Pediatric Associates

Food Recalls and Your Child

Thu, 16 Jan 2025 01:53:20 GMT

A news alert pops up on your phone: there has been a recall of organic carrots because

of E. coli. Oh no! You remember packing carrots in your children’s lunch boxes this

morning. Food recalls can be concerning and might affect your family’s health. When

these events happen, like recent recalls of carrots and cucumbers, it’s important to

know what steps to take and what warning signs to watch for.

Foods can be recalled by the Food and Drug Administration (FDA) if there is a problem,

like incorrect labeling or if the food could make people sick. The FDA learns about these

issues when two or more people get sick from eating the same contaminated food.

Food can get contaminated at any step—from being grown on a farm to being sold in

stores or prepared at home. For example, dirty water might be used to water crops,

storage bins might have germs, refrigerated foods might get too warm, or food might be

prepared in unsanitary conditions.

Even though farmers, sellers, and food preparers work hard to keep food safe, about 48

million people in the U.S. still get sick from foodborne illnesses each year. Children are

more likely to get sick because their immune systems are not as strong as those of

adults.

The chart below shows some of the most common disease-causing germs in the United

States.

As you can see, these germs can cause a variety of symptoms. But which symptoms

are worrisome?

Common symptoms of foodborne illnesses are upset stomach, vomiting, diarrhea, and

fever. Mild to moderate symptoms include stomach cramps, diarrhea, nausea, and

vomiting. Severe symptoms, like bloody diarrhea, fever over 102°F, convulsions

(seizures), or dehydration, need quick attention.

Vomiting and diarrhea can lead to dehydration, especially in young children. Infants can

go 3 to 4 hours without food or liquids, while older kids can go 6 to 8 hours. If your

child’s symptoms last longer than this without enough fluids, contact a doctor. Watch for

signs of dehydration, such as low energy, dry mouth, or—in severe cases—extreme

sleepiness and sunken eyes.

If you’re ever unsure, it’s always better to check with a healthcare provider.

Knowing basic food safety tips can help keep your family safe. At the grocery store,

check the “sell by” dates, keep raw meat in separate bags from other groceries, and

only buy pasteurized dairy and juice. At home, refrigerate perishable food (like fruits and

vegetables) within 2 hours of buying it. Keep raw meat separate in the fridge or freezer.

Wash your hands with soap and water for 20 seconds before and after handling food,

using the bathroom, changing diapers, or touching pets. Rinse fruits and vegetables

with water and a brush before cutting into them. Also, clean cutting boards and counters

after using them for raw meat.

Be sure to put leftovers in the fridge within 2 hours of serving. Leftovers can stay in the

fridge for 3-4 days or in the freezer for 3-4 months. Finally, check FoodSafety.gov for

updates on food recalls and throw away any recalled items you might have at home.

By keeping these things in mind, you can keep mealtime safe and enjoyable for your

family while reducing the risk of foodborne illnesses.

American Academy of Pediatrics website for parents

Center for Disease Control

Food and Drug Administration

Destri Eichman MS3 University of Missouri School of Medicine Springfield Clinical Campus

Alpha GAL Syndrome

Tue, 01 Oct 2024 12:43:33 GMT

Alpha-Gal Syndrome (AGS) is an allergic reaction to a sugar called galactose alpha-1,3-galactose (alpha-gal for short). It is found in the cells of non-primate mammals such as cows, pigs, & sheep. The allergy is usually triggered by the bite of the Lone Start tick (Amblyomma americanum). Not everyone who is bitten by the tick will develop AGS. Because the Lonestar tick is very common here in southern Missouri, tick bite prevention is very important to prevent triggering AGS or other conditions caused by the tick.

After a tick bite, it can take 1-3 months for a person’s immune system to become sensitive to alpha gal. The person’s body sees alpha gal as an “invader” that should not be there and makes lots of antibodies to fight the “invader” if it is exposed to alpha gal again. If the person eats foods with alpha gal after this, their body will try to fight off the “invader” by releasing lots of antibodies, resulting in symptoms of an allergic reaction.

In AGS, symptoms usually develop 2-6 hours after eating foods containing cow, pig, or sheep products.

The most common symptoms of AGS include:

· abdominal pain

· diarrhea

· nausea

· vomiting

· hives

More serious or life-threatening symptoms such as signs of anaphylaxis can be seen such as:

· low blood pressure

· swelling of the face (lips, tongue, nose, eyelids)

· airway inflammation

· difficulty breathing

AGS can be difficult to diagnose because it shares similar symptoms with more common conditions such as gasteroenteritis (sometimes called a “stomach bug”) or more common food allergies. Additionally, a person or parent of an affected child may not remember being bitten by a tick weeks or months before their symptoms begin. Traditional skin-prick allergy testing is not recommended as there may be a high amount of false positives (when a person has a positive test but does not have the condition) or false negatives (when a person shows no reaction or only a very mild reaction with a skin test even though they may have the condition) [2, 3]. A blood test to look for high levels of IgE antibodies against alpha gal for cow, pig, and lamb is currently the preferred way to diagnose AGS.

AGS is a newer condition that we are still trying to understand. Scientists are still trying to find out why some people develop AGS and why it occurs after a tick bite. It can affect people of any age but tends to be rarer in children than in adults. This is different from other food allergies that tend to be more common in childhood and then improve as the person gets older. More research needs to be done to see if a person is more likely to develop AGS if they have a close relative who has AGS.

There is no cure for AGS. Prevention of tick bites during outdoor activities is important to minimize AGS and diseases spread by tick bites. For immediate symptom relief, antihistamines (such as Benadryl) or epinephrine (such as an epinephrine pen injector) can be used. Avoiding eating beef, pork, and lamb meat or products derived from these animals is recommended to prevent the allergic reactions from occuring in the long run.

For more information check out:

American Academy of Allergy Asthma & Immunology

CDC Alpha Gal Syndrome webpage

CDC Tick bite prevention page

CDC list of foods & products that may contain Alpha Gal

Bethany Thompson-Gordon MS3 University of Missouri School of Medicine Springfield Clinical Campus

Parent's Guide to Concussion

Fri, 27 Sep 2024 17:58:58 GMT

Traumatic brain injuries can happen with any sport and are not always associated with obvious symptoms such as passing out. Even mild symptoms can be long-lasting. Current research recommends rest for 1-2 days then gradually returning to full activities. The following links give more information on when to seek emergency care, managing rest and recovery periods after a concussion and more.

Concussions: What Parents Need to Know

Prolonged rest is not the best plan

Newborn Jaundice

Wed, 18 Sep 2024 17:47:37 GMT

Why is my baby yellow and what does it mean?

When your baby's skin and the whites of their eyes turn yellow, it's called jaundice. This happens when something called bilirubin, which is made by the body, builds up too much. Normally, the body gets rid of bilirubin through urine and feces. There are a few reasons why bilirubin might get too high in newborns. Three common reasons are called physiologic jaundice, breast milk jaundice, and breastfeeding jaundice.

Physiologic Jaundice

This type of jaundice happens because the baby's liver isn't fully developed yet, and their red blood cells don't live as long.
It usually starts a little over a day after birth.
The baby's liver isn't mature enough to handle all the bilirubin and the red blood cells break down quickly.
Most of the time, nothing needs to be done. But if bilirubin levels are high, the baby might need phototherapy, a special light treatment.
It usually goes away on its own in 1-2 weeks.

Breast Milk Jaundice

This happens because of certain naturally occurring substances in breast milk can cause the bilirubin to stay in the baby's body.
It usually starts within 2 weeks after birth.
A normal enzyme in breast milk, beta glucuronidase, makes it harder for the baby to get rid of the bilirubin.
Keep breastfeeding and make sure the baby is getting enough milk. Sometimes adding formula can help.
It can last 4-13 weeks but will get better as breastfeeding continues.

Breastfeeding Jaundice

This happens when the baby isn't getting enough milk which can cause them to get dehydrated and have fewer poops, making it harder for them to get rid of bilirubin.
It usually starts within 1 week after birth.
Not enough milk intake leads to fewer bowel movements so less bilirubin is removed from the body.
Increase how often you breastfeed; make sure the baby is staying hydrated and add formula if needed.
It will go away as soon as the baby starts eating enough.

Important Things to Know

The first place that will turn yellow is the whites of the eyes then it moves to the head and finally to the arms and legs. When the jaundice starts to go away, it will get better in the opposite order, with the eyes getting better last. As previously stated, there are many causes of increased bilirubin. jaundice can be a medical emergency. If your baby is yellow and acting sick, lethargic or fussy go to the emergency room. Otherwise call our office for guidance.

Jaundice in Children

Jaundice in Newborns

Ransome Drexler MS3 University of Missouri School of Medicine Springfield Campus

New RSV Strategies for Your Baby

Fri, 16 Aug 2024 20:22:06 GMT

RSV is a common respiratory illness usually in the wintertime. Symptoms include runny nose, cough and fever and can progress to difficulty breathing severe enough to need a hospital stay. Serious infection is more likely for babies in their first RSV season. You can protect your baby by washing hands, breastfeeding and limiting childcare and smoke exposure.

An antibody medicine called Beyfortus has been developed to significantly decrease babies' risk of serious RSV disease. It is a one-time injection given in the fall and winter seasons that gives five months of protection starting in just a few hours. Most babies from birth to 7 months and high-risk infants and toddlers 8-19 months may qualify to receive a dose. This medicine is not a vaccine but it can be administered at the same time as routine vaccines. This medicine is recommended by our providers, the American Academy of Pediatrics and the Centers for Disease Control.

When a mother receives Abrysvo (RSV vaccine) during pregnancy, her baby may not qualify for Beyfortus. In this case, the mother's antibodies provide a similar benefit to the medicine.

We are expecting Beyfortus to be available starting October 1, 2024 and that it will be covered by most health insurance plans. However, we cannot guarantee supplies or insurance payment.

Please consider the following links for more information:

RSV illness RSV vaccine for moms and antibody medication for infants

Tick Bite Prevention and First Aid

Wed, 10 Jul 2024 17:28:27 GMT

Tis The Season for Ticks

Summer is the season of tick bites. This will cover information from the American Academy of Pediatrics (AAP) and the CDC on how to prevent tick bites and what to do when those prevention efforts fail.

There is an increased risk for tick bites when you are spending time in grassy or wooded areas, specifically in the summer months. When you know your children are going to be at an increased risk, dress them in long clothing that covers as much skin as possible and tuck the ends of their pants into their socks to deny the ticks a route of entry. Good repellents for clothing contain permethrin. Important note: permethrin is only used on clothing and becomes ineffective when it touches skin. For exposed skin, 30% DEET containing repellent is approved for use in children over 2 months old and is protective for 6 hours before it needs to be reapplied.

Even when all precautions are taken, ticks can still find a way. Tick checks at the end of each day are extremely beneficial. The faster a tick is removed, the lower the risk of disease. Check the entire body for ticks but pay special attention to the scalp, armpits, waistline, and other body creases.

If a tick is found, the best way to remove it is with tweezers. Grasp the tick as close to its head as possible and pull the tick directly out while maintaining steady pressure and without twisting or crushing the tick. Using petroleum jelly, nail polish, hot, or cold items on the tick does not help. If the head remains in the skin, clean the skin with rubbing alcohol and use clean tweezers to remove as much as possible. If a small piece of the tick remains, the body will naturally shed it. Once a tick is removed, wash the wound with soap and water and then apply antibiotic ointment.

If the tick did transfer a disease, it will likely show up with a rash in the next 2-4 weeks. Continue to monitor any new symptoms that arise in your child. The CDC has made an interactive tool to help parents decide what to do if their child has a tick bite.

To learn more about tick removal, what diseases can be spread by ticks, and insect repellent please click the following the links.

How to remove a tick

Tick diseases

Insect Repellents

Joshua Scheiderer MS3

University of Missouri School of Medicine

Springfield campus

Burn Prevention

Wed, 22 May 2024 12:38:10 GMT

What can cause burns?

Burns are a common injury in kids that can cause pain, tissue damage, and permanent scarring.

They can happen with hot liquid, fire, electricity, chemicals, hot metal, or steam. It’s important to

take preventative steps because of how fast they can occur.

The majority of burns occur at home and in the kitchen, with most kids being under 5 years old.

Below are some basic safety tips that can help make your home a safer place and aid in

preventing your children from getting burned.

How to prevent burns in the kitchen:

- Keep hot liquids out of reach of your child.

- Don’t leave anything cooking on the stove unattended.

- Use the back burner when able and turn pot handles toward the back of the stove.

- Don’t carry your child while cooking with hot liquid to avoid splashing them.

- Don’t let your child grab anything out of the microwave without your help.

- It can be fun to get your child involved in the kitchen, just don’t leave them unattended.

How to prevent burns in other areas of the house:

- Test the temperature of the bath water yourself before your child.

- Always keep matches and lighters far from reach of your child.

- Keep all household chemicals locked up so there’s no chance of your child getting ahold

of them.

- Tuck away all electrical cords and utilize outlet covers if possible.

- Avoid placing hot drinks or food near the edges of tables or on placemats that kids could

drag toward them.

- Don’t let your child hold sparklers or play with fireworks.

- Remember to have your kids wear protective clothing and sunscreen when outside.

When your child is old enough, talk to them about fire safety and why these rules are important.

Kids are curious and don’t understand all the things that can cause them harm.

For more information on how to prevent burns, you can find more tips here and here .

Callyn Heavin MS3 University of Missouri School of Medicine Springfield Campus

Bedwetting

Wed, 20 Mar 2024 12:53:40 GMT

What is Bedwetting?

Bedwetting is a common issue for many children. In fact, there are about 5 million children in the U.S. who wet the bed past the recommended age. Many children are toilet trained between the ages of 2-4, but some children develop and train at their own rate. If your child has accidents at night, they are not alone. And as a parent, neither are you.

Effects of Bedwetting

Bedwetting can cause strain on children and parents, and may worsen social anxiety, depression, and isolation from peers. If your child experiences bladder control problems after age five and it is bothersome to them and your family, it may be worth reaching out to the child’s pediatrician to seek help.

Types of Bedwetting

There are two types of bedwetting:

#1) Primary bedwetting is the focus of this article and describes children who never achieved dry nights since potty training (typically these children have no accidents during the daytime).

#2) Secondary bedwetting is when a child achieved consistent dry nights for at least 6 months but has started bedwetting again. This can be related to many factors, including urination dysfunction, constipation, or neurologic dysfunction. This type of bedwetting is an urgent concern so please call your PCP promptly.

Common reasons for bedwetting

Communication between the brain and bladder . If the brain is sensing the bladder is filling up and sends a message to empty, bedwetting will happen. On the contrary, if the brain does not recognize that the bladder is filling, your child may not wake up to use the restroom, and bedwetting will happen.
Stress or trauma . Sometimes when children experience stress or traumatic events, such as an illness or life stressor, they can have bouts of bedwetting. This can occur even if the child was previously dry at night.
Medical concerns . Rarely, some children begin to wet the bed because of a medical problem.

Managing bedwetting

Keep the following tips in mind:

Do not blame your child . It is not your child’s fault. Offer support, not punishment, for wet nights.
Be honest with your child about what is going on . Let your child know it is not their fault, and that most children outgrow bedwetting.
Protect the bed . A plastic cover under the sheets protects the mattress.
Let your child help . Encourage your child to help change the wet sheets and covers. This can teach responsibility, as well as keep your child from feeling embarrassed if the rest of the family knows . Important note : if you child views this as a punishment, it is not recommended.

Bedwetting Treatment

The initial treatment for bedwetting includes behavioral and lifestyle changes. These may include, but are not limited to:

limiting fluid intake after a certain time at night
eliminating bladder irritants such as carbonation or artificial colors
constipation management
creating a schedule for bathroom use

You can reach out to your child’s pediatrician for guidance on what changes may work best.

If bedwetting does not stop after behavioral changes, there are additional medical treatments that may be warranted. Please discuss these options with your child’s pediatrician if other methods have not been effective.

For further details, you can read more about bedwetting here and here

Clayton Brinkley MS 3 University of Missouri School of Medicine Springfield Campus

Type 2 Diabetes

Fri, 15 Dec 2023 16:15:32 GMT

Diabetes mellitus is a metabolic disorder that is due to insulin resistance, the body’s hormone

that regulates sugar, which leads to increased sugar levels in the body known as hyperglycemia.

There are two common types of diabetes mellitus:

 Type I is an autoimmune form that leads to destruction of cells in the pancreas that

produce insulin. Children with type I are typically born predisposed to the disease and are

often diagnosed early in life.

 Type II is the acquired form of diabetes that is due to insulin resistance in the body.

Insulin is produced in pancreas normally, but constant exposure of insulin in the body due

to persistent high sugar levels leads to resistance.

Type II diabetes (T2DM) is mostly associated with obesity. While T2DM is more commonly

diagnosed in adults, increasing rates of obesity in children has led to more cases of T2DM in

children, typically adolescents.

While T2DM in children develops slowly, there are some signs of hyperglycemia:

 Increased thirst and/or hunger

 Frequent urination

 Fatigue

 Darkened areas of skin, commonly around neck, armpit, or groin

 Frequent infections

 Blurry vision

It is recommended to screen your child for diabetes if they have started puberty, or at least 10

years old, and are overweight or obese. Consider screening your child for diabetes if they have

these risk factors:

o Family history of diabetes

o Overweight

o Poor diet

o Inactivity

o Adolescent girl

o Black, Hispanic, American Indian and Asian American ethnicity

o Low birth weight or preterm birth

o Maternal gestational diabetes

Prevention

Instilling healthy lifestyle habits in your children is the best way to prevent T2DM. Encourage

the household to eat healthy foods and get more physical activity.

Healthy foods include whole foods such as fruits, vegetables, and whole grains. Cut down on

processed foods, sugary drinks, and fatty foods.

References

Tillotson CV, Bowden SA, Shah M, et al. Pediatric Type 2 Diabetes. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Sai Supriya Vuda MS3

University of Missouri

School of Medicine

Springfield Clinical Campus

Xray Safety and Your Child

Tue, 24 Oct 2023 13:05:41 GMT

Have you ever wondered why your provider didn’t order an x-ray? Like many medical tests, there are benefits and risks to imaging studies.

Medical imaging is useful for diagnosing many medical problems and can help determine the treatment

for some patients. Certain forms of imaging such as X-rays and CT scans contain ionizing radiation.

Ionizing radiation can damage the DNA in our cells, which may increase the risk of developing cancer.

The harmful effects from radiation are seen with large doses and lots of doses given in a short amount

of time. Children are more sensitive to radiation and have a longer life expectancy, so it’s especially

important to reduce their radiation exposure.

While medical imaging may sound dangerous, it’s important to consider that we are all exposed to low

levels of radiation every day. This “background radiation” comes from rocks, soil, building materials, and

space. Some forms of medical imaging use higher amounts of radiation than others. For example, a

single chest x-ray is comparable to 1 day of background radiation, while a CT scan of the abdomen is

equivalent to 20 months of background radiation.

Healthcare providers are aware of these risks, which is why they try to order imaging only when

medically necessary. It is recommended to use the lowest amount of radiation possible that still

provides a good quality image. Techniques are used to lower radiation doses for pediatric patients.

Additionally, radiation is focused only on the area of the body that needs imaged rather than the entire

body.

What you can do to reduce radiation risk for your child:

Keep a record of your child’s imaging studies and share them with your healthcare team. This can help reduce the need to repeat imaging if you need to switch providers.
Ask your healthcare provider or imaging facility if the radiation dose is lowered for pediatric patients.
Ask your provider if it is possible to use imaging methods that do not require radiation, such as MRI and ultrasound.

More information:

Sally Heil MS3 University of Missouri School of Medicine Springfield Campus

Healthy Moms

Wed, 23 Aug 2023 13:13:44 GMT

Preventing Postpartum Maternal Mortality in Missouri: A Guide for Moms

While becoming a new parent is a joyous time, it is also important to consider the postpartum period is a vulnerable time for mothers. Postpartum maternal mortality, though rare, is a serious concern. In Missouri, where we rank 44/50 worst in maternal mortality, understanding the signs, symptoms, and taking preventive measures us essential in helping to ensure a healthy postpartum experience. This article hopes to discuss how moms can play an active role in preventing postpartum maternal mortality by recognizing signs and symptoms early.

Importance of Postpartum Maternal Health:

The postpartum period, spanning the first few weeks after childbirth, is a critical time for a mother's physical and emotional well-being. Complications can arise during this time, so being vigilant about signs and symptoms is crucial. Maternal mortality is defined as the death of a woman during pregnancy, childbirth, or within 365 days of delivery, and addressing this issue requires awareness and action. 

Recognizing Signs and Symptoms:

Moms should be attentive to any unusual physical or emotional changes during the postpartum period. Some common signs and symptoms that may indicate a potential issue include:

Excessive bleeding: If bleeding is heavy and doesn't seem to be slowing down, it could be a sign of postpartum hemorrhage, which requires immediate medical attention.
Severe headache, vision changes, and high blood pressure: These could be symptoms of preeclampsia, a serious condition that can occur after childbirth.
Shortness of breath, chest pain, or palpitations: These may indicate blood clots or heart-related problems.
Intense mood swings, extreme sadness, or thoughts of self-harm: These could be signs of postpartum depression or anxiety, which should be addressed promptly.

Preventive Measures:
Moms can take several steps to prevent postpartum maternal mortality:

Attend postpartum check-ups: Regular visits to healthcare professionals can help identify and address any potential health issues early.
Educate yourself: Learn about common postpartum complications, their signs, and the steps to take in case of emergencies.
Reach out for support: Don't hesitate to ask for help from family, friends, or support groups. Emotional well-being is just as important as physical health.
Remember mental health is just as important as physical health: post-partum patients with substance use history or intimate partner violence are at increased risk of overdose death. Additionally, suicide risk is highest between 43 days to one year postpartum with 92% of cases involve white women, aged 20-29 years, living in metropolitan counties.
Follow healthcare provider's advice: If you're given medications or instructions for recovery, follow them diligently.
Maintain a healthy lifestyle: Optimizing your BMI with proper nutrition, hydration, and gentle exercise can reduce the risk of complications.
Seatbelt safety: Always wear seatbelts correctly, with the lap belt positioned low over the hips and the shoulder belt crossing the chest between the breasts. Adjust the seat and steering wheel for comfort and to ensure a safe distance from the airbag.

