Tips to prevent skin cancer:

1. Avoid sun exposure between the hours of 10 a.m. to 4 p.m. when the sun is strongest. Teach your child the shadow rule: if your shadow is shorter than you, the sun’s rays are at their strongest.
2. Even a single sunburn increases your risk of developing melanoma, the deadliest form of skin cancer; suffering five or more sunburns doubles your lifetime risk. Avoid spending long periods in the sun, and when you see or feel your skin redden, take cover.
3. Wraparound sunglasses that block 99-100 percent of the sun’s UV rays effectively shield both eyes and the surrounding skin, helping prevent serious conditions from cataracts to melanomas of the eye and eyelid.
4. Just one severe burn in childhood doubles the chances of developing melanoma later in life. Remember, sunburns can be dangerous for babies and toddlers, possibly leading to dehydration and heat stroke.
5. Keep infants out of direct sunlight. Because an infant’s skin possesses little melanin, babies are especially susceptible to the damaging effects of the sun. If your child is under six months and out in the sun, make sure they are covered by clothes or in the shade of an umbrella or stroller hood.

It is important to use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.

Are you confused about all the sunscreen options available? View the Skin Cancer Foundation’s list of of recommended products.

Feeding an Infant

At birth, you should either feed your baby breast milk or formula. You can tell if your newborn is getting enough to eat if they are having at least 6-10 wet diapers daily. A general rule is that your baby should have 2-3 ounces of breast milk or formula for every pound of body weight. Your baby does not need any solid foods at this time and they should eat about every 2-3 hours.

Feeding a 4-6 Month Baby

Starting at 4- 6 months of age, you should start to incorporate rice or oatmeal cereal your child’s diet. They should eat 1-2 tablespoons of cereal twice daily. Start by making cereal very thin and gradually make the cereal thicker until it is normal oatmeal consistency. Your child should still drink 6-8 ounces of formula or breast milk 4-5 times per day. During this time, you may also add light colored baby foods to their diet such as apples, pears or squash. Stick to feeding your child one new food per week.

Feeding a 6-8 Month Baby

At 6-8 months of age, your baby should eat 6-8 ounces of breast milk or formula 3-5 times daily. You should continue to feed them cereal, but increase it to 2-4 tablespoons daily. Also, begin feeding your child about 2-3 tablespoons of 2-4 servings of fruits and vegetables each day.

Feeding a 8-12 Month Baby

By the time your baby is 8-12 months old, he or she should drink about the same amount of breast milk or formula, but you may remove one of their breast milk or formula feedings and replace it with solid foods. At this point, you should start to incorporate all food groups into their diet. You may give your baby dairy, such as yogurt or cottage cheese, 1-2 times daily. They should continue to eat grains such as baby cereal, but may prefer other grains like crackers or bread. Your baby can start eating more textured foods as they get more and more teeth. You should make sure they have 3-4 tablespoons of fruits or vegetables 3-4 times daily and 3-4 tablespoons of meat 1-2 times per day. Do not give your child whole milk until they are 12 months old.

Remember no two kids are alike. Some will follow these guides exactly while other babies may not follow them at all. Hopefully, this guide will help you navigate through your child’s rapidly changing appetite and nutrient requirements during their first year of life.

Hepatitis B

Hepatitis B is a blood born virus that affects the liver and can lead to liver cancer. Hepatitis B may also be transmitted from a pregnant mother to her baby, which is why this vaccine is routinely given to babies within the first few days of life. Through this common practice, hepatitis B is much less prevalent in our society.

Tetanus

Tetanus is a bacterial infection that affects the central nervous system. A person may be infected with tetanus through an open wound or puncture wound caused by sharp objects such as nails, screws, and the teeth of animals. Tetanus causes muscle spasms, fever, difficulty breathing, and possibly death. If possible, recovery may take months.

Diphtheria

Diphtheria is a bacterial infection that releases a toxin that produces a thick membrane. This can result in difficulty breathing and swallowing. The disease is spread though contact with infected droplets such as when someone sneezes or coughs. This disease may also affect the heart, kidney, and nervous system.

Pertussis

Pertussis, commonly known as Whooping Cough, is a highly contagious bacterial infection. Pertussis causes severe cough and fever. The infected person may suffer from complications such as pneumonia, seizures, and respiratory distress. Infants may have fatal outcomes from contracting Pertussis, which is why Pertussis has been added to the Tetanus vaccine that adults routinely receive to help battle Pertussis outbreaks.

