As a pediatrician who sees many pre-teens and teenagers, I am frequently asked "My child wants to take ______ (sports supplement). Is it safe?" I explain that the current supplements available have not proven to be safe and effective. It is possible to have sports performance worsen because of supplements. In addition, the short and long term safety of these are in doubt, with side effects including kidney damage, growth issues, stomach issues, heart issues and high blood pressure all under investigation.
Here is a link about safely improving sports performance. Here is a link to a different article about the sale of these products to under-age teens. It is good to remember the store is trying to make a sale, not look after your safety. Be very skeptical about claims these sports supplements.
The safest way to gain strength and muscle is to add lean protein in your diet. If you Google search this, millions of articles come up. Some of these, sadly, will lead you to purchase their supplements (which I hope our patients will avoid)! Here is an article with good information about good sources of protein.
Wednesday, February 1, 2017
Monday, January 16, 2017
CVS Is Offering a Cheaper Alternative Epinephrine Injector
As previously discussed in this blog, epinephrine injectors are often very expensive. They also can be life-saving in the case of a dangerous life threatening allergic reaction.
As is being publicized, CVS is offering a less expensive alternative. It is a generic equivalent of a prescription epinephrine injector called Adrenaclick. They are going to be offered at $109 for a twin pack. Here is a webpage from CVS about these. Note that the doctor's office will need to write something specific ("epinephrine auto-injector") to qualify for this. When your child who needs an epinephrine injector needs a refill or is getting a new prescription, ask your doctor about this less expensive alternative.
As is being publicized, CVS is offering a less expensive alternative. It is a generic equivalent of a prescription epinephrine injector called Adrenaclick. They are going to be offered at $109 for a twin pack. Here is a webpage from CVS about these. Note that the doctor's office will need to write something specific ("epinephrine auto-injector") to qualify for this. When your child who needs an epinephrine injector needs a refill or is getting a new prescription, ask your doctor about this less expensive alternative.
Thursday, January 12, 2017
Another great blog about the new peanut guidelines.
Dr. Carina Venter is a nutritionist with extensive knowledge of food allergies. She also has an excellent blog post about the new guidelines encouraging early introduction of peanut products. It includes some excellent answers to questions that might come up. Here is a link to the post.
Tuesday, January 10, 2017
New Guidelines About Introducing Peanuts At a Young Age
Dr. Dave Stukus is a terrific pediatric allergist at Nationwide Children's Hospital. I can highly recommend him. Dr. Stukus is very active on social media in addition to his busy practice. He is a trustworthy source of information.
Dr. Stukus' has a terrific blog post that summarizes the recent new recommendations about introducing peanut products at a young age. The blog post can be found here. It is well worth reading.
Dr. Stukus' has a terrific blog post that summarizes the recent new recommendations about introducing peanut products at a young age. The blog post can be found here. It is well worth reading.
Tuesday, December 6, 2016
Auvi-Q's return in 2017
A while back the epinephrine auto-injector for severe allergic and anaphylactic reactions called Auvi-Q was taken off the market. The reason was a concern with it delivering the proper dose (0.15 or 0.3 mg) every time, across all the units that were made. The company that originally developed the Auvi-Q is now bringing it back to the market in early 2017 after extensive work to ensure that the units work just right.
For years, the Epi-Pen and Epi-Pen Jr. have been the leading epinephrine auto-injector. When Auvi-Q was originally introduced, we applauded that it introduced competition to the marketplace (a good thing for consumers). Also nice is that a unit was introduced that would talk someone through the dosing of the injector, which in the frightening situation of a life-threatening allergic reaction may help caregivers or patients use the injector correctly. The size and shape of the Auvi-Q units also have appealed to many patients.
With recent frustrations with the rising costs of many medications, including the Epi-Pen brand, I welcome the Auvi-Q return in 2017. Here is a link to the Auvi-Q website with further information about their product. Here is a link to the Epi-Pen website. Realize that even with the return of the Auvi-Q to the marketplace, different insurance plans cover these medications differently. Some plans may prefer Epi-Pen, others Auvi-Q. If you have questions regarding coverage, contact your insurance provider in 2017.
