Author: sspcobb

Springtime Allergy Remedies

Does your child suffer from spring time allergy symptoms like nasal congestion, runny nose, or watery eyes? We are often asked when the best time to start your child’ allergy medications.

The best time for you to start your daily antihistamine like Claritin, Zyrtec, and Allegra is before the pollen counts are high to help prevent some of these symptoms. Often antihistamines take up to one to two weeks to build up in your body to reduce the histamine levels and provide relief. Starting these medications earlier might help reduce the severity of your child’s allergy symptoms when the pollen counts are at their highest.
The best time of day to take your antihistamine and nasal sprays is in the evening because usually pollen counts are at the highest in the early morning hours.

If nasal congestion, runny nose or a post nasal drip cough are your child’s symptom a nasal steroid or nasal antihistamine might give your child some relief. Nasacort and Flonase are now over the counter but please call us if you have questions about dosing. The nasal antihistamines are prescriptions. Often using these nose spray at night will also help reduce your child’s allergy symptoms.

If watery itchy eyes are your child’s main symptom there are over the counter allergy eye drops like Zaditor 1 drop twice a day, Opcon A 1 drop 4 times a day, Visine allergy 1 drop twice a day, and Alaway 1 drop twice a day.

The Weather Channel app and other weather app have pollen counts for the day that you view from your smart phone. For your convenience, we also have a link to the daily pollen count on our website in the upper right hand corner. Another great website for allergy information is the Asthma and Allergy Foundation of America http://www.aafa.org/

If your child’s allergy symptoms are not improving or if your child is running a fever please make an appointment to see one of us.

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Love Dr. Kim! One of the most genuine and thorough doctors I know. I have absolute trust in him when it comes to my children's health.
- Elizabeth Q.

The entire staff is just awesome, kind, honest, helpful. It is always a great experience even with sick kiddos!
- Marlo M.

Wonderful practice, wonderful providers, wonderful office staff! Knowledgeable, loving, and kind!
- Vanessa M.

Acne

If you’ve ever worried about acne, you’re definitely not alone – many teens are concerned with keeping their skin clear. But with entire aisles of skin care products to pick from, it can be difficult to figure out what works best for your skin, and how to manage breakouts.

Our bodies do a lot of great things for us that we don’t even think about – including keeping our skin moisturized by releasing oils from thousands of hair follicles. During your teen years, your body naturally produces more oils when your hormones change. Sometimes your hair follicles get blocked with oil and dead skin, forming acne – usually white heads and black heads. These blocked follicles can also trap bacteria under the skin, and make acne red and inflamed.

A lot of people think the foods they eat make their skin break out. The truth is, eating pizza or chocolate or drinking sodas has no effect on your acne (though staying well hydrated may help!).

Things that do make your acne worse include:

  • Picking or squeezing breakouts – this can push dirt and bacteria deeper into the skin!
  • Scrubbing skin too hard or too often
  • Leaving makeup on overnight
  • Not washing your face after sports
  • Caps, helmets and clothes that are too tight against the skin
  • Using skin products (lotions, hair products or makeup) that are greasy
    • Try noncomedogenic products (these won’t irritate acne!)
  • Stress!

A good skin care routine followed for 4-6 weeks or longer is the best treatment. Your skin care products don’t have to cost you a fortune either.
For mild to moderate acne (think the occasional breakout, or some white and black heads) look for products available over the counter that contain either:

Benzoyl peroxide
Body wash with benzoyl peroxide are good for acne on the chest or back. Ointments or creams are useful for “spot” treatments for occasional breakouts

Salicylic acid
Typically this is an “active ingredient” in face wash, but is also available in creams and ointments.

Both products can be drying, especially if used daily! Use ointments or creams sparingly, and make sure to moisturize your face with a noncomedogenic lotion with SPF 15.

Prescription ointments and antibiotics are sometimes needed for persistent or severe acne. Antibiotic ointments and washes can help treat bacteria that is trapped in the skin, making acne red and inflamed, or that has formed a cyst (a bump under the skin).

If you’re concerned about acne, know you’re not alone! When your skin isn’t looking its best, it can be hard for you to feel your best. If over-the-counter products aren’t working, make an appointment – we’ll help you find a routine that works best for your skin.

How Much Sleep Do I Need?

