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Cough - when to be concerned ... See MoreSee Less

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Cough - when to be concerned ... See MoreSee Less

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SCIENCE EXPLAINS WHY FRIGHT IS FUN

Health experts discuss the biological reasons why human beings get enjoyment from being scared in settings like horror movies and haunted houses. Fright can stimulate the same centers of the brain as happiness and pleasure, and it's enjoyable because there is no real threat of harm. Fear also triggers the release of stress hormones and neurotransmitters that induce a "fight, flight or freeze" response, an evolutionary development that helped early humans avoid danger. Full Story: ABC News (10/31)
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SCIENCE EXPLAINS WHY FRIGHT IS FUN

Health experts discuss the biological reasons why human beings get enjoyment from being scared in settings like horror movies and haunted houses. Fright can stimulate the same centers of the brain as happiness and pleasure, and it's enjoyable because there is no real threat of harm. Fear also triggers the release of stress hormones and neurotransmitters that induce a "fight, flight or freeze" response, an evolutionary development that helped early humans avoid danger. Full Story: ABC News (10/31)
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WHY FOOD ALLERGIES ARE ON THE RISE?

We are over-protecting our kids. That practice was tragically exacerbated by the American Academy of Pediatrics, which, alarmed by rising food allergies, advised parents in 2000 to avoid exposing kids to peanuts or peanut products until age 3. That’s way too late to avoid most food allergies through exposure.

Contrary to advice a couple of decades ago, parents would do well to introduce their tots to peanut butter — though perhaps not by the pallet load.
“That led to this whole epidemic of people not feeding their kids the allergens early, which then probably contributed to the increase in allergies, because you’re not giving the immune system a chance to train when it’s best suited to learn,” (Center for Food Allergy and Asthma Research)

Those guidelines are now reversed. The National Institute of Allergy and Infectious Diseases recommended in 2017 that children be exposed to peanuts as early as 4 months — particularly if they have eczema. The new advice was based on a landmark study out of the United Kingdom that found that early exposure led to a massive drop in the incidence of allergies.

“If you can get anywhere close to an 81 percent decrease that we saw in the original study, we’re talking about saving thousands and thousands of kids from peanut allergies,” Anthony S. Fauci, then the institute’s director, said
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CHILDHOOD LONG COVID SYMPTOMS IS A SIGNIFICANT CONCERN

Recent research suggests that about 16% of pediatric COVID-19 patients end up with long COVID symptoms, which often interfere with their schoolwork and activities. Specialist Dr. Katherine Clouser says the pediatric long COVID clinic where she works is partnering with school nurses and teachers to identify signs of the condition in children, and clinicians are treating it with different combinations of methods, including talk therapy, intensive rehabilitation and antivirals, depending on individual symptoms.
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Scent dogs may be a cheaper, faster and more effective way to detect COVID-19

A review in the Journal of Osteopathic Medicine found that scent dogs detected COVID-19 in symptomatic, presymptomatic and asymptomatic patients faster and with better sensitivity than current RT-PCR or antigen tests. "We believe that scent dogs deserve their place as a serious diagnostic methodology that could be particularly useful during pandemics, potentially as part of rapid health screenings in public spaces," the researchers said. Full Story: News Medical (7/17)
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Scent dogs may be a cheaper, faster and more effective way to detect COVID-19

A review in the Journal of Osteopathic Medicine found that scent dogs detected COVID-19 in symptomatic, presymptomatic and asymptomatic patients faster and with better sensitivity than current RT-PCR or antigen tests. "We believe that scent dogs deserve their place as a serious diagnostic methodology that could be particularly useful during pandemics, potentially as part of rapid health screenings in public spaces," the researchers said. Full Story: News Medical (7/17)
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Study Finds Social Media Impact On Children & College's Want To Create Gambling Addicts ... See MoreSee Less

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The most important virus you’ve never heard of ... See MoreSee Less

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The most important virus you’ve never heard of ... See MoreSee Less

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The most important virus you’ve never heard of ... See MoreSee Less

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BIG RESPIRATORY PLAYER THIS SEASON:
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I WANT TO HEAR YOUR OPINION, please comment
BIPARTISAN BILL WOULD BAN CHILDEN UNDER 13 FROM SOCIAL MEDIA USE
NBC News (4/26) reports that on Wednesday, a bipartisan group of senators introduced the Protecting Kids on Social Media Act, which “aims to protect children from any harmful effects posed by using social media.” The new legislation “would set a minimum age of 13 to use social media apps, such as Instagram, Facebook and TikTok, and would require parental consent for 13 to 17-year-olds.” NBC adds that “studies in recent years have suggested that social media has been linked to a rise in mental health disorders in teens and depression in adults.”
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I WANT TO HEAR YOUR OPINION, please comment
BIPARTISAN BILL WOULD BAN CHILDEN UNDER 13 FROM SOCIAL MEDIA USE
NBC News (4/26) reports that on Wednesday, a bipartisan group of senators introduced the Protecting Kids on Social Media Act, which “aims to protect children from any harmful effects posed by using social media.” The new legislation “would set a minimum age of 13 to use social media apps, such as Instagram, Facebook and TikTok, and would require parental consent for 13 to 17-year-olds.” NBC adds that “studies in recent years have suggested that social media has been linked to a rise in mental health disorders in teens and depression in adults.”
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EAT FOODS WITH VITAMIN C FOR OVERALL HEALTH
Vitamin C, or asorbic acid, is an essential nutrient that you need to acquire through your diet, says registered dietitian Devon Peart, adding that adequate intake of this antioxidant helps protect against cell damage, promotes healing, and supports eye and skin health. Eating one orange daily likely will supply the recommended amount of vitamin C, Peart says. Full Story: Cleveland Clinic (4/5)
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EAT FOODS WITH VITAMIN C FOR OVERALL HEALTH
Vitamin C, or asorbic acid, is an essential nutrient that you need to acquire through your diet, says registered dietitian Devon Peart, adding that adequate intake of this antioxidant helps protect against cell damage, promotes healing, and supports eye and skin health. Eating one orange daily likely will supply the recommended amount of vitamin C, Peart says. Full Story: Cleveland Clinic (4/5)
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DIET RICH IN MAGNESIUM LINKED TO BRAIN HEALTH
A study involving 6,001 cognitively healthy adults found an association between a diet high in magnesium and brain health. The research, published in the European Journal of Nutrition, showed that over a 16-month period higher consumption of magnesium-rich foods, including leafy greens, legumes, nuts, seeds and whole grains, was linked to larger brain volumes and possibly better brain health. Full Story: Medscape
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DIET RICH IN MAGNESIUM LINKED TO BRAIN HEALTH
A study involving 6,001 cognitively healthy adults found an association between a diet high in magnesium and brain health. The research, published in the European Journal of Nutrition, showed that over a 16-month period higher consumption of magnesium-rich foods, including leafy greens, legumes, nuts, seeds and whole grains, was linked to larger brain volumes and possibly better brain health. Full Story: Medscape
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WALNUTS ARE HELPFUL IN NEGATING EFFECTS OF STRESS AND SUPPORTING MOOD

