Tips (be sure to scroll down for all of them!)

• PNEUMOCOCCAL VACCINE: The FDA has formally approved the new pneumococcal vaccine(Prevnar®) for young children at ages 2,4,6 months and a fourth dose between twelve and fifteen months. Pneumococcal disease can cause septicemia (bacteria in the blood), meningitis and other invasive diseases. It is a particular risk for children under two years and for older high risk children. This vaccine comes at a time when we are seeing increasing antibiotic resistance of the pneumococcal organism also known as Strep pneumoniae. We await guidelines from the American Academy of Pediatrics regarding routine administration. Commentary: Will this mean four shots at these visits?? Hoping we can get some combined vaccines soon-for the children's sake.10/16/01 09:16 PM

• ADDENDUM TO ABOVE: Prevnar is available through Pediatric Specialists as of June 23,2000. Please discuss this option with a provider at your upcoming visit or call the office for an appointment to start this series if you wish your child to receive this vaccine.The vaccine has received recommendations from the CDC and the American Academy of Pediatrics. For additional information see the press release at the American Academy of Pediatrics site.

• ASTHMA GROUP: Pediatric Specialists will be sponsoring a parents' group devoted to discussion and sharing of information regarding children with asthma. This group will meet at set intervals in the evening at our office. A professional from our office will be in attendance. We hope this will be a valuable resource for parents' of asthmatic children and may provide a prototype for other parent groups which we may initiate. If you have interest in participating in such a group please e mail (giuliano@massmed.org) or call the office and provide your name and phone number so that we may contact you when this group gets underway.10/16/01

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• ADD/ADHD GROUP: Pediatric Specialists plans on sponsoring a group for parents of  children with ADD or ADHD. The purpose of this group is educational and for parents to share ideas. New  ideas, treatment, school issues and psychosocial issues are appropriate material for discussion. We would also like to invite guest speakers to some meetings for additional information. Please let us know your interest by leaving your name and phone number at either the Wrentham or Foxborough office. 

• Our phones tend to be the busiest between 9AM and 10AM on most days. If you are calling for a routine scheduling of a physical or for some non urgent advice try calling later in the morning or the afternoon to avoid the possibility of a busy phone line.

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• Most schools require physicals at entry into kindergarten, fourth grade, eighth grade and eleventh grade. An examination is also required for many camps and for participation in high school sports and Pop Warner football. Please make appointments for these exams in a timely fashion so that we can be sure to get them done before they are due.

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• As the weather is improving and we are getting outdoors again, please remember to use that sun screen on your children. For babies under six months you will have to rely on shading the child as these sun screens are not recommended for the younger infants.

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• Have you thought about how as adults we would just as soon get away from the phones and be inaccessable for a time while our teenagers are buying beepers so that anyone can reach them any time?

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• ALTERNATIVE TREATMENTS FOR LICE:In the April 1998 edition of Infectious Diseases in Children an article by John Connolly reports the research out of Hebrew University and the American Head Lice Institute which demonstrated the effectiveness of applying household olive oil to lice. The effect was impressive in killing or drowning the living lice when used correctly. Although it can be used as the primary treatment it can also be effectively used after a commercial pediculocide (louse killer) containing permethrin or pyrethrim. The olive oil is applied to the hair and scalp in copious amounts and then a shower cap is applied to the child's head and allowed to remain overnight. Pediatric Specialists expresses concern however with a child sleeping with a plastic shower cap at night. We fear the possibility of such a cap slipping to the child's face and possibly being a cause of suffocation. We feel that if this treatment is used it might be better to apply the olive oil in the morning, apply the shower cap and leave on for eight to ten hours. Before removing the oil, the hair should be carefully combed out with a special metal nit comb. It is reported that the lice are easier to remove after the oil treatment. When certain that all have been removed and discarded the child's hair may be shampooed. After this treatment the environment must be meticulously cleansed. Vacuuming environmental areas and washing bedding is essential. Some researchers recommend using a hair dryer on possibly infested environmental surfaces and items to eradicate lice, as the heat from the drier is effective against the lice. Finally they recommend checking the child's hair close to the scalp for nits over a three-week period with a metal nit remover. As lice are becoming more resistant to our commercial products this method may be helpful. Remember, if you are using a cream rinse such as Nix, to wash the hair prior to application with a shampoo that does not contain silicones. At our office we have been recommending plain Prell.

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• CHOKING:PREVENTION AND FIRST AID: A constant concern with your child is the fear of choking. The American Academy of Pediatrics has published its guidelines of prevention and response to choking. Please check this out and print it out for your future reference. Click here to go to the site.This is a must read!!!

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• CHICKENPOX:HOLD ON THE IBUPROFEN:Recent research has shown some association of the use of ibuprofen (Motrin,Advil) in chickenpox and the possible increase in a condition called necrotizing fasciitis(NF). NF is a serious deep seeded gangrenous infection which can occur as a complication of chickenpox. Although more studies will need to be done to prove or disprove this association, it seems wise to avoid ibuprofen (as well as aspirin) to treat the fever and discomfort of chickenpox and use acetaminophen instead. Until further notice!!

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• Lyme Vaccine:The vaccine for Lyme disease is available through Pediatric Specialists. It is only licensed for individuals 15 years old and older. It is recommended for those who live or spend a good deal of time in endeminc areas for Lyme disease. Campers, people who spend a good deal of time at the Cape and Islands or other risky areas should consider getting the vaccines. The vaccines comprise a series of three shots with the first two given a month apart and the third given a year later. Side effects and other issues can be discussed with one of our nurses or providers. Also see our article on Lyme disease.

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• Meningococcal Vaccine: Although it has not received universal recommendations, one should consider having your college bound student immunized with the meningococcal vaccine (Menimune). Each year we hear reports of small outbreaks of meningitis caused by N.meningitidis on college campuses. This form of meningitis is potentially fatal.  If a college student is living on campus in a dormitory setting you should seriously consider arranging to have him/her immunized. Although the vaccine is not 100% effective against all strains of this bacteria this added degree of protection will be helpful.