Preventing postpartum maternal mortality requires a collaborative effort between healthcare professionals, families, and mothers themselves. By being aware of the signs and symptoms of potential complications and taking proactive steps, moms in Missouri can help ensure their own well-being during the postpartum period. Remember, seeking prompt medical attention and fostering an open dialogue about any concerns are crucial elements in safeguarding maternal health after childbirth.

2018-2020 Pregnancy-Associated Mortality Review

Rebecka Ernst MS3 University of Missouri College of Medicine Springfield Clinical Campus

Gastroschisis

Tue, 15 Aug 2023 12:52:57 GMT

What is Gastroschisis?

"Gastroschisis" is a congenital condition where the baby's bowels are often outside the body, mainly to the right of the belly button.

Why does this happen?

This condition is thought to result from a combination of genetic and environmental factors.

What do you need to know about your pregnancy?

Your baby will likely be smaller than average.
Expect your baby to arrive at 37 to 38 weeks, earlier than the expected 40 weeks.
Understand that you could have done nothing to prevent this according to current scientific guidelines.
Most deliveries occur vaginally.

What should I expect after my baby is born?

This is a significant question, with the answer varying based on how much of the baby's intestine is outside the body and the overall gut condition – simple or complex. Fortunately, 75% of American cases are simple.
Whether simple or complex:
After delivery, the focus will be on keeping the bowels clean and moist by covering the exposed area.
Hydration and nutrients will be given via a needle inserted in the hand, foot, or scalp. Antibiotics will be administered through the same line to prevent infection.
A tube will be inserted through the baby's nose to release air from the stomach, reducing inflammation and distension, making it easier to reposition the intestines.
A breathing tube might also be necessary to assist with respiration.
In complex cases, surgery might be delayed to address inflammation or treat the bowel before placing it back inside the baby. This leads to better outcomes.
For simple cases, the bowel will either be kept clean, hydrated, and wrapped, allowing it to naturally return to the abdomen, or it will be surgically reinserted and the abdominal opening closed. Research shows that both approaches have similar lengths of stay and progress results.
Depending on the case complexity, hospital stay duration varies from weeks to months.

What's the Long-Term Outlook?

While there might be some gastrointestinal challenges or developmental considerations, many children with Gastroschisis go on to live healthy, fulfilling lives. Regular medical check-ups will help monitor your child's progress and address any issues that may arise.

Follow-Up Care : After leaving the hospital, consistent follow-up care is crucial. Regular appointments with the medical team will ensure that your baby's growth, development, and overall health are carefully monitored. Any concerns or questions can be addressed during these visits, and adjustments to the care plan can be made as needed.

Parental Support : Dealing with Gastroschisis can be emotionally overwhelming. Remember that you're not alone. Seek support groups or counseling services to connect you with other parents who have gone through similar experiences. These networks can provide valuable emotional support and share practical insights to smooth your journey.

Don't hesitate to contact your surgical team if your baby displays feeding intolerance (vomiting) or any signs of infection at the surgery site (redness, swelling, drainage). Your active involvement and communication are crucial for ensuring the best possible outcomes for your child's health and well-being.

CDC

NIH

Global Gastroschisis Foundation

Alexander Alvarado MS4 University of Missouri School of Medicine Springfield Clinical Campus

Ashlynn Harmon RN Gastroschisis parent

Toxic Shock Syndrome and Tampon Safety

Tue, 18 Jul 2023 17:45:55 GMT

Tampon Safety: Preventing Toxic Shock

Did you ever think that the proper use of tampons could be a matter of life or death? Well, surprisingly, it can be! It can be easy for people to forget to change out their tampons regularly, especially when they first start getting their period. However, if a tampon is left unchanged for too long, bacteria can use it as a home to grow and release toxins which can make a person very sick. Initial signs of toxic shock syndrome could be diarrhea, throwing up, fever, achy muscles, sore throat, light-headedness, confusion, or a combination of these symptoms. Over a few days, these symptoms can progress to life-threatening organ damage which requires hospitalization. This is why it is important to teach young people about proper tampon safety and methods to reduce the risk of toxic shock syndrome.

Below are some ways to reduce the risk of toxic shock syndrome from happening:

Only use tampons when on your period
Change out tampons every 4 to 8 hours
Use electronic devices such as a smartphone or smartwatch to set reminders to change out tampons
Wash your hands well before inserting a tampon
Use pads (sanitary napkins) instead of tampons overnight
Consider the use of a silicone menstrual cup or period panties

With the busy lives that people live, it can be easy to forget proper tampon hygiene. With a few of these steps, the risk of toxic shock can be greatly reduced. Learn more about tampon safety and toxic shock syndrome at the links below:

American Academy of Pediatrics

Consumer Safety FDA

Cleveland Clinic

Better Health Agency

If you have any further questions, you can contact us at 417-882-1600

Evan Reeves MS3 University of Missouri College of Medicine Springfield Campus

Restless Legs Syndrome in Children

Tue, 07 Feb 2023 19:11:40 GMT

Have you ever felt like your legs were tingling or itching, and you just couldn't stop moving them? This could possibly be due to a condition called Restless Leg Syndrome (RLS). RLS affects the nervous system, causing an irresistible urge to move the legs. This can happen to children as well as adults, and it can make it difficult for them to fall asleep and stay asleep. RLS can also cause feelings of discomfort, such as tingling, crawling, or aching sensations in the legs.

The exact cause of RLS is not well understood, but it is thought to be related to a problem with the way the brain sends signals to the legs. Some children may develop RLS as a result of a medical condition, such as iron deficiency or diabetes. However, in most cases, the cause is unknown.

Symptoms of RLS in children can include:

⦁ An irresistible urge to move the legs, especially when sitting or lying down

⦁ Tingling, crawling, or aching sensations in the legs

⦁ Symptoms that are worse at night

⦁ Difficulty falling asleep or staying asleep

⦁ Daytime fatigue or irritability

If your child is experiencing these symptoms, it's important to talk to their doctor. A proper diagnosis of RLS requires a physical examination and a detailed description of your child's symptoms.

Treatment for RLS in children typically includes lifestyle changes and medications. The child’s provider can also prescribe medications that may help and iron supplements if the child has low iron levels. If your child has RLS, there are lifestyle changes that you can do to help:

⦁ Regular exercise. Encourage your child to exercise during the day. Exercise can help make the legs feel better when your child is trying to sleep at night.

⦁ Stretching. Have your child stretch their legs before bed. Stretching can help relax the muscles and make it easier to fall asleep.

⦁ Maintaining a consistent sleep schedule. A consistent routine before bed can help to fall asleep faster.

⦁ Avoiding stimulants, such as caffeine. Stimulating substances can make it harder to fall asleep.

⦁ Have your child take a warm bath before bed. The warm water can help relax the legs and make it easier to fall asleep.

It's also important to keep in mind that RLS can affect a child's daily life and school performance. They may find it hard to concentrate or stay still in class, which can have an impact on their academic performance. It is important to work with the school to make accommodations as needed.

If your child is experiencing symptoms of RLS, talk to their doctor and work together to come up with a plan. You can learn more about RLS through this link from the Cleveland Clinic.

Kevin Luton MS3 University of Missouri School of Medicine Springfield Clinical Campus

Seizures in Children

Tue, 07 Feb 2023 19:02:24 GMT

Seizure disorder and epilepsy are conditions that affect brain activity. Seizures are sudden bursts of electrical activity in the brain that can cause changes in behavior, movement, and sensation. Seizure disorder and epilepsy can happen to anyone, but they are more common in children.

Seizures can happen for many different reasons. Some children are born with a seizure disorder or develop it at a young age, while others may have a seizure because of a brain injury or infection. Seizures may be associated with other conditions and sometimes run in families. In some cases, the cause of seizures is unknown.

Epilepsy is a type of seizure disorder that is characterized by recurring seizures. Seizures that happen more than once are considered epilepsy. In children, epilepsy is one of the most common neurological disorders.

There are many different types of seizures, and each type can have different symptoms. Some common symptoms of seizures include:

• Loss of consciousness

• Jerking or twitching of the muscles

• Staring spells

• Confusion or disorientation

• Unusual behavior

• Sudden fear or feelings of déjà vu

If you suspect that your child may have a seizure disorder or epilepsy, it is important to seek medical help. A doctor will be able to diagnose the condition and recommend treatment options.

Treatment for seizure disorder and epilepsy typically includes medication, which is used to control seizures and prevent them from happening. The most common medications used to treat epilepsy are called antiepileptic drugs. These drugs work by changing the way electrical signals move through the brain to make seizures less frequent.

In addition to medication, there are other ways to help control seizures. For example, a special diet called the ketogenic diet has been shown to be effective in controlling seizures in some children. Surgery may also be an option for some children with epilepsy.

It's important to remember that seizure disorder and epilepsy can be managed. With the right treatment, children with these conditions can lead normal and healthy lives.

If your child has been diagnosed with seizure disorder or epilepsy, it's important to work closely with their healthcare team to manage the condition. This may include regular check-ups and adjustments to treatment as needed. It is also important to educate yourself and your child about the condition, its triggers and warning signs, and how to respond in case of a seizure. It is also important to be aware of the possible impact that seizures can have on the child's academic and social life, you can work with the school to make accommodations if needed.

If your child is experiencing seizure or seizure-like symptoms, you can talk to their doctor and work together to come up with a treatment plan. You can learn more about seizure and epilepsy through this link from the Cleveland Clinic.

Kevin Luton MS3 University of Missouri School of Medicine Springfield Clinical Campus

Urgent Care Visits for RSV

Fri, 28 Oct 2022 14:58:01 GMT

RSV Bronchiolitis: When is it an Emergency?

RSV bronchiolitis can seem very scary as it is making headlines all over social media. Here are some tips to help treat this illness at home and decide if a trip to the urgent care or emergency department is necessary.

What is RSV?

RSV (Respiratory syncytial virus) is one of many viruses that causes respiratory illness. In some kids, usually <2 years of age, RSV can cause illness more severe than the common cold. Similar to the common cold, it can cause a fever (>100.4 F), cough, congestion, runny nose, and poor feeding. However, RSV can also affect the lower airways causing wheezing and increased work of breathing (belly breathing or using the muscles between the ribs and/or the lower neck). These episodes of labored breathing are often broken up by coughing spells and vomiting swallowed mucus that help clear the airway temporarily. These are followed by an brief period of relief that allow for feedings and rest. Home pulse oximeters can be inaccurate in infants but please call if you're concerned.

What can I do at home?

Like any bad cold, treating the symptoms of RSV to make your child more comfortable is the first thing to do.

Nasal saline with suctioning: Squirting nasal saline in the nose and suctioning with a NoseFrida or a blue bulb will allow for easier breathing and feeding. Closing one nostril while you are suctioning the other will allow for better suction.
Humidity: Humidity will help thin and break up mucus. Sitting in the bathroom with your baby while running a hot steamy shower or a cool mist-humidifier in the room can help.
Fluids and frequent feedings: Feedings can be difficult as it can be hard for your baby to breath and handle mucus while eating. Milk, their main source of fluid, can also thicken mucus making it harder for your baby to breathe. Smaller, more frequent feedings may be needed during times of heavy mucus. Supplementing with rehydration fluids (Pedialyte) during this illness will help keep your baby hydrated if breast milk or formula lead to excessive mucus.
Fever Reducer Medicine: When your baby has a fever, they will increase how fast and hard they breathe. Acetaminophen (Tylenol) or ibuprofen (if over 6 months) will help make them more comfortable.

When do babies need an urgent care evaluation for RSV?

Dehydration (less than 3-4 wet diapers in a 24-hour period). This may be treated with IV fluids or hospital admission.
Labored breathing ( video ) that continues without relief for hours. This may be treated with deep suctioning, oxygen or hospital admission.

This link from the AAP has more information.

If you are uncertain or have any questions, call us at (417) 882-1600.

Justin Chu MS3

University of Missouri School of Medicine

Springfield campus

Constipation in Children

Wed, 20 Jul 2022 13:36:28 GMT

Constipation is common in children. Knowing the causes, signs, and prevention strategies can

help you and your child keep bowel healthy habits at home.

What is constipation?

- Fewer than normal number of bowel movements (also called poops or stools) a week.

It’s important to note that how often your child usually stools will be different from

what’s normal for another child.

- Hard, dry, or painful to pass bowel movements

- Other signs include stomachaches, soiling underwear, and making faces or clenching

their bottom while passing stool

What causes constipation?

- Withholding or holding back stool

- Illness

- Diet

- Life stressors

The most common cause of constipation in children is withholding stool. This can happen when

children are potty trained too early, as children may withhold stool to gain control in the

situation. Withholding stool can make the stool dryer and harder to pass which can then cause

pain with bowel movements. Now the child associates pain with bowel movements which can

worsen the issue. This is why it is best not to push children into toilet training and to treat

constipation when symptoms first arise.

Older children may withhold stool whenever they are away from home or because they don’t

want to stop what they’re doing to go to the bathroom.

How can I help my child develop good bowel habits?

- Create a toilet routine with your child. Pick a regular daily time when you encourage

your child to sit on the toilet.

- Put something beneath your child’s feet that they can press on. This makes it easier for

them to push out stool.

- Ensure your child is drinking enough fluid and eating fiber-rich foods like fruits,

vegetables, beans, and whole grains. These foods help soften the stool so that it’s easier

to pass.

- Encourage play and activity.

When do I call my child’s doctor?

Call or schedule a visit with your child’s doctor if your child is constipated for more than 2

weeks or is also having a fever, pain with their bowel movements, blood in their stool, swelling

of their belly, appetite change, or weight loss.

learn more about the signs, causes, and treatment of constipation.

Jihane (Jiji) Oufattole MS3 University of Missouri School of Medicine Springfield Campus

Anesthesia and Your Child

Mon, 09 May 2022 13:07:52 GMT

What is anesthesia and what is the risk?

Anesthesia consists of many different types of medications that temporarily put your child to sleep to allow for a surgery, test, or imaging to be performed. The type of anesthesia your child receives will depend on his or her medical history and the procedure or test being performed.

The anesthesia care team will guide your child through each surgery or test safely and comfortably. Your child’s blood pressure, heart rate, breathing, oxygen level, and temperature will be measured before, during, and after the procedure or test.

While there are risks to any type of medicine, anesthesia is very safe. In fact, it is safer today than ever before! Some of the more common side effects of anesthesia include sore throat, nausea, vomiting, and feeling tired, groggy, or a little confused when waking up. These side effects usually aren’t dangerous and go away very quickly.

What should I expect?

Before the procedure

Before your child undergoes anesthesia, the anesthesiologist will talk with you and your child. They may ask questions about the following:
Your child’s health history, including any breathing problems (asthma, croup, wheezing, snoring)
Recent illnesses, such as bad colds or fevers
History of bleeding problems
Any prescription medications, over-the-counter medications, and herbal supplements and vitamins your child is taking
Allergies (drugs, foods, latex)
Past experiences your child or any family members have had with anesthesia

During the procedure

Anesthesia medications are usually given through an intravenous (IV) line in your child’s arm
A mask with anesthetic gas and oxygen may be used first to allow your child to fall asleep and receive their IV line quickly and painlessly
You may be allowed to go back to the room where the procedure or test is being performed at first to help ease your child through the transition of falling asleep. This is not always the case though, so be sure to ask your anesthesiologist.
Once asleep, a breathing tube may be inserted into your child’s mouth and windpipe that provides oxygen and protects their airway and lungs
Your child will be closely monitored and given additional medications as needed

After the procedure

After the procedure or test is complete, your child will wake up in a slow and controlled manner, either in the room where the procedure took place or in the Post Anesthesia Care Unit (PACU)
This is often the time where side effects from anesthesia occur, so your child may be a little groggy at first!
Your child will continue to be closely monitored

How can I best help my child prepare for anesthesia?

Members of the anesthesia care team will contact you beforehand to help prepare. However, there are many ways you can play a role in your child’s preparation for anesthesia:
Be prepared to discuss your child’s health history, medications, allergies, and experience with anesthesia in the past
Follow the anesthesia care team’s recommendations about what to do before anesthesia, including:

When to stop eating and drinking
Whether your child should stop or start any medications or supplements
When to call the surgeon or doctor performing the procedure or test
What to do if your child gets sick shortly before their scheduled procedure or test

Have a discussion with your child about their upcoming anesthesia

Talk about the hospital visit 5 to 6 days ahead of time for older children and 2 to 3 days ahead for toddlers
Children 3 to 12 years of age may not be ready to hear about or fully understand the risks of anesthesia and may feel scared
Explain to your child that it is OK to be scared
Reassure your child that their anesthesia care team will make them feel as safe and comfortable as possible
Mention that they will never be alone, and that a member of the team will be always with them
Ask for printed or online resources to help you and your child prepare
Try to stay calm and reassure yourself!

Additional information

What is a Pediatric Anesthesiologist?

Imaging and Medical Radiation

Your Child's Health Story

Including Children in Discussions about Their Medical Care

Sources

Tyler Austin MS3 University of Missouri School of Medicine Springfield campus

What Is Diabetes?

Wed, 16 Mar 2022 16:40:40 GMT

Most people in society think of diabetes as a disease often associated with adults that are overweight. This is because the most common form of diabetes in adults is Type 2. However, in children the most common form is Type 1 Diabetes Mellitus.

So, what is type 1 diabetes mellitus exactly? Type 1 is an autoimmune disease (where the body’s immune system attacks itself) that affects the pancreas by destroying the cells of the pancreas that create insulin. This results in very low levels of insulin to be made or no insulin at all. Insulin is needed to regulate glucose (blood sugar) levels by helping cells take up the sugar. Without insulin the blood sugar will build up in the blood and where at high levels it begins to damage the body. The symptoms of diabetes are from high levels of blood sugar and the damage to the body that it causes.

Who is at risk?

All children have the potential for developing Type 1 diabetes. There are those that are at higher risk than others though. Things that can increase risk of Type 1 diabetes are:

Other autoimmune disease such as thyroid disease

Genetics - Children with a first degree relative (parent or sibling) with Type 1 diabetes

Age - most common in children and young adults

Race - higher rates in Caucasian children

Some viral infections - German measles (aka Rubella), Coxsackie, and mumps. Covid-19 has also shown an association with a 1 1/2 x greater risk being seen up to 6 months after infection

Symptoms to be on the lookout for:

Increased thirst (drinking a lot more water and can’t seem to get enough)
Increased hunger (seem to always be hungry)
Peeing a lot
Waking up to pee at night
Unexpected weight loss
More tired than usual
Blurred vision
Dry skin
Wounds are slow to heal
Numbness or tingling in hands or feet

If Severe

Nausea and vomiting
Stomach pain
Rapid breathing and/or shortness of breath
Confusion
Drowsy, hard to arouse
Weakness
Fatigue

Please call our office at (417) 882-1600 if these symptoms develop or you have any concerns.

Sources:

https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html

https://www.diabetes.org/diabetes/type-1

https://covid19.nih.gov/news-and-stories/the-diabetes-virus

Jessica Lier MS3 University of Missouri School of Medicine Springfield Campus

Testicular Self-exam

Mon, 24 Jan 2022 18:32:06 GMT

Performing monthly testicular self-exams is important so that teens can become familiar with their anatomy – the shape and size of their testicles – which will make it easier to identify any lumps or bumps that might need to be checked out by a physician. Three possible problems that commonly affect adolescent males are infections, hernias, and testicular cancer. Though cancer is rare among children and adolescents, testicular cancer is the most common cancer found in males between ages 15 and 35.

How to perform a testicular self-exam?

You should start doing a testicular exam when you enter puberty, and you should do the exam once per month. The exam should be done after you’ve taken a bath or shower when when the scrotum (the skin that covers the testicles) is most relaxed. First, stand in front of a mirror and examine the testicles for any swelling or abnormalities. Next, gently grip the top of the scrotum with your thumb and finger. You should feel the rope-like spermatic cord (the structure that connects the testicle to the rest of your body) between your fingers. Lastly, use your free hand to gently roll the testicle between your thumb and fingers to feel for any bumps. Remember that a lump could be as small as a grain of rice.

What is normal?

It is normal for one testicle to be larger than the other. If one starts to enlarge or change in size, it may be a sign of something being wrong.

A soft, small bulge at the back of the top of the scrotum that may feel tender. This is the epididymitis (a tube that carries sperm)

In most males, the left scrotum hangs lower than the right.

What is not normal?

A new lump or swelling

Pain or discomfort

A change in the size, feeling, or color of the scrotum

A dull ache in the testicle

Remember, not all abnormal findings represent cancer, but should be evaluated by your doctor. Testicular cancer is usually curable, especially when caught early, and other abnormalities that may be found on a testicular self-exam often require treatment to avoid future complications like infertility. Feeling comfortable with and knowledgeable about your body is a sign of responsibility and maturity, so you should never feel embarrassed to ask your health care team about your questions or concerns.

For a cartoon explaining how to perform a testicular exam, see this link:

https://www.miumenshealthfoundation.org/resources-1.

For more information about testicular cancer, see this link: https://www.cancer.gov/types/testicular

Katherine Campbell MS3

University of Missouri School of Medicine Springfield Campus

Testicular self-exams (TSE) can help you check for things like cancer. Although testicular cancer is rare in teenage guys, overall it is the most common cancer in males between the ages of 15 and 35.

It's important to try to do a TSE every month so you can become familiar with the normal size and shape of your testicles, making it easier to tell if something feels different in the future.

Body Image Concerns

Wed, 25 Aug 2021 13:09:41 GMT

Changes in eating patterns can be an expression of body image issues. One of the most difficult to notice is bulimia nervosa.

What is bulimia nervosa?

