to bring some hope and optimism to football players.”

Weighing the risks

In 2015, the American Academy of Pediatrics (AAP) issued a position statement on football-related concussion.

“Most injuries sustained during participation in youth football are minor, including injuries to the head and neck,” the statement says.

It also cites numerous sources that “have argued that football is a generally safe sport that carries with it the substantial benefits of regular exercise on health as well as social and academic outcomes that outweigh the risks involved, pointing out that the risk of catastrophic injury is low, that most concussions resolve within a few days or weeks, and that there are substantial limitations to the current understanding of CTE.”

Whatever the risk factor actually is, the AAP argues that “repetitive trauma to the head is of no clear benefit to the game of football or the health of football players.”

The APP’s position statement therefore is focused on how to prevent such trauma.

Preventing concussion

Should tackling be banned in youth football?

“The majority of concussions result from tackling or being tackled,” the statement asserts. “Head-to-head contact is one of the leading causes of concussions sustained by youth football players.”

From our clinical experience at Bee Well, about half the football injuries we see are from head-to-head contact. However, whiplash from one large mass slamming into another large mass is enough trauma to cause a concussion, even if their helmets don’t hit each other.

One preventive option considered by the AAP would be to ban tackle football in favor of “flag football,” in which tackling is substituted by pulling a “flag” from the ball-carrier’s belt.

But the AAP acknowledges the inherent controversy in such a plan: “The American Academy of Pediatrics recognizes, however, that the removal of tackling from football would lead to a fundamental change in the way the game is played. Participants in football must decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling.”

A compromise would be to have tackle football for older players, and flag football for younger players.

However, the AAP speculates that players accustomed to only flag football might be unprepared for tackle football once they get older.

“Lack of experience with tackling and being tackled may lead to an increase in the number and severity of injuries once tackling is introduced,” the AAP writes. “Therefore, if regulations that call for the delaying of tackling until a certain age are to be made, they must be accompanied by coaches offering instruction in proper tackling technique as well as the teaching of the skills necessary to evade tackles and absorb being tackled.”

Is safer tackling the answer?

“Proper tackling” — or “textbook tackling” as it is often called — uses the shoulder instead of the head as the primary point of contact. The tackler’s head is positioned to one side of the ball-carrier’s body, with a shoulder delivering the hit and absorbing the impact, while the arms are wrapped around the body.

“Not only are textbook tackles more effective, but they’re also safer,” explains an NFL website that’s designed to teach young players how to tackle. “By training and teaching young players on proper technique, the hope is to establish proper tackling habits and make the game even safer.”

However, while textbook tackling is easy to practice, it’s not always possible during an actual game. Obviously, ball-carriers try to evade defenders, and don’t stand still waiting for them to get into position to make textbook tackles.

Plus, textbook tackling is relevant only in one-on-one situations. But there are often numerous tacklers involved in a play, and such “gang tackling” rarely makes textbook tackling a possibility.

In reality, tacklers usually do whatever is necessary to bring a ball-carrier to the ground.

As for teaching safer tackling, former professional linebacker Chris Borland is skeptical. “I wouldn’t want to be charged with the task of making violence safer,” he said. “I think that’s a really difficult thing to do.”

Furthermore, he doesn’t agree that safer tackling is necessarily more effective. He told ESPN: “Some of my best tackles were the most dangerous!”

Are better helmets the answer?

Some players think that better helmets would prevent concussions, but there’s little evidence to support this belief.

A 2013 study by the AAP concluded:

“Our preliminary findings suggest that neither any specific brand of football helmet nor custom mouth guards result in fewer concussions in kids who use them. Despite what manufacturers might claim, newer and more expensive equipment may not reduce concussion risk.”

Final Thoughts

Bee Well’s position is that tackle football and other high-risk sports put athletes at risk for repetitive traumatic brain injury that may have long-term cognitive damage.

We believe it is important that young people stay active and enjoy their exercise of choice, but keeping your child safe and healthy is our biggest priority.

We are here to help parents and athletes weigh the risks and make an informed decision.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Heat Stress Issues For The Marching Band

Football season is almost here, and it’s not just the players who are warming up with pre-season practice. Any football fan knows the games would not be the same without the support and sounds of the marching band. Our young musicians work hard to make sure their performances are half-time ready and often compete on the national stage march in popular parades. Maintaining adequate health, fitness, and hydration is vital to their success. Here are a few tips to help your band member endure one of the most grueling aspects of their training, summer band camp.

Most marching bands start in early August with “band camp” — all day rehearsals prior to the season opener.

And when normal preseason researsals begin, many bands rehearse during the hottest part of the day, when the football team is not using the field.

As veteran band director Jim Duncan explained: “Most football teams are smart enough to practice in mornings and evenings when they do 2-a-days. That leaves the super hot afternoon for the band to use the football field. Some schools have a secondary field where the band can practice when football is practicing, so they choose mornings or evenings for their field rehearsals. But many schools don’t have that option.”

The National Athletic Trainers Association has a few simple recommendations for marching band rehearsal in the heat.

  • Get acclimatized to the heat by starting routines slowly and building endurance.
  • Wear light or white colored shorts and shirts.
  • Keep hydrated before AND after routines.
  • Stand in the shade during breaks to cool down before and after practices and performances.

Wearing hats is also important, adds Duncan. “Without hats, the sun bakes your head and kids have many more issues.”

Regarding shade, he also recommends having on hand “some big EZ up tents for kids to get in the shade if they start feeling bad.”

Schools that have playing fields with artificial turf pose a special problem.

“Synthetic turf fields have black rubber pellets down in the blades of synthetic grass for cushioning,” Duncan explains. “The problem is, the black rubber pellets absorb heat and make the field 10 degrees warmer than areas around it when in direct sunlight.”

Duncan says that band directors and instructors also need to be mindful of something else.

“We run the rehearsal from the top of the pressbox so that we can see the field well. Up on the box, there is a breeze, and it is a good 15 degrees cooler that the field. So we have to make sure we stay aware that kids on the field are much hotter that we are.”

However, he is quick to point out that even in extreme heat, marching band is perfectly safe. “You just have to use common sense” — and keep these precautions in mind.

Sun Smart: Safety Tips for Parents and Kids

In moderation, sunlight is healthy. It’s a great source of vitamin D, for example, and it gets kids out of the house for plenty of good exercise.

But too much sun can have serious health consequences. It takes only 15 minutes for unprotected skin to be damaged by the sun’s rays.

Even a minor sunburn is painful, but a bad sunburn is truly miserable. It can also have implications on health many years down the road. “Just a few serious sunburns can increase your child’s risk of skin cancer later in life,” warns the Centers For Disease Control.

Here are some tips to enjoy the sun safely:

SEEK SHADE

The sun’s ultraviolet rays are the strongest and most harmful during the midday, so try to plan indoor activities during that time. If your child does play outside during the hottest part of the day, be sure there is plenty of shade nearby, and that they seek its shelter most of the time.

WEAR PROTECTIVE CLOTHING

You can also protect the skin with long-sleeved shirts, long pants, and long skirts. Darker clothes provide more protection than lighter ones. For a bit more cost, parents can purchase clothing with SPF and UV protection. However, wearing clothes with built-in sun protection doesn’t mean you get to skimp on the sunscreen. Be sure to follow the care instructions for the garment so it retains its sun-protecting power for as long as possible.

And don’t forget about protecting the head! An appropriate hat does the job very well, but baseball caps don’t do much good. Find a hat with a brim that goes all the way around the head, so that it shades the scalp, face, ears and neck. A minimum 3-inch brim recommended. The ears are a common place for skin cancers to appear later in life because they often get overlooked when applying sunscreen or choosing sun protection.

The eyes can also be damaged by UV rays, so be sure that your child wears sunglasses. Check the label for information on the level of UV protection that it provides. You want as close to 100% of both UVA and UVB rays as possible.

DON’T GET A TAN!

Perhaps the easiest way to avoid harming the skin is to avoid deliberately lying in the sun or in a tanning bed. Tanning remains very popular, but tanned skin is damaged skin, and it should be strongly discouraged.

ALWAYS USE SUNSCREEN

Choose a sunscreen with at least SPF 30 and UVA and UVB (broad spectrum). For the best protection, apply it 30 minutes before going outdoors. In addition to arms, shoulders and legs, remember to put it on ears, noses, lips, and the tops of feet. Check out the Environmental Working Group for environmental and human friendly brands at ewg.org.

SPECIAL PRECAUTIONS FOR INFANTS

A baby’s skin is more delicate and thinner than an adult’s skin, and therefore it burns and irritates more easily.

The American Academy of Pediatrics recommends that infants avoid sun exposure. They should be dressed in lightweight cotton clothing with long sleeves and long pants, plus a sun hat with a wide brim that shades the neck to prevent sunburn.

Due to the risk of heat stroke, babies younger than 6 months should be kept out of direct and indirect sunlight. The shade of a tree, beach umbrella, or stroller canopy will suffice.

When adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least 30 SPF (sun protection factor) to small areas, such as the infant’s face and the back of the hands. For babies younger than 6 months, sunscreen may be applied to small areas of skin uncovered by clothing and hat. Be sure to cover all exposed areas of a baby’s skin, including the face, back of the hands, back of the neck, tips of the ears, and tops of the feet.

If an infant gets a sunburn, apply cool compresses to the affected area.

Splishin’ and Splashin’

Your guide to water safety this summer.

Swimming is the most popular summer activity, but it is not without risks.