For years, the Epi-Pen and Epi-Pen Jr. have been the leading epinephrine auto-injector. When Auvi-Q was originally introduced, we applauded that it introduced competition to the marketplace (a good thing for consumers). Also nice is that a unit was introduced that would talk someone through the dosing of the injector, which in the frightening situation of a life-threatening allergic reaction may help caregivers or patients use the injector correctly. The size and shape of the Auvi-Q units also have appealed to many patients.
With recent frustrations with the rising costs of many medications, including the Epi-Pen brand, I welcome the Auvi-Q return in 2017. Here is a link to the Auvi-Q website with further information about their product. Here is a link to the Epi-Pen website. Realize that even with the return of the Auvi-Q to the marketplace, different insurance plans cover these medications differently. Some plans may prefer Epi-Pen, others Auvi-Q. If you have questions regarding coverage, contact your insurance provider in 2017.
Monday, December 5, 2016
Safe Help for Teething in Infants and Toddlers
Most infants get their first teeth at 5-9 months of age. For months before this, you may not see much happening at the gums (not puffy or swollen). But leading up to the teeth breaking through, many infants drool more than ever and chew more for comfort. Although some infants and toddlers cruise through teething without much pain and discomfort, other little ones are intermittently uncomfortable. The pain and the teeth actually breaking through do not always correlate well. In other words, your infant might be having a great week when a tooth actually breaks through, but the previous week was filled with fussiness. You may be wondering how to safely help with teething discomfort.
Teething toys are a good option for teething discomfort. Teething rings, wet washcloths kept in the freezer for 10 minutes or so (we want them cold but not frozen), a favorite blanket or toy, and your fingers (can be a big ouch!) are all good options. The liquid filled teethers are thought to be unsafe as they can break open - so avoid those.
Another treatment option for teething pain that you may have heard about is Amber Teething Necklaces. Here is a link to more information about these necklaces. We do not recommend them, as we feel they may not be safe and there is no scientifically sound information to show that they work.
We have recommended the Baby Orajel and Ambesol for many years. These products contain benzocaine, a topical numbing agent. Recently recommendations have changed and the Federal Drug Administration no longer recommends the routine use of benzocaine because of the risk of methemoglobinemia, a rare but serious condition when the blood cannot carry the oxygen properly. In addition to possible safety issues with the benzocaine, anything massaged on to the gums washes away very quickly because of all the drool.
We are asked about the use of acetaminophen (Tylenol) and ibuprofen (Motrin and Advil) for teething discomfort. The truth is we think these are safe to use on occasion for discomfort, but we do not think it safe to dose many times in a week. A safe guideline might be to "save it" for the 2-3 times a week when things are at their worst and nothing else seems to help. Daily doses of Tylenol or Motrin for teething given on a regular doses may not be safe for your liver or kidneys.
I love referencing the Healthy Children website. They have so many good articles about so many issues in kid's health. Their page about teething found here has lots of good information. Ask your doctor at an appointment if you have questions or call during regular office hours. Good luck!
Teething toys are a good option for teething discomfort. Teething rings, wet washcloths kept in the freezer for 10 minutes or so (we want them cold but not frozen), a favorite blanket or toy, and your fingers (can be a big ouch!) are all good options. The liquid filled teethers are thought to be unsafe as they can break open - so avoid those.
Another treatment option for teething pain that you may have heard about is Amber Teething Necklaces. Here is a link to more information about these necklaces. We do not recommend them, as we feel they may not be safe and there is no scientifically sound information to show that they work.
We have recommended the Baby Orajel and Ambesol for many years. These products contain benzocaine, a topical numbing agent. Recently recommendations have changed and the Federal Drug Administration no longer recommends the routine use of benzocaine because of the risk of methemoglobinemia, a rare but serious condition when the blood cannot carry the oxygen properly. In addition to possible safety issues with the benzocaine, anything massaged on to the gums washes away very quickly because of all the drool.