Teens need 8-10 hours of sleep every night. Some teenagers get 6 or 7 hours, or less, during the school week, stay up late on weekends, and “catch up” by sleeping in late. Many teens say it’s hard to fall asleep at night, that they don’t feel tired until very late in the evening, but feel sluggish and sleepy in the morning at school.

Believe it or not, this is natural and happens for a reason! During your teen years, your body does a few things differently.

1. Melatonin (a hormone in your body that helps regulate sleep) is released later in the day
2. Your body is very sensitive to evening light and blue light (the kind of light from a tv, computer, or phone screen).

While it’s natural for your body to feel awake later in your teen years then when you were young, staying up late watching a TV show, playing computer or video games, or texting on a phone keeps your body and brain awake even longer.

So you got 4 or 5 hours of sleep Thursday because you crammed for a test, and then you slept 10 hours on Saturday – you caught up, right? Wrong! You’ve built up a sleep debt ¬– literally sleep your body owes itself – and this is next to impossible to make up. You’ve lost hours of sleep, but you’ve also lost REM sleep, or rapid eye movement sleep. This part of sleeping restores your body and brain, and only happens in the early morning hours before you wake. When you only sleep 5 or 6 hours, your body never gets the opportunity for restorative REM sleep.

This lack of REM sleep makes you more than just sleepy the next day, too. When you don’t get enough sleep, you’re more likely to have problems with:

– Daytime sleepiness or fatigue (like falling asleep in first period)
– Memory and academic performance
– Anxiety and sadness
– Decreased ability to recognize social cues with friends and family
– Decreased physical ability
– Weight gain
– Increased blood pressure

So what can you do to help yourself sleep better?

– Avoid caffeinated beverages, especially after noon
– Go to bed at the same time every day – even on weekends!
– Turn off and put away all electronics (phones included) at least an hour before bedtime
– Make your room sleep friendly – dark, quiet, and cool (68 degrees is the optimum temperature for your body to sleep)

If you have trouble falling asleep, try doing something relaxing – reading, or listening to quiet music, or even having warm tea or milk all help relax your brain.

Sometimes sleep problems are bigger than putting away screens and having healthy sleep habits. If your family tells you that you snore, if you feel the need to move a lot as your falling asleep at night, or if a family member has a history of a sleep disorder, it’s a good idea to come in for an appointment.

Introducing the Healthy Lifestyles Clinic at Stepping Stone Pediatrics…. Where Small Changes Lead to Huge Impacts (Part 2)

Jim Rohn, American entrepreneur and motivational speaker, said, “You must take personal responsibility. You cannot change the circumstances, the seasons, or the wind, but you can change yourself. That is something you have charge of.” This has been a philosophy of the Healthy Lifestyles Clinic since its beginning. Tanya Wilcox, CPNP, the Director of the Healthy Lifestyles Clinic at Stepping Stone Pediatrics, works with families to help them identify and make simple changes in their lifestyle that will lead to huge impacts later in life and the improved health of their family.

Change is a scary idea for kids and adults. On the other hand, it is important to be sensitive to each family’s personal circumstances. It is generally more effective for families not to make huge changes all at once, but to help them identify small changes that can be easily addressed by setting mutually-agreed upon goals. In the Healthy Lifestyles Clinic, Tanya strives to help families understand that these goals – which lead to change – should be small and easily attainable. This is important because once a child begins to achieve those goals, he/she feels successful. This is the fuel that builds momentum to keep going and propels continued change. Nothing succeeds like success!

A perfect example of this is the “drink discussion.” There is a great deal of research out there today that supports the slogan “Rethink Your Drink”. Let’s say that a 10-year old child drinks 2-3 cups of skim milk, 2-4 cups of water, and one sweet tea or sprite daily. Sounds pretty harmless and actually like a healthy balance, right? Take into account that the one sugary drink that is being consumed daily has, (on average) 130 calories. Still doesn’t sound like too many calories? Maybe not, on a daily basis, but I would recommend cutting out 3 of those sugary drinks per week to see what that does to the calorie count. This would cut total calorie consumption at the end of the week by 390 calories. Still doesn’t sound like a lot? Well, if that family continued to cut out 3 sugary drinks per week, at the end of the month they’ve decreased the monthly calorie count by 1560 calories. At the end of the year, continuing this small change, this family has shaved off 18,720 calories. Now consider that it requires a 3500 calorie deficit to lose one pound of body weight. By cutting out a single sugary drink 3 days out of the week for one year, this family has prevented a 5 pound weight gain at the end of the year. That’s 20 pounds off the course of a 4 year high school career! Small changes can lead to huge impacts over time!!!