According to the Centers for Disease Control and Prevention, drowning is the second leading cause of unintentional injury death among children ages 1-14, and about 60% of drowning deaths among children occur in swimming pools.

So, with that in mind, we’ve put together a few of the most important safety tips.

SWIMMING LESSONS

If your child doesn’t yet know how to swim, it’s time for swimming lessons. The Austin Parks and Recreation Department, civic groups like the YMCA, and numerous private instructors offer age-appropriate lessons. Being a capable swimmer is the single most important factor in water safety.
Colin’s Hope is a local organization that has great resources on water safety. Their website has downloadable water safety games for kids, like bingo and word find exercises that can be a great way to get a conversation started with your children about safety. Parents can test their water safety know how with this quiz.

SWIMMING PRECAUTIONS

Choose locations where a lifeguard is on duty. The vast majority of drownings each year occur at unguarded locations. When on vacation, keep in mind that many hotel pools do not have lifeguards, but merely a sign that says “swim at your own risk.”

Never let children swim alone. Even when a lifeguard is present, parents should maintain constant supervision of children whenever they’re around water. We recommend that an adult is assigned to watch the kids instead of just assuming that another parent is doing it.

Have young children and inexperienced swimmers wear life jackets around water. But never rely on life jackets alone.

Even when not swimming, be careful around ocean shorelines, rivers and lakes. An accidental fall into these waters can be very dangerous due to cold temperatures, currents and underwater hazards.

If you have a home pool or hot tub, don’t leave unused toys nearby. Toys can attract young children to the pool. As an added precaution, make sure there are barriers that prevent children from having easy access to the water We recommend the pool be fenced and gated and/or an alarm on the gate or backdoor so no one wanders in the pool unnoticed.

SWIMMING EMERGENCIES

If a child is missing when near any body of water, check the water first. When someone in the water is in distress, seconds are crucial in preventing death or disability. We urge parents to take basic CPR classes. Check the American Red Cross for classes in your area.

Having fun swimming and playing in water is one of the joys of childhood. Observing these safety tips can help keep it that way.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Spring has sprung! And so has another allergy season.

It’s spring allergy season again, with its tell-tale signs of coughing, sneezing, watery eyes, scratchy throat, and accompanying itchiness.

Allergies affect about 40% of all children, so every spring Bee Well sees an increase in those symptoms among our patients.

The symptoms can be misleading, because they are similar to those associated with the viral infection of a common cold. However, itching is usually a sign of allergens instead of a virus.

In severe cases, allergies can cause more serious symptoms — such as rash, hives and even difficulty breathing — so no allergic reaction should be taken lightly.

What exactly is an allergy?

Simply stated, it’s when the immune system reacts to a foreign substance, called an allergen. The symptoms are the body’s way of trying to expel the source of irritation. There are many things that people are allergic to, and various ways for allergens to enter the body. In the case of seasonal allergies, it’s caused primarily by inhalation of pollen, mold, and other irritants that are in the air.

How can allergies be treated?

There is no cure for allergies, but the symptoms can be managed with treatment, and can be avoided to some extent.

Avoidance-

Totally eliminating exposure to allergens is virtually impossible, especially for active children, but there are things you as a parent can do to minimize it. Keeping the windows closed at night definitely helps. A bath and clean clothes before bed helps keep the bed free of allergens. And when the allergy count outside is particularly high, it’s best to stay inside as much as possible. The local news usually reports the day’s levels of pollen, mold, and other irritants, so it’s easy to keep aware of what’s in the air.

Medication-

Once allergy symptoms are present, over-the-counter medications often are helpful in providing relief. Antihistamines are usually effective against itching and sneezing, and nasal sprays can comfort dry and irritated nasal passages. However, both medications have side effects — drowsiness with antihistamines, and possible nasal irritation with sprays — so their use should always be carefully administered and closely monitored.

Other over-the-counter options for treating allergies include the supplements Quercetin and Bromelain. Quercetin is a compound typically found in many foods suchs as garlic, onions, and apples — and in the concentrated pill form it can help prevent the release of histamine from mast cells. This a similar mechanism of action as the prescription drug Singulair.

A chewable version of this supplement for kids called D-Hist is available over the counter. It also contains Bromelain, an anti-inflammatory naturally found in the skin of pineapples.

Immunotherapy-

Allergy shots or drops can provide long-term relief while reducing the amount of medication your child needs.

At Bee Well, we use a needle free allergy skin test for environmental (inhalant) allergens to discover what may be triggering our patients’ allergy symptoms.

While allergy shots are typically administered by an allergist, we also offer allergy drops (oral immunotherapy), which is safe for use in children 2 years and older. Allergy drops based on skin testing done in the office can be ordered through a third party pharmacy, at a cost of typically $60-$70 per month. The length of treatment is typically 1-2 years with significant reduction or complete elimination of allergy symptoms. Less sneezing, less medicines, less trips to the doctor’s office!

If your child is feeling the symptoms of allergies, make an appointment with Bee Well today.

Food Buyer’s Guide to Health and Wellness

by Jessica Morgan, MD
Whole, real, fresh food is the most powerful medicine you can use to prevent, treat, and reverse chronic illnesses. As a consumer of groceries, what you buy has an impact on agriculture, energy consumption, the environment, politics, the economy, and your biology. The more demand there is for clean and healthy food, the cheaper and more available it will become. You have the opportunity every time you make a purchase to be part of the change towards a healthier you, a healthier family, a healthier community, a healthier world.

To make room for health-giving foods, first throw out the disease-promoting junk. Get rid of foods with high-fructose corn syrup, hydrogenated fats, and sugars. If fat or sugar is one of the top 2 ingredients on the label, toss it. Next, stock up on real foods such as fresh fruits, vegetables, whole grains, beans, nuts, seeds, and lean animal protein such as fish, chicken and eggs, or even tofu.

Go organic. Pesticides and chemical fertilizers can mess with your metabolism, thyroid function, sex hormones, and our planet. Sometimes buying organic can be expensive. The Environmental Working Group keeps a list of low-pesticide retaining foods (aka The Clean 15) and those that have higher levels of toxins (aka The Dirty Dozen). If you’re on a budget, the dirty dozen are the ones you are going to want to make sure you buy organic. You can request a free PDF of these lists at www.ewg.org.

Eat Clean. Look for animal products that are pasture-raised, grass-fed, and antibiotic, hormone, and pesticide-free. Animal fat is great at storing pesticides and other toxins. The quality of fat in animals raised naturally is drastically different than from that of animals raised on feedlots, pesticides and fertilizers aside. Choose the best-quality meat you can afford. Keep your mercury intake low by sticking with small, wild, or sustainably farmed fish. Salmon, shrimp, and scallops are low-mercury and low-toxin options. Tuna, swordfish, and Chilean sea bass are heavy on the mercury. Eat them sparingly, if at all. Be conscious of the environmental impact your foods choices have.

farmers marketStay Local. Peruse the local farmer’s market or join a CSA (community supported agriculture project). The foods from these places are generally healthier, taste better, and are usually sustainably grown. CSAs deliver fresh produce to you once a week or every other week. They typically require membership based on harvesting seasons. Other companies such as Farmhouse Delivery allow you to order one box at a time or schedule regular deliveries any time of year. Here are just a few of the farmer’s markets in the Austin area for you to check out.

Barton Creek Farmer’s Market, Saturdays 9am-1pm

Lone Star Farmer’s Market at Bee Cave, Sundays 10am-2pm

Dripping Springs Farmers Market, Wednesdays 3pm-7pm

Stay Super Local. Plant a garden in your backyard! The Sustainable Food Center offers classes for new gardeners. Closer to Bee Cave, The Natural Gardner, has plenty of supplies and information to get you started and keep you going. Plus they have an amazing butterfly garden the kids are sure to enjoy.

To get started on using whole, fresh produce in your daily diet, try this delicious recipe I adapted from Williams-Sonoma. It makes plenty for leftovers. Freeze for a quick ready-to-go meal in the future.

Farmers Market Roasted Vegetable Soup With Cashew Pesto

Enjoy your food! And your health!


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Families That Eat Together, Stay Healthy Together: Why making family meal time a top priority is good for kids and their long term health.

Jessica Morgan, MD

It’s no longer news that obesity and all its related chronic diseases are plaguing the US and a good portion of the rest of world. The U.S. has the highest rates of overweight and obesity of all high income countries. Currently 30% of the American population is classified as obese. By 2030, it is estimated that this rate will be closer to 50%. Obesity now affects children in alarming amounts. Roughly 20% of U.S. children ages 2-19 years are obese. These statistics effect us all in ways you may not think of- close to 30% of young people in the U.S. are now too heavy to qualify for military service. Childhood obesity is considered to be one of the most serious public health challenges of the 21st century and for good reason. Obesity is harmful to a child’s heart and lungs, muscles and bones, kidneys and digestive tracts, as well as hormones that control blood sugar and puberty. Kids who are overweight are much more likely to remain overweight or obese into adulthood. It is estimated that one in three children born today will develop diabetes.  But there is good news!! Obesity and all of its disease friends (diabetes, hypertension, heart disease, cancer, etc) are preventable and, with a lot of hard work, reversible.

As a pediatrician and nutrition coach, my goal is to empower families and communities to prevent chronic diseases and reverse this epidemic of obesity, diabetes, cardiovascular disease, cancer, and stress. The change starts with you, your family, and your community. What you decide to put on your fork, how you spend your family’s “free time” can promote health and happiness or it can promote disease- not just for you and your loved ones, but for your neighbors, your community, your country, the food industry, agriculture, marketing practices, and the environment. Be the change. Start at home.

