NEWS LETTERS

APRIL 2009

Spring is here and it’s so nice to see the bulbs coming up!

Here’s some news from Beach Pediatrics.


We are delighted to have Dr. Bilello back from maternity leave following the birth of her daughter. As a new mom, Dr Bilello brings with her a new appreciation for some of the trials and tribulations of first time motherhood- for instance, helping babies sleep at night! Dr. Bilello has helped expand our evening appointments even more with later Thursday evening hours. Please call the office to book your check ups soon if you need an evening time slot.



On another note, we are sorry to be saying “so long” to Dr. Nolan. Those of you who have had recent appointments with Dr. Nolan have noticed she has an expanding glow about her! We wish her an easy delivery and the best of luck in all her future endeavors.



We want to remind everyone to book their summer and fall checkups early. Most summer programs and after school programs require a recent physical and immunization update. For your convenience, there are many late evening and weekend appointments.



Because we are a Beach community, it’s never too soon to talk about some warm weather safety issues. Here are some useful tips from the American Academy of Pediatrics.geo FUN IN THE SUN
Source: http://www.aap.org/advocacy/archives/tanning.htmBabies under 6 months:
The two main recommendations from the AAP to prevent sunburn are to avoid sun exposure, and dress infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn. However when adequate clothing and shade are not available, parents can apply a minimal amount of suncreen with at least 15 SPF (sun protection factor) to small areas, such as the infant's face and the back of the hands. If an infant gets sunburn, apply cold compresses to the affected area.
For Young Children:

Apply sunscreen at least 30 minutes before going outside, and use sunscreen even on cloudy days. The SPF should be at least 15 and protect against UVA and UVB rays.
For Older Children:

The first, and best, line of defense against the sun is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that block 99-100% of ultraviolet rays), and cotton clothing with a tight weave.
Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.
Use a sunscreen with an SPF of 15 or greater. Be sure to apply enough sunscreen - about one ounce per sitting for a young adult.
Reapply sunscreen every two hours, or after swimming or sweating.
Use extra caution near water, snow, and sand as they reflect UV rays and may result in sunburn more quickly.
HEAT STRESS IN EXERCISING CHILDREN
Source: http://www.aap.org/policy/re9845.html

The intensity of activities that last 15 minutes or more should be reduced whenever high heat and humidity reach critical levels.
At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of exercise should be limited initially and then gradually increased during a period of 10 to 14 days to accomplish acclimatization to the heat.
Before prolonged physical activity, the child should be well-hydrated. During the activity, periodic drinking should be enforced, for example, each 20 minutes, 5 oz of cold tap water or a flavored sports drink for a child weighing 90 lbs, and 9 oz for an adolescent weighing 130 lbs, even if the child does not feel thirsty.
Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated shirts should be replaced by dry clothing.
Practices and games played in the heat should be shortened and more frequent water/hydration breaks should be instituted.
POOL SAFETY
Source: http://www.aap.org/family/tipppool.htm

Install a fence at least four-feet high around all four sides of the pool. The fence should not have openings or protrusions that a young child could use to get over, under, or through.
Make sure pool gates open out from the pool, and self-close and self-latch at a height children can't reach.
Never leave children alone in or near the pool, even for a moment.
Keep rescue equipment (a shepherd's hook - a long pole with a hook on the end - and life preserver) and a portable telephone near the pool. Choose a shepherd’s hook and other rescue equipment made of fiberglass or other materials that do not conduct electricity.
Avoid inflatable swimming aids such as "floaties." They are not a substitute for approved life vests and can give children a false sense of security.
Children may not be developmentally ready for swim lessons until after their fourth birthday. Swim programs for children under 4 should not be seen as a way to decrease the risk of drowning.
Whenever infants or toddlers are in or around water, an adult should be within arm's length, providing "touch supervision."
BUG SAFETY

