January 2017
This Month's Newsletter

We hope your new year is off to a great start! As we move into February, it's a good time to continue to enjoy outdoor winter activities and go out and have some fun.

 

In this month's newsletter, we discuss the new HPV vaccination guidelines for Gardasil. In addition, this January, the NIH (National Institute of Health) announced new guidelines for food introductions in babies. We provide more information from an article published in the NPR. Finally, we include an article on sports injury prevention for young athletes.  

Our goal is to further develop our relationship with our patients and create an open forum. We welcome your comments and ideas. If you would like to see something included in this newsletter, please email us at pedcenter.com@gmail.com  with ideas only, please no medical requests.

As always, we welcome you to share your experience with our practitioners with an online review. 

Sincerely,
The Pediatric Center Staff
New Gardasil (HPV 9) Dosing Guidelines
Federal health authorities have approved a new two-dose schedule for HPV vaccine for adolescents under age 15 years.

Subsequent research shows a two-dose schedule for younger adolescents provides effective, long-lasting protection from HPV-related cancers, according to a report from the Centers for Disease Control and Prevention (CDC). "Based on the available immunogenicity evidence, a 2-dose schedule (0, 6-12 months), will have efficacy equivalent to a 3-dose schedule (0, 1-2, 6 months) if the HPV vaccination series is initiated before the 15th birthday," according to the report.

The American Academy of Pediatrics (AAP) and CDC recommend HPV vaccine as part of routine immunization for males and females at age 11 or 12 years, and that vaccination starting at 11 or 12 years will provide the best protection possible long before the start of any kind of sexual activity.

HPV is associated with cervical, vulvar, and vaginal cancer in females, penile cancer in males, and anal and oropharyngeal cancer in both females and males.

The vaccine, now available as the 9-valent Gardasil 9, traditionally has been given in a three-dose series, but in October 2016, the Food and Drug Administration approved a two-dose series for children ages 9-14. The CDC's latest move modified the ACIP's recommendations for a two-dose schedule for girls and boys who start the series at age 9-14 (before the age of 15 years). Those children should receive the second dose six to 12 months after the first dose.

For those starting the series at age 15-26 and for immuno-compromised people, a three-dose series is recommended. The second dose should be given one to two months after the first dose, and the third dose should be given six months after the first dose.

Those who already started the series with any HPV vaccine will be considered adequately vaccinated if they:  
  • started before their 15th birthday and received two doses, with the second dose six to 12 months after the first,
  • started before their 15th birthday and received three doses at the recommended dosing schedule or
  • started on or after their 15th birthday and received three doses at the recommended dosing schedule.
A schedule that has been interrupted does not need to be restarted, and the 9-valent vaccine may be used to complete a series started with a quadrivalent or bivalent vaccine (Cervarix - GSK).

If you have any questions, please call and speak to one of our practitioners.

New Guidelines On Infant Food Introductions
This month, The  National Institutes of Health announced that a panel of allergy experts recommends that parents introduce peanut-containing foods into the diets of babies as young as 4 to 6 months.

Below is an article from NPR capturing the new recommendations of the NIH:

After multiple recent studies showing that feeding peanut-containing foods to infants can reduce the risk of peanut allergies, there are new federal guidelines for parents about when to start feeding their infants such foods.

As the NIH summary for parents and caregivers states, introducing babies with severe eczema or egg allergy - conditions that increase the risk of peanut allergy - to foods containing peanuts at that age can reduce the risk of developing peanut allergy. However, the guidelines spell out that these infants should be evaluated by an allergy specialist before their parents or caregivers introduce them to peanuts.
 
For infants without the risk factors of eczema or known food allergies, parents can stick to whatever age-appropriate diet they prefer.

As NPR's Allison Aubrey reports, "parents of infants used to be told to hold off on introducing peanut-containing foods, sometimes until the toddler years, especially if there was a family history of allergies." Experts thought this could reduce the chances of developing an allergy. But over the past few years, Allison says, several large studies "have found that babies at high risk for becoming allergic to peanuts are less likely to develop the allergy if they are regularly fed peanut-containing foods in the first year of life."

"The guidelines are largely based on dramatic findings from a large study published in the New England Journal of Medicine in 2015. Researchers found that babies at high risk of developing a peanut allergy who were fed the equivalent of about 4 heaping teaspoons of peanut butter each week, starting at the age of 4 to 11 months, were about 80 percent less likely to develop an allergy to the legume by age 5 than similar kids who avoided peanuts. The benefit held up even after the children stopped getting the puree, a follow-up study found.

"Allergic reactions to peanuts can range from hives or rashes to, in the most extreme cases, trouble breathing and even death."

The National Institute of Allergy and Infectious Diseases has published the full text of the guidelines for the prevention of peanut allergies, as well as summaries for doctors and parents, on its website.

Infants and small children should never be given whole peanuts due to the risk of choking, the NIH cautions. A video aimed at parents warns that even undiluted peanut butter can be dangerous for infants because it is thick and sticky.