In a separate study, using advanced mathematical techniques, researchers found when a small handful (~1/oz.) of walnuts was added into the daily diet of children, adolescents and adults who don't currently eat nuts, it improved intake of plant-based protein foods, along with higher intakes of nutrients to encourage, such as unsaturated fats, versus nutrients to limit like saturated fats and increased intake of under-consumed nutrients like fiber and potassium for some groups, as well as folate and magnesium.
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WALNUTS ARE HELPFUL IN NEGATING EFFECTS OF STRESS AND SUPPORTING MOOD

In a separate study, using advanced mathematical techniques, researchers found when a small handful (~1/oz.) of walnuts was added into the daily diet of children, adolescents and adults who don't currently eat nuts, it improved intake of plant-based protein foods, along with higher intakes of nutrients to encourage, such as unsaturated fats, versus nutrients to limit like saturated fats and increased intake of under-consumed nutrients like fiber and potassium for some groups, as well as folate and magnesium.
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HOW TO LESSEN EFFECTS OF THE TIME CHANGE
Disrupted sleep rhythms due to the twice-yearly time change can throw off a person's rest patterns for days, leading to accumulated sleep loss, which studies have shown may inrease the risk of stroke, heart attack, high blood pressure, accident, injury and mental health issues. To lessen the effects of the change, exercise regularly, get seven to nine hours of rest a night, go to bed earlier the week before, try an earlier wake time with exposure to bright light, do relaxing activities the evening before, eat a protein-heavy breakfast, and limit caffeine and alcohol.
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HOW TO LESSEN EFFECTS OF THE TIME CHANGE
Disrupted sleep rhythms due to the twice-yearly time change can throw off a person's rest patterns for days, leading to accumulated sleep loss, which studies have shown may inrease the risk of stroke, heart attack, high blood pressure, accident, injury and mental health issues. To lessen the effects of the change, exercise regularly, get seven to nine hours of rest a night, go to bed earlier the week before, try an earlier wake time with exposure to bright light, do relaxing activities the evening before, eat a protein-heavy breakfast, and limit caffeine and alcohol.
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POSITIVE PARENTING ... See MoreSee Less

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POSITIVE PARENTING ... See MoreSee Less

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INVOLVING KIDS IN MEAL PALANNING AND PREP TEACHES HEALTHFUL LESSONS
Planning ahead and making time to involve the whole family in meal planning and preparation teaches children about healthful eating, encourages them to try new foods, and with older children, can serve as a lesson in budgeting, says registered dietitian Danielle Townsend. "The adults in children's lives are the main role models when it comes to learning about healthy eating," Townsend says, offering tips for involving kids in food prep and recipes to try.
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INVOLVING KIDS IN MEAL PALANNING AND PREP TEACHES HEALTHFUL LESSONS
Planning ahead and making time to involve the whole family in meal planning and preparation teaches children about healthful eating, encourages them to try new foods, and with older children, can serve as a lesson in budgeting, says registered dietitian Danielle Townsend. "The adults in children's lives are the main role models when it comes to learning about healthy eating," Townsend says, offering tips for involving kids in food prep and recipes to try.
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ABOUT 40% OF PARENTS TO QUICK TO GIVE CHILDREN FEVER REDUCING MEDICATION
HealthDay (2/20) reports the study has found that about 40% of parents reach for fever-reducing medicines too quickly.” This poll “surveyed nearly 1,400 parents of children aged 12 and under” and found that “even though parents recognize the benefits of a low-grade fever for fighting off infection, about one-third would still give their child fever-reducing medication at temperatures below 100.4.” Half of parents “would do so at a temperature between 100.4 and 101.9, while about one-quarter of parents would give another dose later to help prevent a fever from returning.
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COVID-19 TIED TO GREATER RISK OF DIABETES
(2/14) reports people who have had COVID-19 “have a higher risk of developing diabetes, and that link seems to have persisted into the Omicron era, a new study” published in JAMA Network Open found. The researchers found COVID-19 “increased the odds of a new diabetes diagnosis by an average of about 58%.”
Medscape (2/14, Subscription Publication) reports the study also found:
“vaccination against SARS-CoV-2 appears to diminish” the likelihood of “diabetes following COVID-19 infection.”
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COVID-19 TIED TO GREATER RISK OF DIABETES
(2/14) reports people who have had COVID-19 “have a higher risk of developing diabetes, and that link seems to have persisted into the Omicron era, a new study” published in JAMA Network Open found. The researchers found COVID-19 “increased the odds of a new diabetes diagnosis by an average of about 58%.”
Medscape (2/14, Subscription Publication) reports the study also found:
“vaccination against SARS-CoV-2 appears to diminish” the likelihood of “diabetes following COVID-19 infection.”
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POOR SLEEP CAN REDUCE LIFE EXPECTANCY BY 15%

Did you know that sleeping less than 5 hours a night on average reduces life expectancy by 15%? For someone with a standard life expectancy of 78 years, that's almost 12 years off your life.

Truth is, when you aren't getting high-quality sleep consistently, you don't just feel groggy - you're also setting yourself up for less time on this planet. Research has shown that a lack of high-quality sleep can lead to higher stress, a bad mood, and significantly lower energy and vitality.
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POOR SLEEP CAN REDUCE LIFE EXPECTANCY BY 15%

Did you know that sleeping less than 5 hours a night on average reduces life expectancy by 15%? For someone with a standard life expectancy of 78 years, that's almost 12 years off your life.

Truth is, when you aren't getting high-quality sleep consistently, you don't just feel groggy - you're also setting yourself up for less time on this planet. Research has shown that a lack of high-quality sleep can lead to higher stress, a bad mood, and significantly lower energy and vitality.
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STUDY LINKS DIETARY ZINC TO MIGRAINES
A study involving 11,088 American adults found those whose diet included 15.8 milligrams or more of zinc daily had a lower risk of migraines, compared with those who consumed 5.9 mg or less each day. The findings, published in the journal Headache, suggest that "zinc is an important nutrient that influences migraine," researchers wrote.
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STUDY LINKS DIETARY ZINC TO MIGRAINES
A study involving 11,088 American adults found those whose diet included 15.8 milligrams or more of zinc daily had a lower risk of migraines, compared with those who consumed 5.9 mg or less each day. The findings, published in the journal Headache, suggest that "zinc is an important nutrient that influences migraine," researchers wrote.
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KIWI CONSUMPTION LINKED TO IMPROVED CONSTIPATION
Eating two kiwis daily followed by a four-week washout period was associated with an increase in complete spontaneous bowel movements and improved gastrointestinal symptoms among people with constipation, according to research published in The American Journal of Gastroenterology. Researchers noted specific improvements in indigestion, stool consistency, abdominal pain and constipation.
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KIWI CONSUMPTION LINKED TO IMPROVED CONSTIPATION
Eating two kiwis daily followed by a four-week washout period was associated with an increase in complete spontaneous bowel movements and improved gastrointestinal symptoms among people with constipation, according to research published in The American Journal of Gastroenterology. Researchers noted specific improvements in indigestion, stool consistency, abdominal pain and constipation.
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EXPERTS WARN LATEST OMICRON SUBVARIANTAS SHOW GREATED IMMUNE ESCAPE WILL LIKELY LEAD TO RISING CASES