The food families keep at home and how families share meals influence what children eat and how much of it they eat. If you keep fresh fruit and vegetables at home, chances are kids will eat more of them than if you didn’t keep the fridge stocked. If you keep soda, chips, and sugary snacks at home, they’ll eat more of those disease-promoting food-like products. It’s nearly impossible for the primitively wired parts of our brains to resist sugar and fat. Don’t tempt yourself or your kids. Keep it out of the house.

A century ago, 98% of all meals were eaten at home. Now, that number is less than fifty percent. On average, family meals happen about 3 times per week, last less than 20 minutes and are spent watching TV or texting. The average kid spends 7.5 hours a day in front of a screen. Overweight kids eat half of their meals in front of the TV, often being exposed to billions of dollars in advertising for junk food. Think you don’t have enough time to cook? More people in this country spend more time watching cooking shows on television than they actually spending cooking. Go on a TV diet and use that extra time to prepare healthy foods.

Eating together as a family allows for time to communicate and connect with those most important to you. Make dinner special- create a place to sit down together, set the table with thoughtfulness and care, have the whole family get involved. Research shows that children who have regular meals with their parents do better in school and have healthier peer relationships. They also are 42% less likely to drink, 50% less likely to smoke cigarettes, and 66% less likely to smoke pot than those who don’t gather round the table with their folks. Family dinners also reduce the risk of obesity, anorexia, bulimia, and depression.

Dinner doesn’t have to be complicated or take a long time to prepare. Here’s a quick and easy recipe to try:

Salmon and Roasted Brussel Sprouts

Pro tip: Add brown rice or another whole grain to round out the meal. Try a different vegetable to roast like broccoli or carrots. Have fun with seasonings. Experiment with roasted red pepper flakes, basil, oregano or rosemary.

For great ideas on making family dinners more enjoyable and engaging for the younger audience, checkout thefamilydinnerproject.org.

Enjoy your dinner, your family and your health! In the coming blog posts, I’ll be going more in depth about circumstances contributing to society’s poor health; how to prevent chronic disease and stay healthy; and how to make an impact in your homes, communities, and beyond. Good health starts with you!

References:

Gruber KJ, Haldeman LA. Using the family to combat childhood and adult obesity. Prev Chronic Dis. 2009; 6:A106.

Larson NI, Neumakr-Sztainer D, Jannan PJ, Story M. Family meals during adolescence are associated with higher quality and healthful meal patterns during young adulthood. J Am Diet Assoc. 2007; 107:1502-10.

Sen B. Frequency of family dinner and adolescent body weight status: evidence from the national longitudinal survey of youth, 1997. Obesity. 2006; 14:2266-76

Taveras EM, Rifas-Shiman SL, Berkey CS, Rockett HR, Field AE, Frazier AL, et al. Family dinner and adolescent overweight. Obes. Res. 2005; 13:900-6

Gable S, Chang Y, Krull JL. Television watching and frequency of family meals are predictive of overweight onset and persistence in a national sample of school-aged children. J AM Diet Assoc. 2007;107:53-61.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Say Buzz Off to Mosquitos This Summer

by Dr. Jessica Morgan, MD

Summertime in Texas brings longer, sunnier days, countless outdoor activities, and those relentless mosquitos! Here’s how to reduce your chances of becoming a mosquito buffet and what to do to bring relief to annoying, painful, and itchy bites. Mosquitos can carry and spread deadly diseases such as West Nile Virus, so it’s important to know how to protect yourself and your family from the pesky critters.

Prevention can include use of repellents such as these described below:

DEET. This is the most commonly used active ingredients in mosquito repellents. When used excessively and inappropriately, it can be harmful to you and your child’s neurological system. We recommend using products with lower percentages of DEET such as OFF! For Families and following the directions for use.   Frighteningly, some disease-carrying mosquitoes are growing resistant to DEET. This DEET-resistant trait can even be passed down to offspring.

Natural Alternatives to DEET:

Picaridin. A chemical derived from pepper. Some studies have found it to be just as effective as DEET and a small number showed it to be even more effective. You can find picaridin products at most drugstores.

Oil of lemon eucalyptus. This is the only plant-based repellent recommended by the CDC. Look for products containing at least 26% oil of lemon eucalyptus. These products can be effective for up to 3 hours longer than repellants containing lower amounts of DEET (7%).

IR3535. This ingredient found in Avon Skin So Soft is a synthetic version of amino acids found in vitamin B, and has been used for decades in Europe.

Other plant-based repellents. A 2004 study in the Journal of Medical Entomology reviewed several plant based repellents. The study found soybean oil to be effective for up to 7 hours, similar to products containing 15% DEET, picaridin, oil of lemon eucalyptus, and IR3535. Geraniol (geranium oil) warded off bugs for up to 5 hours. Citronella and neem oil worked for up to 3 hours before needing to be reapplied.

Other strategies to elude mosquitos include wearing white or light colored clothing, avoid floral fragrances, avoid being outside around dusk or dawn, and wearing long-sleeves and pants when spending time outdoors.

So you’ve tried all these strategies and the stubborn pests, still found you?! Here are some tips to get relief from redness and itching caused by mosquito bites:

  • Put it on ice: Ice a bite as soon as possible to prevent inflammation. About 10-15 minutes should do.
  • Hit up the drugstore: For over-the-counter itch relief, apply topical hydrocortisone, Benadryl, or calamine lotion as needed.
  • Go green: Aloe can assist in healing and calming inflammation caused by bites.
  • Raid the kitchen cabinet: Use honey to help soothe bites. Try a baking soda and water paste.
  • Itch-free with tea tree: Tea tree oil not only has antiseptic properties, but It can also be anti-inflammatory and help control itching. Try Burt’s Bees Bug Bite Relief which contains tea tree, lavender and lemongrass oils to aid in reducing discomfort.

Insect Repellents: FAQ’s

noahMosquito bites are itchy, sometimes painful, but most of the time a little hydrocortisone cream or Benadryl will do the trick. Unfortunately our pesky summertime guests can carry and spread diseases, like West Nile Virus. The most effective way to avoid West Nile virus disease is to prevent mosquito bites. The dark green states in the map below have had cases of West Nile reported this year.

WNV-Activity-071514

Most people (70-80%) who become infected with West Nile virus do not develop any symptoms. About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months. Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues). The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.

People with certain medical conditions, such as cancer, diabetes, hypertension and kidney disease are also at greater risk for serious illness. Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent. About 10 percent of people who develop neurologic infection due to West Nile virus will die. No vaccine or specific antiviral treatments for West Nile virus infection are available. In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.

The answers to the following questions will help you decide how to best protect your family.

Which mosquito repellents work best?


The CDC recommends the use of products containing active ingredients which have been registered with the U.S. Environmental Protection Agency (EPA) for use as repellents applied to skin and clothing.

Of the products registered with the EPA, those containing DEETpicaridinIR3535, and some oil of lemon eucalyptus and para-menthane-diol products provide longer-lasting protection.

EPA registration means that EPA does not expect the product to cause adverse effects to human health or the environment when used according to the label.

How often should repellent be reapplied?


Repellents containing a higher percentage of the active ingredient typically provide longer-lasting protection. Regardless of what product you use, if you start to get mosquito bites, reapply the repellent according to the label instructions.

What precautions should I follow when using repellents?


Always follow the recommendations appearing on the product label. EPA recommends the following when using insect repellents:

  • Apply repellents only to exposed skin and/or clothing (as directed on the product label). Do not apply repellents under your clothing.
  • Never use repellents over cuts, wounds or irritated skin.
  • Do not apply to eyes or mouth, and apply sparingly around ears. When using repellent sprays, do not spray directly on your face—spray on your hands first and then apply to your face.
  • Do not allow children to handle or spray the product. When using on children, apply to your own hands first and then put it on the child. Avoid applying repellent to children’s hands because children frequently put their hands in their eyes and mouths.
  • Use just enough repellent to cover exposed skin and/or clothing. Heavy application does not give you better or longer lasting protection.
  • After returning indoors, wash treated skin with soap and water or bathe. This is particularly important when repellents are used repeatedly in a day or on consecutive days.
  • If you (or your child) get a rash or other reaction from a repellent, stop using the repellent, wash the repellent off with mild soap and water, and call a local poison control center for further guidance. If you go to a doctor, it might be helpful to take the repellent with you.

Can insect repellents be used on children?


Yes. Most products can be used on children. Products containing oil of lemon eucalyptus should not to be used on children under the age of three years. EPA does not recommend any additional precautions for using registered repellents on children other than those listed above.

Can insect repellents be used by pregnant or nursing women?


Yes. EPA does not recommend any additional precautions for repellent use by pregnant or nursing women.

Can I use an insect repellent and a product containing sunscreen at the same time?


Yes. People can, and should, use both a sunscreen and an insect repellent when they are outdoors. Follow the instructions on the package for proper application of each product. In general, the recommendation is to apply sunscreen first, followed by repellent.

Should I use combination sunscreen/insect repellent products?


It is not recommended to use a single product that combines insect repellent containing DEET and sunscreen. Repellent usually does not need to be reapplied as often as sunscreen. There are not specific recommendations for products that combine other active ingredients and sunscreen. Always follow the instructions on the label of whatever product you are using.

What is permethrin?