Bulimia nervosa is an eating disorder in which a child has abnormal or unhealthy eating habits, often due to desire for a certain appearance or body type. With this disorder, a child will eat large amounts of food at once and will feel as if they don’t have the control to stop (binge eating). They will then self-induce throwing up (purging) to avoid gaining weight. They may also try to control their weight by using laxatives, diuretics, weight loss pills, exercising or fasting.

Who is at risk?

Any child can be affected by bulimia. It is more common in girls and usually begins between ages 10-15. Many factors play a role in a child becoming bulimic such as genetics, stress, and pressures to have a particular appearance or weight. Children with low self-esteem, weight concerns, or those with anxious or depressive systems are at a higher risk for developing bulimia.

What are the symptoms of bulimia nervosa in a child?

Many children with bulimia are a normal weight for their height, so it can often go unnoticed. Main features include:

Binge eating at least once a week for three months
Feeling out of control, ashamed, guilty, or afraid after binge eating
Purging or exercising after eating to avoid weight gain
Judging themselves based on their body shape and weight

Additional red flags that may indicate bulimia nervosa include:

Anxiety about eating meals in public
Stealing or hiding food
Constant talk about their weight or food
Spending excessive time in the restroom, especially after meals
Consuming large amounts of food at once
Constantly exercising
Depression or isolation

How is bulimia nervosa diagnosed in a child?

There is no medical test used to diagnose bulimia nervosa, but there are many clues that help doctors and nurses identify children with bulimia. Most information is obtained by talking to the child or parents about the child’s eating habits, behaviors, and thoughts.

Many children with bulimia nervosa present with a history of tooth or gum decay, sore throat, swollen salivary glands, dizziness/weakness, abdominal pain, or calluses on the fingers or knuckles due to induced vomiting.

There are also tests that doctors or nurses use to help assess other areas of the child’s health, since bulimia nervosa can lead to many additional health problems. These tests include blood tests, urine tests, or an electrocardiogram (which assesses a child’s heart).

What are possible complications of bulimia nervosa in a child?

Bulimia nervosa can cause many health problems including:

Dehydration
Feeling tired
Stomach pain, bloating, and constipation
Damage to the esophagus
Damage to teeth, gums, or cheeks
Irregular menstrual periods
Problems with heart, kidneys, or glands

How is bulimia nervosa treated in a child?

Treatment for bulimia nervosa includes:

Psychotherapy which involves the child meeting with a therapist to talk about their feelings, thoughts, and life and how that has affected their body image and eating habits. This can be done with individualized sessions, or with a group or the family.
Use of medications such as antidepressants
A healthy eating plan
Dental care for damaged gums and teeth
When should I call my child’s healthcare provider?

Call us at (417) 882-1600 if your child’s weight changes dramatically (losing or gaining), if your child’s cheeks or glands swell, if you notice tremors, extreme thirst or cold, or if your child demonstrates the signs mentioned above.

Follow this link for who to contact in the Springfield area for help and treatment

Follow this link for a review of medical research on this topic

Follow this link for more information on bulimia nervosa and other eating disorders

Hannah Peck University of Missouri School of Medicine Class of 2023

Apophysitis - A Common Sports Injury

Mon, 02 Aug 2021 12:42:47 GMT

It's estimated that one-third of school-aged kids visit their doctor every year for a sport

related injury. Soft tissue pain and overuse injuries represented a majority of causes of

musculoskeletal pain that resulted in office visits. Overuse injuries may result in a condition

that is known as "apophysitis." Apophysitis is inflammation of the portion of the bone where

muscles attach near the growth plates.

Why does this occur in children?

The area of muscle attachment (apophysis) in children is much weaker than the surrounding

muscles, ligaments, and bones. These muscles are also often tight and limit flexibility, this

limited flexibility along with rapid growth (growth spurts) that occur in children results in

stress/tension at these areas of muscle attachment. Then, when repetitive movements occur

involving the muscles that are attached, this results in pulling, or traction of the tight muscles

at the site of bony attachment. This pain is more common in areas that are heavily used

with activity - including the knee, elbow, hip, and ankle joints. Below is a table referencing the

common diagnoses that results from this mechanism of injury, where the pain is occurring,

and recommendations for treatment and prevention.

Follow this link for more information on this topic.

Follow this link for tips on prevention .

Ways to reduce injuries that may occur in this manner include

F ollow the 10% rule: increase sport specific activity by by 10% per week to avoid a rapid

increase in intensity, duration, or frequency of activity to allow your body enough time to

to respond and recover. Do not go from zero baseball activity to pitching everyday

overnight.

L isten to your body! The old saying of "no pain, no gain" is not to be followed here.

Promote proper time for warming up - including stretching just beyond the point of

resistance and holding the stretch for 1012 seconds.

O btain proper training on technique as poor technique or improper training often play a

role in these injuries.

A void playing the same position on multiple teams.

C onsider the importance of strength, flexibility, and core stability in the role of preventing

injury.

Follow this link for a review of medical research on this topic.

Aaron Brown MS3 University of Missouri College of Medicine Springfield Campus

HPV

Wed, 30 Jun 2021 20:49:58 GMT

What you should know about HPV Vaccination

What is HPV?

HPV is a virus that can cause cancer or genital warts. There are more than 100 known strains of the virus. Research has shown that infection with some of these strains over time can lead to cancer.

How common is HPV?

About 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that almost every person who is sexually-active will become infected with HPV at some time in their life if they don’t get the HPV vaccine.

True or false: HPV can only be transmitted through unprotected sex

False! Although unprotected sex significantly increases risk for HPV transmission, it is not the only way someone can be exposed to the virus. The virus can be transmitted through open-mouth kissing, oral sex, and skin to skin contact where a condom cannot provide protection. There have even been reports of people acquiring the virus who have never had sex before.

How does someone know if they are infected with HPV?

Most often, these infections are asymptomatic and go unnoticed. Most of the time the immune system will clear the infection on its own, but sometimes the virus persists in the body causing cellular changes that can lead to either cancer or warts.

What kind of cancer does HPV cause?

Cancers associated with HPV include:

-Cervical cancer

-Throat and mouth cancer

-Vulvar cancer

-Anal cancer

-Penile cancer

An estimated 34,800 HPV-attributable cancers are diagnosed each year in the US.

92% of these cancers could have been prevented with the HPV vaccine.

What does the HPV vaccine protect against?

-Researchers have identified the the most dangerous strains of HPV and developed a vaccine to target those strains

-The current version targets 9 types of HPV including HPV 16, 18, 31, 33, 45, 52, and 58

-HPV types 16, 18, 31, 33, 45, 52, and 58 are the strains that can lead to cancer

-HPV 6 and 11 are the strains that cause genital warts

When should the HPV vaccine be given?

-The current recommendation is to give the first dose at 11 or 12 years old (or as early as 9) and the second dose at least 6 moths after that

-The best time to give the vaccine is BEFORE a child may come into contact with the virus

-The vaccine has recently been approved up to age 45 for those who have not been immunized before

Learn more about HPV here:

https://www.cdc.gov/media/releases/2019/p0822-cancer-prevented-vaccine.html

https://www.cdc.gov/std/hpv/stdfact-hpv.htm

https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/How-to-Talk-to-Your-Preteen-About-HPV-Vaccine.aspx

Miranda Eubank, 3rd year medical student

University of Missouri class of 2021

Growing Pains

Fri, 25 Jun 2021 21:48:29 GMT

Children often complain of leg pain. Distinguishing everyday growing pains from serious conditions is considered in this link

Toilet Training Regression

Fri, 25 Jun 2021 21:35:49 GMT

When a child who has been using the toilet successfully, it can be frustrating when toileting accidents start to happen again. The first step is to make sure your child has no underlying issues such as a bladder infection. This article gives information on what a parent can do next to help his or her child.

Sports and Preschoolers

Fri, 25 Jun 2021 21:35:48 GMT

Sports can be a great way to encourage fitness for your child. This article discusses the motor skills expected for preschoolers, when to start sports activities and the benefits of sampling many sports. We enjoy talking with you and your child about development and fitness at his annual check-up. Please call us when it is time to schedule at (417) 882-1600.

Baby's Temperament

Fri, 25 Jun 2021 21:35:46 GMT

Babies express their temperaments and personalities from the beginning. Siblings can be as different as you and I when it comes to how they express their feelings and respond to situations. Adjusting to the differences can one of the biggest challenges of parenting. This article looks at this topic in detail.The body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.

Evaluating Telemedicine Services

Fri, 25 Jun 2021 21:35:44 GMT

Telemedicine services are now covered by many insurance policies. They can be beneficial in some circumstances but checking the details is important for your child's well-being. Suggestions on evaluating a telemedicine service are provided in this link .

Insurance Coverage for Well Visits

Fri, 25 Jun 2021 21:35:43 GMT

Requirements for health insurance coverage of well child visits have changed in the past few years. Knowing what to expect can help keep your child's health care on track, prevent surprise bills and help you choose the health insurance policy that suits your family's needs at the time. Details are discussed in this well-written article . Please call our bookkeeping department at (417) 882-1600 if you have any questions.

Fun in the Sun - Sunscreens

Fri, 25 Jun 2021 21:35:38 GMT

There are so many different types of sunscreens. It can be down right confusing which sunscreen is best for your child. Click here to help understand what type of sunscreen is best for your child and why.

Have a Safe and Fun Fourth of July

Fri, 25 Jun 2021 21:35:36 GMT

We hope that your family enjoys a safe and fun Fourth of July! We know fireworks go hand in hand with the 4th of July, but did you know that each year thousands of people, most often kids and teens, are injured? Unfortunately, fireworks can cause serious injuries to children, including devastating burns and other injuries. More than 3,000 children under the age of 15 are sent to the emergency room each year in the United States because of fireworks. Sparklers, which are typically viewed by parents as relatively harmless fireworks for children, account for one-third of the injuries to children under five. We would like to share some important safety tips to consider to keep your family safe.

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.

Closely supervise children around fireworks at all times.
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.
Always have a bucket of water and/or a fire extinguisher nearby. Know how to operate the fire extinguisher properly.

Fingertip Injuries

Fri, 25 Jun 2021 21:35:35 GMT

Closing a door on a finger is a common childhood injury. This article discussed first aid, deciding when to take your child with an injured fingertip to the emergency room and what to expect there through this link

Preparing Your Child for the Arrival of a New Sibling

Fri, 25 Jun 2021 21:35:28 GMT

Including siblings in the excitement and joy of planning for the arrival of a new baby eases transitions for the entire family. This article discusses different ways to do so for different age groups. If you have specific concerns, please call our office for more information. Calling us with your delivery information during your second or early third trimester let's us notify the Labor and Delivery unit that we will be caring for your infant when he or she arrives. The office phone number is (417) 882-1600.

Scrapes and Cuts: When Should I See a Doctor?

Fri, 25 Jun 2021 21:35:16 GMT

Reasons your child needs to see the doctor for their minor cut, scrape, or wound:

It is located on the face, neck, or genital area
It is deep (¼ inch or more, or if you can see fat or muscle), wide or gaping, long (1/2 inch or more), or has jagged edges
The wound is across a joint
It won’t stop bleeding after applying pressure for 5 minutes or if it is spurting blood
You can’t get all the dirt or debris out of the wound when cleaning
The wound was caused by something rusty or very dirty
The wound causes numbness
The wound was caused by a human or animal bite

When can a minor cut, scrape, or wound be managed at home?

It is shallow, and does not involve fat or muscle
It is not bleeding heavily
It is less than ½ inch long
It does not involve the face

How to care for your child’s wound at home:

Wash your hands
Apply pressure to the wound with a clean cloth or bandage for several minutes
If the blood soaks through the cloth or bandage, put another on top of the old one
Run water over the wound to get rid of as much debris as possible
Wash around the wound using a soft washcloth with mild, non-scented soap
Rinse off soap
If any dirt or debris remains and will not rinse away with water, you can attempt using tweezers that have been cleaned with isopropyl alcohol
Antiseptic solution like hydrogen peroxide can be used on minor cuts and scrapes if you wish
Apply over-the-counter antibiotic ointment like Neosporin
Cover wound with Band-Aid or gauze pad if the wound is at risk for being exposed to dirt (hands or feet). If it is small and in a clean area, there is no need to cover it
Change Band-Aid or gauze as needed
Check area daily and keep clean

Signs of infection and things to look out for:

Increased redness, warmth, swelling, pain, or drainage in the area
Purulent (or whitish) and foul smelling drainage are more concerning
Fever or chills

More information:

https://www.chop.edu/conditions-diseases/lacerations-without-stitches

https://www.webmd.com/first-aid/relieving-wound-pain#2

https://kidshealth.org/en/parents/stitches.html

https://www.webmd.com/first-aid/qa/when-should-you-call-the-doctor-about-minor-cuts-or-scrapes

Core Exercises

Fri, 25 Jun 2021 21:35:14 GMT

Core Exercises

Strong trunk muscles are key to all physical activity and are very helpful in preventing sports injury and chronic back pain. The following link gives guidelines and examples of core exercises to strengthen the muscles of the spine, abdomen and pelvis for school age children and teens. Discussing injury prevention and fitness is part of your child's check-up. Please call (417)882-1600 to schedule your child's next visit (annually at age 2 and up).

Talking to Children About Racial Bias

Fri, 25 Jun 2021 21:35:13 GMT

Racial issues come up in our social interactions regularly. The American Academy of Pediatrics has updated its policy on racial bias and this article gives some good tips on discussing race and incorporating your family values into that discussion with your children.

Helping Teens Who Need Medication

Fri, 25 Jun 2021 21:35:12 GMT

Teens need practice handling their own medical care as they build responsibility and maturity. One way to do this is discussing before your teenager's appointment what concerns need to be addressed and practice how to express this to the provider. Another is giving your teen responsibility for remembering to take prescribed medication. These ideas and more are presented in this link . If you have any questions, please call us at (417) 882-1600.

Friendships

Fri, 25 Jun 2021 21:35:11 GMT

We love to see our children making friends.....friends that support them and love them as they grow throughout the years. As parents there are friendships we readily support and others that may make us more leery. The age old saying that 'you are who you hang out with' is never far from our minds. Click here for more information on how to help your child navigate socially because life is better with a good friend or two.

Discipline Ideas for Toddlers

Fri, 25 Jun 2021 21:35:10 GMT

Growing independence and communication skills can challenge parents in the toddler years. This article gives excellent tips for handling toddler discipline in a positive way. These techniques can shape your parenting style for years to come.

Bedwetting

Fri, 25 Jun 2021 21:35:07 GMT

Bedwetting is a common condition varies at different ages. This article discusses what parents can do to help and when they should be concerned. Please call at us at (417) 882-1600 with your questions.

Birthmarks in Infants

Fri, 25 Jun 2021 21:35:06 GMT

Birthmarks often appear in the weeks after birth and increase in size for months. Many of these resolve on their own but some need intervention. This article provides detailed information about birthmarks involving extra blood vessels (hemangiomas). Please call us if you have concerns at (417) 882-1600.

Understanding Health Insurance Cost-sharing

Fri, 25 Jun 2021 21:35:03 GMT

Health insurance has its own rules and language. Understanding them before you have an emergency or unexpected bill can save time and frustration. Explanations are presented in this article .

Sports and Grade School

Fri, 25 Jun 2021 21:35:01 GMT

If your child is a grade-schooler, this is a great age to let them try out different team sports. Let them try out several sports if feasible to see what it is they really enjoy. Sports teach your child about life in many ways including how to work with others, how to practice and become better at something, what it is like to have friendly competition, winning, losing, etc. It gives parents time to engage with their children, through practicing together or coaching your child. Perhaps your child will be coaching you? That’s okay too as it shouldn’t be taken too seriously at this age, have fun with it! For more detailed information regarding grade-schoolers playing sports, click here.

Bug Safety

Fri, 25 Jun 2021 21:29:06 GMT

Stop the Bug Bites!

Here are some helpful tips from the American Academy of Pediatrics (AAP) to help keep your child safe from bugs this summer:

Don't use scented soaps, perfumes or hair sprays on your child.

Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.

Avoid dressing your child in clothing with bright colors or flowery prints.

To remove a visible stinger from skin, gently back it out by scraping it with a credit card or your fingernail.

Combination sunscreen/insect repellent products should be avoided because sunscreen needs to be reapplied every two hours, but the insect repellent should not be reapplied.

Use insect repellents containing DEET when needed to prevent insect-related diseases. Ticks can transmit Lyme Disease, and mosquitoes can transmit Zika,West Nile, Chikungunya Virus and other viruses. Click here for more info: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx

The current AAP and CDC recommendation for children older than 2 months of age is to use 10% to 30% DEET. DEET should not be used on children younger than 2 months of age.

The effectiveness is similar for 10% to 30% DEET but the duration of effect varies. Ten percent DEET provides protection for about 2 hours, and 24% protects for about 5 hours. Choose the lowest concentration that will provide the required length of coverage.

The concentration of DEET varies significantly from product to product, so read the label of any product you purchase. Children should wash off repellents when they return indoors.

As an alternative to DEET, picaridin has become available in the U.S. in concentrations of 5% to 10%.

When outside in the evenings or other times when there are a lot of mosquitoes present, cover up with long sleeved shirts, pants and socks to prevent bites.

- See more at: https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Summer-Safety-Tips.aspx

Don't Let It Bug You! Pesticide Safety

Fri, 25 Jun 2021 21:25:45 GMT

Children are at higher risk for health effects from exposure to pesticides than adults, because their internal organs are still developing and maturing. They can come into contact with pesticides stored or applied in their homes, yards, child care centers, schools, parks, or on pets. Babies and toddlers love to put their hands in their mouth. They also crawl and play on floors, grass, or in spaces that might contain pesticides. Because pesticides are still in many places in our environment, a child’s amount of exposure can add up quickly.

Take a moment today and make sure that any pesticides in your home are stored away in childproof areas.

For more ideas on preventing pesticide exposure for you family please visit the following AAP link: Protecting Children from Pesticides

Warm Water Infections

Fri, 25 Jun 2021 21:25:40 GMT

DON'T LET LAKE, RIVER RECREATIONAL ILLNESS PUT A DAMPER ON SUMMER FUN

Warmer days are here! For many families that means it's a perfect time to go swimming or boating in a nearby lake or river. Before you dip your toe, check the health of the water. Young children, those with weak immune systems and pregnant women can be at greater risk of getting sick from some water illnesses. Watch for the following:

Diarrheal illnesses caused by norovirus, Giardia, Cryptosporidium, Shigella and Escherichia coli can be spread when children swallow lake water that is polluted with feces. Children and adults should avoid swimming if they have diarrhea, according to the American Academy of Pediatrics. Follow home care advice or seek medical treatment if necessary. Before visiting a beach, check for community health advisories. https://watersgeo.epa.gov/beacon2/
Swimmer's itch is caused by parasites found in snails in lakes. The tiny germs can cause an allergic rash when they burrow into skin. Symptoms appear within two hours and include itchy, tingling or burning skin and sometimes small red pimples or blisters. The rash usually disappears within two weeks. Use an anti-itch lotion and cool compresses to relieve symptoms. http://bit.ly/2oa49EU
The germ that causes hot tub rash is common in hot tubs but also can be found in lakes. The Pseudomonas aeruginosa germ causes a rash and blisters. It usually clears up on its own. The same germ also can cause swimmer's ear , an infection that is treated with ear drops. http://bit.ly/2oaz583
Leptospirosis infects about 100 to 200 people who canoe or swim in rivers and lakes each year. Bacteria enter through cuts or the nose or mouth. Symptoms include fever, headache, muscle soreness in the calves and back, red eyes, stomachache and a rash over the shins. The illness is treated with antibiotics http://bit.ly/2nL6keC
A rare illness caused by Naegleria fowleri amoeba is found in warm freshwater lakes. It affects swimmers by attacking the brain when it travels up the nose. Parents can remind children to plug their noses when they jump or dive into the water to avoid getting lake water up their noses. Symptoms include fever, nausea, headache, stiff neck, seizures and death.

For more water safety tips from the AAP, go to http://bit.ly/2oak9qq

Written by Trish Korioth for the AAP

Evaluating Health Insurance Options

Wed, 23 Jun 2021 17:57:39 GMT

Choosing health insurance is a major decision that comes up every year. Balancing cost with benefits and your family's future needs is challenging. Information to help with this process in detailed in this article .

Nightmares vs Night Terrors

Tue, 22 Jun 2021 17:32:35 GMT

Nightmares vs Night Terrors

Does your child suffer from nightmares or night terrors? Did you know there is a difference? Disruptions in sleep patterns can be signs of underlying health issues such as stress, illness, being overtired, etc. A regular bed time routine is helpful to your growing child.

Nightmares:

Nightmares usually occur during the second phase of the night, during the deep dream (REM) stage of sleep. You have probably experienced a nightmare so you likely remember waking up, feeling scared, and able to remember portions of the nightmare. It likely took you or your child extra time to fall asleep after the nightmare.

What Parents Can Do:

Go to your child as quickly as possible.

Assure her that you are there and will not let anything harm her.

Encourage your child to tell you what happened in the dream. Remind your child that dreams are not real.

Allow your child to keep a light on if it makes them feel better.

Once your child is ready, encourage her to go back to sleep.

See if there is something that is scaring your child, like shadows. If so, make sure they are gone.

Night terrors:

Night terrors occur most often in toddlers and preschoolers and take place during the deepest stages of sleep. Deepest sleep is usually early in the night, often before parents' bedtime. During a night terror, your child might:

Cry uncontrollably

Sweat, shake, or breathe fast

Have a terrified, confused, or glassy-eyed look

Thrash around, scream, kick, or stare

Not recognize you or realize you are there

Try to push you away, especially if you try to hold him

While night terrors can last as long as 45 minutes, most are much shorter. Most children fall right back to sleep after a night terror because they actually have not been awake. Unlike a nightmare, a child will not remember a night terror.

What Parents Can Do:

Stay calm. Night terrors are often more frightening for the parent than the child.

Do not try to wake your child.

Make sure your child cannot hurt himself. If he tries to get out of bed, gently restrain him.

Remember, after a short time your child will probably relax and sleep quietly again. If night terrors persist, talk with your child's doctor.

For ideas on healthy sleep routines click here .