COVID-19 Hospitalizations Rise Following Thanksgiving Holiday
The Washington Post (12/4) reports a post-Thanksgiving uptick in patients with COVID-19 “at U.S. hospitals is arriving even as health systems contend with waves of feverish, coughing people stricken with RSV and influenza infections.” COVID-19 hospitalizations last week “reached their highest level in three months, with more than 35,000 patients being treated, according to Washington Post data tracking.” Public health authorities “are concerned that the increase in the number of” patients with COVID-19 “will worsen the strain on hospitals already under pressure from the effects of” influenza and RSV. Experts “warn that holiday gatherings are a prime time for the coronavirus to spread as millions of Americans travel and get together.” The increase “in hospitalizations probably reflects a combination of patients who were infected before the Thanksgiving holiday rush and those exposed during Thanksgiving week, health experts said.”
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EXPERTS WARN LATEST OMICRON SUBVARIANTAS SHOW GREATED IMMUNE ESCAPE WILL LIKELY LEAD TO RISING CASES

COVID-19 Hospitalizations Rise Following Thanksgiving Holiday
The Washington Post (12/4) reports a post-Thanksgiving uptick in patients with COVID-19 “at U.S. hospitals is arriving even as health systems contend with waves of feverish, coughing people stricken with RSV and influenza infections.” COVID-19 hospitalizations last week “reached their highest level in three months, with more than 35,000 patients being treated, according to Washington Post data tracking.” Public health authorities “are concerned that the increase in the number of” patients with COVID-19 “will worsen the strain on hospitals already under pressure from the effects of” influenza and RSV. Experts “warn that holiday gatherings are a prime time for the coronavirus to spread as millions of Americans travel and get together.” The increase “in hospitalizations probably reflects a combination of patients who were infected before the Thanksgiving holiday rush and those exposed during Thanksgiving week, health experts said.”
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STUDY SUGGESTS EARLY PENUT INTRODUCTION FOR ALL INFANTS
Early introduction of peanuts to all infants, regardless of risk category and ethnicity, may reduce the incidence of peanut allergy by 88%, as opposed to introducing peanuts only to those with risk factors like severe eczema, according to research presented at the American College of Asthma & Immunology Annual Scientific Meeting. Introduction before 6 months of age is optimal with "all infants in the general population...encouraged to consume peanut products once they have reached 4 months of age," according to researcher Dr. Gideon Lack.
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STUDY SUGGESTS EARLY PENUT INTRODUCTION FOR ALL INFANTS
Early introduction of peanuts to all infants, regardless of risk category and ethnicity, may reduce the incidence of peanut allergy by 88%, as opposed to introducing peanuts only to those with risk factors like severe eczema, according to research presented at the American College of Asthma & Immunology Annual Scientific Meeting. Introduction before 6 months of age is optimal with "all infants in the general population...encouraged to consume peanut products once they have reached 4 months of age," according to researcher Dr. Gideon Lack.
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PFIZER TO SEEK FDA APPROVAL FOR MATERNAL RSV VACCINE
Pfizer plans to submit its maternal respiratory syncytial virus vaccine for FDA approval by the end of this year, citing trial results that showed it to be more than 80% effective at preventing serious RSV illness and reducing the need for medical care in a baby's first months of life. The vaccine is given to pregnant people, whose bodies create antibodies that cross the placenta and provide protection for infants after they are born.
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PFIZER TO SEEK FDA APPROVAL FOR MATERNAL RSV VACCINE
Pfizer plans to submit its maternal respiratory syncytial virus vaccine for FDA approval by the end of this year, citing trial results that showed it to be more than 80% effective at preventing serious RSV illness and reducing the need for medical care in a baby's first months of life. The vaccine is given to pregnant people, whose bodies create antibodies that cross the placenta and provide protection for infants after they are born.
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PFIZER TO SEEK FDA APPROVAL FOR MATERNAL RSV VACCINE
Pfizer plans to submit its maternal respiratory syncytial virus vaccine for FDA approval by the end of this year, citing trial results that showed it to be more than 80% effective at preventing serious RSV illness and reducing the need for medical care in a baby's first months of life. The vaccine is given to pregnant people, whose bodies create antibodies that cross the placenta and provide protection for infants after they are born.
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RSV: WHEN IT'S MORE THAN JUST A COLD
By: Andrea Jones, MD, FAAP

Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold. But, some children get very sick with RSV.

What is RSV?
RSV (or respiratory syncytial virus) is one of the many viruses that cause respiratory illness―illnesses of the nose, throat, and lungs. This virus occurs in the late fall through early spring months, but can vary in different parts of the country.

With mask-wearing and physical distancing for COVID-19, there were fewer cases of RSV in 2020. However, once safety measures relaxed with the arrival of COVID-19 vaccines, a rise in RSV cases began in spring 2021. The spread of RSV and other seasonal respiratory illnesses like influenza (flu) has also started earlier than usual this year.
RSV symptoms in babies
Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days.

Cold: Upper Respiratory Tract Infection
Bronchiolitis: Lower Respiratory Tract Infection
Cold symptoms may include:

Fever (temperature of 100.4 or higher)

Cough (dry or wet sounding)

Congestion

Runny nose

Sneezing

Fussiness

Poor feeding

Symptoms may include cold symptoms, plus:

Fast breathing

Flaring of the nostrils

Head bobbing with breathing

Rhythmic grunting during breathing

Belly breathing, tugging between the ribs and/or the lower neck (see video, below)

Wheezing

How hard is your baby breathing? What to look for.
Chest wall retractions happen when a baby must use muscles between the ribs or in the neck to breathe. It is a sign that your baby is having to work harder than normal to breathe.

Watch your child's rib cage as they inhale. If you see it "caving in" and forming an upside-down "V" shape under the neck, then they are working too hard.

Is your baby or young child at a greater risk of this respiratory illness?
Those infants with a higher risk for severe RSV infection include:

12 weeks old or younger at the start of RSV season

Premature or low birth weight infants (especially those born before 29 weeks gestation)

Chronic lung disease of prematurity

Babies with certain types of heart defects

Those with weak immune systems due to illness or treatments

Additional risk factors for severe RSV infections include low birth weight, having siblings, a mother's smoking during pregnancy, exposure to secondhand smoke in the home, history of allergies and eczema, not breastfeeding, and being around children in a child care setting or living in crowded living conditions.

When should you call the doctor?
RSV symptoms are typically at their worst on days 3 through 5 of illness. Fortunately, almost all children recover from an RSV infection on their own.

Call your pediatrician right away if your child has any:
Symptoms of bronchiolitis (listed above)

Symptoms of dehydration (fewer than 1 wet diaper every 8 hours)

Pauses or difficulty breathing

Gray or blue color to tongue, lips or skin

Significantly decreased activity and alertness

Some children with RSV may be at increased risk of developing a bacterial infection, such as an ear infection. Call your doctor if your child has:

Symptoms that worsen or do not start to improve after 7 days

A fever (with a rectal temperature of 100.4°F or higher) and they are younger than 3 months of age (12 weeks).

A fever that rises above 104°F repeatedly for a child of any age.