Permethrin is a repellent and insecticide. Certain products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated products repel and kill ticks, mosquitoes, and other arthropods. These products continue to repel and kill insects after several washings. Permethrin should be reapplied following the label instructions.

A Day in the Sun

While it may not be a smart idea for Olaf, it’s good for children and adults to spend time playing and exercising outdoors.  It’s important to protect our skin while enjoying time in the sun. While those with darker skin coloring tend to be less sensitive to the sun, everyone is at risk for sunburn and its associated disorders. Children especially need to be protected from the sun’s burning rays, since most sun damage occurs in childhood. Like other burns, sunburns leave the skin, red, warm, and painful. In severe cases it may cause blistering, fever, chills, headache, and general feeling of illness.

Your child does not actually have to be burned, however, in order to be harmed by the sun. The effects of exposure build over the years, so that even moderate exposure during childhood can contribute to wrinkling, toughening, freckling, and even cancer of the skin in later life. Also, some medications can cause skin reaction to sunlight, and some medical conditions may make people more sensitive to the sun.

Some people assume the sun is dangerous only when it’s shining brightly. In fact, it’s not the visible light rays bur rather the invisible UV rays that are harmful. Your child may be exposed to more UV rays on foggy or hazy days when it’s more tolerable to stay outdoors for longer periods of time. Even a big hat or an umbrella is not absolute protection because UV rays reflect off sand, water, snow, and many other surfaces.

Special consideration for babies:


A baby’s skin is more delicate and thinner than an adults and burns and irritates more easily. Even dark-skinned babies may be sunburned. Babies cannot tell you if they are too hot or beginning to burn and cannot get out of the sun without an adult’s help. Babies also need an adult to dress them properly and to apply sunscreen.

  • Babies younger than 6 months should be kept out of direct and indirect sunlight because of the risk of heat stroke. Particularly, avoid having a baby out between 10 am and 2 pm when the sun’s rays are the strongest.
  • Keep babies in the shade as much as possible- under a tree, umbrella, or stroller canopy. It’s important to note that an umbrella or canopy may reduce UV ray exposure by only 50%.
  • Dress babies in lightweight cotton clothing with long sleeves and long pants and a sun hat with a wide brim.
  • In general, it is not recommended that babies under 6 months use sunscreen except for small areas of skin uncovered by clothing or hats.
  • Apply sunscreen 15-30 minutes prior to heading outside. No sunscreens are truly waterproof, and thus they need to be reapplied every one and a half to two hours, particularly if a baby goes into the water.

Simple rules to protect your family from sunburns:


  • When possible, dress yourself and your children in cool, comfortable clothing that covers the body, such as lightweight cotton pants, long-sleeved shirts, and hats.
  • Select clothes made with a tight weave; they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to the see how much light shines through. The less light, the better. Or you can look for protective clothing labeled with an Ultraviolet Protection Factor (UPF).
  • Wear a hat with an all-around 3 inch brim to shield the face, ears and back of the neck.
  • Limit your sun exposure between 10:00 am and 4:00 pm when UV rays are strongest.
  • Wear sunglasses with at least 99% UV protection. Look for child-sized sunglasses with UV protection for your child.
  • Use sunscreen.
  • May sure everyone in your family knows how to protect his or her skin and eyes. Remember to set a good example by practicing sun safety yourself.

Sunscreen


Sunscreen can help protect the skin from sunburn and some skin cancers but only if used correctly.

How to Pick a Sunscreen

  • Use a sunscreen that says “broad spectrum” on the label; that means it will screen out both UVB and UVA rays
  • Use a broad spectrum sunscreen with an SPF of at least 15-30. More research studies are needed to test if sunscreen with a SPF > 50 offers any extra protection.
  • If possible, avoid the sunscreen ingredient oxybenzone because of concerns about mild hormonal properties.
  • For sensitive areas of the body, such as the nose, cheeks, tops of the ears, and shoulders, choose a barrier sunscreen with zinc oxide or titanium dioxide. These products stay more visible on the skin even after you rub them in, and come in fun colors that children enjoy.

How to Apply Sunscreen

Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet, hands, and even backs of the knees. Rub it in well.

Put sunscreen on 15-30 minutes prior to going outside to give it plenty of time to be absorbed by the skin.

Use sunscreen any time you or your child spend time outdoors. Remember that you can get sunburn even on cloudy days because up to 80% of the sun’s UV rays can get through the clouds. Also, UV rays can bounce back from water, sand, snow, and concrete so make sure you’re protected.

Reapply sunscreen every 2 hours and after swimming, sweating, or drying off with a towel. Because most people use too little sunscreen, make sure to apply a generous amount.

Treating a sunburn


The signs of sunburn usually appear 6-12 hours after exposure, with the greatest discomfort during the first 24 hours. If your child’s burn is just red, warm, and painful you can treat is yourself by doing the following:

  • Give your child water to replace fluid losses
  • Use cool compresses to help your child’s skin feel better.
  • Give your child pain medicine to relieve painful sunburns.
  • Only use medicated lotions if your child’s doctor says it’s okay. Aloe Vera can be cooling to mildly burnt skin.
  • Keep your child out of the sun until the sunburn is fully healed.

If your baby is younger than 1 year and gets sunburn, call your baby’s doctor right away. For older children, call your child’s doctor if there is blistering, pain, or fever. Severe sunburn must be treated like any other serious burn, and if its’ very extensive, hospitalization sometimes is required. In addition, the blisters can become infected, requiring treatment with antibiotics. Sometimes extensive or sever sunburn also can lead to dehydration and, in some cases fainting (heat stroke). Such cases need to be examined by your pediatrician or the nearest emergency room.

Fireworks Safety for the 4th of July

We know fireworks are fun and it’s tempting to try to put on your very own show. But this is the time of year when there is a significant increase in the amount of injuries and fires due to the use of fireworks. That’s why we recommend leaving fireworks to the professionals. It’s the best way to enjoy the show and stay safe at the same time.

Leave Fireworks to the Professionals

  • The best way to protect your family is to not use any fireworks at home. Instead, attend public fireworks displays and leave the lighting to the professionals.
  • If you plan to use fireworks, make sure they are legal in your area.

Be Extra Careful With Sparklers

  • Little arms are too short to hold sparklers, which can heat up to 1,200 degrees. How about this? Let your young children use glow sticks instead. They can be just as fun but they don’t burn at a temperature hot enough to melt glass.
  • Closely supervise children around fireworks at all times.

Take Necessary Precautions

  • Do not wear loose clothing while using fireworks.
  • Never light fireworks indoors or near dry grass.
  • Point fireworks away from homes, and keep away from brush, leaves and flammable substances

Be Prepared for an Accident or Injury

  • Stand several feet away from lit fireworks. If a device does not go off, do not stand over it to investigate it. Put it out with water and dispose of it.
  • Always have a bucket of water and/or a fire extinguisher nearby. Know how to operate the fire extinguisher properly.
  • If a child is injured by fireworks, immediately go to a doctor or hospital. If an eye injury occurs, don’t allow your child to touch or rub it, as this may cause even more damage.

Check out 4th of July festivities in Lakeway:

http://www.lakeway-tx.gov/index.aspx?NID=718

Or the Austin Symphony 4th of July show at Austin 360 Amphitheater.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Use Your Head, Wear a Helmet.

Dr. Morgan’s simple rule is ‘No helmet, no wheels.’  Wearing a helmet is the single most effective safety device available to reduce head injury and death from bicycle accidents.  In fact, helmets reduce the occurrence of head injuries by 88%!

Find the Right Helmet Fit.


  • Make sure your child has the right size helmet and wears it every time when riding, skating, or scooting.  Let your child pick out their own helmet when it’s time to buy a new one.  They’re more likely to enjoy wearing it.
  • Make sure the helmet fits and your child knows how to put it on correctly.  A helmet should sit on top of the head in a level position, and should not rock forward, backward or side to side.  The helmet straps must always be buckled but not too tightly.  A good way to test this is have your child shake their head yes and then no. The helmet should move with your child’s head stay put.  For the chin strap, you should be able to fit no more than a finger between the strap and the child’s chin. We recommend kids take the Safe Kids Helmet Fit Test.
  • Eyes check: Position the helmet on our head. Look up and you should see the bottom im of the helmet. The rim should be one to two finger widths above the eyebrows.
  • Ears check: Make sure the straps of the helmet form a ‘V’ under your ears when buckled.  The strap should be snug but comfortable.
  • Mouth check: Open your mouth as wide as you can.  Do you feel the helmet hug your head? If not, tighten those straps and make sure the buckle is flat against your skin.

helmet

Use Appropriate Helmets for Different Activities


  • Children should always wear a helmet for all wheeled sport activities
  • A properly-fitted bike helmet is just as effective when riding a scooter, roller skatin or in-line skating.
  • When skateboarding and long boarding, make sure your child wears a skateboarding helmet.

External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Heads Up: Advice on Preventing Concussions from the CDC

A concussion is a brain injury. Concussions are caused by a bump, blow or jolt to the head. They can range from mild to severe and can disrupt the way the brain normally works.

Most people will only experience symptoms from a concussion for a short period of time. But sometimes concussion can lead to long-lasting problems.  The best way to protect yourself and your family from concussions is to prevent them from happening.

