Monday, June 24, 2013

Food Allergy Action Plan

      The Food Allergy and Anaphylaxis Network (FAAN) has a terrific Food Allergy Action Plan form. In the case of a child having an exposure to the food or foods they are allergic to, it provides clear-cut instructions on what to do and when to do it. A link here connects you to the website and their form, the Action Plan.
      When the child has a food allergy and needs to have school or preschool prepared, they will have a form to be completed and signed by the physician. Many times, they will appreciate and we will strongly recommend that in addition the FAAN Food Allergy Action Plan also be completed. This provides more precise information. The school forms will essentially allow us to say "if there is a food allergy reaction, give Benadryl and epinephrine". However, the Action Plan allows us to say more accurate information such as "if they are wheezing, pale, and dizzy, give epinephrine and then do these other steps". We have the Action Plan available in the office to complete at your child's appointment or you can print out at home and bring in at your child's appointment.
      One other point: it is strongly recommended to have two epinephrine injectors (EpiPen or Auvi-Q) available with the child at all times. There are two injectors in the "twin pack" so that a second injection is available if needed if a reaction occurs. Over the years, it has been found at least 1 out of 5 times (20%), a second dose is needed soon after the first. And there are many occasions when someone did not have a second dose and died because of a severe reaction that could have been avoided with a second dose of epinephrine.

Wednesday, June 19, 2013

Swaddling Infants

     Swaddling infants is something of a controversial topic recently. It is done from the start at the hospital for newborns. There is a new article from the American Academy of Pediatrics here that has an excellent discussion of the topic.
     What do I recommend? It is fine to swaddle from birth until 8 weeks of age, make sure there is room at the chest for the infant to comfortably breath (you should be able to get your hand between the blanket and the infant), and make sure the swaddling is looser around the hips.