Poor sleep or fussiness, chest pain, ear tugging or ear drainage

How do doctors diagnose RSV?
Pediatricians diagnose children with a cold or bronchiolitis by asking about their symptoms and by doing a physical exam. Your pediatrician may do a nasal swab test to determine if your child has RSV or another virus. A chest x-ray and/or oxygen saturation test may also be done to check for lung congestion. Because most children recover without difficulty and because there is no treatment for RSV, these tests usually are not necessary.

Is RSV contagious?
Yes. RSV spreads just like a common-cold virus―from one person to another. It enters the body through the nose or eyes or, usually from:

Direct person-to-person contact with saliva, mucus, or nasal discharge.

Unclean hands (RSV can survive 30 minutes or more on unwashed hands).

Unclean objects or surfaces (RSV can survive up to 6 hours on surfaces, toys, keyboards, door knobs, etc).

Symptoms can appear 2 to 8 days after contact with RSV. According to the U.S. Centers for Disease Control and Prevention (CDC), people infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks―even if they are not showing symptoms.

Keep in mind, children and adults can get RSV multiple times–even during a single season. Often, however, repeat infections are less severe than the first one.

What can you do to help your child feel better?
There is no cure for RSV and medications, like steroids and antibiotics, do not help with RSV.

To help your child feel more comfortable, begin by doing what you would for any bad cold:
Nasal saline with gentle suctioning to allow easier breathing and feeding.

Cool-mist humidifier to help break up mucus and allow easier breathing.

Fluids and frequent feedings. Make sure your child is staying hydrated. Infants with a common cold may feed more slowly or not feel like eating, because they are having trouble breathing. Try to section baby's nose before attempting to breast or bottle-feed. Supplementation with water or formula is unnecessary for breastfed babies. If difficult for the baby to feed at the breast, expressing breastmilk into a cup or bottle may be an option.

Acetaminophen or ibuprofen (if older than 6 months) to help with low-grade fevers. Always avoid aspirin and cough and cold medications.

Only 3% of children with RSV will require a hospital stay. Those children may need oxygen to help with breathing or an (intravenous) IV line for fluids. Most of these children can go home after 2 or 3 days. Rarely, a child may need care in a pediatric intensive care unit (PICU).

How can you protect your children from RSV?
Wash your hands! Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds. Remind children to practice good hand hygiene all through the year.

Other things that can help prevent RSV
Vaccinate. Keep your children up to date on their immunizations and get the whole family annual flu shots. Getting vaccinated with Tdap―to protect against whooping cough is especially important for adults who are around infant—new parents, grandparents, babysitters, nannies, etc. Your child should also be immunized against COVID-19.

Limit your baby's exposure to crowds, other children, and anyone with colds. Keep them home from school or child care when they are sick and teach them to cover their coughs and sneezes.

Go germ-free. Disinfect objects and surfaces in your home regularly and avoid exposing your child to smoke from tobacco or other substances.

Feed your baby breastmilk. It has unique antibodies to prevent and fight infections.

Injections for high-risk infants
There is a monoclonal antibody treatment that may reduce the risk of severe RSV infection in some high-risk infants. Your pediatrician will let you know if your baby is a candidate.

Hope on the horizon
Medicine is always advancing! Scientists are currently studying vaccines to prevent and medications to treat RSV. We may have more options in the future. In the meantime, rest assured that most children recover well from RSV and grow to be healthy adults.

More information
COVID-19 & Other Respiratory Illnesses: How Are They Different?
Treating Bronchiolitis in Infants
HealthyChildren.org Parent Webinar on RSV
RSV in Infants and Young Children (CDC)
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RSV: WHEN IT'S MORE THAN JUST A COLD
By: Andrea Jones, MD, FAAP

Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold. But, some children get very sick with RSV.

What is RSV?
RSV (or respiratory syncytial virus) is one of the many viruses that cause respiratory illness―illnesses of the nose, throat, and lungs. This virus occurs in the late fall through early spring months, but can vary in different parts of the country.

With mask-wearing and physical distancing for COVID-19, there were fewer cases of RSV in 2020. However, once safety measures relaxed with the arrival of COVID-19 vaccines, a rise in RSV cases began in spring 2021. The spread of RSV and other seasonal respiratory illnesses like influenza (flu) has also started earlier than usual this year.
RSV symptoms in babies
Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days.

Cold: Upper Respiratory Tract Infection
Bronchiolitis: Lower Respiratory Tract Infection
Cold symptoms may include:

Fever (temperature of 100.4 or higher)

Cough (dry or wet sounding)

Congestion

Runny nose

Sneezing

Fussiness

Poor feeding

Symptoms may include cold symptoms, plus:

Fast breathing

Flaring of the nostrils

Head bobbing with breathing

Rhythmic grunting during breathing

Belly breathing, tugging between the ribs and/or the lower neck (see video, below)

Wheezing

How hard is your baby breathing? What to look for.
Chest wall retractions happen when a baby must use muscles between the ribs or in the neck to breathe. It is a sign that your baby is having to work harder than normal to breathe.

Watch your child's rib cage as they inhale. If you see it "caving in" and forming an upside-down "V" shape under the neck, then they are working too hard.

Is your baby or young child at a greater risk of this respiratory illness?
Those infants with a higher risk for severe RSV infection include:

12 weeks old or younger at the start of RSV season

Premature or low birth weight infants (especially those born before 29 weeks gestation)

Chronic lung disease of prematurity

Babies with certain types of heart defects

Those with weak immune systems due to illness or treatments

Additional risk factors for severe RSV infections include low birth weight, having siblings, a mother's smoking during pregnancy, exposure to secondhand smoke in the home, history of allergies and eczema, not breastfeeding, and being around children in a child care setting or living in crowded living conditions.

When should you call the doctor?
RSV symptoms are typically at their worst on days 3 through 5 of illness. Fortunately, almost all children recover from an RSV infection on their own.

Call your pediatrician right away if your child has any:
Symptoms of bronchiolitis (listed above)

Symptoms of dehydration (fewer than 1 wet diaper every 8 hours)

Pauses or difficulty breathing

Gray or blue color to tongue, lips or skin

Significantly decreased activity and alertness

Some children with RSV may be at increased risk of developing a bacterial infection, such as an ear infection. Call your doctor if your child has:

Symptoms that worsen or do not start to improve after 7 days

A fever (with a rectal temperature of 100.4°F or higher) and they are younger than 3 months of age (12 weeks).

A fever that rises above 104°F repeatedly for a child of any age.

Poor sleep or fussiness, chest pain, ear tugging or ear drainage

How do doctors diagnose RSV?
Pediatricians diagnose children with a cold or bronchiolitis by asking about their symptoms and by doing a physical exam. Your pediatrician may do a nasal swab test to determine if your child has RSV or another virus. A chest x-ray and/or oxygen saturation test may also be done to check for lung congestion. Because most children recover without difficulty and because there is no treatment for RSV, these tests usually are not necessary.

Is RSV contagious?
Yes. RSV spreads just like a common-cold virus―from one person to another. It enters the body through the nose or eyes or, usually from:

Direct person-to-person contact with saliva, mucus, or nasal discharge.

Unclean hands (RSV can survive 30 minutes or more on unwashed hands).

Unclean objects or surfaces (RSV can survive up to 6 hours on surfaces, toys, keyboards, door knobs, etc).