The American College of Allergy, Asthma and Immunology video, which features Northwestern University pediatrician Ruchi S. Gupta, recommends adding hot water to 2 teaspoons of peanut butter to make a warm puree. Feed a little bit of the puree to the child, and then monitor for about 10 minutes to make sure there is no reaction such as hives, rash or trouble breathing before continuing to feed the child peanut-containing foods.
Preventing Overuse In Young Athletes
Half of all sports medicine injuries in  children  and  teens  are from overuse.  2_lacrosse_players.jpg

The following information is from the American Academy of Pediatrics about overuse injuries and injury prevention tips:

What is an overuse injury?
An overuse injury is damage to a bone, muscle, ligament, or tendon due to repetitive stress without allowing time for the body to heal. Shin splints are an example of an overuse injury.

The following are the 4 stages of overuse injuries:
  1. Pain in the affected area after physical activity
  2. Pain during physical activity, not restricting performance
  3. Pain during physical activity, restricting performance
  4. Chronic, persistent pain even at rest 
Who is at risk?
Children and teens are at increased risk for overuse injuries because growing bones are less resilient to stress. Also, young athletes may not know that certain symptoms are signs of overuse (for example, worsening  shoulder pain in  swimmers). If you think your child has an overuse injury, talk with your child's doctor. A treatment plan may include making changes in how often and when the athlete plays, controlling pain, and physical therapy.

How to prevent overuse injuries
Athletes should stay away from excessive training programs that could be harmful. The following are guidelines to help prevent overuse injuries by promoting a healthy balance of activities:

Prepare
Athletes should have a pre-participation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for regular health well­-child checkups.

Athletes should maintain a good  fitness level during the season and off­season. Preseason training should allow time for general conditioning and sport­ specific conditioning. Also important are proper warm-­up and cool­-down exercises.

Play smart
Athletes should avoid specializing in one sport before they reach  puberty. Child "superstars" are often injured or burned out prior to college. Children should be encouraged to try a variety of sports.

Participation in a particular sport should be limited to 5 days per week.
Athletes should sign up for one team and one sport per season.

Rest up
Athletes should take at least 1 day off per week from organized activity to recover physically and mentally.

Athletes should take a combined 2 to 3 months off per year from a specific sport (may be divided throughout the year [that is, 1 out of every 6 months off ]).

Training
Increases in weekly training time, mileage, or repetitions should be no more than 10% per week. For example, if running 10 miles this week, increase to 11 miles the next week.

Cross ­train. Athletes should vary their endurance workouts to include multiple different activities like  swimmingbiking, or elliptical trainers.

Perform sport ­specific drills in different ways. For example, running in a swimming pool instead of only running on the road.

How to prevent burnout
Burnout (overtraining syndrome) includes mental, physical, and hormonal changes that can affect performance. To help prevent burnout in your child, follow the guidelines in this handout. Other suggestions include:
  • Keep your child's practice fun and age-appropriate.
  • Focus on your child's overall wellness, and teach them how to listen for problems with their bodies.
The goal is to promote well­-rounded athlete who can enjoy regular physical activity for a lifetime.

Do You Need A Pediatric Specialist?
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If you are in search of a pediatric specialist, please know we are here to guide you.

We have a wide network of doctors we can refer to ensure you are in good hands.

We specialize in developmental & behavioral health and focus on positive parenting practices. We can offer guidance on depression, eating disorders, developmental concerns and many other issues.

You are not alone. 
Please call to make an appointment to meet with one of our physicians:  
908-508-0400.
The Pediatric Center Online Bill Pay
Online Bill Payment
The Pediatric Center offers the ease and convenience of online bill baby_laptopbuying.jpg payment.   

Simply visit our " Bill Payment & Insurance" page on our website. 

Payments Over The Phone
If you prefer, you can still make a payment over the phone by calling The Pediatric Center's billing department, HealthCare Billing, Inc:  
Toll Free:  877-852-9092  or
Local:  908-237-9092
On-Site Lactation Support Center

Reminder, T he Pediatric Center offers an on-site Lactation Support Center.

Our modern and private on-site lactation suite provides a warm and relaxed environment for the mother and infant to enjoy a positive breastfeeding experience. 

We also offer a free prenatal class every month, open to the public. 

To schedule your lactation consultation, attend our free prenatal class or make an appointment please call us at 908-508-0400.

Vaccine Education Center

Did you know our website includes a Vaccine Education Center where you can find the immunization schedule for your child?

 

Reminder - we are offering the new meningitis vaccine Trumenba in our office. Insurance companies have started to cover this vaccine. It is recommended it be administered to all students starting college as part of their pre-college physical.

 

View all the details here.

We Love Your Feedback!

Your feedback is very important to us! We would love to hear about your positive experience with our doctors and nurse practitioners.  

 

Did you know you can write and post a review right on our website? Click here.

 

You can use this page to provide feedback, kudos, or just share thoughts. 

 

Thank you for your kind words!

Free Prenatal Class
We offer a free prenatal class on the 3rd Thursday of every month with our own
Dr. McKegney!
Click here to learn more.
It's A Partnership
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The Pediatric Center

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