Developmental Screening

Your child’s growth is much more than simply physical. Starting at birth, children learn throughout their lifetimes. As your child develops, they’re supposed to achieve developmental milestones, such as smiling and waving “bye-bye” for the first time. Developmental delays are when your child fails to reach a developmental milestone at the same time as other children the same age. However, developmental screening is designed to help identify developmental delays and administer solutions.

What Is Developmental Screening?

Developmental screening can be used to determine if your child is learning the basic skills they should. The goal is to see how the child moves, behaves, speaks, learns, and plays. If the developmental screening suggests there might be a problem, your provider will discuss your child’s development with you and make any appropriate referrals, if necessary.

How Often Should Developmental Screening Be Conducted?

The American Academy of Pediatrics suggest all kids have developmental screening to detect early delays and disabilities. Some basic questions will be asked at every Well Child Check, but more intense screening will occur at:

  • Nine months
  • 18 months
  • Two years or 30 months

If the child is at high risk for developmental problems caused by low birthweight, preterm birth, or other factors, extra screening may be needed.

Why Is Developmental Screening Important?

A large number of children with developmental delays are not identified as early as possible. When a developmental delay is not recognized early, your child may have to wait to get the help they need. These delays could make it very difficult for your child to learn when they actually start school.

In the United States, 17% of children suffer from some degree of developmental or behavioral disabilities, including delays in speech or other areas. Unfortunately, less than 50% of these children with developmental problems are actually identified before they start school. Our goal is to make sure any developmental issues are identified early so that any problems can be addressed as soon as possible.

How Can I Help My Child’s Development?

Rest, proper nutrition, and exercise are vital for your child’s health and development. It’s important to spend time playing, reading, singing, and simply talking to your child. All of these activities are extremely important to your child’s development. However, it’s also imperative to have developmental screening at Stepping Stone Pediatrics. Developmental screening will help detect abnormalities earlier and help you work toward a solution.

ADHD Consultation

Most people know at least one child who is unable to sit still and can never seem to follow instructions or listen. While these children may be labeled as undisciplined, lazy, or even troublemakers, this isn’t always the case.

ADHD affects a significant number of children in the United States.  It can show up in a variety of ways and the effects of this disorder are often associated with negative consequences.

What Is ADHD?

Attention Deficit/Hyperactivity Disorder (ADHD) is a relatively broad term and can range from child to child.  According to the Centers for Disease Control and Prevention, there are approximately 6.4 million children diagnosed with ADHD in the United States. Children with ADHD may have trouble completing tasks at school or at home, trouble sitting still, and following directions.

Unfortunately, while a number of screening tools have been developed that are useful in helping to identify the condition, there is no definitive test for ADHD.  This can make ADHD very tricky to recognize.  The same symptoms caused by ADHD can also be caused by a number of other conditions.  It takes time and judgement to avoid erroneously labeling patients as “ADHD” when in fact there is something else going on.  Should such a misdiagnosis occur, the treatment plan may target the wrong condition, masking the true problem until much later in life when it will almost certainly be more difficult to address.

Helping Your Child with ADHD

Left untreated, ADHD can cause significant problems. It may cause your child to have difficulty controlling themselves or focusing. They may also find it harder to get along with other students and make friends. These difficulties can transcend the classroom and result in low self-esteem as well as stress and friction for the entire family. However, treatment can make a significant difference in the symptoms your child experiences.

Interested in Scheduling an ADHD Consultation with Stepping Stone Pediatrics?

If your child has been displaying symptoms that mirror ADHD, Dr. Kim and his experienced medical team at Stepping Stone Pediatrics can assist in addressing your child’s symptoms of impulsivity, hyperactivity, and inattention and help identify whether your child has ADHD.