Symptoms can appear 2 to 8 days after contact with RSV. According to the U.S. Centers for Disease Control and Prevention (CDC), people infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks―even if they are not showing symptoms.

Keep in mind, children and adults can get RSV multiple times–even during a single season. Often, however, repeat infections are less severe than the first one.

What can you do to help your child feel better?
There is no cure for RSV and medications, like steroids and antibiotics, do not help with RSV.

To help your child feel more comfortable, begin by doing what you would for any bad cold:
Nasal saline with gentle suctioning to allow easier breathing and feeding.

Cool-mist humidifier to help break up mucus and allow easier breathing.

Fluids and frequent feedings. Make sure your child is staying hydrated. Infants with a common cold may feed more slowly or not feel like eating, because they are having trouble breathing. Try to section baby's nose before attempting to breast or bottle-feed. Supplementation with water or formula is unnecessary for breastfed babies. If difficult for the baby to feed at the breast, expressing breastmilk into a cup or bottle may be an option.

Acetaminophen or ibuprofen (if older than 6 months) to help with low-grade fevers. Always avoid aspirin and cough and cold medications.

Only 3% of children with RSV will require a hospital stay. Those children may need oxygen to help with breathing or an (intravenous) IV line for fluids. Most of these children can go home after 2 or 3 days. Rarely, a child may need care in a pediatric intensive care unit (PICU).

How can you protect your children from RSV?
Wash your hands! Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds. Remind children to practice good hand hygiene all through the year.

Other things that can help prevent RSV
Vaccinate. Keep your children up to date on their immunizations and get the whole family annual flu shots. Getting vaccinated with Tdap―to protect against whooping cough is especially important for adults who are around infant—new parents, grandparents, babysitters, nannies, etc. Your child should also be immunized against COVID-19.

Limit your baby's exposure to crowds, other children, and anyone with colds. Keep them home from school or child care when they are sick and teach them to cover their coughs and sneezes.

Go germ-free. Disinfect objects and surfaces in your home regularly and avoid exposing your child to smoke from tobacco or other substances.

Feed your baby breastmilk. It has unique antibodies to prevent and fight infections.

Injections for high-risk infants
There is a monoclonal antibody treatment that may reduce the risk of severe RSV infection in some high-risk infants. Your pediatrician will let you know if your baby is a candidate.

Hope on the horizon
Medicine is always advancing! Scientists are currently studying vaccines to prevent and medications to treat RSV. We may have more options in the future. In the meantime, rest assured that most children recover well from RSV and grow to be healthy adults.

More information
COVID-19 & Other Respiratory Illnesses: How Are They Different?
Treating Bronchiolitis in Infants
HealthyChildren.org Parent Webinar on RSV
RSV in Infants and Young Children (CDC)
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CDC: US MAY EXPERIENCE SEVERE FLU SEASON
CDC Director Rochelle Walensky said the US may experience a severe flu season amid reports of higher than normal levels of influenza and other respiratory illnesses, particularly in the South Central and Southeast US. "Not everybody got flu vaccinated last year, and many people did not get the flu. So that makes us ripe to have potentially a severe flu season," Walensky warned, but Americans can protect themselves by getting a flu vaccine, "ideally by the end of October," the CDC said.
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CDC: US MAY EXPERIENCE SEVERE FLU SEASON
CDC Director Rochelle Walensky said the US may experience a severe flu season amid reports of higher than normal levels of influenza and other respiratory illnesses, particularly in the South Central and Southeast US. "Not everybody got flu vaccinated last year, and many people did not get the flu. So that makes us ripe to have potentially a severe flu season," Walensky warned, but Americans can protect themselves by getting a flu vaccine, "ideally by the end of October," the CDC said.
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SCIENTISTS WORK TO UNDERSTAND COVID-19 SENSORY LOSS
Loss of smell and taste due to SARS-CoV-2 infection can create a ripple effect that erodes appetite and quality of life and may lead to poor nutrition, cognitive problems and depression, and a recent study found that 5% of COVID-19 survivors may be suffering from it. Scientists now understand that the virus attacks sustentacular cells that nourish and protect the body's neurons, and they are developing interventions to help.
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SCIENTISTS WORK TO UNDERSTAND COVID-19 SENSORY LOSS
Loss of smell and taste due to SARS-CoV-2 infection can create a ripple effect that erodes appetite and quality of life and may lead to poor nutrition, cognitive problems and depression, and a recent study found that 5% of COVID-19 survivors may be suffering from it. Scientists now understand that the virus attacks sustentacular cells that nourish and protect the body's neurons, and they are developing interventions to help.
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4 CUPS OF TEA A DAY MAY REDUCE DIABETES RISK
Drinking at least four cups of black, green or oolong tea each day for 10 years was associated with a 17% reduction in the risk of diabetes, according to a review of 19 studies covering more than 1 million adults across eight countries. The review, to be presented at the European Association for the Study of Diabetes' annual meeting, found that one to three daily cups of tea was linked to a 4% reduction in Type 2 diabetes risk, and the researchers found no association between tea consumption and cancer risk. NBC News (9/17)
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4 CUPS OF TEA A DAY MAY REDUCE DIABETES RISK
Drinking at least four cups of black, green or oolong tea each day for 10 years was associated with a 17% reduction in the risk of diabetes, according to a review of 19 studies covering more than 1 million adults across eight countries. The review, to be presented at the European Association for the Study of Diabetes' annual meeting, found that one to three daily cups of tea was linked to a 4% reduction in Type 2 diabetes risk, and the researchers found no association between tea consumption and cancer risk. NBC News (9/17)
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ADOLESCENT SLEEP TIMES LINKED TO METABOLIC HEALTH
Adolescents who slept less than the recommended eight hours each night had higher average metabolic syndrome scores and a greater likelihood of overweight or obesity, compared with those who slept the recommended time, according to a study presented at the European Society of Cardiology Congress. "On top of stressing the importance of dietary habits and physical activity, adequate sleep needs have to be considered too," said researcher Jesus Martinez-Gomez.
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STUDY LINKS BREAKFAST TO PSYCHOLOGICAL BEHAVIOR IN KIDS
Eating breakfast or not having it, as well as the foods consumed and where it is eaten, may be linked to psychosocial behavior problems for children ages 4 to 14, according to a study involving 3,773 children in Spain. The research, published in Frontiers in Nutrition, found that both skipping breakfast and eating breakfast away from home were associated with behavioral problems.
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ADJUST CHILD'S SLEEP SCHEDULE BEFORE SCHOOL RESUMES
Children may fall into irregular sleep habits over the summer, making it difficult for them to return to a normal sleep schedule during the school year. Gradually moving the child's bedtime back by about 15 minutes every other night for two weeks before school begins, and getting them up 15 minutes earlier, can help avoid sleep deprivation and disruption once school begins; daytime exercise and avoiding electronics an hour before bedtime can help as well.
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ADJUST CHILD'S SLEEP SCHEDULE BEFORE SCHOOL RESUMES
Children may fall into irregular sleep habits over the summer, making it difficult for them to return to a normal sleep schedule during the school year. Gradually moving the child's bedtime back by about 15 minutes every other night for two weeks before school begins, and getting them up 15 minutes earlier, can help avoid sleep deprivation and disruption once school begins; daytime exercise and avoiding electronics an hour before bedtime can help as well.
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EXPOSURE TO KIDS LINKED TO PROTECTION FROM COVID-19 IN ADULTS
A study published in Proceedings of the National Academy of Sciences found that adults with young children -- and who were exposed to their colds -- were less likely to have severe COVID-19 illness, while adults without children had a 49% increased risk of COVID-19-related hospitalization and up to 76% increased risk of requiring ICU admission. Researchers examined medical records of over 3 million adult members of Kaiser Permanente Northern California between February 2019 and January 2021 and noted that the study was conducted before the availability of COVID vaccines.
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EXPOSURE TO KIDS LINKED TO PROTECTION FROM COVID-19 IN ADULTS
A study published in Proceedings of the National Academy of Sciences found that adults with young children -- and who were exposed to their colds -- were less likely to have severe COVID-19 illness, while adults without children had a 49% increased risk of COVID-19-related hospitalization and up to 76% increased risk of requiring ICU admission. Researchers examined medical records of over 3 million adult members of Kaiser Permanente Northern California between February 2019 and January 2021 and noted that the study was conducted before the availability of COVID vaccines.
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COVID-19 & OTHER RESPIRATORY ILLNESSES
HOW ARE THEY DIFFERENT