There are many ways to reduce the chances that you or your family member will have a concussion or more serious brain injury:

  • Use seat belts and child safety seats every time you drive or ride in a car.
  • Wear a helmet and make sure your children wear helmets that are fitted and maintained properly when:
  • Riding a bike, motorcycle, snowmobile, or scooter;
  • Playing a contact sport, such as football, ice hockey, lacrosse, or boxing;
  • Using in-line skates or riding a skateboard;
  • Batting and running bases in baseball or softball;
  • Riding a horse; or
  • Skiing, sledding, or snowboarding
  • Ensure that during athletic games and practices, you and/or your children:
    • Use the right protective equipment;
    • Follow the safety rules and the rule of the sport;
    • Practice good sportsmanship;
    • Do not return to play with a known or suspected concussion until you have been evaluated and given permission by an appropriate health care professional.
  • Make living areas safer for children by:
    • Installing window guards to keep young children from falling out of open windows;
    • Using safety gates at the top and bottom of stairs when young children are around;
    • Keeping stairs clear of clutter;
    • Securing rugs and using rubber mats in bathtubs; and
    • Not allowing children to play on unsafe platforms, i.e. fire escapes or balconies.
  • Make sure the surface on your child’s playground is made of shock-absorbing material, such as hardwood mulch or sand, and is maintained to an appropriate depth.

When to Call the Pediatrician: Signs and Symptoms of Concussion

Here is a list of common signs and symptoms of a concussion.  If you or a family member has an injury to the head and you notice ANY of the symptoms of the list, call Bee Well right away.  You likely need an appointment to see one of our doctors or specialist.

  •   Difficulty thinking clearly
  •   Feeling slowed down
  •   Difficulty concentrating
  •   Difficulty remembering
  •   Difficulty following conversation or   directions
  •   Answers questions more slowly or repeatedly
  •   Dazed or stunned
  •   Headache
  •   Nausea or Vomiting
  •   Clumsiness or balance problems
  •   Dizziness
  •   Fuzzy or blurry vision
  •   Feeling tired all of the time, having no   energy
  •   Sensitivity to light
  •   Sensitivity to noise
  •   Numbness/tingling
  •   Irritability
  •   Sadness
  •   More emotional
  •   Nervousness or anxiety
  •   Sleeping more or less than usual
  •   Trouble falling asleep
  •   Drowsiness

When you visit Dr. Van or Dr. Morgan, here are some important questions to ask:

  • What can I do to help my recovery or my child’s recovery from this injury?
  • When is it safe to get back to my daily routine, such as school, work, or playing sports, and doing other physical activities?
  • What can I do to keep from injuring myself again?

At Bee Well Pediatrics, our physicians are trained and knowledgeable at diagnosing and treating concussions and provide a comprehensive assessment and return to play and school protocols for our patients. We work with local school nurses teachers, athletic trainers, and coaches in Austin, Lakeway, and surrounding areas to ensure your child’s safe return to regular activity and to reduce long-term effects.  Preventing concussions makes a difference.

Medical Ear Piercing Now Available!

We are excited to offer medical ear piercing, using the Blomdahl medical ear piercing system, made in Sweden for use by physicians only. Please read on for more information about this popular service!

Why should I use Bee Well Pediatrics for ear piercing?

We believe that using the Blomdahl medical ear piercing system, available only to physicians, provides your child with a safer and more sanitary alternative to the mall or jewelry store. Blomdahl is a sterile system where a disposable cartridge is replaced with every piercing and uses medical-grade plastic or titanium piercing studs to reduce the chance of allergic reaction.

In a medical office, you have professional care from doctors trained in sterile technique and wound management. You also have ready access to medical professionals for any questions, problems or concerns before, during or after the procedure. We also offer pre-procedure topical anesthesia, which is not available in non-medical settings.

Can I get it done during another scheduled visit or as a walk-in?

Ear piercing is performed by appointment only and will not be performed as part of a sick or well visit. Ear piercing will be conducted during a visit dedicated solely to that procedure which will allow time for the anesthetic to take effect and the procedure to be explained and performed with detailed aftercare instructions.

How old must my child be to have his/her ears pierced?

This service is available for patients 3-6 months old and 7 years and older who are up to date with their tetanus vaccines.  Some exceptions to this age policy may be made at the discretion of the pediatrician.  We need your child to be able to sit quietly during the procedure and to allow or participate in responsible aftercare to ensure a good outcome. The staff reserves the right to cancel the procedure if they feel, for any reason, the situation may be unsafe due to a child’s inability to cooperate.

Where can I get pierced?

The only location we will pierce is the earlobe. We will pierce no more than two earrings per ear lobe. A maximum of one pair of piercings (one per lobe) will be performed at a single visit. We do not provide cartilage (upper earlobe) piercing.

How much will it cost?

This is a cosmetic procedure and will not be filed against insurance. Payments are due at time of service and include the price of the earring, procedure, and topical anesthesia. A single piercing is $40 and both ears are $70.

What kind of earrings are used?

The earrings come in single-use sterile cartridges and are available in medical-grade plastic or medical-grade titanium, the most superior non-allergenic metal.

Why is it important to have nickel-free earrings?

5.8% of Americans are allergic or sensitive to nickel. A 2008 report in the Journal of the American Academy of Dermatology found no particular price point or country of origin that assured earrings did or did not contain nickel, and a survey of earrings in a wide range of locations and price points marketed at children and women under 40 revealed high nickel concentrations in 24-85% of earrings sampled.

Titanium and gold contain similar trace amounts of nickel, but titanium leaches less nickel into the body and is the superior choice for avoiding nickel sensitivity. Any Blomdahl metal earring, even gold-plated, will only contain titanium on the portion of the earring that touches the skin.

What styles are available?

We currently stock crystal medical-grade plastic piercing studs. For more colors and styles including titanium and gold-plated titanium, please see our in-office display and let us know what you’d like us to order at least two weeks prior to your appointment.

Will it hurt?

We use a local topical anesthetic to reduce the discomfort associated with ear piercing. We apply it to the skin and allow it to remain on the ear for 30 minutes to maximize its effect. Afterwards, the child will experience only a pinch and a small sting, similar to a vaccination.

What are the risks?

Ear piercing is a minor surgical procedure with similar risks to stiches or abscess drainage. Despite our precautions and sterile technique, there is a small change of infection, scarring, or allergic reactions. As some people are prone to scarring, there is a small risk that a keloid, or overgrown scar, could form at the site. We will ask you to sign an informed consent to verify that you have been notified of these risks.

How do I care for the piercing afterwards?

After piercing, you must clean the earlobe with soap and water twice daily, or with sterile saline.  Always use clean hands to touch ears and earrings. Do not twist the earrings or apply rubbing alcohol as this will impede healing. The earrings will need to stay in place for 6 weeks before replacing. You will be provided with an Aftercare Instructions handout for more detailed information.

Love Your Puppy Well: Part 1 – How to Approach an Unfamiliar Dog

How to Approach an Unfamiliar Dog


ASK PERMISSION

  • Say something like, “May I pet your dog?’
  • If there is no person with the dog, do not attempt to pet them!

HAND SNIFF

  • If the person says yes to petting, show the dog the back of your hand with your fingers curled under. Let the dog sniff your hand.
  • Curling the fingers under offers some protection from nips. If your fingers are extended, the dog may think that you are offering her food and they might nip. If fingers aren’t easy targets, they won’t get nipped.

WATCH THE DOG’S REACTION

  • Respect what the dog “tells” you. If the dog folds their ears back, tucks their tail in, growls or moves away from you – DO NOT PET THE DOG. The dog is telling you they do not want to be petted. If the dog licks your hand and wags their tail, they are letting you know that it is all right to pet them

BE GENTLE!

  • Stroking the back from the head end toward the tail is usually agreeable to most dogs.
  • Listen to suggestions from the dog’s person as to what the dog does or does not like.

Do:


  • Stay away from the dog’s face and eyes.
  • Speak softly to the dog while you pet them.
  • Stop immediately and move away if the dog gives any indication that they do not want to be petted anymore.

Do not:


  • Pick up the dog.
  • Pull the dog’s tail or ears, poke the dog, pull the dog’s fur, or pet the dog harshly
  • Put your face near the dog’s face. You can frighten or overwhelm them by getting too close.
    dogface

Dog’s Body Language: What is It Telling You?

Love Your Puppy Well: Part 2


Dogs have a language that allows them to communicate their feelings and their intentions to others around them.  Although dogs do use sounds like barking and growling, much of the information that they send is through their body language, specifically their facial expressions and body postures. Understanding what a dog is saying can give you a lot of useful information, such as when a dog is spooked and nervous about what is going on, or when a dog is edgy and might be ready to snap at someone. You do have to look at the dog’s face and his whole body. Here are some visuals that will help you to interpret the eight most important messages a dog is sending to you.

Relaxed, Approachable


approachable

ALERT: Checking things out


Learn more about animal assisted child therapy.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Top Ten Tips for Breastfeeding Success

Do get your baby on the breast within the “golden hour”, the first hour after birth. Speak with your OB or Midwife about putting this in your birth plan. Even with a C-section, this is still realistic.

Do room in with your baby in the hospital and at home. The American Academy of Pediatrics recommends co-sleeping (but not bed-sharing) with your baby until at least 6 months, and most hospital nurseries are moving towards rooming-in as standard practice.

Don’t offer a pacifier until breastfeeding is firmly established (about 6 weeks). Pacifiers aren’t necessary, but can reduce SIDS risk in babies up to 6 months old. If introduced too early, they can interfere with baby’s ability to communicate early signals of hunger and cause nipple confusion. Lactation specialists and the AAP recommend waiting until about 6 weeks to consider introduction of a pacifier.