We will work to create a personalized treatment plan that meets the individual needs of your child with careful attention paid to other possible diagnoses that may be contributing factors. Our treatment plans include parental education and training, behavioral therapy, social support, assistance at school and possibly medication. We recognize that virtually no parent is excited about starting their child on medication for these symptoms and place a high priority on working collaboratively with you to define a treatment plan that all are comfortable with.

You can schedule a consultation to discuss concerns about ADHD and your child by simply calling for an appointment.   Let the scheduler know that you are requesting an “Initial ADHD Consult” and she will be happy to assist you.  Please note that we ask that the child NOT be present for the first consultation.  This is important to insure the ability to conduct a frank and candid conversation.

Allergy & Asthma: An Overview

Air is filled with dust, pollen, and several other pollutants. While the majority of adults and children may be unaffected, these contaminants can make life miserable for children with asthma and allergies. Allergies and asthma are by far the most common chronic diseases among children in the United States. Continue reading to learn more about these conditions and how you can help your child live a healthier and more active life.

What Are Allergies?

Allergies are reactions caused by an overactive immune system. Allergic reactions can happen anywhere in your body, such eczema (skin) or asthma (lungs). Your immune system is responsible for protecting your body against diseases by actively searching out and destroying foreign substances, such as bacteria and viruses. When your child has an allergic reaction, their immune system has overreacted and has sprung into action against a typically harmless substance, such as animal dander or pollen. The substance that causes the allergic reaction is called an allergen.

Common Signs of Allergy

Allergies can cause a wide array of conditions. While some are relatively easy to spot, others are more subtle and may be masked as something else. Some of the most common clues your child may have an allergy are:

  • Formation of hives or welts
  • Patches of itchy or bumpy red skin that will not subside (Eczema)
  • Itchy, runny eyes
  • Nausea, diarrhea, or vomiting
  • Intestinal discomfort and cramps
  • Drippy nose, sneezing, snorting, sniffling, and nose rubbing
  • Scratchy or itchy sensation in the throat and mouth
  • Hacking dry cough or a cough that produces clear mucus
  • Wheezing or feeling of chest tightness
  • Shortness of breath and rapid breathing

However, there are several other potential symptoms. If you believe your child has an allergy to a particular substance, it’s best to speak to an experienced pediatrician at Stepping Stone.

What is Asthma?

Asthma is a chronic condition originating in the lungs that affects more than 6.25 million children under the age of 18. Asthma can appear at any age, but the majority of children develop symptoms by the time they are four or five years of age. When asthma is properly managed with environmental measures and medications, most flair ups or asthma attacks can be prevented.

What Happens During an Asthma Attack

During an asthma attack, your child may feel chest tightness and began coughing as they breath. The child may begin to wheeze, breath fast, and become fearful. If the child doesn’t know to manage their symptoms and live with an asthma attack, it can be frightening.

Recognizing Asthma

In many cases, your child may exhibit early warning signs, such as eczema in their early months. They may also exhibit problems with their lower respiratory system before their first birthday. The key to managing asthma is to recognize the warning signs. This chronic condition can masquerade as a chronic cough, recurrent bronchitis, lower respiratory infections, or recurrent pneumonia for several years before it is properly diagnosed. It’s important to speak to your pediatrician if you notice your child:

  1. Is short of breath often;
  2. Coughs regularly after exertion or at night;
  3. Complains of a tight feeling in their chest

How Are Asthma and Allergies Related?

Although allergies can trigger an asthma attack, they are two very different things. Allergies are reactions in the immune system that may affect several organs, but asthma is a chronic condition originating in the lungs. In addition to a long list of allergens, several circumstances and substances can trigger an asthma attack:

  • Viral infections
  • Exercise
  • Cold air
  • Tobacco smoke
  • Noxious fumes
  • Air pollution

Approximately 80% of children with asthma also have allergies. While allergies may trigger asthma attacks, many of the most severe asthmatic attacks are caused by the cold virus.

Schedule an Appointment for Asthma and Allergy Management at Stepping Stone Pediatrics

For asthma and allergy symptoms, the sooner the condition is identified, the sooner treatment can provide relief so it’s important for a diagnosis to be made as early as possible. Schedule an appointment with Stepping Stone Pediatrics for comprehensive asthma and allergy management solutions.

Newborn FAQs

Bringing your newborn baby home is an exciting experience, but can be confusing and overwhelming. As a new parent, you may have countless questions, and the following information answers some of the FAQs about feeding, bathing, and the sleeping habits of newborn babies.