Getting Ready to Read

Tue, 22 Jun 2021 17:32:33 GMT

As parents, we would like to assume our children will be good readers. Reaching that goal takes planning and effort. This article tells how to reach that goal with simple, achievable steps.

Seizures

Tue, 22 Jun 2021 17:32:28 GMT

Many parents worry that high fevers may cause seizures and brain damage. Many studies have shown that when seizures do occur with high fever but no other serious symptoms, there are usually no lasting complications. Seizures also occur in other situations and several conditions can mimic seizures. Seizures can be scary to observe and how to respond can be reassuring. Much more detailed, helpful information for parents is included in this excellent link .

Cocooning Your Newborn

Sun, 28 Mar 2021 20:42:40 GMT

Cocooning Your Newborn

One of the greatest things you can do to help keep your newborn healthy is to make sure the people around them are healthy. We refer to this as cocooning your newborn. A great way to make sure other people are not transferring germs to your little one is through hand washing, making sure contacts do not have any contagious illnesses, and making sure close contacts are up to date on their vaccines . We recommend limiting their contacts to close family and friends. In general, we also recommend avoidance of unnecessary public settings until your newborn is older. For further information from the AAP regarding cocooning and caregiver vaccine recommendations, please click here.

Thank you and please call our office with any questions.

Splish Spash I was Taking a Bath

Fri, 26 Mar 2021 19:52:27 GMT

Splish Spash

Next to the kitchen, the bathroom is one of the most utilized rooms in our home. It can also be a common place for injuries for small children. We know that small children should never be left alone in the bath, but here are some other bathroom safety tips to think about:

Water temperature: To prevent scalding, adjust your water heater so the hottest temperature at the faucet is no more than 120 degrees Fahrenheit (48.9 degrees Celsius). Always test the water before your child gets in. When your child is old enough to turn the faucets, teach him to start the cold water before the hot.

Slips and falls: Install no-slip strips on the bottom of the bathtub. Put a cushioned cover over the water faucet so your child won't be hurt if he bumps his head against it.

Medicine and toiletry storage: Keep all medicines in containers with safety caps. These caps are child-resistant, not childproof, so store all medicines and cosmetics high and out of reach in a locked cabinet.

Electric appliances: If you use electrical appliances in the bathroom, particularly hair dryers and razors, be sure to unplug them and store them in a cabinet with a safety lock when they aren't in use.

Other helpful childproofing ideas can be found at: Home Water Hazards

Bullying- It's Not OK!

Thu, 02 Jul 2020 01:58:43 GMT

Bullying- It's Not Okay!

With the start of the new school season, it is a good time to remind children about bullying prevention. The American Academy of Pediatrics estimates that up to half of all children are bullied at some time during their school years. Ten percent of these are bullied on a regular basis. Bullying can occur through personal contact at school as well as online contact via e-mail or social media. All children should learn ways to prevent, recognize and respond to bullying. Talk to your child about bullying throughout the year. For more details, click here. Please call our office if you have any further questions or concerns about coping with bullying.

Impacts of Gestational Diabetes after Pregnancy

Sun, 05 Apr 2020 18:57:00 GMT

Did you know gestational diabetes affects your health and your child's health even after you deliver? This article discussed ways to moderate those effects for both you and your child. Please feel free to bring up your concerns at your well visits or call us at (417) 882-1600.

Breast Milk Storage

Sun, 01 Mar 2020 18:52:00 GMT

Pumping breast milk is a true act of love for your baby. Having to discard that hard-earned milk from improper storage is heart-breaking. This article gives guidelines on safe storage of pumped milk.

Food Serving Sizes for Toddlers

Sun, 23 Feb 2020 18:51:00 GMT

After the first year of life, growth slows and many new foods are offered. This can lead to confusion on appropriate serving sizes for toddlers. Detailed information is provided on nutrition guidelines in this article .

The Importance of Chores

Sun, 16 Feb 2020 18:50:00 GMT

The Importance of Chores

Let's be honest......getting our children to do chores can be a complete chore. But having chores teaches them valuable life skills. Starting early is best, but it is never too late to begin. It may be a fight at first, think of it as growing pains. Your child is learning new tasks and contributing to the family team, celebrate this together! After a while, it will be regular part of routine. Don't forget, the way we as parents approach chores is also being closely observed by our children.

Need some more chore ideas for the adolescent? Click here .

Depression for Fathers

Sun, 02 Feb 2020 18:38:00 GMT

The arrival of a new baby brings big changes for both parents. Health care providers are growing more aware of how common depression is among new dads as well as new moms. Indeed, when a mom has depression, a dad is much more likely to have depression as well. This can strongly impact the health of the entire family. We will ask you about any symptoms of depression at your baby's first few well visits but please call us at (417) 882-1600 if you have concerns for yourself, your partner or your baby.

Preschoolers Don’t Need a Fat-free Diet

Sun, 29 Dec 2019 08:00:00 GMT

Preschoolers Don't Need a Fat-free Diet

Adult diets are often not a good match for children's nutritional needs. Growing children need food groups such as healthy fat and carbohydrates that adults sometimes avoid. Guidelines on healthy fat intake is discussed in this article .

Melatonin and Sleep

Sun, 15 Dec 2019 08:00:00 GMT

Melatonin and Sleep

Parents are eager for their children to sleep, and sleep is vital to one's development. There are a few things that should be done consistently to accommodate a restful night's sleep such as a regular bed time routine, limiting blue light exposure, etc. Melatonin use as a sleep aid over the past few years has steadily increased, but are we too quick to jump to it? Please click here to read more about Melatonin use versus other sleep related ideas.

Making Your Own Baby Food

Sun, 18 Aug 2019 18:09:00 GMT

Choosing fresh ingredients from your own garden or the farmer's market for your baby makes the extra work of homemade baby food very rewarding if you have time. Care must be taken to cleanse and store these meals to avoid causing gastrointestinal infections. Details are included in this link

Earwax Tips

Sun, 11 Aug 2019 17:32:00 GMT

by Jacob Sanders MS3 University of Missouri School of Medicine Springfield Campus

There is no doubt that good hygiene is an important part of good health. But sometimes in our attempt to do something good, we can end up causing a problem. This can certainly be the case when it comes to trying to clean inside ears with cotton-tipped swabs. Cotton-tipped swabs push the earwax further into the ear canal and can cause cerumen impaction or injury to the eardrum, doing more harm than good. So, here is a quick overview of ear hygiene…

What is earwax and why do we have it? Earwax (aka cerumen) is normal and healthy. Everyone has it. New earwax is soft and golden yellow in color. Older earwax becomes dryer and darker brown. It is made by special glands in the ear to line and protect the skin of the ear canal. Earwax provides a natural water-proof coating and has bacteria-killing properties.

Ear Canals are designed to be self-cleaning. Earwax slowly moves toward the outside of the ear, carrying dirt and debris with it. Over time the earwax becomes dry and falls out the ear naturally. Generally, earwax does not need to be removed unless it is causing problems. Or a doctor may need to remove it to see into the ear. Some people may produce more earwax than others, and they may require periodic cleaning.

Are All Fish Created Equal?

Sun, 04 Aug 2019 20:44:00 GMT

Are All Fish Created Equal?

No, not all fish are created equal in terms of nutrition. Sorry fish. But why are we talking about fish?

In addition to high-quality protein, vitamins and minerals, fish is a great source of healthy fats such as docosahexaenoic acid (DHA) that are essential for a child's developing brain, nervous system and vision. There’s also some research suggesting that consuming fish early in life may help prevent allergic diseases such as asthma and eczema. Plus, if you feed your child fish as a youngster, chances are they will continue to consume fish as an adult.

Your growing child should eat small servings of a variety of fish and shellfish about 2 times weekly.

What kind of fish is best for my child? The amount of mercury in fish and pollutants in the water are taken into consideration to determine 'healthy fish' options as below:

Tuna . "Light" is best. The EPA and FDA rank canned light tuna (solid or chunk) to be among the "best choices" for children to eat, recommending 2-3 servings a week. "Light" tuna, which means it has a pinkish color, includes species such as skipjack. This is considered a better choice than white (albacore) and yellow fish tuna, although these are still considered "good choices," with 1 serving a week recommended.
More good choices . Salmon, trout and herring are considered low in mercury and high in brain-boosting DHA. Other types of seafood considered "best choices" include shrimp, cod, catfish, crab, scallops, pollock, tilapia, whitefish, trout, perch, flounder, sole, sardine, anchovy, crawfish, clams, oyster, and lobster.

For more information as above, including what to avoid, please click here . Go Fish!

Whooping Cough and What You Should Know

Sun, 28 Jul 2019 20:15:00 GMT

Whooping cough is also referred to as pertussis. Interestingly, pertussis activity peaks during the summer and fall months. The classic sign of pertussis is a "whooping" sound made at the end of an episode of violent coughing, giving the common name of "whooping cough." The Chinese name for pertussis is "the 100-day cough," which describes the duration of illness, since it often lasts up to 3 to 6 months.

Per the American Lung Association immunity decreases with age. It is recommended that all adults age 19-65 get at least one "booster" vaccination. Older adults should also get a "booster" vaccine if they come into contact with babies less than 12 months old. Check your vaccines! When in doubt, check with your physician if you should get a booster vaccination!

Pertussis is the most severe in the first 6 months of life and in preterm or under immunized infants. Almost all deaths and over 80 percent of hospitalizations associated with pertussis have been in infants less than 3 months of age. Children under 6 months of age usually experience a shorter respiratory symptom phase and the infant may gag or gasp, or even stop breathing temporarily. That means the whooping sound may not even be present.

In preschool children, pertussis is exhausting and may even lead to rib fractures. In some older children and adults, the cough doesn't happen in fits and doesn't have a whopping sounds. Vomiting with cough is often the best predictor of pertussis as the cause of prolonged cough.

More severe complications may occur in infants, including pneumonia, heart failure, collapsed lung, brain bleeds and death.

More information can be found at www.cdc.gov/whooopingcough, or the above information and more by clicking here .

Heart health screening

Sun, 14 Jul 2019 16:04:00 GMT

Heart Health Screening in Children and Teens

In 2008, the American Academy of Pediatrics came out with new recommendations regarding lipid screening and cardiovascular health. This report has taken on new urgency given the current epidemic of childhood obesity with the subsequent increasing risk of type 2 diabetes mellitus, hypertension, and cardiovascular disease in older children and adults. The report recommends screening children and adolescents with a blood test called a fasting lipid profile, and focuses on lowering the lifetime risk of cardiovascular disease.

The current recommendation is to screen toddlers and school-age children with a positive family history of high cholesterol or lipids, or early cardiovascular disease . Other family history risk factors of interest are: obesity, hypertension, and diabetes mellitus. For children with positive family history risk factors, the first screening should take place after 2 years of age but no later than 10 years of age. Screening before 2 years of age is not recommended. If values are within the reference range on initial screening, the patient should be retested in 3 to 5 years.

Universal lipid screening is also recommended for all children around the ages of 9 or 10 years , regardless of any risk factors.

Overweight children belong to a special risk category of children and are in need of cholesterol screening regardless of family history or other risk factors.

Lipid screening tests are ordered as an outpatient lab at the hospital and should be drawn when your child is fasting. We recommend having the lab drawn first thing in the morning, before your child eats or drinks. It is ok to drink water prior to the lab draw.

Please call the office if you have any questions or concerns regarding the lipid screening recommendations for your child.

Sharing Books: 2 and 3 Year Olds

Sun, 16 Jun 2019 16:29:00 GMT

How to Share Books with 2 and 3 Year Olds

Even toddlers can enjoy books and learn from sharing books with you. Sharing books with your children can help them learn to talk better and get them ready to listen and learn in school.

A bedtime routine is a great time to read with your child. Setting aside 15 minutes nightly, with all electronics turned off, is the perfect opportunity to share books with your children. This is a great time to focus on one another without distractions. Bedtime routines also help toddlers transition to falling asleep on their own and decrease night time awakenings. Here are some ideas what you toddler can do and what you as a parent can do to help share books.

2 Year Olds Can:

Choose a book to share; enjoy sharing the same book over and over again; repeat some of the words and phrases you say or read; ask you questions, such as: “What’s that?”; enjoy a trip to your local public library for Story Time or to borrow some books.

What Parents Can Do:

Use book-sharing as a way to calm and comfort your child.
Start a conversation by repeating an important word your child has just said, You can say: “Balloon. Lots of balloons. The girl has lots of balloons.” Then wait for your child to say something more.
Count pictures and wait for your child to repeat the numbers after you.
Respond with enthusiasm to your child’s questions and comments.

3 Year Olds Can:

Name the books they want to share with you; pretend to read a favorite book aloud to you; tell you how a story is like things they have seen or done; ask you questions about books you are enjoying together; “correct” you if you skip a word or page in a favorite book; tell you the story in a favorite book in their own words.

What Parents Can Do:

Ask your child to tell you about the pictures and the story.
Respond with enthusiasm to your child’s questions and comments.
Ask your child to show you all the things in a picture that are alike in some way. You can say: “Can you find all the blue things?” or “Show me all the things that can fly.”
Point out colors, shapes, numbers in their books.
Take your child to the local public library to borrow books or to enjoy Story Time

The above information can be found on www.healthychildren.org along with other helpful resources from the AAP.

Separation Anxiety

Sun, 02 Jun 2019 16:29:00 GMT

Separation Anxiety

Separation anxiety is a normal part of development. Infants from around four to six months of age are able to distinguish between familiar and unfamiliar situations. They are also beginning to learn “object permanence”, meaning that they know things exist in their environment even when they are not observed. This period of development usually peaks between ten and eighteen months and then fades during the last half of the second year.

This can be a stressful and emotional time for families. Often mixed emotions are felt by parents as they transition through this stage. They may feel more of a sense of attachment or bonding with their child. They may also feel frustrated or anxious when having to leave their child.

Anxiety around strangers is often one of the first signs that are noted. Your child may even begin to cry or shy away from familiar faces of relatives or sitters. They often become clingy and may resist leaving the familiarity of your arms. Although this stage of development can be stressful, the predictable anxieties are evidence of a healthy relationship with you. The following link, Emotional and Social Development: 8 to 12 months, has some helpful tips for your family on coping with these developmental transitions

Measles: What You Need To Know About the MMR Vaccine Before Traveling

Sun, 19 May 2019 08:00:00 GMT

With the recent outbreaks of measles in the nation many families have been asking how to best protect their child. According the CDC, from January 1 to May 10, 2019, 839 individual cases of measles have been confirmed in 23 states. This is the greatest number of cases reported in the U.S. since 1994 and since measles was declared eliminated in 2000.

Measles is a highly contagious disease, and it can be serious for young children. Protect your child by making sure he or she is up to date on measles vaccine, including before traveling abroad.

If current recommendations for the MMR vaccine change due to outbreaks we will post an update.

For more information on measles and vaccination recommendations visit CDC, Measles: Make Sure Your Child is Fully Immunized

Healthy Protein Guidelines

Sun, 12 May 2019 16:46:00 GMT

High protein diets are popular right now but they are not appropriate for growing children. This link provides detailed information on protein requirements for all stages of childhood and includes great menu suggestions. Call our office if you have any questions or talk with your provider at your child's annual well visit.

Bunk Bed Safety

Sun, 05 May 2019 16:42:00 GMT

Many kids love the adventure of a bunk bed and sharing a room with a brother or sister. However, bunk beds have significant safety risks. The following link gives suggestions to improve bunk bed safety. Please call our office if you have further questions or bring it up when your provider asks about sleep concerns at your child's annual well visit.

Vegetarian Diet for Children

Sun, 28 Apr 2019 19:07:00 GMT

Vegetarian diets for children require extra planning since their bodies are still growing. This article provides good information to make sure your child's vegetarian diet is meeting all your goals.

First Aid for Severe Allergic Reactions

Sun, 14 Apr 2019 16:21:00 GMT

Severe allergic reactions, also known as anaphylaxis, require immediate first aid. Learning about this topic and how to respond quickly are very important for parents and caregivers. When a child has had a previous reaction, he may benefit from keeping medication such as epinephrine injectors (Epipen or AuviQ) or diphenhydramine syrup (Benadryl) nearby at all times.

The injectors often come with a practice or trainer injector and links to video instructions that should be used by all caregivers as soon as the injectors are prescribed. They come in a two-pack that is intended for one episode, in effect, giving a second dose if symptoms have not resolved 15 minutes after the first dose. If your child has such a dual pack, please do not split up the injectors and call us if you prefer extra prescriptions to keep a pack at multiple locations rather than keeping the pack with your child at all times. This link provides more information.

Raising an Adventurous Eater

Sun, 07 Apr 2019 16:47:00 GMT

Eating a balanced, nutritious diet is paramount to your child's healthy growth and development. However, after the rapid growth and calorie requirements of infancy, your child's appetite may slow considerably, allowing him or her to be more choosey about the foods he or she eats. It is very common for kids to become picky eaters, and it can be difficult and frustrating as a parent to get them to try new and diverse foods. Fortunately, there is a lot you can do! Follow these tips to help your child enjoy a balanced diet:

Get ahead of the game. The easiest way to overcome picky eating habits is to stop them from ever forming in the first place. Prior to 9 months of age, your baby's taste buds are not fully developed. Use this opportunity to introduce him to a variety of foods, flavors and textures before he establishes his preferences.
Wait until you child is hungry to give her foods she have not liked in the past. With an empty stomach and an active appetite, she may be more adventurous and may also be more apt to try new foods.
Stay strong! It can be difficult not to conform to your child's eating habits, especially if he refuses to eat what you have put in front of him. However, it is important to remember you are the one who decides what your child will eat; she can only decide if she will eat it. Rest assured you are not starving your child. If she is hungry, she will eat.

Find more information about feeding picky eaters in this article

Written by

Jeff Ruggeri MD Candidate Class of 2020 University of Missouri College of Medicine

Helping your child develop self-esteem

Sun, 24 Mar 2019 15:44:00 GMT

Self-esteem is shaped by a child's perceptions and expectations of himself and also by the perceptions and expectations of the significant people in his life such as you. The following link reviews how each of us can help each child in our lives build a healthy sense of self-esteem. Your child's check-up will include a review of her emotional development. Please call (417) 882-1600 to schedule your child's next visit (annually at age 2 and after).

Family Media Plan

Sun, 17 Mar 2019 15:43:00 GMT

Family Media Plan

Media should work for yo u and within your family values and parenting style. When used thoughtfully and appropriately, media can enhance daily life. But when used inappropriately or without thought, media can displace many important activities such as face-to-face interaction, family-time, outdoor-play, exercise, unplugged downtime and sleep. You and your family can create your own individualized media plan at HealthyChildren.org/MediaUsePlan .

Home apnea monitors: To use or not to use?

Sun, 10 Mar 2019 15:43:00 GMT

Home Apnea Monitors: To Use Or Not To Use?

Questions regarding the use of home apnea monitors have increased as the use of these monitors have gained popularity. The American Academy of Pediatrics (AAP) does not recommend these monitors unless prescribed by a physician. Research has found no link between the use of these monitors and a decrease in adverse events such as SIDS. In fact, these monitors may make parents more anxious due to false alarms. False alarms may lead to loss of sleep for an already sleepy parent, leading to less alert parenting. False alarms may also lead to unnecessary testing, stressing the baby and the parents out further.

Does this mean you are a bad parent if you still want to use one? Absolutely not! There's simply not enough evidence to support their use at this time. For more information regarding this topic and safe practices to prevent SIDS please click here .

Rear-facing Car Seats Until Age Four

Sun, 03 Mar 2019 15:42:00 GMT

https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx

Car safety seats are one of the best tools we have as parents to keep our children healthy. Choosing and using the right seat for each stage of development and growth can get complicated. Indeed, the AAP suggests toddlers continue to face rear in car seats until they outgrow the rear-facing component of their seats. For seats manufactured since April 2019, this will be age 4 yr. This detailed link has all the latest recommendations on car seats. Cox Safety Office offers help with car seat installation by calling (417) 269-0920 or emailing carseats@coxhealth.com

Tooth Decay: Prevention

Sun, 24 Feb 2019 15:38:00 GMT

Above information can be found on www.healthychildren.org or by clicking here .

ADHD and Behavior Therapy

Sun, 17 Feb 2019 15:35:00 GMT

Medication therapy is often utilized to help manage and improve symptoms of ADHD, but it is not the only option. Behavior therapy is a different but an equally important approach to managing ADHD symptoms. Behavior and medication therapy work well in combination and produce favorable results. Under this approach, parents, teachers, and other caregivers learn better ways to work with and relate to the child with ADHD. For more information please click here .

Choosing an Infant Formula

Sun, 10 Feb 2019 15:34:00 GMT

Choosing an Infant Formula

Shopping may be an enjoyable hobby to some mothers. But, when it comes to shopping for the right formula for your baby, the options can be overwhelming! To better understand different types of infant formulas please click here . If you feel that a different formula may be a better fit for your baby please discuss this with your provider first. Usually when trialing a new formula, a trial period of at least a couple of weeks is recommended. If you have further questions or concerns please follow up with the office. Thank you and happy feeding!

Nebulizer Options

Sun, 03 Feb 2019 15:33:00 GMT

Did you know that they are multiple options available when it comes to selecting a nebulizer for your home?

Most pharmacies and home support companies have nebulizers available for rental and purchase. Some companies also have options to purchase refurbished nebulizers which can equate to a great cost savings.

When selecting a nebulizer it is important to keep in mind the type of use that you will need. If you travel often, you may want to consider a model that is lightweight and compact. There are also models available with car adapters.

Remember that if you plan to file with your insurance company you will need a prescription prior to purchase or rental.

Gassy Babies: Normal or Not?

Sun, 27 Jan 2019 15:32:00 GMT

Gassy Babies: Normal or Not?

Gassy babies can be normal. Babies eat around the clock. In reaction to eating around the clock, their bowels are moving around the clock producing endless gas. But if it seems like your baby is uncomfortable or extra fussy, and they keep squirming and pulling up their legs, they may have some gas that refuses to pass.

