Cereal with milk used to be a healthy, fast breakfast for school children. More and more, though, cereals are part of the "junk group", as my kids call it. Many cereals marketed to children have more sugar than store-bought desserts! I encourage all parents to read the labels of breakfast cereals before buying. Look for a cereal with 10 g of sugar or less, and at least 2 g of fiber. For some good suggestions and lists of the "best" and "worst" breakfast cereals, see the environmental working groups report on sugar in children's cereal.
Thursday, January 26, 2012
Wednesday, January 25, 2012
The Finney County Health Department confirmed today a 6th case of measles in their county this month. Garden City is a short 4 hour drive away from Wichita. I'm feeling nervous. If any of you out there have children age 12 months or older who have not yet received the MMR vaccine, or age 4 years or above who haven't had the 2nd MMR booster shot: don't delay-- go and get the MMR vaccine for your child today.
Measles is a scary illness for several reasons:
1.) It's highly contagious. It's so contagious that if an unvaccinated person is sitting in the same room with someone who has the measles, they are likely to catch it simply by breathing the same air that was coughed in. This is why it causes "outbreaks". Large outbreaks result in epidemics in areas with poor vaccination rates.
2.) Measles has a high risk of complications including hospitalizations with dehydration, pneumonia, encephalitis, and death.
3.) Persons who have Measles infection can spread it for days before they themselves even show signs of illness, and continue being able to spread the disease for days after they have recovered. The time period of contagiousness is lengthy-- about 3 weeks. (Think of the implications of the burden to a family from time missed from school and work alone.)
Measles usually starts with a high fever, more than 101 degrees. This lasts for a few days before the other symptoms start: cough, sore throat, very runny nose, watery and red eyes, and a rash. The rash starts at the head and neck, then heads down the body over the next week to eventually include even the hands and feet. Persons with the measles feel miserable.
We have been so fortunate to live in a country and at a time when we rarely see death and complications from vaccine preventable diseases, that some of us do not know what are supposed to be afraid of. Vaccines save lives. Illnesses like measles cause suffering and death. That this outbreak of measles in Garden City is happening during the same week that at an anti-vaccine bill is proposed to our Kansas state legislature is beyond irony. House bill 2094 would allow parents to send their children to public daycares, preschools, and public schools without any vaccinations by simply declaring that it is against their "personal beliefs".
Parents, please don't fall prey to pseudo-science websites that engender fear about vaccines. For reliable information about vaccines, please refer back to my website. There is a list of excellent websites to inform and educate about immunizations. Feel good about protecting your dearest little ones from outbreaks like the one happening right now in Garden City.
Tuesday, January 24, 2012
Pediatricians spend a lot of time talking about pooping and peeing. So, it's only fitting to blog about it, too. . .
I have recently seen several little girls aged 3-6 years old in my practice with a common problem: they have to pee "all the time", every hour or so, and sometimes are having accidents. This is of course alarming to parents, who are worried about a urine infection. It is important to check the child's urine for an infection, but if finding there is none, what is the next step? Often, simply changing the way the little girl uses the bathroom will cure the problem, which I call "the busy little girl syndrome".
Typical 3-6 year old girls do not have good bathroom habits. They are busy little preschool and kindergarten students who often have to use adult sized toilets. They go to the bathroom in a rush. Pants are pushed down to just above the knees, and their hands grasped on the toilet seat so they won't fall in. Then, as soon as they pee enough to relieve some pressure on their bladder, they are "done!", and stop, rub dry, and pull up their undies and pants.
Going pee in this manner can cause lots of problems: 1.) Sitting with the thighs together means that the urine has to spray through the closed and sensitive labia and surrounding skin on it's way out and into the toilet. This can cause irritation and sometimes even a rash. 2.) Sitting upright and gripping the toilet seat so as not to fall in causes the back of the thighs and therefore all the the muscles that control the "private parts", to be tense-- making it difficult to relax the muscle that lets all the urine come out of the bladder. 3.) Going to the bathroom quickly often means that, while some pee did come out, the bladder did not have time to fully empty. 4.) Rubbing or "wiping" dry can be irritating to sensitive skin.