Hepatitis A

Hepatitis A is a food and water born virus that affects the liver. Hepatitis A is spread by unsafe cooking environments where food is handled by the hands of people that have the disease.

Haemophilus Influenzae Type B (Hib)

Haemophilus Influenzae Type B (Hib) is a bacterial illness that commonly affects young children and may lead to meningitis, pneumonia, and epiglottitis (severe swelling of the throat). Hib is spread through infected droplets and may have severe consequences such as hearing loss, brain damage and even death.

Pneumococcal Disease

Pneumococcal disease is a bacterial disease that commonly may be found in ear infections. The infections can have serious consequences such as meningitis, blood poisoning, brain damage, and death.  The disease is spread by infected droplets and a person may spread the disease by carrying it and not having symptoms themselves. This disease may be especially hard to treat because of emerging bacterial resistance.

Polio

Polio is a virus that leads to paralysis, permanent muscle weakness, and occasionally meningitis. Thanks to vaccination, Polio has become very rare.

Meningococcal Disease

Meningococcal disease causes life-threatening meningitis and sepsis conditions. It is a serious bacterial illness that affects the central nervous system and may lead to brain damage or even death. Meningitis is spread by contact with infected droplets and direct contact with infected people.

Measles

Measles is a viral illness that is very contagious and may be spread before people know that they have the disease. The disease causes fever and rash and may lead to encephalitis and pneumonia.

Mumps

Mumps is a viral infection affecting the salivary glands. The disease may lead to meningitis, infertility, and hearing loss.

Rubella

Rubella is a viral disease that causes rash and fever. Rubella is especially harmful to pregnant women and can cause birth defects.

Rotavirus

Rotavirus is a virus that causes severe vomiting and diarrhea and can lead to life threatening dehydration, especially in young children. This disease is commonly spread in day care settings.

Chicken Pox

Chicken pox is a virus that causes an itchy rash. The disease may cause skin infections, pneumonia, encephalitis, and severe secondary bacterial infections.

Influenza

Influenza is a highly contagious viral infection that may lead to severe dehydration, pneumonia or even death.

Talk to your health care provider if you have any questions in regards to these vaccine preventable diseases. Through vaccination we can ensure that our children and their families live in a healthier society.

Brooke Holway A.R.N.P.

Nutrition

There are a few key nutrients that a mother must have in her diet. Everything you eat can affect the baby that you may one day have. By ensuring that your diet includes adequate amounts of Folic Acid, Vitamin B12, Iron, and Zinc will affect the fundamental development of the baby’s DNA. Vitamins A, C, E, Zinc , Selenium, and Omega 3-fatty acids protect from oxidative damage from free radicals.

Avoiding Malnutrition

Mothers that suffer from malnutrition often times will lead to having low birthweight babies. Low birthweight is not genetic, but a direct correlation of the prenatal environment and the developing baby. Severe malnutrition may lead to higher incidences of heart disease and mood disorders in the offspring.  Mothers with low protein diets may result in babies prone to vascular dysfunction, impaired immune systems, and diabetes. Mothers with high protein diets, where they avoid carbohydrates in pregnancy, tend to have children who are predisposed to having high cholesterol.

Reduce Stress

Ensuring that you live in a stress free environment is also important in preconception planning. Stress does not only include common stressors such as anxiety, although that is important to decrease as well, but can also include exposure to toxins, such as polycyclic aromatic hydrocarbons found in cigarette smoke. Prenatal exposure to cigarette smoke may result in developmental delay, behavioral disorders, and low birth weight.  Other sources of toxin exposure may come from substances that we come into contact with in our everyday life such as BPA found in plastics.

By being aware of our lifestyles in the preconception planning time, we can help influence the development of our children.

Brooke Holway A.R.N.P

Jacksonville, FL- October 23, 2012 – Pediatric Associates of Jacksonville, an integrative pediatric practice, is pleased to announce a new partnership with The Willow, a daily yoga program. Encompassing all things yoga, The Willow speaks of life and how the lessons of yoga can be intertwined in our daily routine.

Dr. Aylin Ozdemir, known to her patients as Dr. O., and the staff of Pediatric Associates of Jacksonville will be regularly featured on the show. Segments will feature health tips on a variety of topics from their in-house Nutrition Kitchen at the Ponte Vedra location as well as their therapy services available including their cognitive control therapy, Brainjogging. Services offered by Pediatric Associates of Jacksonville focus on the 5 pillars of physical body, mind, spirit, nutrition and education. As with all services offered, the focus of the partnership will be on helping families to “Love, Growing Healthy.”