Feeding the Newborn Baby

Should I breastfeed my newborn baby?

While breastfeeding is a hugely personal decision, it may offer you and your child several benefits, such as:

  • Bolstering postpartum weight loss.
  • Giving the child antibodies to fight infection and diseases.
  • Providing essential fatty acids and nutrients.

How often should I feed my baby?

Newborn babies should be fed every two to three hours. Simply put, if the baby is hungry let him nurse, even if they ate an hour ago. Pay attention to the following signs to make sure you baby is getting enough to eat:

  • Baby should spend 10 to 15 minutes on each breast or drink two to three ounces of formula.
  • The child starts gaining weight during the second week.

If you are concerned whether your baby is growing or eating enough, consult with your pediatrician.

Is it normal for my baby to spit up?

It’s completely normal for newborn babies to spit up after being fed. However, if you feel as if something is wrong or if the baby spits up more often, speak to your pediatrician at Stepping Stone Pediatrics immediately.

Bathing Your Newborn Baby

How should I care for my child’s umbilical cord?

According to the American Academy of Pediatrics (AAP), it’s best to keep the umbilical cord dry and clean. When it starts to fall off or crust off, keep it clean by using a small amount of rubbing alcohol a couple times of day. The cord should fall off between one and two weeks. However, if you notice a foul odor or significant redness, contact the team at Stepping Stone Pediatrics immediately.

Should I bathe my newborn baby each day?

No, you shouldn’t bathe your newborn baby every day. As a matter of fact, many babies suffer from dry skin and get rashes from too many baths. Until the child’s umbilical-cord stump falls off, you should wash your baby with a soft sponge instead of placing the baby in a tub. Even after the umbilical-cord has healed, you should only bathe the baby once or twice a week. After a few months, daily baths are okay, but make sure you moisturize the child’s skin.

If my baby’s skin is yellow, is it serious?

Jaundice is a relatively common problem for newborns, but it’s commonly confused with carotenemia. Carotenemia is harmless and the result of your child eating a lot of food with beta-carotene, such as carrots, sweet potatoes, and even chicken. The easiest way to tell the difference between jaundice and carotenemia is by checking the whites of your child’s eyes. With jaundice, their eyes will also look yellow. If your child’s skin is yellow, they’re not feeding well, they’re losing weight, and not sleeping well, it’s imperative to consult with your pediatrician at Stepping Stone Pediatrics immediately.

Newborn Sleeping Habits

How much should my newborn baby sleep?

During the first three months, newborn babies may sleep up to 16 hours each day. They will typically wake every two to three hours to be changed or fed. After the baby reaches six months, they may sleep up to six to seven hours each night. The number of consecutive sleep hours will continue to increase as they age.

Should I wake my sleeping baby to feed?

With newborns that are less than six pounds at birth, you may want to wake your baby every three hours to feed. Contrary to popular believe, not every baby will let you know when they are hungry, especially during the first few weeks of life. If your baby is larger and has several feedings during the day, he or she may be able to sleep through the night without waking up for feedings.

Should I place my baby on their back to sleep?

All healthy newborns should be placed on their back to sleep. Babies should be placed on a firm mattress in a safe environment. it’s best to avoid heavy blankets, stuffed animals, and pillows. When the baby reaches about five months, they may learn to roll over. At this point, you shouldn’t have to worry about flipping the child onto their back in the middle of the night. Even so, you should still take SIDS precautions.

Contact Stepping Stone Pediatrics for an Appointment

One of the best things you can do for your newborn is create a relationship with a pediatrician. Your baby’s pediatrician will get to know your baby and be better prepared to know when something’s awry.

Immunization

When children are born, they naturally inherit certain antibodies from their mother through the placenta. These antibodies will protect the child from certain diseases. After birth, breastfeeding provides additional antibodies through breast milk. However, these antibodies are only temporary. Vaccines (i.e., immunizations) are one of the best ways to protect your child from many dangerous diseases.

Benefits of Vaccinating

Immunization boosts your child’s immunity to specific diseases by using tiny amounts of killed or weakened versions of the disease-causing microorganism. Regardless of whether the disease-causing microorganism is a bacteria or virus, the vaccine causes the child’s immune system to react as if there was a real infection. The child’s immune system then remembers the organism. If the organism ever enters your child’s body at a later date, the immune system will remember how to fight it.