We are asked about the use of acetaminophen (Tylenol) and ibuprofen (Motrin and Advil) for teething discomfort. The truth is we think these are safe to use on occasion for discomfort, but we do not think it safe to dose many times in a week. A safe guideline might be to "save it" for the 2-3 times a week when things are at their worst and nothing else seems to help. Daily doses of Tylenol or Motrin for teething given on a regular doses may not be safe for your liver or kidneys.
I love referencing the Healthy Children website. They have so many good articles about so many issues in kid's health. Their page about teething found here has lots of good information. Ask your doctor at an appointment if you have questions or call during regular office hours. Good luck!
Friday, December 2, 2016
Baby Led Weaning
I am getting more questions about baby led weaning recently. I must admit, the first time I heard the term, I was not sure what the parent was referring to exactly. If you are unfamiliar, baby led weaning is really baby self feeding, with infants 6 months and above offered the opportunity to feed themselves from the start of transitioning to solid (complementary) foods. There is much more detail here on a website all about it.
Are there advantages and disadvantages to transitioning to solid foods this way? This is not easy to answer as there has been VERY limited scientific research into the area. My biggest three questions are: 1. Is it a choking hazard? 2. Will the infants who do self-feeding eat a well balanced diet that allows them to get all the nutrition, vitamins, and minerals that they need? 3. Are these children more or less likely to develop food allergies than a child who does another feeding strategy?
Although the concern for this strategy leading to choking issues, this article reviews a recent study that showed it could be done safely. Having said that, I remain worried about infants choking with baby led weaning.
The answer to the question about balanced nutrition is not answered yet. I have seen at least two 9 month old infants who have done a baby led weaning strategy who were anemic. I remain concerned, as do other pediatricians, that there may be some important things missing from their intake. Trusting that the baby's instincts will lead them to good nutrition makes me nervous. Toddlers, for instance, might eat bananas, cheese, and noodles all day if left to their own choices -- not bad nutrition, just not all that one needs.
The answer to the food allergies question also is unanswered. We seem to be headed in the right direction by now introducing those foods most likely to trigger reactions. I would hate to lose this momentum. Items like the Osum Bamba Peanut Snacks are a terrific way to introduce peanuts into the diet for children who can self-feed.
So much time and research has gone into pediatricians feeling confident about traditional transition to solid foods with purees. If you are interested in following a baby led weaning plan, I encourage you to keep the above issues in mind. Ask your pediatrician if you have more questions or concerns.
Are there advantages and disadvantages to transitioning to solid foods this way? This is not easy to answer as there has been VERY limited scientific research into the area. My biggest three questions are: 1. Is it a choking hazard? 2. Will the infants who do self-feeding eat a well balanced diet that allows them to get all the nutrition, vitamins, and minerals that they need? 3. Are these children more or less likely to develop food allergies than a child who does another feeding strategy?
Although the concern for this strategy leading to choking issues, this article reviews a recent study that showed it could be done safely. Having said that, I remain worried about infants choking with baby led weaning.
The answer to the question about balanced nutrition is not answered yet. I have seen at least two 9 month old infants who have done a baby led weaning strategy who were anemic. I remain concerned, as do other pediatricians, that there may be some important things missing from their intake. Trusting that the baby's instincts will lead them to good nutrition makes me nervous. Toddlers, for instance, might eat bananas, cheese, and noodles all day if left to their own choices -- not bad nutrition, just not all that one needs.
The answer to the food allergies question also is unanswered. We seem to be headed in the right direction by now introducing those foods most likely to trigger reactions. I would hate to lose this momentum. Items like the Osum Bamba Peanut Snacks are a terrific way to introduce peanuts into the diet for children who can self-feed.
So much time and research has gone into pediatricians feeling confident about traditional transition to solid foods with purees. If you are interested in following a baby led weaning plan, I encourage you to keep the above issues in mind. Ask your pediatrician if you have more questions or concerns.
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