“Our offices offer a pediatric approach to integrative medicine, taking into account the factors that affect an individual’s health on a physical, mental and spiritual level,” stated Aylin Ozdemir, MD, FAAP. “The Willow partnership perfectly complements our offices’ holistic health practices like healthy eating, Occuplay and yoga,” she added.

The Willow airs weekdays at 7:00 a.m. on the CW17 network. Highlights from each segment are also available on the Pediatric Associates of Jacksonville You-Tube Channel, http://www.youtube.com/user/PediatricAssocJax.

It should come as no surprise that success — or failure — at school starts at home. Studies have linked poor academic performance to factors such as a lack of sleep, poor nutrition, obesity, and a lack of parental support.

Making the First Day Easier

Remind your child that she is not the only student who is a bit uneasy about the first day of school. Teachers know that students are anxious and will make an extra effort to make sure everyone feels as comfortable as possible. Point out the positive aspects of starting school: It will be fun. She’ll see old friends and meet new ones. Refresh her positive memories about previous years, when she may have returned home after the first day with high spirits because she had a good time. Find another child in the neighborhood with whom your youngster can walk to school or ride with on the bus. If you feel it is appropriate, drive your child (or walk with her) to school and pick her up on the first day.

Eating During the School Day

Most schools regularly send schedules of cafeteria menus home. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat. Try to get your child’s school to stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice in the vending machines. Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Restrict your child’s soft drink consumption.

Before and After School Child Care

During middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning and watch over them after school until you return home from work. Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.
If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone. If you choose a commercial after-school program, inquire about the training of the staff. There should be a high
staff-to-child ratio, and the rooms and the playground should be safe.

Developing Good Study and Homework Habits

Create an environment that is conducive to doing homework. Youngsters need a permanent workspace in their bedroom or another part of the home that offers privacy.
Students should set aside ample time for homework. Establish a household rule that the TV set stays off during homework time. Supervise computer and Internet use. Be available to answer questions and offer assistance, but never do a child’s homework for her. Take steps to help alleviate eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch, and take a break periodically when it will not be too disruptive.
If your child is struggling with a particular subject, and you aren’t able to help her yourself, a tutor can be a good solution. Talk it over with your child’s teacher first.

So in summary…

1. Enforce healthy habits of eating, sleeping, snacking and playing (computer games.)
2. Stick to a routine
3. Create a “Launch Pad”- have a single place to put backpacks, jackets, etc.
4. Designate a study space
5. Read, again and again
6. Learn always – There’s only so much teachers can do. Parents have to fill in with good support at home. Look for ways to teach your child throughout the day. For example, cooking combines elements of math and science. Use the time when you make dinner as an opportunity to read and follow directions, to discuss fractions, to make hypotheses (“What will happen when I beat the egg whites?”), and to examine results.
7. Take the lead -Children learn by example. Let your kids “catch” you reading. Take time to learn a new skill and discuss the experience with them. Sit down and pay bills or do other “homework” while your kids do their schoolwork. If you display a strong work ethic and continually seek out learning opportunities for yourself, your kids will begin to model that same behavior in their own lives.
8. Talk Often – Do you know how your child feels about her classroom, her teacher, and her classmates? If not, ask her. Talk with her about what she likes and doesn’t like at school. Give her a chance to express her anxieties, excitements, or disappointments about each day, and continue to support and encourage her by praising her achievements and efforts.
9. Show interest – Don’t limit your support to your child; extend it to her teachers as well. Meet the teachers and stay in regular contact by phone or e-mail so that you can discuss any concerns as they arise. Not only will it pave the way for you to ask questions, but it will also make the teachers more comfortable with calling you if they have concerns about your child.
10. Expect Success – Perhaps the most important way you can support your child’s efforts at school is to expect him or her to succeed. That doesn’t mean that you demand they be the best student or the best athlete or the best artist. Rather, let them know that you expect them to do “their best” so that they’ll be proud of what they can accomplish. If you make that expectation clear and provide a home environment that promotes learning, then your child will have a greater chance of becoming the best student they can be.

Asthma Management at School

Children spend a significant part of their day at school. That is why it is so important that asthma symptoms are well managed while they are there. It is also important that you are aware of your child’s symptoms and any problems with how your child’s asthma is managed in school.