"Proper Pottying" can be taught to your little girl:
1. push your undies and pants down all the way to the ankles before sitting on the toilet.
2. Sit on the toilet and spread the knees apart (at least shoulder's width or a little wider). This allows the labia to open up so the pee can go straight out and down into the toilet, without spraying much.
3. Lean the body forward, with elbows or forearms relaxing on the thighs. This makes the bladder (in the lower belly) smash up against the upper thighs which helps it to empty better.
4. Sing a little song (the ABC's works well)-- this makes the child stay on the toilet long enough for the bladder to empty fully. (It also allows time for them to realize "gosh, maybe I have to poop, too!".)
5. Drying off: "PAT, PAT, PAT" . no wiping after going pee, just patting.
**** Bonus points for giving a nightly bath (no bubbles) instead of a shower and swishing water gently around/at the vaginal area to clean out any stray bits of toilet paper, poo, or whatever else is stuck there causing irritation to the sensitive vaginal skin.
Thursday, January 5, 2012
Yesterday my website went live! I am so thankful to our good friend and neighbor, DJ LaChapelle, for all of his web design work. I will be adding to the website in the upcoming months to include a link for parents and patients to search and access information about specific medical problems, and a secure patient portal. Patient portals are becoming a new standard for medical offices. They allow for approved users to access their medical records online. The Redbud Pediatrics patient portal will allow parents to review and print immunization records and physical exams in daycare or school-friendly format, as well as check on lab work and other account information. If you have comments about the website, please post them on my blog! Thanks!
Tuesday, January 3, 2012
Our clinic opened today! The clinic looks beautiful thanks to the design work by my cousins Sandra and Eric Denneler. See Sandra's blog at Project Denneler for some great photos of the office! My first patients of the morning were twins - double the fun! My staff, "Team Redbud" was fantastic. Thank you to all our friends, family, neighbors and colleagues for the well wishes, cards, flowers, plants, food(!) and good vibes you sent today! It worked!
I am a Wichitan with a classic Kansas upbringing. I was raised in a large family, in a small farming community. My family and upbringing have instilled in me the “small town” values and attitudes that continue to define me today: get along with others (you’ll have them in your classroom until you graduate from high school), take responsibility for your actions (before someone sees your parents and tells on you), look out for one another (because they are looking out for you), and participate in your community (you can’t sit on the bench if there are only five girls on the team).
I became a pediatrician because I was drawn to the incredible resiliency, openness, and innocence of children in the face of illness or even chronic diseases. A pediatrician is trained not only to diagnose and treat the illnesses of childhood, but also to respect and recognize the vulnerabilities and strengths of children. A good pediatrician will work with families to improve their child’s health and behaviors in a way that will impact them into their adult lives. A good pediatrician can help parents enjoy their children more and worry about them less. This is the kind of physician that all children deserve and that I strive to be.
I have a lot of things that I feel strongly about as a pediatrician: fruit is good for kids, fruit juice is not. Breast milk is best, but formula is not toxic! Immunizations save lives, and your child should get all the recommended ones on time. Not all infections need antibiotics. Routines are very important for all children, especially bedtimes. You should read or share books with your child every day. Most nosebleeds are caused by fingers in noses. Seat-belts save lives. Brush your teeth twice a day. . .
I hope you enjoy this blog as I hope to inform, educate and empower my patients/parents. Your comments will stimulate discussion and help me select new topics to discuss. As any physician, I am always learning from my patients. If you would like your child to become a patient with me, please call 316-201-1202. I would love the opportunity to get to know your family and care for your child at Redbud Pediatrics!
Disclaimer: Please note that my entries are for general informational purposes only and are not intended as professional medical advice, diagnosis or treatment. I advise readers to always seek the advice of their physician with any questions regarding personal health or medical conditions.