What may help with this? You could try a gentle tummy massage, bicycling their legs, or giving your baby a warm bath. To help prevent gas, try to burp your baby regularly during feeds and after feeding. If your baby is using a bottle to feed, try to keep the nipple filled with milk to help your baby avoid swallowing air. If you are mixing a formula bottle, let it settle before giving it to your little one; the more bubbles in the milk, the more gas your baby may have. Make sure when feeding your baby, that the head is higher than the stomach. Allowing your baby to get tummy time daily encourages movement in your child and this helps mobilize gas.

For more ideas and information please click here .

Back Pain in Children and Teens

Sun, 20 Jan 2019 15:31:00 GMT

Back Pain in Children and Teens : Symptoms of back pain are commonly heard in the pediatrician's office. Often times back pain in youngsters is not serious, but this is not always the case. As a parent it is helpful to know and seek care if your child has any 'danger signs' related to back pain. Please click here for further information on these signs and what you should do if they occur. If you have any questions about your child's back pain, please call the office at (417)- 882- 1600.

Hassle Free Formula Preparation?

Sun, 13 Jan 2019 15:03:00 GMT

Hassle Free Formula Preparation?

It's no secret, our life and our world is fast paced. We are constantly looking for items to make things faster and easier. One of the latest 'hot items' in the baby world are counter top devices that are designed to mix your baby's bottles for you. It mixes the infant formula and water, warms it to the right temperature, and dispenses it directly into a bottle. While these devices may look attractive, please pay close attention to the instructions that come with them.

It is imperative that babies get the right concentration of water and formula per feeding. Inappropriate amounts of water and or formula could cause serious health issues for your baby such as electrolyte imbalances, seizures, water intoxication, dehydration, undernourishment, etc. Proper sanitation and regular inspection of the device and its' parts for things such as mold or a clogged filter must also take place per the device manual instructions and as needed. We welcome anything to make life more convenient, but not at the expense of our children's health.

Winter Fitness

Wed, 02 Jan 2019 13:56:00 GMT

Winter is Coming!

With cold weather comes new challenges for parents. One is getting enough exercise for the whole family. We all know that physical activity leads to better health, but how, exactly? Some examples of benefits to exercise include:

A stronger heart = less risk of heart disease
Lower blood pressure = less risk of heart attack and stroke
Stronger bones and joints = less breaks and aches
More sensitive to insulin = less risk of diabetes
Improved self-confidence and self-esteem
Opportunities to make new friends
Better concentration at school

Did you know that only 1 in 3 children are physically active every day? Make your child one of them! Overweight teens have a 70% chance of becoming overweight or obese as adults. Now is the best time to start exercising. Here are some winter-friendly tips.

For the latest recommendations, see

http://www.healthychildren.org/English/healthy-living/fitness/Pages/default.aspx

Scott Berndt, MS3, University of Missouri College of Medicine

Puberty: Discussions with Your Daughter

Sun, 12 Aug 2018 15:16:00 GMT

Puberty: Discussions with Your Daughter

It is best to be honest and to have multiple little talks or discussions with your daughter about what to expect during puberty and menstruation. One big talk can be overwhelming and a lot of information to process! The best time to have these discussions is before any changes take place.

If your daughter has a good understanding of what puberty and menstruation are then she won’t be surprised by it. She will also understand that she and her friends may mature at different rates and that may look different. Ultimately, it is important to explain that puberty is a positive and healthy process. Help your daughter understand she is changing and maturing into a woman as she should.

How do you know if puberty has started? Usually breast development is the first sign, followed by the growth of some pubic hair. After breast development, most girls enter a phase of rapid growth. They become taller and curvier. Typically about one and half years after their growth spurt or about 2 and a half years after breast development, the first period arrives.

For more information on how to explain puberty to your child here are some great resources: ‘The Care and Keeping of You’ by American Girl, the website www.girlology.com, further information can also be found by clicking here.

Cox Health also offers a class for mothers and their daughters, ages 10-13. It includes a discussion of the changes of puberty, presented by an experienced nurse and mother. Call 417-269-5239 for more information.

Puberty and Your Son

Sun, 05 Aug 2018 15:15:00 GMT

Puberty and Your Son

As a parent, it is important to talk to your son about puberty and expected body changes before they occur. Parents may feel awkward at times discussing puberty with their children, but being open and honest about puberty allows room for discussion and questions. If you treat the idea of puberty awkwardly then your child will likely follow your lead. Like anything in life, it feels better to go into a new situation prepared, and puberty is no different for your child.

For more information about the changes puberty bring and how to discuss them with your son, check out the following resources: the book ‘Guy Stuff: The Body Book for Boys’, and also from Healthy Children’s website through the AAP by clicking here .

Body Talk and Your Preschooler

Sun, 29 Jul 2018 15:14:00 GMT

Body Talk and Your Preschooler

When your child is around the age of three years old, it is a good time to start talking to them more about their body. This should include teaching them the proper names of their body parts, teaching them what parts of their body are private, and teaching them about appropriate versus inappropriate touch. Educating your child regarding these topics should be a priority but may feel uncomfortable to some. Please click here for more information on how to talk to your child about body safety.

Stuttering: Normal or Not?

Sun, 22 Jul 2018 15:14:00 GMT

Stuttering: Normal or Not?

As your toddler or preschooler increase their vocabulary and language development, they may encounter some bumps along the way. Disfluencies in their speech (e.g., word or phrase repetitions) is often observed in these age groups, but can actually be a normal part of their development. Below is a chart from the AAP to help identify speech behaviors that should be further investigated:

Here are some ways to differentiate typical disfluency from stuttering:

For more information please click here .

A Tough One to Tackle – Football and Head Injuries

Sun, 15 Jul 2018 18:32:00 GMT

With fall sports around the corner, many parents are weighing the risks and benefits of youth tackle football and wondering the all-important question “is it safe for my child?”

Growing evidence suggests that repeated blunt force impacts to the head put children at risk of developing a neurogenerative disease, known as Chronic Traumatic Encephalopathy (CTE), that can impair mood control, cognition, and sensation. Researchers believe the number of concussions and even sub-concussive impacts, those without signs or symptoms, play a role in the development of CTE. Unfortunately, studies on the true risks of developing CTE are ongoing and difficult to assess because there are no current tests to diagnose CTE until after death. Current research does not suggest that every child who participates in youth tackle football will develop CTE, but a recent study estimates that 3 out of 14 (21%) high school athletes have clinical signs suspicious for CTE.

The only foolproof way to minimize risks of developing CTE from tackle football is to avoid it altogether, but that might not be an option for some parents and players. For this reason, several educational campaigns listed below have been developed to educate parents and coaches and improve safety for players.

“Flag Football Under 14” was launched by the Concussion Legacy Foundation to inform parents about the risks and support noncontact football under 14 years of age.
https://concussionfoundation.org/programs/flag-football
“Heads Up to Youth Sports” was created by the Centers for Disease Control and Prevention (CDC) to improve the culture of concussion by teaching signs of concussion, steps for returning to play, and focusing on prevention and preparedness during the season with proper technique.
https://www.cdc.gov/headsup/youthsports/athletes.html
“When in doubt, sit it out” is a phrase that has been developed to discourage coaches, parents, and trainers from allowing players to return to the field without proper, unbiased evaluation.

It is worth mentioning that risks of head impacts are most studied in football players, but head injuries are possible in hockey, soccer, baseball, basketball, and other sports, so football is certainly not the only contributing factor to CTE. Additionally, research is constantly evolving in this field, so it is wise seek reputable sources to help you make an informed decision. Please visit the campaigns listed above for more information.

Elliott Voss MS3 University of Missouri School of Medicine

Alcohol: Time to Talk!

Sun, 24 Jun 2018 15:06:00 GMT

Alcohol: Time to Talk!

Alcohol is the substance most abused by teenagers. Alcohol abuse is responsible for the most injuries and deaths from accidents, homicides, and suicides among teens. As parents, we must acknowledge that at some point our child will be exposed to alcohol in one way or another.

Have you talked to your child about alcohol? If your child is 9 years of age or older, the AAP recommends you start speaking with them about alcohol. I know what your thinking, 'that seems so early though'. If you start having small talks about alcohol and the potential harms of its' abuse starting at a young age then when your child is older they will be educated and hopefully have a healthy opinion on the matter.

Most parents don't realize their children drink– research shows that only 10% of parents think their teens drink, yet 52% of teens admit to drinking alcohol. Out of those parents, they thought that 60% of other children were drinking. This is sobering and it's time to get real.

You may be asking, what does my teen or child care what I say? According to the AAP, 80% of teenagers stated that their parents influence their decision to drink or not to drink. Those are staggering statistics. Remember, don’t talk at them, but with them. For more information, please click here .

Digital Rules for Home

Sun, 10 Jun 2018 15:04:00 GMT

Digital Rules for Home

Rules, rules, rules. There are rules about bedtime, rules about mealtime, rules about traveling, rules about pretty much the entire childhood. BUT, what about rules for the computer? The AAP recommends setting up established rules for internet and computer use in your home. These rules should be established in early childhood and can be expanded upon as your child grows. These rules then follow your child everywhere they go (neighbor's house, sleepover with cousin, etc). These rules allow your child to have a clear expectation of how you expect responsible use in this digital world. For more ideas please visit the following link from the AAP: Tips for Parents in the Digital Age

Talking to your teen about drugs

Sun, 27 May 2018 13:47:00 GMT

Talking to your Teen about Drugs

Talking to your teenager may at times feel like talking to a wall, but the truth is they hear more than you think! As a parent, if you talk to your kids about the harms of drugs, you will not regret it. What you will regret is not talking to them about drugs, and wondering if it would have made a difference.

It is important to give them the facts of why drugs are a bad choice and then opening up a discussion with them and what they think about drugs. This allows them to have their own voice. Let them know you that love them. They may not want to hear it, but they need to know that your love is present and not going anywhere--no matter what challenges life brings their way.

Research has found that if parents regularly discuss the harms of drugs, their teens are 50% less likely to use drugs. That is huge! So what are you waiting for parents? The time is now.

For more information on how to talk to your teens about drugs please click here .

To floss or not to floss?

Sun, 20 May 2018 13:35:00 GMT

To floss or not to floss?

Children need to clean between their teeth too by flossing! The American Dental Association (ADA) recommends cleaning between your teeth daily with an interdental cleaner (like floss) in addition to brushing twice daily. Start as soon as your child has two teeth that touch. Because cleaning between teeth demands more manual dexterity than very young children have, children are not usually able to do a thorough job on their own until sometimes age 10 or 11! That means as parents the job is yours until then. A great resource for your child and healthy teeth can be found at www.MouthHealthyKids.org provided through the ADA.

If you and your child would like to watch a video on how to floss correctly, please click here .

Skin picking: normal or not?

Sun, 13 May 2018 13:33:00 GMT

Skin picking: normal or not?

at Does your child pick at their skin often? Repetitive skin picking may be a sign of something more going on with your child, such as anxiety or depression. It could be that they pick at healthy skin, or minor skin lesions--such as pimples, calluses, scabs, etc. This disorder is typically chronic, with periods of remission alternating with periods of greater symptom intensity. If you are seeing any of the following signs along accompanied by skin picking, please notify your pediatrician for further evaluation:

Recurrent skin picking that results in skin lesions
Repeated attempts to stop the behavior
The symptoms cause significant distress or impairment in their every day life
The symptoms are not caused by a medical or dermatological condition

Please call our office at (417) 882-1600 if you have further questions regarding this behavior.

Sun Safety Tips

Sun, 06 May 2018 13:27:00 GMT

Sun Safety Tips

Hello sunshine! Let’s get proactive and get ready for the summer sun! Protecting our children’s skin from damaging rays not only increases their comfort now but decreases there risk for developing skin cancer later. Make sure to stock up on sunscreen for the summer…… below you will find other helpful tips regarding sun safety from the AAP:

Sun Safety and Protection under 6 Months

Sun Safety for Kids and Up

For more information please click here . We hope you have a great summer!

Anchor It: Preventing tip-over tragedies

Sun, 29 Apr 2018 13:38:00 GMT

Anchor It: Preventing tip-over tragedies

Do you have a toddler in your home? If you answered yes, then you have likely already witnessed their inherent need to scale every piece of furniture or vertical structure in their path. Coupled with this new climbing skill is the risk for injury from furniture or TV falls. Within the past few decades we have witnessed an alarming rise in these pediatric injuries.

These injuries can be largely avoided by properly anchoring and mounting your furniture and TV’s. That bookcase you have had for years may seem steady… until your toddler prepares to reach its’ summit. There are numerous options available for securing those existing furniture pieces or TV’s. Many furniture pieces now include anchoring hardware when they are purchased new.

So what are you waiting for? Get going and happy anchoring!

For more information please visit the following link from the AAP:

https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Preventing-Furniture-and-TV-Tip-Overs.aspx

What’s the scoop: cereal for breakfast

Sun, 22 Apr 2018 13:45:00 GMT

What’s the Scoop: Cereal for Breakfast

You have likely heard this before! Research has proven a connection between breakfast and a better memory, better test scores, better attention span, decreased irritability, healthier body weight, and improved overall nutrition in our children. Breakfast has proven itself beneficial time and time again.

Let’s face it though, mornings with children can be chaotic to say the least. Getting out the door often seems a monumental task and then adding in a healthy breakfast to the routine may seem impossible! Cereal is a quick and healthy option if chosen appropriately. It can be a great way to get in milk and other healthy nutrients like fiber, folic acid, vitamin C, iron, and zinc.

Here are some helpful tips on choosing a healthy cereal:

Look beyond the eye-catching packages of children’s cereal. While cartoon characters can be appealing, cereals not specifically marketed to children tend to contain more fiber and less sugar.
Find cereals with a fiber content of at least 2 (if not 5) grams per serving.
Focus on finding cereals that contain no more than 10 to 12 grams of sugar per serving. Even when children in the low-sugar cereal group added extra sugar, they still ended up consuming far less sugar than the high-sugar cereal group.
Consider sweetening cereal naturally by simply adding cut up fruits like bananas, strawberries, or peaches.
Go for whole grains whenever possible.

So, parents, don’t be hard on yourselves! It doesn't have to be an all out breakfast attempt! Cereal proves a worthy breakfast food opponent!

For more information click here .

Homework habits

Sun, 15 Apr 2018 13:41:00 GMT

Support your child in their homework, but do not act as a taskmaster. Provide them with a quiet place, supplies, encouragement, and occasional help—but it is their job to do the work. Homework is your youngster's responsibility, not yours. For more information on how to make homework a time of less stress and more progress please click here .

Labial Adhesions

Sun, 08 Apr 2018 18:03:00 GMT

Labial Adhesions

This common condition, where the thin inner flaps near the vaginal opening temporarily grow together, is most often noticed at a well visit. Awareness of this condition can decrease bladder infection risk. For further information please click here .

Anemia

Sun, 01 Apr 2018 18:02:00 GMT

Anemia

Anemia occurs when your child’s oxygen carrying cells, or red blood cells, decrease below the normal amount for their age. This may cause symptoms such as pale skin, shortness of breath, tiring easily, weakness, etc. They may also exhibit a condition called pica where they eat uncommon things such as dirt, clay, ice, etc.

Because rapid growth may cause anemia, the first year of life and adolescence are two age groups where infants and children are at increased risk of anemia.

Close attention to your child’s diet may help prevent anemia from occuring, but some anemias are inherited and must be followed by a hematologist. If your child has had prolonged or heavy bleeding this too may cause anemia. It is important for anemia to be identified and corrected.

For more information about anemia including prevention, diagnosis, and treatment please click here or follow up with our office today. If you feel that your child has symptoms of anemia as discussed above, please follow up with our office or make an appointment with your pediatrician.

Burn Treatment and Prevention

Sun, 25 Mar 2018 17:57:00 GMT

Burns are typically accidental, unexpected, and scary when they occur. There is a lot of advice from others and the internet on how to best treat a burn, but what method is the best method? Information regarding immediate treatment of burns, when to seek care regarding burns, and prevention of burns can be found here as provided by the American Academy of Pediatrics. If your child has a burn and you have questions, please call our office.

Reflux

Sun, 18 Mar 2018 08:00:00 GMT

Many parents worry that a spitty infant has a serious medical condition. Most spitty babies grow just fine and spit up much less after 6 months of age. Newly published research suggests that some medicines used for reflux may increase risk for fractures and should be used infrequently. This article reviews the causes and solutions for this condition as well as guidelines on which symptoms need further evaluation.

https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/GERD-Reflux.aspx

Eat fruit. Don’t drink it.

Sun, 11 Mar 2018 08:49:00 GMT

Eat Fruit. Don’t Drink it.

This is advice from the American Academy of Pediatrics (AAP). Juice can be a popular drink among children, as well as convenient, coming in a variety of boxes and pouches that are easy to pack and handle. But is it worth it? The AAP warns against the use of juice for your children as it can lead to cavities, weight gain or weight loss, and diarrhea. Whole fruit offers fiber and other nutrients that juice cannot. Juice is not recommended under the age of 1 unless recommended by your physician. Here is some more information from the AAP:

Breastfeeding exclusively until 6 months of age and up to one year of age is highly encouraged.
Do not offer juice in a bottle or sippy cup or allow it to be carried around all day with the child.
If choose to buy juice, only buy products labeled "100% juice" to avoid added sugar and other ingredients.
Serve juice that has been pasteurized to avoid germs that put infants and children at risk of getting sick

For more information click here .

What is RSV?

Sun, 04 Mar 2018 20:46:00 GMT

What is RSV?

If you have children, you have probably heard the term RSV, or respiratory syncytial virus. It is one of many viruses that can cause bronchiolitis (an infection of the bronchioles, the small breathing tubes of the lungs). Annual epidemics take place during the winter and early spring. For some children, RSV may cause mild cold symptoms such as congestion and cough, other children may experience labored breathing and or wheezing. For more information about signs and symptoms of RSV, what to expect, and when to call your pediatrician, please visit www.healthychildren.org.

Eczema: How to Help Your Child Avoid the Itch

Sun, 25 Feb 2018 08:08:00 GMT

Eczema: How to Help Your Child Avoid the Itch

Very sensitive skin is the hallmark of eczema. Symptoms of eczema vary from child to child and from day to day even in the same child. They usually involve dry, red, itchy skin and rashes. The rashes can be oozing or very dry. Eczema often runs in families with a history of eczema or other allergic conditions such as hay fever and asthma.
One of the most helpful things you can do is to prevent flare-ups before they happen. Many things can trigger your child’s eczema to flare, including winter weather. Here are some tips to manage your child’s eczema this winter:

If you feel your child may have eczema and have never discussed with your child’s provider, please make an appointment to discuss these symptoms soon as it can lead to other skin infections.

There are many other ways to help manage your child’s eczema, for more information click here

When can my child stay home alone?

Sun, 18 Feb 2018 08:10:00 GMT

When can my child stay home alone?

Child experts generally agree that eleven or twelve is the age at which parents can consider allowing their boy or girl to be home alone, provided that it is during the day and for no more than approximately three hours. Before a parent leaves a child home alone, there are several factors to take into account.

For more information please click here.

Money Management and Your Teen

Sun, 11 Feb 2018 15:28:00 GMT

Money Management and Your Teen Below are some tips for your older child or teen and how to manage money taken from the AAP: When children have their own money to manage — whether it’s a weekly allowance, a clothing budget or a set amount of spending money for vacation — they gain control over their […]

Promoting Physical Activity as a Way of Life

Sun, 04 Feb 2018 15:28:00 GMT

Promoting Physical Activity as a Way of Life

As a parent, encouraging healthy habits in your child—including exercise—is a top priority. Physical activity should become as routine a part of their lives as eating and sleeping.

Click here to find out why physical activity is vital to your child's health.

Family Disruptions

Sun, 28 Jan 2018 15:27:00 GMT

Stressful events happen to every family. This article gives some excellent coping strategies for the entire family in a variety of circumstances.

https://www.healthychildren.org/English/family-life/family-dynamics/Pages/Family-Disruptions.aspx

Celiac

Sun, 21 Jan 2018 15:26:00 GMT

Celiac disease and gluten sensitivity have become hot topics lately but avoiding gluten can lead to poor nutrition. This link helps clarify who needs to be tested and evaluates the gluten-free diet.

https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Celiac-Disease.aspx

Cradle Cap

Sun, 14 Jan 2018 15:24:00 GMT

Itchy rashes of the face and head, fussiness, poor sleep and ear pulling are common ways for cradle cap to come to our attention. This link details this condition and how you can treat it at home.

https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Cradle-Cap.aspx

Aggressive Toddler Behavior

Sun, 07 Jan 2018 08:30:00 GMT

Helping your toddler learn to moderate his or her behavior can be very stressful. This article explains the developmental changes that make this such a challenging time and offers suggestions on helping your toddler express himself more productively.

https://www.healthychildren.org/English/ages-stages/toddler/Pages/Aggressive-Behavior.aspx

New Year’s Resolution Ideas

Mon, 01 Jan 2018 11:00:00 GMT

New Year's Resolution Ideas

Mothers: Thinking of getting more fit in the new year? Research has shown that when mothers exercise more, so do their children. Increased exercise means decreased risk of developing chronic illnesses and mental health disorders. Research has also proven that regular physical activity can boost a child’s school performance.

Fathers: Wanting to make your relationship more of a priority? Research tells us that a healthy relationship with your partner means healthier children. Your relationship with your partner is the emotional environment in which your children live. So go ahead, set a weekly date night, and work on putting your relationship first!

0-2 years of age: Make it a goal to keep your child rear facing until at least four years of age. Safety first! Did you know that children under four are 75% less likely to die or be severely injured in a crash if they are rear-facing? Cox Health offers assistance with proper installation, for more information call (417) 269-0920

3-9 years of age: Perhaps it is a goal for your child to eat healthier. Children like to eat food they make. Cooking and eating together is a good way to encourage healthier eating among other benefits such as science skills, math skills, responsibility of clean up, building self-esteem, etc. At www.chopchopmag.org you can find family friendly recipes that are healthy and fun.

10-14 years of age: Time for a technology curfew? Removing screen time two hours before bed encourages healthy sleep. Healthy sleep has endless benefits. Create a schedule and stick to it. Confusion and arguments will be kept to a minimum once your kids understand that the technology curfew is a nightly event that’s here to stay.

