Tuesday, April 17, 2018

Dr. Jeff's retirement on April 30, 2018

     We are fast approaching Dr. Jeff's retirement on April 30th, 2018!
     Dr. Jeff founded Hilliard Pediatrics in 1990 after finishing his pediatric residency at Columbus Children's Hospital. Starting a practice on your own meant seeing all the patients, taking all the nighttime and weekend call, and seeing both healthy newborns and children hospitalized at Children's Hospital.           The practice grew and grew with Dr. Jeff's hard work and excellent care. 
     Over the years, the office has moved locations - from Leap Court to Berry Leaf Lane (in 1996) to Trueman Court (2011) - and grown as other doctors joined the practice.
     Dr. Jeff has been passionate about Hilliard Pediatrics, his family, sailing and painting, and the environment. Dr. Jeff has run marathons, raised bees, painted exam rooms and portraits, and had some great life adventures.
     What has never changed is Dr. Jeff providing excellent pediatric care for his patients. The patients will miss him and we at the office will sure miss him. He will be remembered for his dedication to his patients, his infectious laugh, and how many lives he positively impacted.
     Thank you Dr. Jeff for all that you have done!

Monday, January 22, 2018

Dr. Mike Patrick's Pediacast pediatric podcasts

     Dr. Mike Patrick, M.D. from Nationwide Children's Hospital has a podcast called Pediacast that has an amazing amount of information for patients and families. I highly recommend it! He and guests cover many topics. If you are unfamiliar with it, http://www.pediacast.org/ is the web address. It can also be found wherever you find other podcasts (iTunes, etc.).

Saturday, January 6, 2018

Is it too late to get the flu shot?

     The simple answer is no. It is not too late to receive the flu vaccine if you or your child has not yet received it this season.
     The influenza season started early this year. By late November, a number of cases were appearing in Central Ohio. The season usually runs from December through March.
     Although a report out of Australia reported that the vaccines effectiveness versus the H3N2 strain (one of 4 in the vaccine) was only 10% last year, the Centers for Disease Control and Prevention report the U.S. effectiveness was between 30-40% (significantly better) and it is likely going to be closer to that percentage in the U.S. this influenza season. Here is a link to more information from the CDC.
     We have been out of the vaccine since early November. But there are other ways to get the vaccine:
1. The Franklin County Health Department is able to give the vaccine to those 6 months and above. You can schedule an appointment to receive the vaccine by calling 614-525-3719 or going to www.myfcph.org/shots to make an appointment.
2. The urgent cares staffed by nurse practitioners (such as Minute Clinics) are able to give the vaccine to children 18 months or 24 months and above (it varies). Check here for more information.
3. Many pharmacists are able to give the flu vaccine to those 7 years of age and above. Check with your favorite pharmacy for more details.

Saturday, December 23, 2017

Storing Breast Milk and Formula

     We are frequently asked in the office about how long breast milk and formula can be safely stored. The major risks for going past this limits is accidentally introducing an unhealthy bacteria to the infant ("spoiled milk") or the breast milk or formula having its ingredients break down.
     Although you can find a wide variety of guidelines on the Internet, I find it easier to keep it simple to remember: follow the Rules of Six for breast milk storage. Breast milk can be safely consumed if stored for 6 hours at room temperature, 6 days in the refrigerator, and 6 months in the freezer. If the breast milk is kept in an insulated cooler bag, it should be used within 24 hours.
     The guidelines for formula are different. A bottle of formula should be kept at room temperature for no more than 1 hour. Formula prepared from powder then stored in the refrigerator should be used within 24 hours. Formula prepared from concentrate or ready-to-feed formula may be stored in the refrigerator for 48 hours. A can of powdered formula should be used within 30 days of opening.
     Here is a link to some more detailed information about safely storing breast milk from the Centers for Disease Control. Here is a link to an article about storing infant formula from Healthy Children.