Your child has a stuffy nose, cough and fever. Is it a cold? The flu? Or are they symptoms of COVID? Some COVID, flu, respiratory syncytial virus (RSV) and cold symptoms can be alike. But there are some clues that set each of these common viruses apart.

Even with masks and vaccines, contagious viruses are still spreading that lead to sniffles, sneezing and coughing.

Is it COVID-19, the flu, RSV or a common cold?
Let's look at the viruses that cause four common childhood illnesses—COVID-19, flu, the common cold and respiratory syncytial virus.

All of them share some similar symptoms. This can make it hard to tell them apart. Here are some clues that help your pediatrician figure out what kind of respiratory illness is making your child sick.

COVID-19 symptoms include fever, cough, fatigue, congestion, shortness of breath, sore throat, headache, sneezing, vomiting/diarrhea, or loss of taste/smell. COVID-19 symptoms can appear 2 to 14 days after infection.

Flu symptoms include fever, cough, fatigue, stuffy nose, shortness of breath, sore throat, headache. Symptoms show up about 1 to 4 days after being exposed to a sick person. The infection can cause pneumonia.

RSV can cause a fever, cough, fatigue, stuffy nose, shortness of breath, sneezing, fast/short breaths, flaring nostrils, wheezing and grunting, poor feeding/no appetite, and head bobbing or chest caving in between and under ribs with each breath. Symptoms of RSV usually are worst on days 3 through 5 and last about 5 to 7 days. The infection causes a cold, which may be followed by bronchiolitis or pneumonia. RSV is common in late fall through early spring. In 2021, however, the pandemic caused a strange thing to happen. The number of RSV infections and hospital rates went up in summer 2021 instead. Nearly all children get RSV by their second birthday.

Common cold symptoms may include fever, cough, fatigue, stuffy nose, sore throat, sneezing. Colds are upper respiratory infections that can be caused by many viruses. A few common cold viruses are rhinovirus, adenovirus, human coronavirus, human parainfluenza virus, human metapneumovirus and RSV. Healthy children get about 6 colds a year.
Can kids get more than one illness at the same time?
Yes. Your doctor may refer to this as a secondary illness. For example, it is not unusual for children with flu or COVID to develop moderate or severe pneumonia. And cold symptoms can lead to another health problem like an ear infection or sinus infection.

Because some of the symptoms of flu, COVID-19 and other respiratory illnesses are similar, the Centers for Disease Control and Prevention (CDC) recommends testing to confirm a diagnosis. People can be infected with both flu and COVID-19 at the same time and have symptoms of both.

How to avoid getting sick now that viruses are so unpredictable

Vaccines are an effective tool to prevent serious illness from the flu, COVID-19 and other vaccine-preventable diseases. Staying up to date on routine immunizations also helps others. The protection from vaccinescan help to keep people at risk of serious problems from flu, COVID-19 (and its complications, like MIS-C), and other viruses out of the hospital.

Everyone 6 months and older should get flu vaccines each year. Get your child vaccinated by the end of October to protect them throughout flu season, which can last until the end of May. Everyone 5 years and older are eligible to receive COVID-19 vaccinations.

There is no vaccine for RSV or the common cold. For RSV, some infants who are at risk of serious problems can receive an injectable medicine called palivizumab. It protects babies who were born significantly premature, had a heart defect or weak immune system.

There are many tools other to help stop viruses from spreading. Children should learn to cover their mouths and noses with a tissue when they cough or sneeze (and then put the tissue in the trash right away). Wearing a mask in public helps prevent COVID, flu and other viruses from spreading. And everyone should be encouraged to wash their hands with soap and water or use an alcohol-based hand sanitizer.

Remember
If your child is sick and you have any questions or concerns about their symptoms, don't hesitate to call your pediatrician. And if you had to delay visits to the pediatrician during the pandemic, it is important to catch up on immunizations, sports physical examinations and routine care.
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CHOOSING AN INSECT REPELLENT FOR YOUR CHILD
www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx?fbclid=IwA...
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CHOOSING AN INSECT REPELLENT FOR YOUR CHILD
www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx?fbclid=IwA...
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100% ORANGE JUICE'S ROLE IN FIGHTING INFLAMMATION

Dr. Taylor Wallace, CEO of Think Healthy Group, recently presented the latest findings on 100% orange juice and the role it may play within a healthy diet. His systematic review and meta-analysis published in the journal, Advances of Nutrition, suggested the potential for 100% orange juice to fight inflammation and oxidative stress among individuals that are both healthy and at high risk of developing chronic diseases. Findings suggest that drinking 100% orange juice may reduce interleukin 6, a well-established marker of inflammation, and helps pave the way for further research on the topic.
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AMERICAN ACADEMY OF PEDIATRICS EXPERTS OFFER ADVICE TO HELP PARENTS THROUGH FORMULA SHORTAGE
Q: I found small quantities of several different formulas. What is the best way to switch among the brands?

A: It is likely that your baby will do just fine with different formulas as long as they are the same type. If your baby does not like the taste or has difficulty tolerating a new formula, you may want to try gradually introducing small amounts of it by mixing it with the usual formula. You can slowly increase the amount of the new formula. Be patient as it may take some time for the baby to get used to a new formula. Try not to give up unless it really isn’t tolerated. If you have questions about whether your baby is tolerating the new formula, call our office.

Q: I have a 3-month-old infant and can’t find my usual formula. What should I do?

A: This is a very difficult problem, and we’re glad that you contacted us. If you can find another similar formula, it’s OK to make the switch. If you use a special formula for allergies or other special health needs, you can find a list of comparable formulas at naspghan.org/recent-news/naspghan-tools-for-hcps-affected-by-formula-recall/.

Q: I have a 7-month-old infant and can’t find any formula. What should I do?