15 years and older: Teens often have goals of independence. Nurture your teen’s independence by allowing them to make choices for themselves. Encourage them to research new fads before trying them so they learn to make healthy choices and to take responsibility for their actions. More information can be found at healthychildren.org .

Pediatric Associates of Springfield wishes you a Happy New Year! We are excited to meet with your child or children this year for their annual checkup when we will discuss healthy ideas as mentioned in this blog. Our goal is that they have the happiest and healthiest life possible. Thank you for allowing us to care for your family.

Cold sores

Sun, 10 Dec 2017 20:23:00 GMT

Cold weather and holiday stress are here. Cold and stress are two of the triggers for recurring cold sores. A first cold sore or "fever blister" can appear between the ages of one and five. More than 50% of adults in the US has had a cold sore. The following link will help you identify triggers, help treat cold sores and prevent their spread to others.

Winter Car Seat Safety Tips from the AAP

Sun, 03 Dec 2017 08:00:00 GMT

Winter Car Seat Safety Tips from the AAP

Winter can be a challenging time for car seats. We have included some important reminders from the AAP on how to keep your family safe and warm while you travel this winter.

For more information please visit: https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Winter-Car-Seat-Safety-Tips.aspx

Tips for Teaching Gratitude

Sun, 26 Nov 2017 08:22:00 GMT

Tips for Teaching Gratitude

A fear of many parents is raising entitled children. As parents, we have to ask ourselves, what are some ways to teach our children to be more grateful? Listed below are a few great tips from the AAP:

Talk about the best parts of your day: Find some time each day to talk about what you are thankful for– perhaps at the dinner table, before bed, or while you are driving in the car. Ask your children, "What was the best part of your day?"

For older children, try keeping a gratitude journal . Gratitude journals have been shown to be an effective approach to helping children be happier. This could be as easy as listing 5 things they are grateful for each day.

Help your children serve someone who does not "need" charity: It's great for kids to participate in scout food collections and other community charity programs, but these events only occur a few times per year and you rarely meet the people you are serving. Find someone in your everyday life for your children to serve regularly, even if this person doesn't really need charity. For example, you could take dinner to an elderly neighbor.

Focus on the positive, all day: A good rule to keep and remind your children of is that, "Attitude IS a choice."

Say "Thank you:" Teach young children to say "thank you" as part of a full sentence, for example, "Thank you, Daddy, for making dinner," and "Thank you Coach for coaching practice tonight."

Lead by example: How many times per day do you say "thank you"? Have you told your children what you are thankful for today? Our children are watching our every waking move.

Monitor your children's media: Our children are bombarded with age-targeted marketing that they are too young to resist or understand. Media fuels materialism. It is our job to carefully monitor their media so that they aren't dragged into marketing and made to feel incomplete or unfulfilled.

Thank YOU for reading and choosing our practice, we appreciate our patients and their families.

Click here for the full article .

Holiday Mental Health Tips

Sun, 19 Nov 2017 08:30:00 GMT

Holiday Mental Health Tips

Try to keep household routines the same. Stick to your child's usual sleep and mealtime schedules when you can, which may reduce stress and help your family enjoy the holidays.

Take care of yourself both mentally and physically. Children and adolescents are affected by the emotional well-being of their parent or caregivers. Coping with stress successfully can help children learn how to handle stress better, too.

Make a plan to focus on one thing at a time. Try a few ideas to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: Stop and pay attention to what is happening at the moment, focus your attention on one thing about it ,and notice how you are feeling at the time.

Give to others by making it an annual holiday tradition to share your time and talents with people who have less than you do. For example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter or sing at a local nursing home. Help your child write a letter to members of the armed forces stationed abroad who can't be home with their own family during the holidays.

Remember that many children and adults experience a sense of loss, sadness or isolation during the holidays. It is important to be sensitive to these feelings and ask for help for you, your children, family members or friends if needed.

Don't feel pressured to over-spend on gifts. Consider making one or two gifts. Help your child make a gift for his or her other parent, grandparents, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons.

Most important of all, enjoy the holidays for what they are -- time to enjoy with your family. So, be a family, do things together like playing games and sharing a favorite story from the year.

Happy Holidays from all of us at Pediatric Associates of Springfield!

More information can be found at https://www.healthychildren.org/English/news/Pages/Holiday-Safety-Tips.aspx

Teach Simple Rules About Safety with Adults

Sun, 12 Nov 2017 08:01:00 GMT

Teach Simple Rules About Safety with Adults

Keeping children safe is an important job for parents. You want your child to respect and trust others, but you also need to teach your child to be careful. Following are some simple rules and ways that you can start a conversation with your child about different safety issues.

“If you’re not sure, ask me.”
“If an adult asks you to do something that you’re not sure is OK, always ask me first. I won’t get mad at you for asking.”
“No secrets.”
“No one should ever tell you to keep a secret from me—one that might make me mad if I found out. Adults should never expect you to do this.”
“Certain body parts are private.”
“No adults (except parents, doctors, and nurses) should touch you where you normally wear a bathing suit.”
“If we get separated, find a security guard or police officer.”
“This is a very busy place. If you can’t find me, find a security guard or police officer, or ask someone to help you find one. That person will help you find me.”
When you take your child to a crowded place, look around and point out the person who is there to help if you do become separated.

Information per www.healthychildren.org

Alternative Immunization Schedules

Tue, 17 Oct 2017 18:03:00 GMT

Choosing to protect you child from disease through vaccination is a very serious responsibility of parenthood. This linked article examines the alternative vaccine schedule aspect of this topic. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Child-Immunization-Schedule-Why-Is-It-Like-That.aspx

Vitamin D and Calcium

Sun, 27 Aug 2017 18:07:00 GMT

Strong bones for life: Vitamin D and Calcium Recommendations

It is very important that your child receives adequate intake of calcium and vitamin D to build healthy bones. Below is listed the Dietary Reference Intake (DRI) for calcium and vitamin D. Receiving the “DRI” ensures that children listed in the age group listed below will meet their daily needs.

Age Calcium (mg/day) Vitamin D (IU/day)

Birth to 6 months 200 400

7-12 months 260-500 400

1-3 years 700 400

4-8 years 1000 600

9-13 years 1300 600

14-18 years 1300 600

Vitamin D

Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life. Formula fed infants who are consuming less than 32 ounces of formula per day should receive a vitamin D supplement of 400 IU a day.

Toddler and older children, who are consuming less than 24 ounces per day of vitamin D-fortified milk, should receive a vitamin D supplement of 400 IU a day. Adolescents who do not get 600 IU of vitamin D per day through foods should receive a supplement containing that amount.

Calcium

Infants normally obtain adequate amounts of calcium through breast milk or formula.

In toddlers and older children it is best to strive to meet daily recommendations through diet. If diet alone is not enough, supplementation may be recommended. Dietary sources high in calcium include: cow’s milk, yogurt, cheese, cottage cheese, beans, broccoli, kale, and sweet potatoes. We have included a recipe for a calcium rich smoothie that is sure to be a hit in your home.

Recipe for Strawberry-Banana Fruit Smoothies

Ingredients

3/4 c. skim milk 2 Tbsp. honey

1/2 c. low-fat plain Greek yogurt 7-9 ice cubes

Instructions

Blend strawberries with milk by adding berries in 1 cup increments with the milk. Blend in Greek yogurt, honey, and banana till smooth. Add ice and blend until desired consistency. Pour into glasses and serve immediately.

Bilingual Children

Sun, 20 Aug 2017 18:06:00 GMT

Recent research on children who are fluent in more than one language has revealed many benefits but some misconceptions persist. The following link discusses these misunderstandings and reminds us making the extra effort to teach our children multiple languages at a young age is truly valuable. Discussing your child's speech and language development is an important part of a check-up, particularly in the first few years. Please call us to schedule your child's next visit at (417) 882-1600.

Amber Teething Necklaces: A Do or Don’t?

Sun, 13 Aug 2017 18:05:00 GMT

Amber Teething Necklaces: A Do or Don’t?

As a parent, it’s only natural to want to relieve pain related to teething in your child. Amber teething necklaces are marketed to do just that and they are quite popular. However, this practice is not supported by scientific evidence and they are considered unsafe for your child.

How can they be of harm? Choking and strangulation are the top two concerns with these teething necklaces for obvious reasons. What if the necklace gets caught or pulled and is too tight when sleeping causing strangulation? What if the beads break off and the child chokes on them?

The American Academy of Pediatrics (AAP) does not recommend that infants wear any jewelry. Suffocation is the leading cause of death for children under a year old and among the top five causes of death for children between the ages of 1 and 4.

To review recalls and safety information, visit the Consumer Product Safety Commission (CSPC) website .

Parents who choose to use these necklaces are advised to:

Always supervise your child when he or she is wearing the necklace or bracelet.

Have your child wear the necklace on a wrist or ankle and not around his or her neck.

Remember to remove the necklace or bracelet when your child is unattended, even if it is only for a short period of time!

Remove the necklace or bracelet while your child is sleeping (day or night).

Safer ways to soothe a teething baby:

There are many teething-pain relievers that can soothe your baby's sore gums safely. Here are a few worth trying:

Chew toys.Plastic and rubber toys are great for soothing aching gums.

Cold things.For help numbing and easing the ache and inflammation, try using damp washcloths that have been twisted and frozen (tie one end in a knot for better gnawing). Avoid teething rings that are frozen solid; they are too hard for children's mouths.

A light, gentle rub or massage might give your little one a lot of relief. Remember to wash your hands, then massage the sore areas in your baby's mouth with your finger or knuckle.

When your baby is having a really tough time, may try giving a dose of acetaminophen (Tylenol) or if over six months, you may try ibuprofen (Advil/Motrin) Note: Numbing gels or creams that contain benzocaine are not recommended for infants.

For more information from healthychildren.org click here .

Does My Child Need a Vitamin?

Sun, 06 Aug 2017 18:03:00 GMT

Vitamins are often marketed as a nutritional safety net however, after the first year of life, vitamins are not recommended for most children. This article discusses why and offers several additional sources of information on healthy eating. Nutrition is major topic at well child visits. Please call (417) 882-1600 to schedule your child's next visit (every 2-3 months in the first year and a half then annually at age 2 and after).

Ready for the First Day of School?

Sun, 30 Jul 2017 18:01:00 GMT

As you and your child prepare for the first day of school, use this checklist to help make sure you have taken care of the necessary tasks. If your child needs a sports physical, school medication forms or allergy paperwork for school, please fax your forms to us at (417) 631-0119.

Backyard Safety

Sun, 23 Jul 2017 18:02:00 GMT

Backyard Safety

It's that sunny and warm time of year! This means your kiddos are likely playing outside more. Your backyard can be a safe play area for your child if you eliminate potential hazards.

Here are some suggestions for keeping your yard safe for children:

If you don’t have a fenced yard, teach your child the boundaries within which she should play. Always have a responsible person supervise outdoor play.
Check your yard for dangerous plants. Among preschoolers, plants are a leading cause of poisoning. If you are unsure about any of the plants in your yard, call your local Poison Help Line (1–800–222–1222) and request a list of poisonous plants common to your area. If you have any poisonous plants, either replace them or securely fence and lock that area of the yard away from your child.
Teach your child never to pick and eat anything from a plant, no matter how good it looks, without your permission. This is particularly important if you let her help out in a vegetable garden where there’s produce that could be eaten.
If you use pesticides or herbicides on your lawn or garden, read the instructions carefully. Don’t allow children to play on a treated lawn for at least forty-eight hours.
Don’t use a power mower to cut the lawn when young children are around. The mower may throw sticks or stones with enough force to injure them. Never have your child on a riding mower even when you are driving. It is safest to keep young children indoors while the lawn is being mowed.
When you cook food outdoors, screen the grill so that your child cannot touch it, and explain that it is hot like the stove in the kitchen. Store propane grills so your child cannot reach the knobs. Be sure charcoal is cold before you dump it.
Never allow your child to play unattended near traffic, and do not allow her to cross the street by herself, even if it is just to go to a waiting school bus.

The information above can be found at www.healthychildren.org .

Scoliosis

Sun, 16 Jul 2017 18:00:00 GMT

Scoliosis

The term scoliosis indicates an abnormal curvature of the spine. Our spines are naturally curved to help support our body, but in scoliosis and abnormal sideways curvature develops. This sideways curvature can resemble an “S” curve or “C” curve.

Scoliosis can be diagnosed through clinical exam, and often an X-ray is required to best determine the degree of the curvature. Depending on the severity of the curvature further evaluation with an orthopedic specialist may be needed. Brace therapy and surgery may also be necessary.

Symptoms that may be concerning for scoliosis can include: uneven shoulders, sunken chest, leaning to one side, and back pain.

Scoliosis often develops in adolescence, which is a time of rapid growth for the body. It is estimated that about one in twenty-five adolescent girls and one in two hundred teenage boys develop scoliosis. It is important to schedule annual well exams for pre-adolescents and adolescents to closely monitor the spine during this period of growth. Please call us at (417) 882-1600 to schedule your teen’s annual exam.

Further information on scoliosis can be found at the following link: https://www.healthychildren.org/English/health-issues/conditions/orthopedic/Pages/Scoliosis.aspx

Your Teen and Responsibility

Sun, 02 Jul 2017 17:57:00 GMT

Your Teen and Responsibility

If your child is now a teen that means they are nearing the young adult years. Are they going to be responsible enough to thrive under the demands of adulthood? Here are some ideas to help encourage responsibility:

Do Less: Parents need to stop doing things for their teens, like making lunch or running an “emergency” load of wash, that teens can do for themselves.

Let Consequences Happen: There is no need to come up with special punishments to discourage irresponsibility. Forgotten homework assignments result in lower grades or having to do make-up work. Not putting clothes into the hamper means that there might be nothing but dirty clothes to wear.

Of course, it is hard to stand by and see your child suffer embarrassment or defeat. A parent naturally wants to jump in and help. Remind yourself that the most helpful thing you can do is allow your child to learn to take responsibility, the sooner the better.

Give A Regular Allowance, But No Extras: When you are seen as a source of ready cash, your child has no incentive to handle money responsibly. Decide on a fair amount, and discuss how to budget. If teens don’t have money for something they want, they soon will learn to budget.

Teach Ways To Be More organized: Teens who have trouble staying organized can appear irresponsible. By teaching specific skills, like always putting keys in a particular spot, you are helping your child become a responsible adult.

Everyone Needs To Help With The Work of The Family: Whether the chores are divided up using a formal schedule or everyone just pitches in when they can, everyone needs to help out at home. You might want to have a family meeting to decide who does what. It’s all about fairness.

A Space To Call Their Own: Even in small homes, providing teenagers with a space to call their own is important. This allows them the freedom to express themselves and to develop their own sense of self-discipline. For example, they can decorate their room as they wish and keep it as messy or neat as they choose, within reason.

For more information from the AAP, click here .

Poison Prevention and Treatment Tips

Sun, 25 Jun 2017 18:42:00 GMT

Poison Prevention & Treatment Tips

Each year, approximately 3 million people—more under the age of 5—swallow or have contact with a poisonous substance. The American Academy of Pediatrics (AAP) has some important tips to prevent and to treat exposures to poison.

How to Poison Proof Your Home:

Most poisonings occur when parents or caregivers are home but not paying attention. The most dangerous potential poisons are medicines, cleaning products, liquid nicotine, antifreeze, windshield wiper fluid, pesticides, furniture polish, gasoline, kerosene and lamp oil. Holidays, visits to and from grandparents’ homes, and other special events may bring greater risk of poisoning if the usual safeguards are not in place.

Store medicine, cleaning and laundry detergents, (including detergent packets) paints/varnishes and pesticides in their original packaging in locked cabinets or containers, out of sight and reach of children.
Safety latches that automatically lock when you close a cabinet door can help to keep children away from dangerous products, but there is always a chance the device will malfunction. The safest place to store poisonous products is somewhere a child can't reach.
Purchase and keep all medicines in containers with safety caps. Discard unused medication. Note that safety caps are designed to be child resistant but are not fully child proof.
Never refer to medicine as “candy” or another appealing name.
Check the label each time you give a child medicine to ensure proper dosage. For liquid medicines, use the dosing device that came with the medicine. Never use a kitchen spoon.
If you use an e-cigarette, keep the liquid nicotine refills locked up out of children's reach and only buy refills that use child resistant packaging. Ingestion or skin exposure with just a small amount of the liquid can be fatal to a child.
Never place poisonous products in food or drink containers.
Keep coal, wood or kerosene stoves in safe working order.
Maintain working smoke and carbon monoxide detectors.
Secure remote controls, key fobs, greeting cards, and musical children’s books. These and other devices may contain small button cell batteries that can cause injury if ingested.

Treatment:

If your child is unconscious, not breathing, or having convulsions or seizures due to poison contact or ingestion, call 911 or your local emergency number immediately. If your child has come in contact with poison, and has mild or no symptoms, call Poison Help at 1-800-222-1222 .

Different types and methods of poisoning require different, immediate treatment:

Swallowed poison : Take the item away from the child, and have the child spit out any remaining substance. Do not make your child vomit. Do not use syrup of ipecac .
Swallowed battery : If your child has swallowed a button-cell battery, seek treatment in a hospital emergency department immediately.
Skin poison : Remove the child’s clothes and rinse the skin with lukewarm water for at least 15 minutes.
Eye poison : Flush the child’s eye by holding the eyelid open and pouring a steady stream of room temperature water into the inner corner for 15 minutes.
Poisonous fumes : Take the child outside or into fresh air immediately. If the child has stopped breathing, start cardiopulmonary resuscitation (CPR) and do not stop until the child breathes on his or her own, or until someone can take over.

For more information please see: https://www.healthychildren.org/English/news/Pages/Tips-for-Poison-Prevention-and-Treatment.aspx.

Iron Supplementation and Your Baby

Sun, 18 Jun 2017 18:40:00 GMT

Iron Supplementation and Your Baby

Results of recent basic research support the concerns that iron-deficiency anemia and iron deficiency without anemia during infancy and childhood can have long lasting detrimental effects on neurodevelopment.

Full-term healthy babies receive enough iron from their mothers in the third trimester of pregnancy to last for the first four months of life.

If your baby is breastfed : Human milk contains little iron, so infants who are exclusively breastfed are at increased risk of iron deficiency after four months of age. The AAP recommends giving breastfed infants a liquid iron supplement, such as Poly-Vi-Sol with Iron, until iron-containing solid foods are introduced at about six months of age. Iron intake of 11 mg/day between six to twelve months is recommended by the AAP. Supplementation may be continued dependent on dietary intake of iron containing solids. Check with your provider for further guidance.
If your baby is partially breastfed : The iron recommendation remains the same as that for fully breastfed babies if more than half of the daily feedings are from human milk and the child is not receiving iron-containing complementary foods.
If your baby is on infant formula : It is recommended that you use iron-fortified formula (containing from 4 to 12 mg of iron) from birth through the entire first year of life.
Premature babies have fewer iron stores, so they often need additional iron beyond what they receive from breastmilk or formula. Check with your provider for further guidance.

Our office routinely screens at 12 months of age for iron deficiency and iron deficiency anemia as recommended by AAP’s guidelines. For further information please click on the following link: https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Vitamin-Iron-Supplements.aspx

Shyness

Sun, 04 Jun 2017 18:31:00 GMT

Is your child shy?

Shyness is quite common among children. Many children are simply born this way and are naturally more withdrawn or introverted. It may take them longer to warm up to new situations.

Time to adjust:

Most shy children do well in relationships and in social settings once they are past an initial period of adjustment. Children who have difficulty establishing and maintaining relationships even after the ice-breaking period are more concerning. With time, many children who are shy learn to act otherwise in social situations. They function in ways that are not obviously shy or quiet, although inside they may still feel shy. Parents can gently guide or direct their children into social situations in which they can learn to successfully interact.

Severe Shyness:

Rarely, shyness can increasingly lead to purposeful avoidance of social settings and withdrawal, please follow up with your provider if this is a concern. If your child's shyness becomes debilitating, it may be caused by an anxiety disorder or a temperament pattern; then an evaluation by a child mental-health professional would be helpful.

How parents can help

Successful peer interactions require a variety of skills and special ways of interacting. Parents can look for these skills in their children and help develop and model them.

Coping with failure and frustration
Coping with success
Coping with change and transitions
Coping with rejection and teasing
Managing anger
Using humor
Forgiving and Apologizing
Thinking up fun things to do
Expressing affection, comforting someone
Avoiding dangerous situations
Defending himself
Sharing
Giving a compliment
Expressing appreciation
Coping with loss
Sticking up for a friend
Doing favors
Asking for help and helping others
Keeping secrets

Please click here for further information as noted above from the AAP.

Kids & Tech: Tips for Parents in the Digital Age from the AAP

Sun, 28 May 2017 18:30:00 GMT

Kids & Tech: Tips for Parents in the Digital Age from the AAP

Here are a few tips from the American Academy of Pediatrics (AAP) to help parents manage the digital side of raising children:

• Treat media as you would any other environment in your child’s life. Set limits; kids need and expect them. Know your children’s friends, both online and off. Know what platforms, software, and apps your children are using, where they are going on the web, and what they are doing online.
• Set limits and encourage playtime. Tech use, like all other activities, should have reasonable limits. Make unplugged playtime a daily priority, especially for very young children. And—don’t forget to join your children in unplugged play whenever you’re able. Screen time should be limited to 2 hours or less daily.
• Be a good role model. Teach and model kindness and good manners online. And, because children are great mimics, limit your own media use. In fact, you’ll be more available for and connected with your children if you’re interacting, hugging and playing with them rather than simply staring at a screen.
• Know the value of face-to-face communication. Very young children learn best through two-way communication. Engaging in back-and-forth “talk time” is critical for language development.
• Create tech-free zones. Keep family mealtimes and other family and social gatherings tech-free. Ban electronics from the bedroom. Evidence is clear that electronics in the bedroom are linked to obesity, poor sleep and worsening depression. Recharge devices overnight in a family charging station away from bedrooms to help children avoid the temptation to use them when they should be sleeping. These changes encourage more family time, healthier eating habits, and better sleep, all critical for children’s wellness.
• Apps for kids – do your homework. More than 80,000 apps are labeled as educational, but little research has demonstrated their actual quality. Products pitched as “interactive” should require more than “pushing and swiping.” Look to organizations like Common Sense Media for reviews about age-appropriate apps, games, and programs to guide you in making the best choices for your children.
• It’s OK for your teen to be online. Online relationships are part of typical adolescent development. Just be sure your teen is behaving appropriately in both the real and online worlds. Many teens need to be reminded that a platform’s privacy settings do not make things actually “private” and that images, thoughts, and behaviors teens share online will instantly become a part of their digital footprint indefinitely.
• Remember: Kids will be kids. Kids will make mistakes using media. Try to handle errors with empathy and turn a mistake into a teachable moment. But some indiscretions, such as sexting, bullying, or posting self-harm images, may be a red flag that hints at trouble ahead. Parents should take a closer look at your child’s behaviors and, if needed, enlist supportive professional help, including from your pediatrician.