Do feed on demand; don’t skip middle of the night feeds to get a break. Skipping feeds sends a signal to your body that it made too much milk and will ultimately decrease your milk supply, and when you wake up engorged, it can be difficult for baby to effectively latch.

Don’t ignore pain that lasts for an entire feeding session. Some discomfort for the first 30-60 seconds of a feed is normal in the first few weeks. Pain that lasts throughout a feed, cracked or bleeding nipples indicate a latch problem.

Do take care of yourself: sleep when the baby sleeps, eat enough food, and drink lots of water. Making milk burns 500 calories a day!

Download the free Lactmed app on your phone to check for interactions with prescribed and OTC medications that may affect breastmilk production and to see if medication crosses into milk. Some doctors will tell you to stop breastfeeding if you are on any medication “just in case” it crosses into breastmilk. With this free app and searchable website from the National Institute of Health, you can prevent unnecessarily disrupting the breastfeeding relationship.

Get a good pump; it’s covered by your insurance thanks to ACA. Breastfeeding supplies are also tax-deductible.

Know your rights in public and the workplace. In Texas, you have the legal right to breastfeed ANYWHERE you are legally allowed to be.

Ask for help if you need it! Turn to a certified lactation consultant or contact La Leche League for assistance over the phone or in person. 

Helpful links:

How to get your tax deduction for breastfeeding supplies http://www.whattoexpect.com/first-year/ask-heidi/tax-deduction-for-breastfeeding-supplies.aspx

How to get your pump covered by your insurance company http://www.ivillage.com/how-get-breast-pumps-covered-insurance/6-a-477000

Listing of state laws regarding breastfeeding in public and the workplace http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx

LLL Austin http://texaslll.org/group/central-texas%20

We hope you found our Top Ten Tips for Breastfeeding Success helpful!


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Nursing in Public: Know Your Rights!

Can you imagine spending hundreds on bras in Victoria’s Secret, then being asked to go to “a nearby alley” to nurse your baby? How about being surrounded by Target employees and publicly shamed for nursing your hungry infant? Both of these incidents happened recently in Texas, and both are illegal.

According to the Centers for Disease Control and Prevention, approximately 75 percent of mothers start breastfeeding immediately after birth, but less than 15 percent of those moms are breastfeeding exclusively six months later. Situations like these remind us why, as many mothers are afraid of the reaction they may face when feeding their child publicly.

In Texas, codified in Texas Health and Safety Code 106.002 “Right to Breast-Feed”, any mother has the right to nurse her child anywhere she is legally allowed to be. Forty-five states, the District of Columbia and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location. (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin and Wyoming.)

If confronted by an employee or nosy passerby, politely inform them that in Texas, you have a legal right to nurse anywhere you are legally allowed to be.
Check breastmilkcounts.org for state-by-state nursing laws.

If you have any questions about nursing in public, or are looking for a baby doctor in Austin Texas, please contact us.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Pacifiers: How and When to Break the Habit

Pacifiers are not necessary, but can be helpful—they reduce the risk of SIDS until 6 months of age and can give even a nursing mother a break every now and then. However, if used too long, they can lead to tooth deformity, speech delay, encourage cavity formation, contribute to inner ear infections, and harbor thrush.

The best time to wean a child off the pacifier is between 6-12 months, with the goal of no more artificial nipples (bottle and pacifier) by 1 year old. When pacifier use is prolonged, the weaning process gets much, much harder. Better to complete it before your child can walk and talk!

Here are some methods that families have found helpful. Some are more applicable to an older child who still uses the pacifier for sleep.

1. Cold Turkey. This is a popular and effective method, but difficult emotionally as there will likely be tears and tantrums. If you live in an apartment or townhouse, warn the neighbors. People have had the police or CPS stop by to investigate! However, if you stick to it, the process will be over in a matter of a few days. Make sure that all family members and caregivers are on board. Pick a date, circle it on the calendar, and after that date, no pacifiers in the house. No secret backup pacifier. No grandma-to-the-rescue. Throw them out in a dumpster somewhere so you are not digging through your kitchen trash in desperation in hour three.

2. Cut a hole in the tip of the pacifier. Cut more off every few days. The child will be unable to get the same amount of suction and will usually discard the pacifier himself.

3. Have a ceremony in which the child leaves the pacifier under the pillow for the “Binky Fairy” who will give it to babies who need it more and leave a small toy in its place, maybe with a glittery note of thanks.

4. Tour a local fire station “in exchange” for turning in the pacifier to the firefighters, who will “make sure” it gets to babies who need it. Plan this a week in advance so you can call and make an appointment for the station tour.

5. Participate in a Build-A-Bear workshop and tuck the pacifier inside so your child can have it nearby but not in her mouth.

6. Replace the pacifier with another comfort object, like a small stuffed animal that can fit in a pocket.

7. Gradually decrease the times of day and places where the pacifier is used: first in the house only, then naps and bedtime, then bedtime, then done.

If you are trying to find a pediatrician in Austin Texas, please give us a call!

Why get a flu vaccine?

Why get a flu vaccine? Many people put off or avoid getting protected from flu because of misconceptions about the vaccine and about influenza in general. Here are a few common myths, with correct information provided by the CDC about the 2013-2014 flu season so far.

Myth: Only children and seniors are at risk. 
Fact: The flu seems to be hitting young and middle-aged adults the hardest this year, rather than seniors or children, said Dr. Michael Jhung, a medical officer in the U.S. Centers for Disease Control and Prevention’s Influenza Division. “The ones that tend to be sick this season are young and otherwise healthy adults,” added Daniel Spogen…board member of the American Academy of Family Physicians. “If you take a look at the data, the people who are getting sick enough to be hospitalized are the ones who didn’t get their flu shot.”

Myth: The flu is just a bad cold.

Fact: An estimated 6.9 percent of all deaths in the United States this season have been caused by flu or pneumonia — just under the epidemic threshold of 7.1 percent. Ten children have died from the flu so far this season, the CDC said.

Myth: I will get the flu from the flu vaccine.
Fact: The flu shot is a killed vaccine. You cannot get the flu from the flu shot. Flumist is live-attenuated, meaning it cannot multiply at body temperature. In blind, randomized trials, there was no difference in reported side effects between groups that got the flu shot or salt water, except for some increased redness and arm soreness with the group receiving the flu shot.

Myth: I will get really, really sick after receiving the flu vaccine.
Fact:
Reactions to the flu shot:
The most common reaction to the flu shot in adults has been soreness, redness or swelling at the spot where the shot was given. This usually lasts less than two days. This initial soreness is most likely the result of the body’s early immune response reacting to a foreign substance entering the body. Other reactions following the flu shot are usually mild and can include a low grade fever and aches. If these reactions occur, they usually begin soon after the shot and last 1-2 days. The most common reactions people have to flu vaccine are considerably less severe than the symptoms caused by actual flu illness.
Reactions to nasal spray flu vaccine:
People also may have mild reactions to the nasal spray vaccine. Some children and young adults 2-17 years of age have reported experiencing mild reactions after receiving nasal spray flu vaccine, including runny nose, nasal congestion or cough, chills, tiredness/weakness, sore throat and headache. Some adults 18-49 years of age have reported runny nose or nasal congestion, cough, chills, tiredness/weakness, sore throat and headache. These side effects are mild and short-lasting, especially when compared to symptoms of seasonal flu infection.

Myth: I got the flu shot, so I don’t need to do anything else to protect myself from flu.
Fact: The flu is a virus like any other. In cold and flu season, it is important to remember to keep yourself and those around you safe by washing your hands frequently, and covering your mouth and nose with the crook of your elbow rather than hand when you sneeze or cough.

Myth: The flu vaccine doesn’t work, so there’s no point in getting it. 
Fact: The flu changes every year, and researchers start racing each spring to beat its arrival in the West by trying to predict which strains are emerging in the East and making vaccines based on that. It’s not perfect, but after analyzing last year’s flu season data, vaccine effectiveness was estimated at 62%, with a 95% confidence interval (CI) of 51% to 71%, according to the CDC. This is much better than the 0% prevention of not immunizing at all!

Myth: Flu season is almost over. It’s too late to get vaccinated. 
Fact: Flu season goes from October through March and typically peaks in December/January. It takes about two weeks for your body to develop protection after being vaccinated, so it is worthwhile to get vaccinated through March. The CDC recommends getting vaccinated as soon as possible, once vaccine becomes available, typically in late summer/early fall.

Myth: I got the flu, so I don’t need to get the flu vaccine. 
Fact: There are multiple strains of flu. Likely you were only infected with one of them. Depending on which form of the vaccine you get, you will receive protection against 3 or 4 types of influenza A and B, including H1N1.

Bee Well Pediatrics stocks Quadrivalent (protects against 4 strains including H1N1) Flumist, appropriate for children age 2 and up without asthma, and Trivalent (protects against 3 strains including H1N1) flu shot, appropriate for children 6 months and older.

Looking for a pediatrician in Westlake Austin TX?  Give us a call, we’d love to speak with you.

“I’m fine! I don’t need to go to the doctor!”

Most parents know that they need to bring their children in for immunizations, but often neglect the routine yearly well checks during non-required immunization years. You may wonder why we need to see your healthy child every year.

What are you checking for? My child is healthy!