A: If your child is older than 6 months of age and usually is on regular formula (not a specialty product for allergies or other special health needs), whole cow’s milk may be a short-term option. In a pinch, you could feed your child whole cow's milk for a brief period of time (no more than one week). This is not ideal and should not be done for more than one week.

One concern about giving cow’s milk to a baby who is 7-12 months old is it does not contain equivalent amounts of iron to formula. If you have to use cow’s milk to feed your infant, ideally do so for as short a time as possible and for less than a week. It’s also important to give the baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.

Q: My infant needs a specialty metabolic formula, but I can’t find any. What should I do?

A: Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic formulas for patients in urgent need. Our office can fill out a request and if it is approved, the formula can be shipped to your home. (Pediatricians can download the form at www.abbottnutrition.com/metabolics and fax the completed form with a physician order to 877-293-9145.).

Q: Only one brand of formula is covered under the WIC program, but I can’t find any. What should I do?

A: Most states are allowing parents who use WIC benefits to buy other brands of formula or different sizes and types like ready-to-feed formula. (To find out what their state is allowing, pediatricians and families can check a map at www.fns.usda.gov/wic/infant-formula-waiver-status.)

Q: What is the earliest age I can start giving my infant solid food to stretch my formula supply?

A: Solid foods should not be used to stretch formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are 6 months old, but it depends on their rate of development. You can introduce solid foods as early as 4 months of age, but infants 4-6 months of age will continue to need breastmilk or formula to supply the majority of their nutrition.

Q: Is it safe to get breastmilk from a friend or online group?

A: We can’t know for sure whether breastmilk from a friend or online group is safe. It is better to obtain donor breastmilk from a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, visit www.hmbana.org/find-a-milk-bank/.

Q: Can I make my own formula? I’ve seen a recipe online using evaporated milk that people say was used safely in the 1940s.

A: Homemade formulas are not recommended. Although homemade formula was used in the past, it also was associated with many risks to infants. Online recipes have significant safety concerns regarding contamination and nutrient concentration. Using homemade formula could harm your infant.

Q: Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?

A: This should never be done. Adding extra water can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders, which could result in a baby needing to be hospitalized.

Q: How long can formula be used past a “best by” date?

A: Generally, formula should not be used past the “best by” date because it may not be safe or have the required levels of nutrients.

Q: I heard the government will be importing formula from other countries? Is it safe?

A: The Food and Drug Administration (FDA) is working to assure procedures are in place to verify production standards, labeling and shipping of brands that previously have not been sold in the U.S. European formulas are regulated by the European Food Safety Agency similar to how the FDA regulates formula in the U.S. and are highly reliable.
Q: I found small quantities of several different formulas. What is the best way to switch among the brands?

A: It is likely that your baby will do just fine with different formulas as long as they are the same type. If your baby does not like the taste or has difficulty tolerating a new formula, you may want to try gradually introducing small amounts of it by mixing it with the usual formula. You can slowly increase the amount of the new formula. Be patient as it may take some time for the baby to get used to a new formula. Try not to give up unless it really isn’t tolerated. If you have questions about whether your baby is tolerating the new formula, call our office.

Q: I have a 3-month-old infant and can’t find my usual formula. What should I do?

A: This is a very difficult problem, and we’re glad that you contacted us. If you can find another similar formula, it’s OK to make the switch. If you use a special formula for allergies or other special health needs, you can find a list of comparable formulas at naspghan.org/recent-news/naspghan-tools-for-hcps-affected-by-formula-recall/.

Q: I have a 7-month-old infant and can’t find any formula. What should I do?

A: If your child is older than 6 months of age and usually is on regular formula (not a specialty product for allergies or other special health needs), whole cow’s milk may be a short-term option. In a pinch, you could feed your child whole cow's milk for a brief period of time (no more than one week). This is not ideal and should not be done for more than one week.

One concern about giving cow’s milk to a baby who is 7-12 months old is it does not contain equivalent amounts of iron to formula. If you have to use cow’s milk to feed your infant, ideally do so for as short a time as possible and for less than a week. It’s also important to give the baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.

Q: My infant needs a specialty metabolic formula, but I can’t find any. What should I do?

A: Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic formulas for patients in urgent need. Our office can fill out a request and if it is approved, the formula can be shipped to your home. (Pediatricians can download the form at www.abbottnutrition.com/metabolics and fax the completed form with a physician order to 877-293-9145.).

Q: Only one brand of formula is covered under the WIC program, but I can’t find any. What should I do?

A: Most states are allowing parents who use WIC benefits to buy other brands of formula or different sizes and types like ready-to-feed formula. (To find out what their state is allowing, pediatricians and families can check a map at www.fns.usda.gov/wic/infant-formula-waiver-status.)

Q: What is the earliest age I can start giving my infant solid food to stretch my formula supply?

A: Solid foods should not be used to stretch formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are 6 months old, but it depends on their rate of development. You can introduce solid foods as early as 4 months of age, but infants 4-6 months of age will continue to need breastmilk or formula to supply the majority of their nutrition.

Q: Is it safe to get breastmilk from a friend or online group?

A: We can’t know for sure whether breastmilk from a friend or online group is safe. It is better to obtain donor breastmilk from a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, visit www.hmbana.org/find-a-milk-bank/.

Q: Can I make my own formula? I’ve seen a recipe online using evaporated milk that people say was used safely in the 1940s.

A: Homemade formulas are not recommended. Although homemade formula was used in the past, it also was associated with many risks to infants. Online recipes have significant safety concerns regarding contamination and nutrient concentration. Using homemade formula could harm your infant.

Q: Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?

A: This should never be done. Adding extra water can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders, which could result in a baby needing to be hospitalized.

Q: How long can formula be used past a “best by” date?

A: Generally, formula should not be used past the “best by” date because it may not be safe or have the required levels of nutrients.

Q: I heard the government will be importing formula from other countries? Is it safe?

A: The Food and Drug Administration (FDA) is working to assure procedures are in place to verify production standards, labeling and shipping of brands that previously have not been sold in the U.S. European formulas are regulated by the European Food Safety Agency similar to how the FDA regulates formula in the U.S. and are highly reliable.Q: I found small quantities of several different formulas. What is the best way to switch among the brands?

A: It is likely that your baby will do just fine with different formulas as long as they are the same type. If your baby does not like the taste or has difficulty tolerating a new formula, you may want to try gradually introducing small amounts of it by mixing it with the usual formula. You can slowly increase the amount of the new formula. Be patient as it may take some time for the baby to get used to a new formula. Try not to give up unless it really isn’t tolerated. If you have questions about whether your baby is tolerating the new formula, call our office.

Q: I have a 3-month-old infant and can’t find my usual formula. What should I do?

A: This is a very difficult problem, and we’re glad that you contacted us. If you can find another similar formula, it’s OK to make the switch. If you use a special formula for allergies or other special health needs, you can find a list of comparable formulas at naspghan.org/recent-news/naspghan-tools-for-hcps-affected-by-formula-recall/.

Q: I have a 7-month-old infant and can’t find any formula. What should I do?

A: If your child is older than 6 months of age and usually is on regular formula (not a specialty product for allergies or other special health needs), whole cow’s milk may be a short-term option. In a pinch, you could feed your child whole cow's milk for a brief period of time (no more than one week). This is not ideal and should not be done for more than one week.

