Bambini Pediatrics PC
- Starting solids: the controversy
- Are we overdoing it?
Oct 2010
- Bambini parent teaches doc new way to treat finger injury
August 2010
- A monitor for babies at greater SIDS risk
- Useful reference for lactating moms
- The study no one is talking about
- More relapses with amoxicillin Rx
The other day I happened upon a url called Visit Vortex. It features short videos of a number of attractions here in the Hudson Valley. I really enjoyed the section on hiking, especially the climb up Mount Beacon, which I had done just a few weeks ago.After browsing some of the other categories, including farmers markets, family entertainment, and our towns, I had two epiphanies:
First, there is so much to see and enjoy right here in our own backyard! After living here for more than a quarter of a century, I feel [after visiting the Visit Vortex] like I haven’t scratched the surface.
Second, online video is becoming the preferred way to absorb information. And with so much available, it’s not difficult to overdo it. jm
A Sixty Year-Old Teaching Begins to Fall
USA Today recently interviewed Dr. Alan Greene, a well-known pediatrician and author of Feeding Baby Green (a great book, BTW). Dr. Greene has challenged the wisdom of offering infants rice cereal as their first food.
A few years ago, I started noticing how a many babies developed eczema, constipation, or excessive weight gain after starting in to processed rice cereal. I also noted that some progressive parents were starting their infants on freshly-made fruits and vegetables – with much better results.
Weston Price, as mentioned on mercola.com, suggests raw egg yolk and liver as first foods. I haven’t had the gumption to suggest that to anyone – and I haven’t yet heard of a parent going that route! jm
Remember this time last year? We were just past the peak of the swine flu pandemic. The associated hype led to a number of drastic measures: children were not permitted in hospitals (unless they were patients), doctors and nurses were ordered (at least for a while) to get a flu shot or stay home, and so forth. Parents in Hyde Park Schools, for instance, received a brochure entitled “Disease Intervention and Response Plan.” It called for a number of measures, including greater availability of hand sanitizer and use of foggers to disinfect school buses.
Since the end of the swine flu pandemic was officially announced several weeks ago, it might be prudent to take a closer look at the safety of these response plan measures.
Hand Sanitizers like Purell are relatively new. Most of us did not grow up with them. Purell is 62% ethanol – that makes it 144 proof! Cases of poisoning have been reported. Clearly, if small children are to use Purell, they must be supervised closely.
With regard to fogging the school buses, I learned a product called Conquer TBD is used. It is put into the bus for six minutes at the end of a run at the request of the driver. The active ingredients include dimethyl benzyl ammonium chlorides. Although these are found in Lysol, which has been around for a while, there are still uncertainties about the toxicity of these chemicals.
So again, we hope that use of these disinfectants will be judicious. jm
October 2010
Over the last few months, we’ve been delighted and honored with the number of prospective parents visiting our practice. Some have travelled as far as Schenectady! Among topics discussed, it’s been interesting to learn what moms are doing in late pregnancy to enhance the health of their newborn. Besides prenatal multivitamins/ folate, omega-3 supplements, and vitamin D, a few have mentioned probiotics.
And that comes as no surprise – given, for instance, the study published this summer in the British Journal of Dermatology that showed a 40% reduction in the incidence of eczema in two year-old children whose mothers began taking probiotics a month prior to delivery.
But that’s not the only reason that probiotics are a prudent practice in pregnancy. In a study that was also conducted by Finnish researchers, only 13% of the women taking probiotics developed gestational diabetes. That compares with 36% on the placebo. Amazing!
Need more? In yet another piece of research from Helsinki, pediatricians there examined the infants of about 1000 mothers, some of whom started taking a mixture of probiotics and prebiotics at 36 weeks gestation. Their infants were then placed on the same mix (they called it called synbiotics) for six months. The result was a modest but statistically significant reduction in colds and antibiotic use in the treated children.