• Growth
We measure your child’s height, weight, and body mass index and plot it on a standardized growth curve. This allows us to see if your child is “growing along their curve”, or if growth is not proceeding as expected, gives us a chance to investigate with detailed family history, dietary history, and bloodwork and/or referral to a specialist if needed. Unintentional weight loss or gain may not be noticed by those who live with the child every day as the change is so gradual. This can reveal eating disorders, hormone imbalances, or lifestyles in need of healthy changes. As recommended by the American Academy of Pediatrics, we screen all children with bloodwork for cholesterol levels at age 12 or sooner if high BMI or family history risk factors are identified.
• Pubertal changes and menses
Puberty that occurs too early can lead to obvious social difficulties as well as advanced bone age, leading to early closure of growth plates and short stature. Both early and late puberty can be caused by genetic abnormalities, hormonal imbalances, tumors, deformities of the reproductive organs or hormone control centers, infections, or trauma. We will ask detailed questions about menstruation and check for anemia with an in-office blood test for 12- and 16-year-old females.
• Scoliosis
During periods of rapid growth, the spine may become asymmetrical. If noted and clinically significant, we will get a baseline spine x-ray and monitor every 6 months.

Why does my child have to put on a gown?

The American Academy of Pediatrics recommends that “…at each visit, age-appropriate physical examination is essential, with infant totally unclothed, older child undressed and suitably draped.” This allows us to see all of your child’s skin and monitor for skin disease, internal disease that can manifest as skin abnormalities, look for any signs of physical abuse or self-harm, and monitor birthmarks. We will point out anything that is concerning to you so you can monitor it as well.

Why do I have to leave the room during the adolescent well check?

Part of the adolescent visit, starting at age 11, involves taking a complete psychosocial history. Often adolescents are physically healthy but are entering a stage of life that encourages independence and risk-taking behaviors. It is our responsibility as physicians to assess this part of their development. After the initial portion of the well visit, we will ask you if you have anything you need to add before we have you step into the waiting room for a few moments. We then complete the interview with your child. The format we use is called HEEADDSS, used by adolescent medicine specialists since 1985 and updated periodically to reflect our changing world. It covers Home environment, Education and employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, and Safety from injury and violence.
Your child may not reveal problems with you in the room as she might feel uncomfortable burdening you with her concerns, or afraid of your reaction. Any indication that your child is in danger from self or others currently or in the recent past will be immediately shared with the parent and is outside the realm of patient confidentiality. We also use other screening questionnaires to identify adolescents at risk for substance abuse, depression, anger issues or inattention.

Brought to you by Bee Well Pediatrics – Austin Texas Pediatricians.

Bee Well has gone to the dog!

grahamby Jessica Morgan, MD

But in a good way.  Our pet therapy dog, Graham, is a vital part of our medical team.  Trained and tested, Graham is certified by Pet Partners International to provide pet therapy services including animal-assisted therapy and other animal-assisted activities.  Animal-assisted therapy is a growing filed that uses dogs or other animals (even llamas!) to help people recover from or better cope with health problems such as heart disease, cancer, and mental health disorders.  Whereas animal-assisted activities have a more general purpose, such as providing comfort and enjoyment for hospitalized patients, nursing home residents, or children visiting the pediatrician’s office.

Animal assisted child therapy and activities can significantly reduce pain, anxiety, depression, and fatigue in people with a range of health problems from children having dental procedures to veterans with post-traumatic stress disorder.  It’s not only the patient that feels better.  Family members and friends who sit in on animal visits say their spirits are lifted as well.  We are well aware that visiting the doctor’s office can be a frightening event for some children. Graham is here to help.

It is well-known and scientifically proven that interaction with a gentle friendly pet has significant benefits on physical and mental health:

Physical Health:

  • lowers blood pressure
  • improves cardiovascular health
  • releases endorphins (oxytocin) that have a calming effect
  • diminishes overall physical pain
  • the act of petting produces an automatic relaxation response

Mental Health:

  • lowers anxiety
  • provides comfort
  • encourages communication and increases socialization
  • reduces boredom
  • decreases feelings of isolation and loneliness
  • lifts spirits and lessens depression

Bee Well Pediatrics is proud to be the only pediatrician’s office in the Austin, Bee Cave and Lakeway area to have their very own certified pet therapy dog.  It is our hope that he makes our patient’s time with us enjoyable and relaxing.  (Not normally words used to describe a doctor’s appointment!)  Even if you’re not a patient of ours, feel free to stop by and meet Graham. He always appreciates making new friends.

 

Bee well.

Top Ten Tips for Traveling with Children

Picture That!

Taking a picture of each child’s immunization record with your smartphone is an easy way to confirm immunization status in an emergency. Take a picture of each child before leaving so you have a record of what they are wearing if you are separated.

Fly and Drive Safely

Using a car seat while on an airplane is the safest way to fly. A CARES harness (age 1 and older, 22-44 lbs), can replace a car seat for airplane use, but does not have a crotch strap or side protection.  “Rider Safe” vests are great for cars but require a shoulder belt or LATCH system, so cannot be used on airplanes. Do not trust car seats provided by car rental companies as they may be expired, involved in a recall, broken, or dirty.

Pack Wisely

Diaper bags are not counted towards carry-ons, and remember that every person who has to buy a ticket is entitled to their own personal bag. Additional helpful items to consider are antibacterial wipes, antibacterial hand gel, and reusable bags that can be folded down to a tiny size for efficient bathroom trips. Bring a backpack instead of a rolling bag if possible to leave your hands free. Use the carry-on for extra diapers, travel toys, a change of clothes for each person, and valuable items.

Be Versatile

Front carriers with a backpack or slings with a messenger bag are a great combination for getting through airports with children up to age 3, leaving hands free.   Wraps and slings can be used as nursing covers, pillows, and blankets. Think of more than one way to transport each child and large piece of equipment so you have a backup plan in case of emergency.

Maximize Seating

When you check in, ask if the seat next to you can be blocked, especially if you are flying with a lap infant, and that seat will be filled last. You can bring your car seat all the way to the aircraft and gate-check it if there is no room. Book window and aisle seats when traveling with two adults and a lap infant so you can use the center seat if the plane is not full.

Divide and Conquer

If there are two adults, consider sending one ahead to gate-check or install the car seat, get carry-on bags in place, settle seating issues with neighbors, and wipe the area with antibacterial wipes so the second adult can settle in smoothly with the children. Remember to leave some supplies behind if one parent is staying with a diapered child!

Takeoff and Landing

Children do not necessarily have to swallow, yawn or chew gum during takeoff. ENT specialists recommend only that children be awake for landing. Consider scheduling a doctor visit prior to a flight to look for any ear fluid or infection that will make flying miserable and can result in ruptured eardrums.

The “Frisk” Diaper Change

All diapers should be changed in the lavatory.  Older children may be taken into the larger handicapped lavatory as they may not fit on the changing table. Change toddlers standing up in the “frisk” position against the wall. Clean the back side first, put a clean diaper on your lap, then have them face away and lean against you as you clean and fasten the front. Keep a change of clothes in case of “wardrobe malfunction” in a large ziplock bag inside the bag you bring to the lavatory.

Be a Good Neighbor

If traveling with two adults or a responsible older child, consider seating arrangements that place a more active toddler behind a carseat or older member of the party. Minimize conflicts by telling your child to not touch (instead of “not kick”) the seat in front of them.  If seated with a stranger in your row, choose carefully who will sit next to them as a parent may need to get up frequently. Consider a quieter, school-age child instead of toddler, infant or parent.

Be a Savvy World Traveler

Check the CDC’s travel advisory page before leaving the country to look for any current disease outbreaks or travel warnings. Some areas that are high risk for malaria or other insect-borne diseases may require protective medication or vaccines started up to 1 month before leaving.

Helpful Resources:

www.travel.state.gov  Travel information, legal

http://wwwnc.cdc.gov/travel/destinations/list Travel information, health

http://www.tsa.gov/traveler-information/travelers-disabilities-and-medical-conditions

http://www.bwiaustin.org/carrier-info/ Baby carrier comparisons

 

Traveling with children can be fun!


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*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

The Season of Giving

Christmas time is the most wonderful time of year, the season of giving. It’s an especially magical time for the children in our lives, full of wonder, joy, anticipation, and of course- TOYS! Keep those holiday memories enjoyable and free of unexpected hospital visits. Here’s some of our expert advice on how to choose age appropriate and safe toys.

Toy manufacturers make it easy to select age appropriate toys. Their age recommendations are made based on four categories: the safety aspects including choking hazards; physical ability of the child to play with the toy; the ability of the child to understand how to use the toy properly; and the needs and interests at various levels of a child’s development.

Real dangers to younger kids are choking and strangulation hazards. Not sure if a toy or its parts are too small? Toys and parts should be larger than a child’s mouth. Look for sturdy construction with parts that cannot easily break off. When purchasing a soft toy or stuffed animal, make sure the eyes, nose, and other smaller parts are secured tightly.

Strings, cords, or ribbons more than 12 inches long pose a strangulation hazard. These are often found on crib toys, pull toys, pacifiers, and clothing (hoodies).

Other toys to be cautious about:

Button Batteries: Found in musical toys and greeting cards. They are a serious health risk if swallowed, causing erosive damage or even electrical burns to the esophagus.

Rare Earth Magnets (and other strong magnets): Have been known to cause intestinal perforation when two or more magnets in the GI tract bind together through intestinal tissue. An intestinal perforation presents with severe and sudden abdominal as well nausea and vomiting and is a medical emergency.

If you think your child has swallowed a battery or magnet or any other nonfood item, a trip to the emergency room is warranted.