Wednesday, December 20, 2017

Updated Information on the Prevention of Tooth Decay

     In the 23 years I have been in practice, the recommendations about fluoride and children has changed. Although there is great deal of information supporting the safe use of fluoride to prevent tooth decay, recommendations about how much and how often have frequently changed. Here is an updated description of the current recommendations.
     One note: you can find a lot of misinformation on the Internet. And a great example is the misleading, non-scientific, and sometimes outright false and outrageous anti-fluoride information on the Internet. Do not believe this misinformation. It safe to use fluoride to prevent teeth decay.
     The current recommendations:
1. It is helpful to have your child drink fluoridated water and to cook using fluoridated water. In Central Ohio, our public water supply has fluoride added. Drinking bottled water does not reliably give enough fluoride. Most household water filters do not remove fluoride, but it is worthwhile making sure (by reading the filter's information).
2. Once babies have their first teeth, brush their teeth daily with a grain of rice sized amount of fluoride containing toothpaste. Once they reach 3 years of age, it should be a pea sized amount of fluoride containing toothpaste.
3. Routinely see the dentist by 3 years of age, sooner if recommended by the pediatrician.
4. Fluoride varnishes are recommended once a number of teeth have extruded. We now do the fluoride varnish at 18 month, 24 month, and 30 month check ups. The kids seem to be tolerating it just fine. The varnish stays on your teeth for 4-6 hours. During those 4-6 hours, it is best to maintain a soft diet and avoid hot liquids. Do not brush or floss during that 4-6 hours after the varnish (you can resume normal dental care the next day). If you take supplemental fluoride, stop for 3-4 days after the varnish is applied.
     If you interested in reading more, here is a link to more information from the website Healthy Children.

Friday, December 8, 2017

What to do when children and teenagers vomit with exercise.

     Some athletes vomit during exercise. This can happen at younger ages, but typically occur when teenage athletes push themselves hard during workouts. There are some things to do to help prevent this issue.
     One of my teenage sons has struggled with vomiting when pushing himself during workouts. He does vomit more easily with bad coughs or stomach upset versus some other folks, but he did not have vomiting with exercise until high school.
     If someone struggles with this issue, we would ask some other questions to make sure it was not from something more complicated. We ask questions about acid reflux and and whether the vomiting happens after coughing. We ask about timing of eating and drinking when it comes to exercise.
     If nothing else is complicated about the history, there are some helpful recommendations to help reduce the chances of vomiting during exercise.
-- Eat a small snack 30 minutes before exercise.
-- Avoid exercising in extreme heat.
-- Watch your exercise intensity. The athlete may need to dial-back their intensity.
-- Stay hydrated. Drink 8 ounces of water every 20 minutes of exercise. If the exercise is going to be high-intensity for more than 45-60 minutes, drink sports drinks instead of water.
-- Cool down gradually.

     If your child struggles with this issue and is not improving while following these recommendations, call during routine office hours to discuss.

Why do children tell lies?

     At some point during your child's early life, they will lie to you. It is aggravating and frustrating for parents, but inevitably it happens. Our hope as parents is that it does not happen very often. Here is some more information about how to approach this issue.
     Why does anyone lie? To get what they want or to avoid punishment. "No, Dad did not give me a cookie today!" (when they have already had their once-a-day treat). "I was not running in the living room!" (when the lamp got knocked over again). "My brother was on the iPad longer than me!" (when they want more iPad time).
     Sadly, we are in a current situation where it is hard to point to well known adults that your child may look up to - athletes, politicians, etc. - as good examples of "always tell the truth". This makes it difficult when we all get mixed messages from daily life, including for children. When others see someone not tell the truth then get what they want or avoid punishment, even otherwise well-behaved children (and adults) are more tempted to not to tell the truth.
     Certainly, when you know (or are quite certain) that your child is not telling the truth, your best bet as parent is - as always - consistency. By that I mean that you should routinely give your child some negative consequences for lying whenever it happens. We all are more likely to keep repeating an action or behavior if we are not negatively reinforced for it. And we are more likely to stop an action or behavior if we are regularly and consistently negatively reinforced for it.
     Those negative consequences may be a time-out, a removal of privileges (no iPad for the day or no cookie for tomorrow), etc. Stick to your guns: if you say it ("no TV today"), follow through with it (they get no TV today). Otherwise, you are accidentally giving your child the idea that they can sometimes "get away with it".
     One more note: I think it is important to model good behavior to your children. I truly believe if you model to your child that it is important to tell the truth, they are more likely to tell the truth themselves. I recall a time my one son and I were in a fast-food restaurant. When I handed the cashier money, they gave me back too much money. I said "Here, take the $5 back. Then we are even. You gave me too much cash back." The cashier was happy and I was happy for a small moment to emphasize to my son that telling the truth is important.
     So to conclude, do not be too frustrated if your children lie, be consistent with your negative reinforcement, and - as always - call us during routine office hours if you have other concerns.