Shouldn’t all women taking probiotics in late pregnancy? They’re safe. They help melt belly fat after delivery! Might future studies show a reduced chance of thrush, group B strep, UTIs? Wouldn’t be surprising. jm
Oprah Saves Our Patient's Finger!
Well, actually it was a savvy parent. A few weeks ago, one of our teenage patients was working out in the gym, getting ready for the football season, when his finger got trapped in a piece of equipment. About a fourth of his index finger was crushed and unsalvageable. He was taken for emergency care and see by an orthopedic surgeon. The wound was debrided and dressed. No hope for anything but a shortened finger was offered to the family.
Undaunted, his mother began searching the web and came across a new treatment called Matristem. She watched the video of Dr. Oz on the Oprah Winfrey show interviewing an older gentleman who lost about a third of his middle finger in a model airplane propeller. Fortuitously, his brother happened to be an expert in tissue re-engineering. He applied some of his sibling’s special formula to his wound for 10 days. Four weeks later, the finger grew back.
So, our mom called the company. She called a doctor in Florida that had recently treated a small child successfully with it – and put me on the line too. Dr. Kim, a surgeon at Westchester, debrided our patient’s finger a few days after the injury and applied the first dose of Matristem. His finger, too, responded– and has just about now grown back as well.
Parents put in a comparable situation certainly may want to consider this option – which many doctors are still not aware of. jm
According to the largest review of US data ever done on circumcision practice, the rates have dropped steadily and markedly over the past four years. National rates fell from 56% in 2006 to 33% in 2009. I hadn’t really thought about it until I read this, but I would have to say that the rates at Vassar pretty much are in line with these numbers.
Why the big drop, we might ask? After all, the World Health Organization is promoting circumcision as a way to reduce the risk of contracting HIV.
The CDC researcher that presented the statistics attributed the drop to a 1999 policy statement by the American Academy of Pediatrics that said there were insufficient data to support circumcision. But an article in the New York Times mentioned that several states have withdrawn Medicaid coverage for the procedure. jm
Rarely a day seems to go by these days that I do not hear about an infant that insists on sleeping in the prone position – despite the best efforts of their conscientious parents. Thanks, perhaps, to the 40% c-section rate and liberal use of intra-partum antibiotics, well over half the babies in our practice have had GERD, gas, or colic in some form or another. Some of these infants can only find relief stomach side down. But we all know that position substantially increases the risk of SIDS. What can a parent do? One mom recently shared her solution with me: an AngelCare monitor. Unlike most apnea monitors which require wires to be attached to the baby, this monitor slides under the mattress. Price (~$100) is affordable – and likely the monitor can be re-used by a friend down the road. Reviews (hundreds have been posted) that I read on Amazon were strongly positive. jm
Meds in Mothers Milk
Occasionally, our office gets calls from nursing mothers who have been prescribed antibiotics, anti-hypertensives, or other pharmaceuticals. Are they safe? Can I still breastfeed?
In the past, we would consult our paperback copy Thomas Hale’s book. It’s the best reference out there on this subject. However, we have found the links on Perinatology.com to be a pretty handy online alternative. jm
A study published last month by researchers from the University of Pittsburgh and Thoughtful House Center for Children in Austin, Texas examined the effects of the 1990’s vaccine schedule on the brains of infant rhesus monkeys. Results were described as alarming by the journal’s editor. Throughout the study period, vaccinated animals showed an increase in total brain volume (a finding associated with autism in humans). After the 12 month vaccines, there was a notable difference in the functional brain scans between the vaccinated and the unvaccinated groups.
Interestingly, there was no mention of this study by any of the major new agencies. Two years ago, the same group reported behaviors suggestive of autism in vaccinated monkeys. This study, although discussed at a scientific meeting, apparently never was published. So we’ll have to draw our own conclusions on this sensitive matter. jm
Does Amoxicillin Cause Ear Infections?
Last year, the findings of a study conducted in 168 Dutch infants was reported. When they developed ear infections, half the group received amoxicillin, the other half got a placebo.