Eggs, Citrus, Peanut Butter, Shellfish - the general wisdom used to be “wait until your child is older and you will reduce the risk of allergy.” This may not be the case. New studies show that a child can safely be fed these foods at an earlier age. In fact, some studies have even suggested that waiting too long to introduce some foods may actually increase the chance of developing food and environmental allergies.

     There is still a lot to learn and more research is ongoing, but we at PHA have some exciting, new recommendations for feeding your infant.

For babies with a strong family history of allergies

• it is best to breast feed, or use a hypoallergenic formula (like Alimentum, Nutramagen) for the first 4-6 months of life.
• wait to introduce the more allergic foods, like eggs, nuts and fish.

For babies without allergies in the family

• 6mos & older - all foods except raw honey, nuts and shellfish should be introduced into the infant’s diet, one at a time. Make an effort to try many different grains, fruits, veggies and meats. Eggs and yogurt too!
• 12mos & older - all foods can be offered (remember to be careful with the sizes and consistency of foods to avoid choking) while still only offering one “new” food at a time.

The typical symptoms of food allergy can include a blotchy rash, difficulty breathing, wheezing, vomiting, or bloody diarrhea. Allergic symptoms usually appear within the first hour after ingesting the food.  Still have questions? Remember to bring them to your child’s next well child care visit. Bon appetite!

Ear Piercing

Ear piercing is a subject that brings out strong opinions.

Some people feel strongly that infancy is the best time because any discomfort
is quickly forgotten. Other people believe that this surgical procedure should
not be done before a child is old enough to ask for it.

Leaving the social implications for another time, here is the medical answer:
Ear piercing can be separated into two categories - infancy and “when she is
old enough to ask for it.” Infancy - best done between 3 and 10 months. Before
three months they are just too young and after 10 months they are more active
making the actual piercing more difficult. Older children - not only do they
have to ask for it, but they have to sit still for the piercing. In our experience
three years old is the youngest, but it really depends on the individual child.
We have had the occassional 20 month old sit still very happily and there was
one teenager that really wanted it done, but required a lot of encouragement
when the time actually came. As to where to have it done, we can not help but
suggest that you have your child’s ears pierced at PHA. Our lady doctors are
very experienced and we have not had an infection yet. While malls and jewelers
may do more piercings as a whole, their employees tend to be short-term and
may or may not be experienced. We think it is a good idea to know the person
you are allowing to put a hole in your child’s body.

Ear piercing in our office is not covered by any insurance. The fee is $90
including the earrings (less for only one lobe.) We will do ear piercing on
a child who is not a regular PHA patient. We will do a second hole if there
is room. We do not pierce the cartilage higher up on the ear because the risk
for infection is too great. We do not pierce any other body parts. We use the
patented Blomdahl sterile cassette system which is only available in a physician’s
office. The earring goes in and the backing goes on at the time of the piercing.
The tiny “diamond” stud is surrounded by 24 karat gold and the only metal touching
your child’s skin is titanium. This inert metal is the least likely to cause
any kind of allergic reaction at the site of the piercing.

The Ear Piercing Procedure: On the day of your appoinment,
your child comes in one-hour early and EMLA (a topical anesthetic cream) is
placed on the ears. This safely numbs the ear lobes so the procedure does not
hurt. Ear piercing can be done at the end of a check-up. Babies are held in
their mother’s (or grandmother’s) arms. The worst part for them is when we hold
their head still, but most babies cry only briefly and we have had a few sleep
right through it all. Older children lean against a parent’s shoulder and must
be cooperative. We will not hold an older child down for this very elective
procedure. We pierce one ear at a time because it allows for more accurate placement
of the earring. Because of the EMLA we have never done one ear and had a child
refuse to do the other. Care of the new earrings is explained before you leave
and involves twice daily application of antibiotic ointment for several weeks.
The earring should remain in place for at least two months to allow the hole
to be established. Even so, when the piercer earring comes out, it should be
replaced immediately with another earring so the hole doesn’t close. If you
have any difficulty putting in the new earrings, come by and we will do it for
you. Avoid tiny earrings with small bases because they will “fall” into the
hole and make it bigger. Whenever you use a new pair of earrings, for the first
time in two months or the 10th time in two years, always keep an eye on it for
the first few weeks. Even 14 and 18 karat gold has impurities and if the ear
reacts to the metal it can “swallow” up the earring.

For the first two month of life if your baby gets a rectal temperature greater than 100.5 you will need to take him to the hospital. So you need to do your best to keep your baby from being exposed to germs.