Effective Communication

Good communication is essential to asthma care and management in school. The school needs to know about your child’s asthma, how severe it is, what medications your child takes, and what to do in an emergency. This communication can be helped by having your health care provider complete an asthma action plan for the school, as well as a medication permission form that includes whether your child should be allowed to carry and use her own inhaler. You should also sign a release at school and at your health care provider’s office to allow the exchange of medical information between you, the school, and your health care provider.
Your child’s school needs to communicate to you its policies on how your child will get access to her medications and how they deal with emergencies, field trips, and after-school activities.
The school should also inform you about any changes or problems with your child’s symptoms while she is at school.

Peak Flow Meter

Peak flow meters can be helpful for school staff in determining the severity of an asthma attack.
If your child’s health care provider has recommended a peak flow meter, determine your child’s best peak flow (your health care provider should tell you how to do this). Then keep a peak flow meter at school. ***Also important to make sure your child sees his or her health care provider every 3 months to check his/her asthma. At these visits they can assess your child’s pulmonary lung functions with a PFT machine or a peak flow meter to make sure their medications are working properly.

Coping With Asthma at School

Students with asthma face a number of problems related to school. Talk to your child about how well his asthma is being managed in school. Also talk to your child’s teachers, school nurse, coaches, and other school personnel to get their opinions on how well your child is coping with asthma in school and to see if asthma symptoms are causing any of the following problems:

• Missing school due to asthma symptoms or doctor visits.
• Avoiding school or school activities. Work with your health care provider and school personnel to encourage your child to participate in school activities.
• Not taking medication before exercise. Your child may avoid going to the school office or nurse’s office to use his inhaler before exercise. Schools that allow children to carry their inhalers with them can help avoid this problem.
• Side effects from medication. Some asthma medications may alter your child’s ability to perform in school. Teachers need to know if and when your child takes asthma medication so that you can be notified if there are any problems.
• Physical activity is important for your child’s physical and mental health. Children with asthma should be able, and encouraged, to participate completely in physical education, sports, and other activities in school. All students should have some knowledge of asthma basics and management. Encourage your school to offer asthma awareness education as part of the health education curriculum.

Know Your Rights

Learn about the federal laws that can help you with asthma management concerns at school.
These include the following:
Section 504 of the Civil Rights Act of 1973
Americans with Disabilities Act (ADA)
Individuals with Disabilities Education Act (IDEA)

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He has a slow-to-warm temperament with atypical social interactions. There is expressive language delay but he seems to understand everything. He is an attractive little boy who seems bright to his primary care physician. His mother brings him to her physician and wonders if he is normal because he struggles and attains skills later than normal. The primary care physician (PCP) refers him to the infants and toddlers community program for speech and language evaluation. He qualifies for speech services. The speech and language pathologist (SLP) refers him to occupational therapy (OT) because he is clumsy and has sensory dysfunction. The OT recognizes developmental dyspraxia, balance issues and graphomotor dysfunction and treats him accordingly. She wonders about the etiology of all these subtle but important differences as well.

At five years of age, he is struggling in kindergarten and his mother returns to the PCP. The PCP considers a psychological evaluation but decides to give the youngster another year since “he is a boy”. Tommy struggles in first grade but by the second grade, he seems to have settled down. However, by the end of third grade, he has behavioral problems, is failing in school, and is acting out at home. Tommy is sent to a pediatric neurologist to determine if medication should be considered for his attention problems.

What does he have?

Did you know more than 500,000 people in the United States are believed to have a Sex Chromosome Anomaly? Research reveals that every day 20 children will be born with XXY, XXX or XYY chromosomal disorders and only 5 of those 20 will be diagnosed in their lifetime and receive appropriate treatment. Ten to twenty percent of these disorders are identified from amniocentesis completed because of advanced maternal age. Although these disorders are associated with language-based learning disabilities, children remain largely undiagnosed because their neurodevelopmental problems are often perceived as “just a speech or motor delay” or, as children become older, “merely a learning disability.” Goal is to…

• Identify children with neurodevelopmental disorders as early as possible.
• Prevent language-based learning disorders
• Provide children with appropriate, targeted treatment and intervention
• Promote recovery and normalization as well as address the neurodevelopmental issues involved through syndrome-specific goals.

As a neurogenetic disorder, X & Y Variations are known by many names, among them: Sex Chromosome Disorders, X & Y Chromosomal Variations, Sex Chromosome Anomaly and Sex Chromosome Aneuploidy Variations.