Because some safety issues are not discovered until after a toy makes it the shelf, we recommend that parents join a recall list like the free one offered by SafeKids.org. The site compiles product recalls specific to children and sends twice monthly email alerts for recent recalls. Sign up is available at http://safekids.org/recallnews.

More recall information for consumer products, motor vehicles, foods, medicines, cosmetics, and environmental products can be found at www.recalls.gov. You can also call the Consumer Product Safety Commission at 1-800-638-2772 or visit http://www.cpsc.gov to search for a specific product or category.

The best advice we can give parents in regards to preventing injuries, is to always supervise your children or have them supervised by a responsible adult.

We hope these tips help you keep your loved-ones happy and safe. For more on this topic, check out this month’s issue of Austin Woman Magazine. Bee Well Pediatrics is featured in the health column, giving advice on making the holidays kid-friendly. You can also stop by our office and pick up one of our Toy Safety Guides.

Happy Shopping and Merry Christmas!

Bee well.


External Content Disclaimer

*Please note that pages of this site may be linked to other websites, which may have different terms of use and privacy practices than Privia Medical Group. Privia does not own, control, manage, supervise, direct, or otherwise have involvement in such other websites or the content of such websites. Privia is not responsible for the content of any linked websites. Privia is not acting as an agent for these websites, nor does Privia endorse or guarantee, in any way, their websites, content, or products. Privia makes no representation or warranty regarding the accuracy of information contained in linked websites, takes no responsibility for the use of copyrighted or otherwise protected materials on such linked websites, and has no control over the privacy practices or use of user information at such linked websites.

Visiting Grandparents Safely

by Dr. Suzanne Van Benthuysen

Grandparents are a wonderful part of children’s lives. Going to visit grandparents can be a joyful and nostalgic family experience as children discover toys, clothes and furniture from their own parents’ childhood. However, grandparents may not necessarily have access to the latest child safety information. Here are some tips to help make your visit as safe as possible!

Toys

Inspect older toys for broken, loose or small parts that may cause injury or choking. Trim any pull cords or connector cords (ex. hammer for xylophone, cord for toy phone) as needed to make sure they are a maximum of 12 inches long. Walkers in which a child is bucket-seated can be dangerous as children can navigate them towards open stairs and off the edges of decks, and the falls tend to cause head injury due to the child’s entrapped position.  Push-toy walkers are safest for the child learning to navigate upright. Bicycles, rollerblades, and scooters should always be used with a helmet. ATVs are dangerous for children and younger adolescents. Although the Consumer Product Safety Board has issued guidelines that children ages 12-15 should not ride ATVs with engine capacity over 90ccs, the American Academy of Pediatrics recommends that no child under 16 should ride on or drive an ATV.

Window Safety

Second-story and higher windows should be closed and locked. Screens will not prevent a fall. Keep cribs, beds and climbable furniture away from windows. Keep all window cords out of reach of young children. Cord winders can shorten cords without cutting. Continuous-loop pull cords on draperies and vertical blinds should be pulled tight and anchored to the floor or wall with a tension device or wrapped around a cleat.

Sleeping Arrangements

Older cribs made before June 2011 may have drop-sides which have been associated with injury and death. All cribs should have stationary sides and should not have decorative cutouts that can entrap clothing or limbs. Check all hardware for loose, broken or missing pieces and only replace with manufacturer-approved parts. If practical, bring or get a collapsible play yard. Check by manufacturer, but most have a 35 lb/30 inch weight/height limit. It should not be used if a child can climb out. Only use manufacturer-approved bedding and padding. Infants should never sleep on a couch or armchair, even with an adult, as the many crevices are suffocation risks. Inflatable mattresses pose a suffocation hazard for infants and toddlers. Infant monitor cords should not be within a child’s reach from the crib. Mobiles and overhanging crib toys should be removed once the child can get to hands and knees. There should be no bumpers, pillows, large stuffed animals, or large quilts in a crib.

Around the House

Rubber-tipped spring doorstops are a choking hazard as children love to play with them and the rubber tip can easily come off. They can easily be replaced with single-unit doorstops that screw into the same hole. Make sure cleaning supplies and household chemicals are out of reach or in child-locked cabinets. Cover any exposed outlets and power strips. Toddler Shield table pads are available to make glass coffee tables as safe as possible, and foam strips can temporarily shield sharp corners and hearth edges. Lid locks for toilets can prevent plumbing disasters and decrease drowning risk. Set the hot water heater upper limit to 120°F to decrease burn risk.

Make sure the TV is as far back on its stand as possible and ideally secured to the wall. Anti-tip kits are available at hardware and baby stores to secure heavy bookcases, dressers and TVs to the wall. Dressers that seem stable can tip over if multiple drawers are pulled out, so consider adhesive drawer locks for a quick fix.

Hardware-mounted baby gates are appropriate where there is a risk of falling, such as the top of stairs. Pressure-mounted baby gates are appropriate to keep children in or out of a room or at the bottom of stairs.

Store purses and daily pill boxes out of reach of children.

Smoke alarms with CO detectors should be ideally in every bedroom, but at least on every level of the house. If there is a firearm in the home, make sure it is stored in a locked box out of sight and reach of children, unloaded, with the ammunition stored and locked separately and a trigger guard or lock in place.

General Safety

Consider taking an infant and child CPR class, usually offered by local hospitals. Professional babyproofers are available for in-home child safety evaluations and babyproofing installations. Save the number for Poison Control (1-800-222-1222) to all family cellphones.

Food Allergies in Lake Travis Schools: Is your child prepared?

by Dr. Jessica Morgan, MD

Last week Dr. Van and I met with the Lake Travis ISD school nurses to talk about food allergies, an area of concern for the school district.  We were surprised to learn that many students with a history of a life-threatening anaphylactic food allergy do not carry an EpiPen, or other type of epinephrine auto-injector, and fail to provide one to the school in case of an emergency.  We wonder ‘Why?’

Food allergies affect 1 in 13 children in the U.S. or about 1 or 2 in every classroom.  Recent studies indicate that 16-18% of school age children who have food allergies have had a reaction in school. In approximately 25% of the reactions that occurred at school, the student had not yet been diagnosed with a food allergy.   Food allergies account for 35-50% of all cases of anaphylaxis in emergency care settings.  Peanut and tree nut allergies are responsible for most cases of fatal or near-fatal reactions in the United States. Peanuts and tree nuts make up two of the 8 food groups that cause 90% of serious allergic reactions. The other six groups are soy, eggs, milk, wheat, shellfish, and fish.   Children may outgrow some of these allergies.  The American Academy of Pediatrics estimates that 80-90% of egg, milk, wheat, and soy allergies resolve by age 5 years.  However, only 1 in 5 children will outgrow a peanut allergy and fewer will outgrow allergies to other nuts or seafood.  In other words, children are less likely to outgrow allergies to the most dangerous allergens.

Not only are food allergies becoming a growing public health concern for Lake Travis schools and our country, but severe reactions like anaphylaxis (multi-system, whole-body reactions) can be fatal when treatment with epinephrine is delayed or not given.  Those at most risk for experiencing fatal or severe reactions are teenagers and young adults, people with a history of asthma, and those with a history of a food allergy.  So when the school nurses informed us that these are the students- teenagers, those with a history of food allergy, those most at risk for a fatal reaction-that do not have access to a life-saving medication we were more than surprised.

The school district, like most others in central Texas, uses individualized doctor-prescribed Food Allergy Action Plans for students with a medically diagnosed food allergy.  This plan serves as orders for the school nurses and staff in case of an emergency.  If a student’s action plan orders an epinephrine injection for symptoms of anaphylaxis, the nurse will administer the medication or sometimes older students are allowed to self-administer.  It is important to know that school clinics do not stock epinephrine.  School nurses can only administer medications if they are prescribed to a student by a physician and if the medication is provided to the school by the parent or guardian appropriately labeled.  A school nurse is not authorized to give another student’s medication to someone else, even in emergency situations.

The school district works hard to help prevent exposure to food allergens. Some schools have food-free zones. All encourage good hand-washing before and after meal times and emphasize that students not share food or utensils to help prevent cross contamination. Teaching students to read food labels also helps with prevention, but even that isn’t a 100% guarantee. The federal Food Allergen Labeling and Consumer Protection Act mandates that when a top 8 allergen is an ingredient in a food product, it must be listed using its common names as an ingredient.  The Act does not address advisory warnings such as ‘may contain {allergen}’ or ‘processed in a facility with {allergen}.’ These kinds of warnings are not currently mandated, but are purely voluntary.

Again, our question is ‘Why?’  Why take the risk of your child experiencing a severe, or even fatal reaction?  Why are schools not being provided with a potentially life-saving prescription?  If your child has a history of a food allergy or anaphylactic reaction, please talk to your pediatrician or allergist and your school nurse regarding the use of epinephrine.

 

For more information on Lake Travis ISD’s Food Allergy Management Plan, visit http://www.ltisdschools.org/Page/349.

To learn more about food allergy and how to recognize the symptoms of anaphylaxis, visit www.allergyready.com.

To review the US DHHS Voluntary Guideline for Managing Food Allergies in Schools and Early Care and Education Programs, visit www.cdc.gov.

Thank you for reading about Kids Food Allergies in Austin Texas. If you would like to learn more, please Contact Us.


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Bee Well Pediatrics opens for business

Bee Well Pediatrics opens for business!! We would enjoy serving as your Pediatrician in Austin Texas.