Try to follow these rules:

·         any one who touches your baby should wash his/her hands. 

·         Sick people should stay away (even grandma and grandpa.)

·         Children get sick much more often than adults, so iunless they are yours.don’t expose your baby to them.

·         Stay away from crowds if possible.

Swine flu (H1N1) swept through Long Island in June then disappeared.  Other parts of the country and areas in upstate NY are currently dealing with outbreaks of swine flu, so it may be back here sooner than we’d like. Here are some reminders about swine flu and the strategies to deal with it.
What is swine flu (H1N1)? - it is a type of influenza A.
How is it different from seasonal flu? - Its genetic base comes from pigs, unlike the seasonal flu which comes from fowl.
How is it similar to seasonal flu? - its symptoms are the same - fever, cough and achiness.
Why is there so much hype around swine flu? -because it is genetically a new type of flu, no one has any immunity to it.  Therefore, it has the potential to make a lot of people sick. When lots of people get sick at the same time, even if the illness is not severe, it affects lots of things - hospitals, schools, the work place, availability of medicines. In addition, it seems that hospitalizations for the swine flu have included many more children than we see with the seasonal flu.
What about vaccines? - Flu shots are the single best way to avoid getting the flu.  The swine flu vaccine should be very effective because the vaccine was made after the flu was already here (unlike the seasonal flu vaccine which is made a year in advance based on scientists best prediction of expected flu strains.)
Will PHA recommend the Swine Flu Vaccine? - Yes

Is it safe to take a vaccine that hasn’t been tested? - flu vaccines have years of use, testing and follow-up behind them.  The swine flu (H1N1) vaccine is made the same way as the seasonal flu vaccine.  Scientists take certain parts of the flu virus and grow it in eggs and make it into a vaccine. Next year the swine flu vaccine will likely be incorporated into the seasonal flu vaccine.

Will PHA be giving the swine flu vaccine? - Yes.  We started vaccinating our high risk patients as soon as we received our first shipment of vaccine.  We are now accepting e-mails with the names of any child age 2-25 years who would like the vaccine. We will schedule appointments as the vaccine becomes available.

What else can I do to prevent the flu?- most of us get the flu when we take our hands which have been contaminated by another person, and touch our mouth, nose or eyes.  If you make a concerted effort to keep your hands away from your face, and to wash them before eating and after potential exposure to sickness, you will dramatically increase your chances of staying well!

We are very excited to announce that Maggie Chalson, M.D. is joining the PHA family starting November. Dr. Chalson joins PHA with a wealth of experience in all areas of private practice and a special interest in obesity and the importance of healthy lifestyle choices.  Her addition allows us to add an extra doctor for those busy Mondays (and other times), as well as to expand our Friday hours until 7PM.  Having another doctor at busier times will allow us to reduce wait times and return phone calls faster.

Dr. Chalson’s easy-going and approachable manner fits perfectly into the PHA philosophy. She has spent the last four years as a private-practice pediatrician in Queens and her skill is apparent as she interacts with parents and children alike.  While taking care of all ages of children and all aspects of pediatric care, Dr. Maggie has distinguised herself by her success with obese teens. “It is not about a diet,” says Dr. Chalson.  “It’s about a lifestyle change that will follow these children for their whole lives.”  Dr. Chalson helps motivated teens set specific goals for change in lifestyle, behavior, and dietary choices and then meets with them monthly to discuss their progress.  Dr. Chalson has appeared on New York Channel One News to discuss the remarkable challenges facing these patients.  She plans to share her expertise in this area with the patients at PHA. Click here to read two accounts of one teen who flourished under Dr. Maggie’s attention.
http://www.ny1.com/Default.aspx?SecID=1000&ArID=82524

Dr. Chalson grew up on the south shore of Long Island graduating from Lawrence High School.  Her undergraduate years were spent at Tufts where she was a dual major in English and Biology with a concentration in medical history. Returning to New York, Dr. Maggie received her Medical Degree from Stonybrook University with recognition in the humanities. She continued her medical education at prestigious Mount Sinai Hospital in Manhattan where she developed her special interest in treating obese patients.

Dr. Maggie’s pediatric education took another step forward as she and husband Jon welcomed baby boy Asa in Spring 2009. In addtion to spending time with “her boys,” she loves to spend time at the beach, to cook and to travel. Dr. Maggie is looking forward to meeting all the wonderful families at PHA.  Please join us in welcoming her and ask for Dr. Maggie at your next appointment.