For more information please visit: https://www.healthychildren.org/English/family-life/Media/Pages/Tips-for-Parents-Digital-Age.aspx

Picky Eater

Sun, 21 May 2017 18:25:00 GMT

Picky Eaters

Toddlers can be unpredictable and particular about food preferences from one day to the next. A favorite food may not be interesting when a child is not hungry. Total calorie needs per pound go down in the second year of life. Serving sizes of table food are only a tablespoonful at age one and a quarter cupful at age two. Don’t let this stress you out as a parent. As parents, your job is to make sure that you always have healthy options available to your toddler and show your child that healthy eating is enjoyable. With time, your toddler will not be a toddler anymore. If you have surrounded them with healthy options consistently, their diet will become more varied.

Toddlers enjoy finger foods or table foods that they can feed to themselves. Try to make these healthy options such as slices of banana, slices of avocado, small pieces of toast, etc. There are several links under the “Education” tab of this site with recipe suggestions.

Beware of finger foods that could be choked on as children do not fully gain the grinding motion involved in chewing until the age of 4 and can be distracted from safely chewing, for example, laughing and eating at the same time. Avoid the following: raw carrots, large sections of hot dogs, raw celery, raw cherries with pits, whole grapes, round/hard candy, and peanuts or other nuts.

Even when your toddler is feeding himself, it’s a good idea to sit with him while he eats. He’s also old enough to join the rest of the family in eating at the dinner table . Use these family meals to model the healthy eating that you want your child to adopt for the rest of his or her life. There are many studies that indicate family meals benefit not only good nutrition but also social and academic skills.

More information can be found at www.healthychildren.org

Lawn Mower Safety and Your Teen

Sun, 07 May 2017 14:39:00 GMT

Lawn Mower Safety and Your Teen

Chores are an important way for your teen to gain a sense of responsibility and accomplishment. Mowing the lawn may be one of your teen’s chores this summer. Here are some safety tips for lawn mowing from the American Academy of Pediatrics:

– See more at: https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Summer-Safety-Tips.aspx

Online Symptom Checker

Sun, 30 Apr 2017 14:35:00 GMT

Online Symptom Checker

Has this happened to you? - Your child is sick again and you aren't sure what to do. You searched your child’s symptoms on the internet for answers. After searching you find that your anxiety level is through the roof because according to this searched information, your child may have a very rare and serious disease. This leads to a visit with your pediatrician only to find that these symptoms are related to a much more manageable diagnosis.

The American Academy of Pediatrics has a pediatric specific symptom checker webpage parents can use instead of random internet advice. It can be found by clicking the following: Symptom Checker .

Remember, if you are concerned and you have questions regarding your child’s health, you can always call our office at (417) 882 – 1600 and speak with our triage staff or book an appointment with your provider today.

Sharing Books: 12 to 23 Months

Sun, 23 Apr 2017 16:02:00 GMT

Sharing Books: 12 to 23 Months

Reading has endless benefits, here are some ideas how to share books with your little one.

Making Books A Part of Your Toddler’s Bedtime Routine

A great time to share books is during your child’s bedtime routine. Set aside 5 to 15 minutes, turn off electronic devices, and allow for time with your child. They will have your undivided attention and this is a great time to read together. Regular bedtime routines started young help prevent bedtime struggles. It’s also an opportunity to bond with your child.

12-14 Month Olds Can:

What Parents Can Do:

15 to 23 Month Olds Can:

What Parents Can Do:

For above information and more, please use www.healthychildren.org. Further advice for reading with toddlers can be found here: PBSparents .

Bee and Wasp Stings

Sun, 16 Apr 2017 15:50:00 GMT

Bee and Wasp Stings

In the warm months of the year when children are eager to play outdoors it is important to be aware of the potential for bee and wasp stings. Stings can occur from a honeybee, bumblebee, hornet, paper wasp, or yellow jacket. Over 95 percent of stings are from honeybees or yellow jackets. Bee and wasp stings can be a painful and scary experience for children and their parents. It is important to know how to care for the sting as well as monitor for more serious reactions.

With bee or wasp stings you can expect severe pain at the site for 1-2 hours following the sting. Itching will often follow the pain. Normal swelling from the venom can increase for 24 hours following the sting and should slowly resolve over the next 7 days. Stings on the upper face can cause severe swelling around the eye, but this is usually harmless. Stings can appear red for several days. Infections rarely occur in stings.

Sometimes a more serious reaction can develop following a sting. Anaphylaxis is a severe life-threatening reaction that can include tightness in the throat or chest, difficulty breathing, cough, or difficulty with swallowing or speech. Anaphylaxis usually starts within 20 minutes and always by 2 hours following a sting. If anaphylaxis is suspected, 911 should be called, and epinephrine should be given if it is available.

More information on bee and wasp stings can be found at the following link: https://www.healthychildren.org/English/health-issues/conditions/from-insects-animals/Pages/Wings-and-Stings.aspx

Shoes for Busy Toddlers

Fri, 07 Apr 2017 11:05:00 GMT

Shoes for Busy Toddlers

Barefoot is best for babies’ feet at home when learning to walk (with nonskid socks when needed for warmth). Once children start walking outdoors, they will need shoes for protection. Here are some tips for buying shoes:

Shoes should be lightweight and flexible to support natural foot movement.
Shoes should be made of leather or mesh to allow your baby's feet to breathe comfortably.
Shoes should have rubber soles for traction to prevent slipping or sliding.
Buy well-made shoes with good arch support and covered toes.
At this stage, children have rapidly growing feet, the first pair of shoes may not last more than 2 or 3 months.

Checking the Fit

Check the fit of your toddler’s shoes at least monthly, and the top of the child’s big toe should be about finger-width distance from the inside edge of the shoe. Remember, it’s better to have no shoes at all than those that are too tight.

This information and more can be found on www.healthychildren.org , a website by the American Academy of Pediatrics (AAP)

Bicycle Safety Tips from the American Academy of Pediatrics

Sun, 26 Mar 2017 14:52:00 GMT

Bicycle Safety Tips from the American Academy of Pediatrics

In 2010 in the U.S., 800 bicyclists were killed and an estimated 515,000 sustained bicycle-related injuries that required emergency department care. Roughly half of these cyclists were children and adolescents under the age of 20. Annually, 26,000 of these bicycle-related injuries to children and adolescents are traumatic brain injuries treated in emergency departments.

–

Lead Screening

Sun, 19 Mar 2017 15:13:00 GMT

Lead screening

Lead screening is an important screening tool in the health monitoring of your child. Lead can cause serious damage to children's brains even at relatively low levels of exposure. The effects of lead poisoning on learning and behavior are largely irreversible.

At our office we routinely screen for lead risk exposures at all well exams from ages 6 months to 6 years in concordance with the state of Missouri’s Healthy Children and Youth program guidelines. If any risk factors for exposure are identified, lead testing is recommend annually through age six. Testing is also recommended for women of child-bearing age with risk factors.

The lead test is done as an outpatient lab at the hospital (usually drawn from a vein in the arm). The test measures the amount of lead in the blood.

If the level is high, repeat testing may be recommended. High blood lead levels generate an investigation to identify and eliminate sources of lead in the child's environment. Annual testing is recommended through age six, even with a normal initial test, when risk factors persist.

More information on lead risk exposures can be found at the following link: Lead Exposure: Steps to Protect Your Family

If you think that your child has been exposed to lead, talk with your pediatrician about getting a blood test to check for lead.

When Should My Child Learn to Swim?

Sun, 12 Mar 2017 16:58:00 GMT

When Should My Child Learn to Swim?

Children need to learn to swim. The AAP supports swimming lessons for most children 4 years and older, and for children 1 to 4 years of age who are ready to learn how to swim. Keep in mind that because children develop at different rates, each child will be ready to swim at her own time.

Some factors you may consider before starting swimming lessons for younger children include:

While some swim programs claim to teach water survival skills to children less than 12 months old, evidence does not show that they are effective in preventing drowning. Swim lessons do not provide “drown-proofing” for children of any age, so supervision and other layers of protection are necessary even for children who have learned swimming skills.

Our area has many indoor pools with zero-entry access that offer both structured lessons and playtime for practice at a variety of price points.

Diving Safety

Serious spinal cord injuries, permanent brain damage, and death can occur to swimmers who dive into shallow water or spring upward on the diving board and hit it on the way down.

Keep safe by following these simple common-sense diving rules.

For more information please see: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Swimming-Pool-Safety.aspx

Binky Baby

Sun, 05 Mar 2017 21:36:00 GMT

Binky Baby

What do I need to know before offering a pacifier?

If your baby wants to suck beyond what nursing or bottle-feeding provides, a pacifier may satisfy that need. Before offering a pacifier, keep the following tips in mind:

Offer a pacifier at nap time and bedtime. This helps to reduce the risk of sudden infant death syndrome (SIDS) up to 4 months of age.

If you are breastfeeding, wait until breastfeeding is well established prior to offering a pacifier.

Do not use a pacifier to replace or delay meals. Only offer it when you are sure your baby is not hungry.

Do not force your baby to take the pacifier if he doesn't want it.

Never tie a pacifier to your child's crib or around your child's neck or hand. This is very dangerous and could cause serious injury or even death.

Be prepared for night waking. If your child depends on a pacifier to fall asleep at night, he may wake up when the pacifier falls out.

What should I keep in mind when shopping for a pacifier?

Pacifiers come in different shapes and sizes. Try different kinds until you find the one your baby prefers.

Look for a 1-piece model that has a soft nipple (some models can break into 2 pieces).

The shield should be at least 1 1/2 inches across so a baby cannot put the entire pacifier into her mouth. Also, the shield should be made of firm plastic with air holes.

Make sure the pacifier is dishwasher-safe. Follow the instructions on the pacifier and boil it or run it through the dishwasher before your baby uses it. Be sure to squeeze the water out of the nipple with clean hands; otherwise, the hot water inside might burn your baby's mouth. Frequent washing to prevent germ transfer is recommended.

Buy some extras. Pacifiers have a way of getting lost or falling on the floor or street when you need them most.

Do not use the nipple from a baby bottle as a pacifier. If the baby sucks hard, the nipple may pop out of the ring and choke her.

Pacifiers fall apart over time. Some manufacturers have expiration dates for pacifiers. Do not keep pacifiers past that time. Inspect them every once in a while to see whether the rubber has changed color or has torn. If so, replace them.

Pacifiers are linked to increased ear infections after 6 months of age and can be more difficult to wean once your baby uses the pacifier to relieve teething discomfort. Plan on discontinuing pacifier use at 6 months of age.

For more information please see https://www.healthychildren.org/English/ages-stages/baby/crying-colic/Pages/Pacifiers-Satisfying-Your-Babys-Needs.aspx

When School is Out, Camp Is In

Sun, 26 Feb 2017 16:06:00 GMT

C hoosing a Summer Camp

Summer camps are a great way for children to learn new activities and social skills while fostering independence. There are no shortages of camps for children to attend over the summer months and it can often be daunting to choose a camp that is well suited for both the child and family. Below we have included some important considerations beyond cost and schedules when looking at your next summer camp.

History. While there are definitely great new camps that come out each year, a camp’s history can often provide you with good information on the camp’s operations. Reviews from previous campers and families might also be a great source of information when considering camps. Accreditation from national organizations such as the American Camp Association or a state licensing body is a good starting point in considering a summer activity.

Staff Training. It is important to consider if the camp allows appropriate numbers for a low campers-to-staffers ratio (about 10 to 1 for kids ages 8 to 14). The staff should be background-checked, too, with references, an interview, and a criminal-records search. It can be helpful to know the minimum age requirements for staff. It is also important to know if the staff is medically trained in things such as first aid and CPR.

Medical Care. How will the camp provide basic medical care if my child requires it? What types of medical care can and will they provide? Are they trained and certified in medical care? Are there any health restrictions for entering the camp such as lack of immunizations or head lice? If your child takes daily medications or requires a specialized diet or care it is important to know the camp’s policies for these medical issues.

Communication. How will the camp notify parents about pertinent events, as well as notifying them if a child becomes sick or injured? Also it can be important to consider if they have a consistent policy on camper phone/internet use. Encouraging your child to build new friendships at camp should be balanced with your child’s need to stay in touch with their familiar routine at home so many experienced camps will have guidelines on camper and family communication.

Please call our office if you have questions about your child’s readiness for camp or if your child needs a camp physical. We can often complete a camp form and immunization record from the information garnered at your child’s annual well visit and save you a trip!

Depression Screening

Sun, 19 Feb 2017 16:55:00 GMT

Depression Screening

Your child's mental health is very important to us. In 2015, an estimated 3 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. Recent surveys indicate that as many as one in five teens suffers from clinical depression. The recent pandemic has increased those numbers.

Depression is serious, and if left untreated, can worsen to the point of being life threatening. The U.S. Preventative Services Task Force recommends screening for depression from age 12 to 18 years. At our office, starting at age 12, a brief set of questions about common symptoms of depression will be asked at annual well exams. Our goal is that your child live the most healthy and happy life possible, mentally and physically. If you have any concerns or questions regarding your child or teen’s mental health, please call our office at (417) 882-1600.

Please go to the following link for more information: https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Childhood-Depression-What-Parents-Can-Do-To-Help.aspx

Parents: Using time outs correctly?

Sun, 05 Feb 2017 19:53:00 GMT

Parents: Using time outs correctly?

Research has shown that time outs are an effective way to manage misbehavior. If you find that you have tried time outs for your child without success, here are some tips that may help:

If you have behavior concerns and would like to make an appointment to speak with a provider, please call our office today at (417)882-1600.

http://www.aappublications.org/news/2017/01/24/TimeOut012417

Acne Tips

Tue, 24 Jan 2017 02:23:00 GMT

Acne Tips

Almost all teens get ‘zits’ at one time or another. Here are some things you can do to keep it under control.

Do’s and Don’ts of Acne Management

Over the counter treatment option:

If washing with a gentle cleanser twice daily is not controlling break outs, it may be time to trial an acne medication. Benzoyl peroxide wash, lotion, or gel—the most effective acne treatment you can get without a prescription. It helps kill bacteria in the skin, unplug oil ducts, and heal pimples. There are a lot of different brands and different strengths (2.25% up to 10%). The gel may dry out your skin and make it redder than the wash or lotion, so try the wash or lotion first.

How to use benzoyl peroxide

For more information or questions regarding acne management please call our office and make an appointment with one of our providers. https://www.healthychildren.org/English/ages-stages/teen/Pages/Teens-and-Acne.aspx

To Treat or Not to Treat the Flu?

Fri, 13 Jan 2017 11:33:00 GMT

To Treat or Not to Treat the Flu?

If your child is 5 years and older and does not have other health problems and gets flu-like symptoms, including a fever and/or cough, make sure your child gets plenty of rest and drinks enough fluids. Children should stay home from school until they are free of fever overnight. Antiviral drugs (such as Tamiflu) are sometimes used to treat influenza. Their benefits are limited. They must be started within 48 hours of when flu symptoms start. The American Academy of Pediatrics (AAP) does not recommend antiviral drugs for low-risk children with mild flu symptoms. The AAP does recommend antiviral drugs for most high-risk children and for children with severe symptoms (typically, those admitted to the hospital). A list of high-risk problems can be found at healthychildren.org or on the CDC website. Antivirals usually reduce the time your child is sick by just 1 to 1.5 days. They reduce the symptoms, but do not make them go away. Side effects are more likely in children and teens, including nausea and vomiting (most commonly reported), serious skin reactions, neuropsychiatric events (self-injury or delirium), vertigo, seizures, etc.

For more information click on the links listed below:

http://www.cdc.gov/flu/about/disease/high_risk.htm

https://www.healthychildren.org/English/tips-tools/Symptom-Checker/Pages/symptomviewer.aspx?symptom=Influenza+Exposure

Peanut allergy prevention

Fri, 06 Jan 2017 19:26:00 GMT

Peanut Allergy Prevention

New research is starting to provide us with clear, reliable data that can decrease your child's risk of developing food allergy. A report published in March 2015 recommended introducing high risk foods such as peanut butter and whole egg between 9 and 12 months of age. Now, a new report, supported by the American Academy of Pediatrics and the National Institute of Allergy and Infectious Diseases, recommends introducing peanut butter even earlier.

If your baby has severe eczema or egg allergy in the first four months of life, he should be tested for peanut allergy right away. If he has a negative test, he should received peanut butter between four and six months of age.

All other babies, especially those with mild to moderate eczema, should start peanut butter at six months of age.

When and how to introduce peanut butter safely will be discussed at your child's 4 or 6 month well child visit. Please call us if you have any questions.

Pre-Travel Appointment

Mon, 12 Dec 2016 19:16:00 GMT

To be well prepared for travel, consider the following questions prior to visiting the pediatrician:

For more information and for your own review prior to your child or teen’s pre-travel appointment, it is recommended to visit the following page at http://wwwnc.cdc.gov/travel .

Why is fiber so important?

Mon, 05 Dec 2016 13:56:00 GMT

WHY IS FIBER SO IMPORTANT?

Dietary fiber is mainly found in fruits, vegetables, whole grains, and legumes. Fiber is best known for its ability to prevent or relieve constipation. But foods containing fiber also provide other health benefits, such as reducing the risk of obesity, diabetes, heart disease, and certain types of cancer.

What is dietary fiber?

Dietary fiber, also known as roughage or bulk, includes the parts of plant foods your body can't digest or absorb. Unlike other food components, such as fats, proteins or carbohydrates — which your body breaks down and absorbs — fiber isn't digested by your body. Instead, it passes relatively intact through your stomach, small intestine and colon and out of your body. Fiber is commonly classified as soluble, which dissolves in water, or insoluble, which doesn't dissolve.

Soluble fiber. This type of fiber dissolves in water to form a gel-like material. It can help lower blood cholesterol and blood sugar levels. Soluble fiber is found in oats, peas, beans, apples, citrus fruits, carrots, barley and psyllium.
Insoluble fiber. This type of fiber promotes the movement of material through your digestive system and increases stool bulk, so it can be of benefit to those who struggle with constipation or irregular stools. Whole-wheat flour, wheat bran, nuts, beans and vegetables, such as cauliflower, green beans and potatoes, are good sources of insoluble fiber.

Most plant-based foods, such as oatmeal and beans, contain both soluble and insoluble fiber. However, the amount of each type varies in different plant foods. To receive the greatest health benefit, eat a wide variety of high-fiber foods.

How much dietary fiber does my child need?

There are different fiber recommendations for children based on energy needs, age, or weight.

Eat 5 . A simple way to make sure your children are getting enough fiber is by making healthful food choices. If your children are eating at least 5 servings of fruits and vegetables each day along with other foods that are good sources of fiber, there is really no need to count fiber grams.
Add 5 . If you find it helpful to keep track of numbers, add 5 to your children’s age. For example, a 5-year-old would need about 10 grams of fiber each day. Note: The total daily recommended amount of up to 25 grams for adults can be used as a general guideline for older children.
Nutrition Facts . Pay attention to the nutrition facts label on foods. Nutrition Facts can tell you all about the nutrients and ingredients in a food. Nutrition Facts can help you choose foods that provide the nutrition that’s right for you, including fiber. Dietary fiber is a nutrient listed under “Total Carbohydrate” on the Nutrition Facts. Excellent sources of fiber have 5 or more grams of fiber per serving. Good sources of fiber have at least 3 grams of fiber per serving.

https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Kids-Need-Fiber-Heres-Why-and-How.aspx

Tummy to Play

Fri, 25 Nov 2016 18:35:00 GMT

Why does my baby need Tummy Time?

Tummy time is an important factor in the motor development of infants. Starting from birth it is recommended to incorporate tummy time in the daily routine. Tummy time is an important factor in mastering basic milestones such as head lifting, turning over, sitting up and crawling. Tummy time can also prevent the back of your baby’s head from becoming flat (positional plagiocephaly).

What if my baby does not like Tummy Time?

Some babies may not like the tummy time position at first. Place yourself or a toy in reach for her to play with. Eventually your baby will enjoy tummy time and begin to enjoy play in this position.

How Much Tummy Time Should An Infant Have?

Starting at birth it is recommended to play and interact with the baby while they are awake and on the tummy 2 to 3 times each day for a short period of time (3-5 minutes). It is recommended to gradually increase tummy time in the first 3-4 months, working up to a total of an hour per day that is divided in shorter increments. A great time to do this is following a diaper change or when the baby wakes up from a nap.

As babies grow older and stronger they will need more time on their tummies to build their own strength.

Tummy time should always be supervised during the day, never leave your baby unattended during tummy time. If your baby falls asleep while on their tummy, flip them over to their back to sleep.

Remember…Back to Sleep, Tummy to Play

More information can be found at the following link: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Back-to-Sleep-Tummy-to-Play.aspx

Is It Strep Throat?

Fri, 09 Sep 2016 13:52:00 GMT

Is It Strep Throat?