Within the disorder are many sub-categories, which are identified by names including Klinefelter’s Syndrome, 49 XXXXY, Tetrasomy X,49 XXXXXX, Pentasomy X, 48 XXY and 47 XXY.

X & Y Variations are common but frequently undiagnosed genetic conditions that differ from the normal sex chromosome pairings of XX for females and XY for males. Due to a chromosomal mistake that produces additional X or Y chromosome to the normal complement of 46, the resulting total of 47 chromosomes (or more) may impact a child’s developing central nervous system and his or her body condition.

• XXY occurs in 1 out of 650 live births
• XXX occurs in 1 out of 900 live births
• XYY occurs in 1 out of 1,000 live births

Information on these disorders is often outdated and incorrect. New research has been done on populations with these disorders and there is now more information than ever. Widespread misinformation about these conditions cause unnecessary distress to families dealing with such a diagnosis:

• Contrary to common belief, people with X & Y Variations are often bright and exceptionally talented in perceptual tasks (such as design and computers).
• They can play a variety of sports.
• They typically do not have Autistic Spectrum Disorder.
• They generally are not hermaphrodites, asexual or sexually confused, and they do not have an increased incidence of homosexual or transgender behavior based on current published scientific literature.
• They are not always infertile (although they can have low fertility).
• They are not characteristically prone to violence or criminal activity.
• And they do not have an increased incidence of mental retardation, provided that their chromosomal variant is identified early and they are given appropriate targeted treatment and syndrome specific goals.

Unfortunately, because most ‘ practitioners often receive insufficient information about sex chromosome disorders, they don’t even consider testing for X & Y Variations when caring for a child who presents with developmental concerns.

I want health care providers, educators and parents to know:

• 1 in 500 children have X & Y Variations that cause complex learning disabilities.
• 20 babies born each day have an X & Y Chromosomal Variation, and only 5 will be diagnosed in their lifetime.
• Developmental Dyspraxia is often mistaken as being “only a minor speech delay” when, in fact, multiple developmental domains are affected and require targeted treatment.
• Symptoms of Dyslexia often present in preschool years and early identification and treatment is highly effective.
• 10 percent of children with X & Y Variations are identified prior to birth and they usually develop Dyspraxia and Dyslexia. The knowledge gained from caring for these infants and toddlers benefits all children who have reading, speech and motor planning dysfunction.
• With the proper diagnosis and intervention, children who have these neurogenetic disorders can be transformed from vulnerable to powerful, from school failure to academic success, from disabled to able!

If you have a child who has recently been diagnosed with an X and Y Chromosomal Variation and you need more information contact The Focus Foundation.

(Click on chart for pdf version with footnotes)

Providers should consult the relevant Advisory Committee on Immunization practices statement for detailed recommendations, including high-risk conditions: http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form is available at http://www.vaers.hhs.gov or by telephone, 800-822-7967.

1. As things stand now, the vast majority of children who develop flu-like symptoms this Fall will have a few miserable days, and nothing more. And those days are best spent at home–not in the ER or a doctor’s office.
2. If you are worried, call Dr. O first. Don’t take your child in to the ER without calling. Two reasons: Your child may not have H1N1 but could become exposed by being around sick children. And after several hours of waiting, you are still likely to be told the basics-plenty of fluids, rest and dose-appropriate acetaminophen for a fever. After all, it is still the flu we are talking about.
3. Remove the term H1N1 from the equation. If your child had the regular flu, would you take him/her to the hospital? If the answer is no, then don’t take him/her to the hospital now.
4. Yes, hearing between 30,000 and 90,000 people could die from H1N1 is scary, but keep in mind-around 40,000 people die from the regular or seasonal flu every year. The numbers may not be that much different, yet there is not panic about the regular flu. As things look now, H1N1 is causing only mild to moderate illness, not the widespread deaths people are worried about.
5. There are some children who should be seen by their pediatrician right away. Call Dr. O if:
   1. A baby younger than 12 weeks has a fever greater than 100.4 degrees Fahrenheit
   2. A child older than 12 weeks has a fever for three days or any fever over 103 degrees Fahrenheit or higher
   3. A child’s fever returns after a 12-24 hour time period
   4. A child is not passing urine or making tears for more than six hours
   5. A child does not smile or show interest in playing for several hours
   6. A child cannot speak while trying to breathe
   7. Has a blue or dark purple color to the nail beds, lips or gums
   8. Is not responding to you because he/she is too tired or weak