One concern about giving cow’s milk to a baby who is 7-12 months old is it does not contain equivalent amounts of iron to formula. If you have to use cow’s milk to feed your infant, ideally do so for as short a time as possible and for less than a week. It’s also important to give the baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.

Q: My infant needs a specialty metabolic formula, but I can’t find any. What should I do?

A: Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic formulas for patients in urgent need. Our office can fill out a request and if it is approved, the formula can be shipped to your home. (Pediatricians can download the form at www.abbottnutrition.com/metabolics and fax the completed form with a physician order to 877-293-9145.).

Q: Only one brand of formula is covered under the WIC program, but I can’t find any. What should I do?

A: Most states are allowing parents who use WIC benefits to buy other brands of formula or different sizes and types like ready-to-feed formula. (To find out what their state is allowing, pediatricians and families can check a map at www.fns.usda.gov/wic/infant-formula-waiver-status.)

Q: What is the earliest age I can start giving my infant solid food to stretch my formula supply?

A: Solid foods should not be used to stretch formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are 6 months old, but it depends on their rate of development. You can introduce solid foods as early as 4 months of age, but infants 4-6 months of age will continue to need breastmilk or formula to supply the majority of their nutrition.

Q: Is it safe to get breastmilk from a friend or online group?

A: We can’t know for sure whether breastmilk from a friend or online group is safe. It is better to obtain donor breastmilk from a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, visit www.hmbana.org/find-a-milk-bank/.

Q: Can I make my own formula? I’ve seen a recipe online using evaporated milk that people say was used safely in the 1940s.

A: Homemade formulas are not recommended. Although homemade formula was used in the past, it also was associated with many risks to infants. Online recipes have significant safety concerns regarding contamination and nutrient concentration. Using homemade formula could harm your infant.

Q: Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?

A: This should never be done. Adding extra water can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders, which could result in a baby needing to be hospitalized.

Q: How long can formula be used past a “best by” date?

A: Generally, formula should not be used past the “best by” date because it may not be safe or have the required levels of nutrients.

Q: I heard the government will be importing formula from other countries? Is it safe?

A: The Food and Drug Administration (FDA) is working to assure procedures are in place to verify production standards, labeling and shipping of brands that previously have not been sold in the U.S. European formulas are regulated by the European Food Safety Agency similar to how the FDA regulates formula in the U.S. and are highly reliable.Q: I found small quantities of several different formulas. What is the best way to switch among the brands?

A: It is likely that your baby will do just fine with different formulas as long as they are the same type. If your baby does not like the taste or has difficulty tolerating a new formula, you may want to try gradually introducing small amounts of it by mixing it with the usual formula. You can slowly increase the amount of the new formula. Be patient as it may take some time for the baby to get used to a new formula. Try not to give up unless it really isn’t tolerated. If you have questions about whether your baby is tolerating the new formula, call our office.

Q: I have a 3-month-old infant and can’t find my usual formula. What should I do?

A: This is a very difficult problem, and we’re glad that you contacted us. If you can find another similar formula, it’s OK to make the switch. If you use a special formula for allergies or other special health needs, you can find a list of comparable formulas at naspghan.org/recent-news/naspghan-tools-for-hcps-affected-by-formula-recall/.

Q: I have a 7-month-old infant and can’t find any formula. What should I do?

A: If your child is older than 6 months of age and usually is on regular formula (not a specialty product for allergies or other special health needs), whole cow’s milk may be a short-term option. In a pinch, you could feed your child whole cow's milk for a brief period of time (no more than one week). This is not ideal and should not be done for more than one week.

One concern about giving cow’s milk to a baby who is 7-12 months old is it does not contain equivalent amounts of iron to formula. If you have to use cow’s milk to feed your infant, ideally do so for as short a time as possible and for less than a week. It’s also important to give the baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.

Q: My infant needs a specialty metabolic formula, but I can’t find any. What should I do?

A: Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic formulas for patients in urgent need. Our office can fill out a request and if it is approved, the formula can be shipped to your home. (Pediatricians can download the form at www.abbottnutrition.com/metabolics and fax the completed form with a physician order to 877-293-9145.).

Q: Only one brand of formula is covered under the WIC program, but I can’t find any. What should I do?

A: Most states are allowing parents who use WIC benefits to buy other brands of formula or different sizes and types like ready-to-feed formula. (To find out what their state is allowing, pediatricians and families can check a map at www.fns.usda.gov/wic/infant-formula-waiver-status.)

Q: What is the earliest age I can start giving my infant solid food to stretch my formula supply?

A: Solid foods should not be used to stretch formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are 6 months old, but it depends on their rate of development. You can introduce solid foods as early as 4 months of age, but infants 4-6 months of age will continue to need breastmilk or formula to supply the majority of their nutrition.

Q: Is it safe to get breastmilk from a friend or online group?

A: We can’t know for sure whether breastmilk from a friend or online group is safe. It is better to obtain donor breastmilk from a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, visit www.hmbana.org/find-a-milk-bank/.

Q: Can I make my own formula? I’ve seen a recipe online using evaporated milk that people say was used safely in the 1940s.

A: Homemade formulas are not recommended. Although homemade formula was used in the past, it also was associated with many risks to infants. Online recipes have significant safety concerns regarding contamination and nutrient concentration. Using homemade formula could harm your infant.

Q: Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?

A: This should never be done. Adding extra water can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders, which could result in a baby needing to be hospitalized.

Q: How long can formula be used past a “best by” date?

A: Generally, formula should not be used past the “best by” date because it may not be safe or have the required levels of nutrients.

Q: I heard the government will be importing formula from other countries? Is it safe?

A: The Food and Drug Administration (FDA) is working to assure procedures are in place to verify production standards, labeling and shipping of brands that previously have not been sold in the U.S. European formulas are regulated by the European Food Safety Agency similar to how the FDA regulates formula in the U.S. and are highly reliable.
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30 EASY HEALTHY SNACKS FOR KIDS
www.goodhousekeeping.com/health/diet-nutrition/a40156696/healthy-snacks-for-kids/
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AGENCIES INVESTIGATE MONKEY POX CASES IN US
Officials from the CDC and the Florida Department of Health are looking into a possible monkeypox infection in Broward County, Fla., after confirming one case each in Massachusetts and New York City last week. The World Health Organization had recorded 28 suspected and 92 confirmed monkeypox infections in 12 countries as of Saturday, but White House COVID-19 response coordinator Dr. Ashish Jha said monkeypox does not spread as readily as SARS-CoV-2, and the availability of vaccines and treatments leaves him "confident we're going to be able to keep our arms around it." Full Story: Reuters (5/23), CNN (5/22)
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36% OF CHILDREN IN US HAVE MYOPIA, MOST LIKELY RELATED TO VIEWING BEHAVIOR WITH MOBILE DEVICES
Researchers used data from the 2020 US Census to estimate that the prevalence of myopia in children was 36.1%, according to a study presented at the Association for Research in Vision and Ophthalmology's meeting. The rate in rural areas was 15.7%, compared with 41% in urban areas
www.healio.com/news/ophthalmology/20200520/childrens-viewing-behavior-with-mobile-devices-may-aff...
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