Strep throat is a common infection seen in the childhood years and is caused by a bacteria called Streptococcus pyogenes. To some extent, the symptoms of strep throat depend on the child’s age. Infants with strep infections may have only a low fever and a thickened or bloody nasal discharge. Toddlers (ages one to three) also may have a thickened or bloody nasal discharge with a fever. Such children are usually quite cranky, have no appetite, and often have swollen glands in the neck. Sometimes toddlers will complain of tummy pain instead of a sore throat. Studies have shown that children under three years of age are less likely to get strep throat infections. Children over three years of age with strep are often more ill; they may have an extremely painful throat, fever over 102 degrees Fahrenheit (38.9 degrees Celsius), swollen glands in the neck, and pus on the tonsils.

Strep throat can be difficult to discern from viral illnesses that cause sore throats. If your child has a sore throat that persists (not one that goes away after her first drink in the morning), whether or not it is accompanied by fever, headache, stomachache, or extreme fatigue, you should call the office.

If your child is diagnosed with strep throat it is important to complete the antibiotics even if your child starts to get better, as failure to complete the antibiotics as prescribed can lead to complications of the strep infection. Generally your child is not considered contagious after they have been on antibiotics for 24 hours. To prevent re-infection it is important to disinfect or replace toothbrushes or other orthodontia once your child has been on antibiotics for 72 hours. More information on can be found by clinking at this link: strep throat .

Allergens Are Everywhere

Mon, 29 Aug 2016 13:05:00 GMT

Allergens Are Everywhere

For more information on allergies please visit the following link: https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Seasonal-Allergies-in-Children.aspx

Is this the Stomach Flu?

Wed, 17 Aug 2016 14:18:00 GMT

Is this the Stomach Flu?

Have you ever had the “stomach flu?” What you probably had was gastroenteritis – not a type of flu at all. Gastroenteritis is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is the second most common illness in the U.S. The cause is often a norovirus infection. It spreads through contaminated food or water, and contact with an infected person. The best prevention is frequent hand washing with warm soapy water, some viruses like norovirus can even survive hand sanitizer!

Symptoms of gastroenteritis include diarrhea, abdominal pain, vomiting, headache, fever and chills. Most people recover with no treatment.

Increased Risk for Dehydration

The most common problem with gastroenteritis is dehydration. This happens if you do not drink enough fluids to replace what you lose through vomiting and or diarrhea. Young children are especially susceptible to dehydration because they are less efficient at conserving water than older children and adults. In addition, small body size means that it takes less fluid loss to lead to dehydration. Please click on the following link for further information on how to prevent dehydration and care for a child ill with gastroenteritis: http://www.pediatricassociatesonline.com/home-care/ .

How long should your child be vomiting?

Remember that vomiting is a protection reaction of your child’s body to clear infection. Once a virus that causes gastroenteritis takes hold of a child, vomiting starts. Children tend to vomit more than adults. Part may be an easy gag reflex. With most viruses that cause the “stomach flu,” as the infection moves through the stomach and intestines, vomiting stops after about 24 hours. But not always. If you advance liquids too quickly or children eat more solids than they are ready for, even after the first meal 1 to 2 days into eating again, they may have a vomit encore. If you have one of those, start back where you started (sips of clear liquids) and go very slow advancing their diet. If vomiting is accelerating at 24 hours, it is time to check in with your child’s doctor.

When does your child need to see the doctor?

If your child is too sick to drink or listless, or shows signs of progressive dehydration such as dry mouth, fewer tears, or urinates less frequently, seek urgent medical attention. Contact your pediatrician immediately. For more information see https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Surviving-the-Stomach-Bug-Truths-Tips-for-Parents-.aspx .

Delayed Drowning

Thu, 04 Aug 2016 16:31:00 GMT

School is rapidly approaching, which means the summer is winding down. But there’s no better way to spend these last few weeks of this hot, summer weather than at the pool or lake with your family and friends!

Awareness of the risk for drowning and teaching your child to swim are keys to enjoying your time in the water. But, even after your children are done swimming for the day, it is imperative to monitor for delayed signs and symptoms of delayed drowning. Although rare, these both must be treated as medical emergencies.

What is delayed drowning?

Dry and Secondary drowning typically occur after a memorable event that day, such as coughing up water, prolonged submersion or the need for rescue. Each warrants a close watch of your child for further symptoms.

After a visit to the pool or lake, monitor your children for the following signs: vomiting, excessive coughing, sleepiness, mental status changes, irritability or changes in mood. Any of these could be a sign of delayed drowning. These symptoms necessitate a visit to the emergency room even if they occur the day after water time.

Please enjoy the rest of your water time this summer with your family and friends, and, don’t forget…always wear your sunscreen!

Please feel free to visit the below websites for more information:

http://childrensmd.org/browse-by-age-group/toddler-pre-school/dry-drowning-every-parent-needs-know/

http://www.parents.com/kids/safety/outdoor/dry-drowning/

Scott Miller

M.D. Candidate, Class of 2018

University of Missouri School of Medicine

Swimming Pool Safety

Mon, 25 Jul 2016 00:26:00 GMT

Swimming Pool Safety

What is the best way to keep my child safe around swimming pools?

An adult should actively watch children at all times while they are in a pool. For infants and toddlers, an adult should be in the water and within arm’s reach, providing “touch supervision.” For older children, an adult should be paying constant attention and free from distractions, like talking on the phone, socializing, tending household chores, or drinking alcohol. The supervising adult must know how to swim.

Pool Rules

If you have a pool, insist that the following rules are followed:

Pool Fences

Children can climb out a window, though a doggy door, or sneak out a door to get to the back yard and the pool. To prevent small children from entering the pool area on their own, there should be a fence that completely surrounds the pool or spa. Combined with the watchful eyes of an adult, a fence is the best way to protect your child and other children who may visit or live nearby.

Pool fences should also:

For more information please follow along to https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Swimming-Pool-Safety.aspx

Pharmacy Discounts

Sun, 17 Jul 2016 19:12:00 GMT

We have had several families stop taking their medications lately due to cost. Some medicines are just very new and expensive. Some are not new but the manufacturers have no competition to keep prices down. Did you know, for example, you can get your kindergartener's chewable fluoride tablets for $3 a month instead of a $30 co-pay?

The first step in managing this is to ask us about alternatives. The vast majority of our prescriptions are written so the pharmacist may substitute a less expensive but equivalent option. Sometimes we can change your child's prescription to another medication with similar effectiveness but perhaps different side effects that may not matter for your situation (for example, two asthma inhalers work the same but the cheaper one can make young children overactive).

Drug makers often offer direct discounts on their websites or through coupons. These often have conditions, however, so read the fine print. Some online resources can help you find the best price at local pharmacies, such as GoodRx http://www.goodrx.com Health insurance companies are working on similar online resources but nothing that works well in Springfield yet.

Some pharmacies have their own discount programs. In Springfield, a popular one is Walmart http://www.walmart.com (search under Health, Beauty and Pharmacy for $4 Prescriptions). Another option is to talk with your pharmacist directly; they may know of some other options to modify your prescriptions.

Charities such as Children's Miracle Network are one-time last resort options that we can help you with but the application process takes some time.

We want your child to get the medication he or she needs. Let us know if we can help in any way.

E-cigarette Health Risks

Tue, 12 Jul 2016 01:33:00 GMT

In the shadow of vast anti-smoking campaigns, e-cigarettes arose as a possible “healthy” alternative to traditional cigarette products. However youth-targeted advertising campaigns have resulted in very high rates of teenage e-cigarette usage at the same time as academic research is beginning to show negative health risks of e-cigarette use. Many parents and teens have questions about this product that will be answered here and in the attached links. Please ask your provider if you have further concerns.

What are E-cigarettes?

Electronic cigarettes, otherwise known as e-cigarettes, e-cigs, vaporizers or Electronic Nicotine Delivery Systems (ENDS), are battery-powered devices that mimic tobacco cigarettes. In place of burning tobacco, e-cigarettes use an atomizer that heats and vaporizes a cartridge of liquid into an inhaled aerosol. Developed as an alternative to traditional cigarettes, they have been around since the 1960s but did not gain prominence until around 2013, and marketing has been heavily targeting youth. There are no federal regulations against selling e-cigarettes to minors, however as of 2014, Missouri outlawed their sale to minors under 18. Despite this, teenage e-cigarette usage continues to rise.

A major misconception, among parents and adolescents alike, is that e-cigarettes replace tobacco with a harmless “water vapor”- in reality, the vapor contains no water. The liquid cartridge, called e-liquid or e-juice, contains propylene glycol, glycerin, flavorings, fine particulates (to produce opaque smoke) and other chemicals; it may or may not contain nicotine.

Courtesy of Wikipedia

So, are e-cigarettes safe for our teens to use?:

Health concerns :

E-cigarettes usually contain nicotine, an addictive neurotoxin that has been shown to harm developing brains. Analysis of off-the-shelf e-liquid cartridges, which are not regulated by the FDA, have shown a wide variance in nicotine concentration. Cartridges labeled having 24mg of nicotine had anywhere from 0.1-21mg, and those labeled nicotine-free had anywhere from 0-22mg. Thus even nicotine-free e-cigarettes can be harmful to adolescents.

The aerosol propylene glycol vapor, when heated, produces carcinogens like propylene oxide, formaldehyde and acetaldehyde. The vapor can irritate the eyes, throat and airways, and can cause particular respiratory difficulty in children with asthma. Additionally, analysis of the vapor showed presence of carcinogens like nitrosamine and heavy metals like nickel, chromium and lead. Though studies have not been done on long-term risk of e-cigarettes, the presence of known toxic compounds is concerning.

Poisoning risk :

Unique to e-cigarettes, the liquid nicotine can cause poisoning through swallowing, inhalation and skin contact. With the nicotine refills coming in vibrant colors and flavors like gummi bear and cotton candy, they are inherently attractive to children. As little as a teaspoon of a 1.8% solution of nicotine can be fatal to a 40lb child. The percentage of calls to US poison control centers involving traditional and e-cigarettes was 0.3% in September of 2010, but jumped to 42% in February of 2014, with over 3800 known exposures.

Cigarette/e-cigarette related exposure calls

Image courtesy of American Association of Poison Control Centers

Risk of injury :

There have been increasing reports of burn injuries from fires and explosions linked to the recharging mechanism in e-cigarettes batteries. Unlike your cell phone, the majority of e-cigarette batteries do not have mechanisms to prevent over-charging, resulting in battery overheating that can lead to fires and explosions.

E-cigarettes and youth:

Adolescent use of e-cigarettes has surpassed that of traditional cigarettes in 2014, with 8.7%, 16.2% and 17.1% of 8th, 10th and 12th-graders respectively using e-cigarettes nationwide. These percentages are often drastically higher than traditional cigarettes.

Recent studies have shown that e-cigarettes have become a gateway to traditional tobacco products. The aggressive marketing campaigns resulted in high adolescent use, and studies have suggested that youth who may otherwise have never smoked tobacco products are becoming addicted to nicotine by using e-cigarettes. Longer-term studies are still being conducted, but early results have suggested that use of e-cigarettes was more likely to result in progression to regular use of traditional cigarettes. Worse yet, adolescents who transitioned from e-cigarettes to traditional cigarettes had less success quitting compared to those who started with traditional cigarettes.

What can parents and caregivers do?:

For more information, please see the following links:

CDC http://www.cdc.gov/vitalsigns/ecigarette-ads/

New York Times http://nyti.ms/29s8dqx

Chris Weil

MS Candidate, Class of 2018

University of Missouri School of Medicine

Bassett, R, et al. “Nicotine Poisoning in an Infant,” New England Journal of Medicine, May 8, 2014. Http:/www.nejm.org/doi/pdf/10.1056/NEJMc1403843

Sogian S, et al. Nicotine’s toxicologic emergencies. 9 ^th ed New York: McGraw-Hill, 2011: 1185-9.

Mayer B. “How much nicotine kills a human? Tracing back generally accepted lethal dose to dubious self-experiments in the nineteenth century.” Arch Toxicol 2014; 88:5-7.

US Department of Health & Human Services. The health consequences of smoking – 50 years of progress: A report of the Surgeon General, in Atlanta GA: US Department of Health and Human Services, Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014.

Abreu-Villaca Y, et al. Nicotine is a neurotoxin in the adolescent brain: Critical periods, patterns of exposure, regional selectivity and dose thresholds for macromolecular alterations. Brain research, 2003. 979(1-2): 114-28.

Dutra LM and Galantz SA. Electronic cigarettes and conventional cigarette use among US adolescents: A cross-sectional study. JAMA Pediatr, 2014.

Miech RA, et al. E-cigarettes surpass tobacco cigarettes among teens, in National Press release. 2014. University of Michigan News Service; Ann Arbor MI.

Farsalinos K, et al. “Evaluation of electronic cigarette liquids and vapour for the presence of selected inhalation toxins.” Nicotine and Tobacco Research, August 2014.

Trehy M, et al. “Analysis of electronic cigarette cartridges, refill solutions and smoke for nicotine and nicotine-related impurities.” Journal of Liquid Chromatography and Related Technologies, 34:1442-1458, 2011.

Protect your Family from Sunburns

Mon, 04 Jul 2016 15:27:00 GMT

Simple Rules to Protect your Family from Sunburns from the American Academy of Pediatrics (AAP)

Sunscreen

Sunscreen can help protect the skin from sunburn and some skin cancers but only if used correctly. Keep in mind that sunscreen should be used for sun protection, not as a reason to stay in the sun longer.

How to Pick Sunscreen

How to Apply Sunscreen

Sunscreen for Babies

For more information see https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Sun-Safety.aspx

Firework Safety

Thu, 23 Jun 2016 17:48:00 GMT

One of the many joys of summer is the magnificent wonder of fireworks. However, if not handled properly, fireworks can cause serious injury. Fireworks have led to thousands of emergency room visits in recent years; more than half were in children.

The best way to prevent harm to your family is to avoid using fireworks at home altogether. Enjoying public fireworks displays is a fun and safe way to enjoy the spectacle of fireworks. However, if you plan to use fireworks, following these tips can minimize the risk for you and your family.

Common sense can keep us happy and healthy on the Fourth. For more info, check out the following links:

http://www.kidshealth.org/en/parents/fireworks.html

http://www.safekids.org/tip/fireworks-safety-tips?/gclid=CJnF2-Pbuc0CFQIOaQod8DkOdA

https://www.healthychildren.org/English/safety-prevention/all-around/Pages/Keeping-Safe-From-Burns.aspx

Devin St. Clair

M.D. Candidate, Class of 2018

University of Missouri School of Medicine

Baby Blues

Mon, 30 May 2016 23:49:00 GMT

Perinatal depression and anxiety are common problems that we can help solve. Your nurse will ask about symptoms at each check-up during the first year of your baby’s life to ensure you have an opportunity to talk over any concerns with us. This link provides more information http://www.thebluedotproject.org

How to Beat Summer Boredom

Thu, 05 May 2016 17:51:00 GMT

How to Beat Summer Boredom

Summer break is quickly approaching for the school aged child. Perhaps you find yourself dreading coming up with ideas to keep your child or children busy during the summer hours. Although it is impossible to keep a child entertained at all times, here are some ideas to avoid summer boredom in your family:

Visit a local zoo, or if feeling adventurous, a zoo further away in a bigger city. Sometimes zoo classes or activities are available if you check the site's specific calendar.
Visit a local botanical garden or public park, perhaps bring a kite or a frisbee for a fun game and exercise. Don't forget your water bottles and sunscreen!
Check out the local library for summer reading programs which often offer reading rewards if reaching goals. Remember it is important to keep your child reading over the summer to build on their skills.
Swimming on a hot day at a public pool or water park is a great way to beat the heat. You could also just attach a sprinkler in your yard to play in. A local waterway could also be an exciting adventure for the family.
Going on a nature walk or hiking is an option at several locations around Springfield. Making your own scavenger hunt to do on the walk could be an enjoyable experience.
Crafting at home on a rainy day has endless options, you can find fun ideas on the internet on multiple different web sites.
A baking day could be an enjoyable and tasty way for your child to learn about measurements and helping in the kitchen.
You could try building your own tent out of blankets inside or plan an actual camping trip with the family, maybe even in your back yard. Insect repellent may be necessary.
Other options include: summer school, summer camp, church camp, martial arts, summer dance or theater programs, horseback riding, pottery classes, skating, golf, etc.

Sit down and make a calendar with your family so they know what's coming. It's always fun to have something to look forward to as a child. Check the internet for other local ideas and discounted rates for local attractions. Summer activities are a great way to make memories with your family.

April is National Autism Awareness Month

Wed, 27 Apr 2016 18:46:00 GMT

April is National Autism Awareness Month

Screening your baby for signs of developmental or communication challenges like autism spectrum disorder (ASD) begins at their very first well-child visit. Your pediatrician observes how your baby giggles, looks to you for reassurance, tries to regain your attention during a conversation, points or waves, responds to his or her name, and cries throughout the first few years of life.

Those observations in combination with family history, health examinations, and parental perspectives remain extremely valuable in helping identify children at risk for ASD.

Formalized Autism Screening Recommended at the 18- and 24-Month Well-Child Visits:

The American Academy of Pediatrics (AAP) recommends screening all children for autism at the 18 and 24-month well-child visits in addition to regular developmental surveillance. This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as well as those with other developmental difficulties. For screening to be most effective, it must be applied to all children – not only those with symptoms.

Modified Checklist for Autism in Toddlers (M-CHAT): The M-CHAT, a 23-point questionnaire is filled out by parents at 18 and 24 month well visits. Most families find it easy to fill out. Using this standardized screening, pediatricians can pick up children at risk for ASD and will be prompted to start conversations about language delay, concerns about behavior, or possible next steps for a child at risk with additional genetic, neurologic, or developmental testing.

Screening Isn’t Diagnosing!

It’s important to note that screening isn’t diagnosing. If your child has a positive screen for an ASD, it doesn’t mean he or she will be diagnosed on the spectrum. And further, if your child screens normally but you continue to worry about ASD, don’t be shy. Screening tests are just that—screening—and don’t identify all children with ASD. The rate of success for the M-CHAT, for example, isn’t 100%, so it is used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the most importance. Please mention any concerns at your child's well visit. Call (417) 882-1600 to schedule.

Is Your Child Ready for Kindergarten Registration?

Thu, 07 Apr 2016 14:49:00 GMT

Is Your Child Ready for Kindergarten Registration?

Spring is a time that many schools begin registering incoming kindergarten students for the new school year. A well child visit before registration is recommended. At this visit, your provider will discuss the various issues related to this important transition.

Immunizations

Immunization boosters are commonly given at 4 to 5 years of age. These can be a source of anxiety for parent and child; we encourage you to make this visit a special occasion with some one-on-one time for you and your child. When you register your child for kindergarten, you will be asked for his immunization record. We can print a copy at your appointment.

Visiting the Doctor

The well exam is an important time to discuss health, development, and behavior concerns with your provider. The transition to school can be stressful for some families; your provider can discuss strategies to ensure a successful transition.

For children with special health needs, this is an important time to discuss any medications or allergies that might affect the child during the school day. Many schools request copies of asthma action plans and allergy plans or have their own forms. Updating this paperwork may take extra time so please mention them when you schedule.

Call (417) 882-1600 to schedule a well or nurse visit.

When to Suspect an Allergy

Sun, 28 Feb 2016 14:41:00 GMT

When to Suspect an Allergy

How can you tell if your child’s symptoms are allergy related? Some patients are able to easily identify allergy symptoms, but for some patients their allergy symptoms are more subtle and can be difficult to pinpoint. This is particularly true for smaller children in which frequent colds can make it difficult to discern underlying allergy symptoms.

Here are some common findings that could lead you to suspect your child may have an allergy.

For more information on allergies please visit the following link: https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Seasonal-Allergies-in-Children.aspx

Coughing: Safe Home Remedies

Tue, 16 Feb 2016 13:30:00 GMT

Coughing: Safe Home Remedies

Coughing can be aggravating to you and your child. When your child develops a cough it is generally caused by a viral infection, also referred to as a cold. When infected by a virus, the airway lining makes mucus to help fight the virus. Coughing clears this mucus from the lower airway. How do you best treat a cough due to the common cold?

Over-the-counter (OTC) cough suppressants and cold medicines can cause serious side effects in young children. In 2008 the Food and Drug Administration (FDA) recommended that OTC cough and cold medicines never be used in those younger than 4 years. Cough medications with codeine or dextromethorphan have been proved ineffective, unsafe and can be abused to get high. They are not recommended.

Home remedies for coughs and colds can be safe, inexpensive, and as helpful as OTC medicines. They are also convenient. Here are some examples of home remedies:

Call the office for an appointment if you feel your child has more than the typical ten days of congestion and cough (e.g. persistent cough more than 14 days; ear pain; persistent nasal discharge more than 14 days; fever more than four days; vomiting and stomach ache with cough; excessively sleepy or cranky) For more information on the information above, click on the following link: https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Coughs-and-Colds-Medicines-or-Home-Remedies.aspx .

My child seems to get a lot of colds, is this normal?

Sat, 30 Jan 2016 12:08:00 GMT

My child seems to get a lot of colds, is this normal?

Colds are common viral infections of the upper respiratory tract and occur quite frequently in younger children. In the first two years of life alone, most small children average 6 to 8 colds per year. If your child is in child care, or they are frequently around other children they may have even more, since colds spread easily among children who are in close contact with one another. Colds can be spread directly through coughing or sneezing, or indirectly through contaminated hands or surfaces. Most colds go away by themselves and do not lead to anything worse. For more information on colds and prevention please visit: https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Children-and-Colds.aspx

September is Childhood Obesity Month

Thu, 10 Sep 2015 01:44:00 GMT

Did you know over the past 30 years, childhood obesity has become twice as common in children and four times more common in teens? In 2012, one in three children and teens were overweight or obese. Obesity increases risks for heart disease, type 2 diabetes, stroke, cancer and arthritis. A shorter lifespan and poorer quality of life are associated with childhood obesity. It is now a national health emergency.

Parents can help. Your child's health is impacted his whole life by the foods you offer even from infancy. Parents who model healthy choices such as eating well and staying active are more likely to have children who do the same. This link provides practical tips and ideas to improve your family's health.