Different Types of Vaccines

A few of the most common types of vaccines include:

  • Weakened or attenuated live viruses are used in certain vaccines, such as in the measles, mumps, rubella vaccine (MMR).
  • Toxoid vaccines have an inactivated toxin created by the bacterium. For instance, tetanus and diphtheria, found in the DTaP combination vaccine, are toxoid vaccines.
  • Inactivated or killed bacteria or viruses are commonly used in certain immunizations, such as the polio vaccine (IPV).
  • Conjugate vaccines include certain parts of bacteria combined with proteins. An example of a conjugate vaccine is the Hib, which has virtually eliminated what used to be the most common cause of childhood meningitis in this country.

Instead of getting a single vaccine, the American Academy of Pediatrics (AAP) suggests your child get combination vaccines whenever they are appropriate and available. This minimizes the number of shots your child receives.

Vaccine and Immunization Concerns

The medical staff at Stepping Stone Pediatrics firmly believe that the routine preschool vaccinations that have been standard for decades are safe and effective.  In fact, Dr. Kim considers vaccination to be one of the three greatest medical advances in history (alongside anesthesia and antibiotics).  However, we recognize that many parents have serious concerns about vaccine safety or even vaccine effectiveness. Conflicting and highly technical information from various sources makes it a confusing and anxiety-inducing decision for many.

It’s easy to feel lost trying to interpret scientific jargon.  Most parents do not feel comfortable, for example, interpreting the differences between a “case-control” study and a “cohort” study.  Our job is to earn your trust so you will feel comfortable with our advice, and the way to earn that trust is through communication.  At Stepping Stone Pediatrics, we want parents to feel comfortable asking questions so they can get answers well before having to make decisions regarding vaccinations.  We firmly believe that the more informed parents are, the more likely it is that they will agree that vaccination is the best option for their child.  Experience has shown this to be true.

Recommended Vaccines and Immunizations

You can see a typical schedule for Well Child visits and what vaccines are commonly given at each visit here.  This schedule conforms to recommendations by the CDC.

Well Child Checkup

Childhood is a time for rapid change and growth. It’s important to have regularly scheduled visits and checkups (“Well Child Checks). Well Child Checks begin shortly after birth and last throughout your child’s teenage years. These visits allow Dr. Kim and the Stepping Stone medical team to keep a close eye on your child’s development and general health.

What Is a Well Child Check?

At Stepping Stone Pediatrics, the goal of the Well Child Check is to find and prevent problems. Each visit includes a comprehensive physical exam where your child’s growth and development will be examined. Our staff will record your child’s weight, height, and other vital signs as well as administer vision, hearing, and other screening tests when indicated. These appointments provide you with the opportunity to talk to one of our experienced and knowledgeable providers about ways to prevent future problems and keep your child happy and healthy.

Well Child Check Schedule

After your child is born, we will usually want to see your child within the first week, often within a day or two of bringing your baby home. Following the initial visit, the recommended Well Child Check schedule looks like this:

• Two to Four weeks
• Two months
• Four months
• Six months
• Nine months
• Twelve months
• Fifteen months
• Eighteen months
• Two years
• Two and a half years
• Three years
• Annually until they turn 21

Information Covered at Well-Child Checkups

At your Well Child Check, we will provide information on a wide variety of subjects affecting the wellness of your child. Some of the most common topics covered include:

• Parental questions
• Developmental milestones
• Diet and Nutrition
• Sleep
• Safety
• Immunizations
• What to expect as your child grows

Our experienced medical team will pay special attention to how your child is growing in contrast to typical developmental milestones. Your child’s weight, height and other measurements are all recorded on a special growth chart, which stays in your child’s medical record. In order to get the most out of your visit, make sure to write down any questions or concerns you have about your child’s growth and development. Speaking to the Stepping Stone Pediatrics medical team is an excellent place to receive expert answers to your questions.

Schedule Your Well-Child Checkup Today

In addition to all of the inherent benefits of well-child checkups, these visits allow you to form a trusting relationship with your pediatrician. Contact Stepping Stone Pediatrics today to schedule your child’s next Well Child Check!