Don't use scented soaps, perfumes or hair sprays on your child.
Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
Avoid dressing your child in clothing with bright colors or flowery prints.
To remove a visible stinger from skin, gently scrape it off horizontally with a credit card or your fingernail.
Combination sunscreen/insect repellent products should be avoided because sunscreen needs to be reapplied every two hours, but the insect repellent should not be reapplied.
Insect repellents containing DEET are most effective against ticks, which can transmit Lyme Disease, and mosquitoes, which can transmit West Nile Virus and other viruses.
The current CDC and AAP recommendation for children over 2 months of age is to use 30 percent DEET. DEET should not be used on children under 2 months of age.
The concentration of DEET in products may range from less than 10 percent to over 30 percent. Ten percent DEET only protects for about 30 minutes – inadequate for most outings.
The concentration of DEET varies significantly from product to product, so read the label of any product you purchase. Children should wash off repellents when back indoors.
For more information on DEET: http://www.aapnews.org/cgi/content/full/e200399v1



BICYCLE SAFETY
Source: http://www.aap.org/family/bicycle.htm
Source: http://www.aap.org/family/tbikmyth.htm
Do not push your child to ride a 2-wheeled bike until he or she is ready, at about age 5 or 6. Consider the child's coordination and desire to learn to ride. Stick with coaster (foot) brakes until your child is older and more experienced for hand brakes.
Take your child with you when you shop for the bike, so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new one. For more information on finding the proper fit, go to http://www.aap.org/family/bicycle.htm#choosing
Buy a bike that is the right size, not one your child has to "grow into." Oversized bikes are especially dangerous.
Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many accidents happen in driveways, on sidewalks, and on bike paths, not just on streets. Children learn best by observing you. Whenever you ride, put on your helmet.
When purchasing a helmet, look for a label or sticker that says the helmet meets the CPSC safety standard.
A helmet protects your child from serious injury, and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.
A helmet should be worn so that it is level on the head, not tipped forwards or backwards. The strap should be securely fastened, and you should not be able to move the helmet in any direction. If needed, the helmet’s sizing pads can help improve the fit.

SKATEBOARD, SCOOTER, IN-LINE SKATING AND HEELYS SAFETY
Source: http://www.aap.org/advocacy/archives/marskate.htm


Children should never ride skateboards or scooters in or near traffic.
All skateboarders and scooter-riders should wear a helmet and other protective gear; wrist guards are particularly important.
Communities should continue to develop skateboard parks, which are more likely to be monitored for safety than ramps and jumps constructed by children at home.
While in-line skating or wearing Heelys, be sure to wear appropriate protective equipment and only skate on designated paths or rinks and not on the street.

WOW !!!
What a list! Believe me, I wouldn't be forwarding this to all of you if I didin't think all these precautions were needed. Yes, they seem like a pain in the neck, but they do pay off.
That's all for now. Please help us with your feedback. I welcome all your comments. See you at your next well visit!
Dr. Jonisch

