Children with Easy Bruising Who Take Fish Oil Supplements

     We are asked regularly about children who bruise easily. If children have impressive bruises that occur after minor injuries, we will likely ask about your child's history with other issues that make us worry about a bleeding disorder. These questions include:
     Does your child have easy bleeding with minor mouth injuries or teeth cleaning?
     Does your child have frequent or hard to stop nose bleeds?
     Has your child had excessive bleeding after minor procedures?
     Does your child pass blood with a bowel movement?
     Has your child had painful, swollen joints after minor injuries?
     What medications or supplements does your child take?

     A combination of history and physical exam can prompt us to do screening labs or a referral to the hematologist at Nationwide Children's Hospital. Other histories and physical exams are reassuring.

     On a personal note: I spoke with my eye doctor in the last year about my eyes being dry. I had already tried some other remedies, so my eye doctor recommended that I try taking fish oil supplements. I began taking Occuvite and noted only so much improvement. I then switched to a higher dosed supplement, this time Member's Mark Triple Strength Wild Alaskan Fresh Fish Oil Softgels with 900mg of Omega 3. At my annual check up last week, I mentioned my easy bruising this year and the first thing my doctor said was "It is those Omega 3 supplements you take!". So now I am weighing the "eyes less dry" with the "easy bruising" tendencies.

     So a good thing to know is that fish oil/omega 3 supplements can increase the tendency to easy bruising. If your child is regularly taking these supplements, let your doctor know this if they are going to have surgery or if they have been prone to easy bruising.

Safe Sleep for Newborns and Beyond

     My oldest son is now 22 years of age. Back in 1990's, the cribs had wide enough slates that it was possible to get an arm or leg stuck between the slats. This prompted it to become nearly universal to use bumper pads to keep the arms or legs getting stuck and to pad the area so an infant would not "get hurt".
     This was not the safest sleep environment. We know now that there were more cases of SIDS and injured arms and legs with that setup. Now the slats are close enough to prevent these issues and it is recommended to not use any bumper pads. The chairman of the Consumer Product Safety Commission, Elliot Kaye states "I reiterate my belief that the public should stop using padded crib bumpers. The overwhelming evidence show that they do nothing more than contribute to the deadly clutter in many of our nation's cribs. Based on the real risk they present, it is a mystery to me why they continue to be sold." I agree.
     The Ohio legislature recently passed a law, Sub Senate Bill 332. It includes a bumper ban. I believe it goes into effect at the end of 2017. The law prohibits the manufacture or sale of non-mesh crib bumpers. The law allows for the sale of mesh crib bumpers for the next 3 years. The law will then ban the mesh crib bumpers if the Consumer Product Safety Commission (CPSC) has not created safe standards for mesh crib bumpers.
     "Bumpers are unnecessary and pose a real risk to the safety of infants." - Dr. Sarah Denny, Nationwide Children's Hospital.
     For more information about safe sleep for infants: here on the Ohio AAP website.

2017 Flu Shot Walk-In Clinic Dates and Times

     It is the flu shot season! We have a good supply this year of the flu shot. We are announcing the dates for walk-in flu shots for Sept.-Nov. 2017. Depending on the supply, we will schedule further dates in the Fall. We have shifted the weekday clinic date to Wednesday from Thursday (to accommodate our exam room needs in the office).
   
     Wednesday clinics are from 2-5 p.m. Saturday clinics are from 9 a.m.-12 noon.
     Wednesday dates: September 13, September 27, October 11, October 25, and November 8.
     Saturday dates: September 23, October 7, October 21, November 4, and November 18.

     We occasionally have to cancel/reschedule dates due to our supply of the vaccine. We will announce on the Hilliard Pediatrics Facebook page (maintained by Dr. Tim) if that occurs.

Solar Eclipse Safety

     Here it comes! The solar eclipse! Exciting as it is a fairly rare event. Now let us experience it safely!
     I love the Healthy Children website. Here is their article about safely enjoying the solar eclipse. Here is an article about eye safety during a solar eclipse from the American Academy of Ophthalmology.
     Be safe out there!

Car seat and car safety website

     I became aware of a very nice, accurate website recently. It is maintained by the National Highway Traffic Safety Administration. It has lots of resources regarding proper car seat use, safety tips for teen driving, and other safety information regarding cars. The website can be found at the Safer Car website.

Nationwide Children's Dublin Urgent Care has reopened.

     Due to staffing issues, Nationwide Children's Hospital's Dublin urgent care was temporarily closed for some months. As of August 2nd, 2017, it has reopened.
     We recommend using Nationwide Children's Hospital facilities when your child needs an urgent care or emergency room.
      The hours for the Main Campus (downtown) and Lewis Center Emergency Departments are 24 hours a day, 7 days a week. The Hilliard and Dublin (the two closest to our office) Urgent Cares are open Mon.-Fri. 3-10 p.m. and Sat.-Sun. 12-8 p.m.
     Laboratory and x-ray services are available as walk-ins with a doctors orders at both the Hilliard and Dublin locations. Laboratory hours are Mon.-Fri. 8:30 a.m. - 10 p.m., Sat. 9 a.m. - 8 p.m., and Sun. 12-8 p.m. X-ray services are available at both locations Mon.-Fri. 8:30 a.m. - 10 p.m. and Sat.-Sun. 12-8 p.m. Of note: patients needing TB screenings (often for volunteering, work, or college) can be seen from 3-7 p.m. everyday with no appointment needed at either the Dublin or Hilliard Close to Home Centers.
     As always, further information is available at www.nationwidechildrens.org

The flu vaccine has arrived!

     The influenza vaccine ("flu shot") has arrived for the 2017-2018 season. We received hundreds of doses. We will receive further doses in the future months.
     There are 4 strains of influenza in the vaccine and one is a new strain this year. Each year, scientists predict what strains are most likely to be in the communities for the coming season. For the '16-'17 season, the protection was only fair. On average, for every year like last year, we will have two years where the protection is much better.
     We agree with the recommendation that all children 6 months and above routinely receive the vaccine each year. This provides the best protection against influenza and it's complications, including dehydration and pneumonia.
     The only influenza vaccine we will stock this year is the flu shot. Although the "flu mist" is back on the market after concerns about its effectiveness, we want to make sure that it provides equal or better protection versus the flu shot before potentially recommending it in the future.
     Although the flu shot contains a small amount of chicken egg protein, the majority of egg-allergic patients can safely receive the flu shot. If a child has a history of anaphylaxis (a severe allergic reaction) to eggs, we should further discuss the issue. Some of these patients will see the allergist to receive the vaccine at their office.
     For those patients receiving the vaccine for the first time AND before their 9th birthday, two doses of the vaccine are needed one month apart. This supplies them with the best protection for that season. All other children need one dose each year.
     The flu shot cannot "give you the flu". In other words, if you or your child felt ill soon after receiving the vaccine, it was just a coincidence. Mild local reactions including soreness, redness, or swelling at the site are common. Less common are fever, achiness, headache, or nauseousness.
     We will soon schedule walk-in flu shot clinics. These have typically been scheduled on select Thursday afternoons and Saturday mornings in the Fall. We will announce on our Facebook page and on our website (www.hilliardpeds.com) when we know the schedule.
     One thing we are often asked about: Is my child too sick to receive the flu vaccine? The answer is "It depends". Mild cold and coughs, mild diarrhea, and low grade temperatures 100.4 degrees and below are not reason to postpone the vaccine. In fact, it has been shown that it is still safe and effective to receive the vaccine if someone has active asthma or croup and will need a steroid -or- has recently been on a steroid.