JANUARY 2009

Dear Parent, Welcome to the online BEACH PEDIATRICS NEWSLETTER! I want to thank you once more for trusting us with your personal email address. Your address will not be shared with anyone else. Our goal is to keep you up to date with what is new at Beach Pediatrics as well as with relevant medical news as it becomes available to us. This information may simply be of interest to you, or it may directly impact your child's health. If you would like to speak to any of the doctors at Beach Pediatrics please call us at 897-5000. We ask that you not e-mail us back to this internet address, as it is not set up for private e-responses.
Congratulations to Dr Rachael Bilello on the birth of her daughter!!!! Dr Bilello and her baby are home and doing well. We wish Dr .Bilello and her family the best (and of course, are looking forward to her return in April).
If your child has asthma or reactive airway disease, you may be very interested in the Food and Drug Administrations new recommendations. Starting this month, there will be a change in the inhalers for all asthmatics. All new hand held inhalers will contain a new propellant called HFA (hydrofluoroalkane) instead of the old CFC (cholorfluorocarbon) This switch is because the old CFC propellant can harm the earth's ozone layer. The new HFA inhalers are environmentally friendly. Unfortunately, you will not be able to use refills on old prescriptions to get this new HFA inhaler. If you need a refill, please call us now. You will not need to come into the office. When you call, please give us your child's name, the name of the current medicine, and the name and phone number of your pharmacy. Our doctors will phone in your new prescription within 48 hours. Here's a heads-up: although the dosing and active ingredient are the same, please tell your kids that the "puff strength" will feel softer and gentler. Also, it may taste slightly different. Here's another thing for parents to remember- be sure to clean the inhaler regularly, as the HFA device can become clogged.
The other news about asthma medicine concerns children whose asthma is more severe. Salmeterol (Serevent) and formoterol (Foradil), also known as long-acting beta agonists (LABAs), should not be used as therapy for severe asthma. The FDA panel did however, approve the use of LABA medicine when combined with an inhaled steroid as in Advair or Symbicort. It's important to know these medicines are not for children with mild asthma. For mild asthma, short acting bronchodilators like proventil or xopenex, or low-dose inhaled steroids or an oral medicine like singulair will treat the majority of symptoms. Please call the office at 897-5000 if you have any questions about this.
Well, it seems like peanut butter is back in the news in a serious way! First we reported the high incidence of peanut allergy in children. Now it's the contamination of some peanut butter products and an outbreak of salmonella across the country affecting 43 states! To read the latest information and view recalls from the FDA, please click on the following link http://www.fda.gov/oc/opacom/hottopics/salmonellatyph.html Please remember that all patient areas at Beach Pediatrics are peanut free zones.
If you are the parent of an infant or toddler you'll be interested to learn researchers have found a connection with using ceiling fans and preventing SIDS or crib death. It seems that the gentle movement of the air has a tremendous benefit for our sleeping little ones. Also found to prevent SIDS, is the "back to bed" sleeping position, not having your baby sleep in the bed with parents, and the avoidance of all second hand cigarette smoke.
Yes there has been another crib recall. The Consumer Product Safety Commission issued a recall on January 13th of the "Stork Crib" due to the risk of breakage, collapse and suffocation. Click on the following link to read more about the recall.http://www.cpsc.gov/cpscpub/prerel/prhtml09/09093.html
There is still time to come in for a flu vaccine. Most influenza hits in February. There is no shortage of flu vaccine this year. Remember the flu vaccine is recommended for all children from 6 months to age 19 years. Influenza is a serious disease striking healthy young children and it is without a doubt vaccine preventable!!! Please call to schedule your vaccine today.
Finally, the feedback has been very positive about our new late hours, Wednesday and Thursday until 7 pm. Please visit our website www.beachpediatrics.com for further information. Well, that ends our newsletter. If you find it interesting, please save it or forward it to your friends and family as well. If you have any suggestions or interests that you'd like to see here, just call the office and tell us or bring it up at your next visit. elise jonisch, mdwww.beachpediatrics.com

NOVEMEBER 2008

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Please do not reply to this email. It is for your information only. To contact us about this email, or any other concern please call 516 897-5000 Dear Parents,
Welcome to the first online BEACH PEDIATRICS NEWSLETTER!

First I want to thank you for trusting us with your personal email addresses. Your addresses will not be shared with anyone else. As mentioned in the last SNAIL-MAIL newsletter, our goal is to keep you up to date with what is new at Beach Pediatrics as well as relevant medical news as it becomes available to us. This information may simply be of interest to you, or may directly impact on your child's health. If you would like to speak to any of the doctors at Beach Pediatrics please call us at 897-5000. We ask that you not e-mail us back to this internet address as it is not set up for private e-responses.

So on with the news!
Many working parents have been requesting later evening appointments. We hear you and want to accomodate your schedules. Starting this month, Beach Pediatrics will try out new office hours and be open until 7 pm three nights a week,- Tuesday, Wednesday and Thursday. Please visit our website www.beachpediatrics.com for more information.

The Consumer Product Safety Commission (CPSC) has just recently issued a voluntary recall of about one million cribs that may pose a danger to children by causing entrapment or suffocation. These cribs were sold between 1/98 and 5/07. If you own a crib purchased during that time, please visit the following website: www.cpsc.gov/cpscpub/prerel/prhtml07/07307.html
You can contact the companies on the site for replacement hardware if needed.

As Thanksgiving and winter holidays will be upon us before we know it, it's always a good idea to review how to keep your home safe at the holidays. Please visit this excellent site at the American Academy of Pediatrics for suggestions on holiday safety. http://www.aap.org/advocacy/releases/novtips.cfm

Well, that ends our first email newsletter. Hope you found it interesting. If you liked this first letter, please save them or, forward them to your friends and family, as well. If you have any suggestions or interests, that you'd like to see here, just call the office and tell us or bring it up at your next visit.

elise jonisch, md
www.beachpediatrics.com
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