Practice News

We hope that you and your family are staying safe and healthy during this coronavirus pandemic. We understand that many families have been directly affected by the drastic changes to everyday life, work and school. We hope the information in these newsletters have brought you some peace of mind and helped you get through this pandemic together. Since many children have switched to a hybrid school schedule (online and in-class learning) or maybe only online learning… children have been using computers, tablets, and/or other devices much more often. It is important to pay attention to how long your child is using these devices, or in other words… it is important to monitor their Screen Time! Our highly qualified physician, Dr. Linda Lukose, has created the acronym “S.M.A.R.T.E.R.” for parents to use & follow when monitoring their child’s screen time. The SMARTER Solution to Screen Time with Dr. Linda Lukose See the below for information from the video! S.M.A.R.T.E.R. SCHEDULE Be sure to schedule “play time” and “screen time” in your child’s routine. Be conscious of how much time they’re spending on their homework/classwork & the amount of time that they’ve spent on the computer. Try to schedule breaks in between screen usage! MOVE Movement is important! So make sure your child moves away from their screens regularly! Children may get up to go take a drink of water every 30 minutes to 1 hour to be sure they keep their body moving throughout the day! “Look away and do some stretches!” ALERTS (ON PHONE) You can use reminders on your phone to help you schedule breaks, and you can set an alert for when your child has had too much screen time! BUT… Alerts can also be distracting, so be sure to put phones out of reach and not to immediately look at it when it’s time for breaks. READ To minimize screen usage, you can print out worksheets & homework as often as possible so that they are able to read hard copies instead of using their screens. Read is also used to mean read a book instead of playing on devices and video games, etc. TURN OFF DEVICES Turn off those televisions and gaming systems. It is not healthy to go from one screen to another all day long. Encourage kids to gravitate towards screen-free interests like music, playing instruments, doing outdoor activities like taking walks and playing with pets! EAT REGULAR MEALS Eat 3 healthy meals regularly per day! Consider making kitchens and/or dining rooms “Screen-Free Zones!” Parents can model this behavior by putting their phones away as well. Kids will follow the good examples made by their parent(s). Cooking with your child is also great screen-free time and fun family activity as well! Just like how our phones and devices need recharging… human bodies need time to recharge as well! RECHARGE By placing your child’s device away from where they are sleeping, it will help reduce distractions in their sleep schedules. This may also include turning off alerts and notifications for the night. Thank you for choosing RBK Pediatrics and Urgent Care Center for all of your child’s medical needs! If you have any questions or need to schedule an appointment, feel free to contact our office with any of the contact methods provided below! Sincerely, RBK Pediatrics

As a mom, it’s almost inevitable that you’ll encounter cuts, scrapes, and bruises in your child’s active and adventurous life. While these minor injuries are a part of childhood, it’s crucial to know how to provide prompt and effective first aid to ensure proper healing and prevent infection. In this blog post, we’ll share essential first aid tips for moms to help them confidently manage cuts, scrapes, and bruises in their children. Cleanse the Wound: The first step in treating a cut or scrape is to gently cleanse the wound with clean, running water. Avoid using alcohol or hydrogen peroxide, as these can delay healing and damage healthy tissues. Pat the area dry with a clean towel or gauze. Apply an Antiseptic: After cleaning the wound, apply a mild antiseptic, such as hydrogen peroxide or povidone-iodine, to help prevent infection. Be sure to follow the instructions on the label and use it sparingly, as excessive use may delay healing. Cover with a Bandage: If the cut or scrape is small and not bleeding excessively, cover it with a sterile adhesive bandage or gauze pad to protect it from dirt and bacteria. Change the bandage and reapply antiseptic as needed. Elevate and Ice Bruises: For bruises, elevate the affected area and apply an ice pack wrapped in a towel to reduce swelling and relieve pain. Avoid placing ice directly on the skin to prevent frostbite. Monitor for Signs of Infection: Keep a close eye on the cut, scrape, or bruise for any signs of infection, such as increased redness, warmth, swelling, pus, or fever. If you notice any of these signs, seek medical attention promptly. Comfort and Reassure Your Child: It’s essential to provide comfort and reassurance to your child during the first aid process. Explain what happened in a calm and reassuring manner, and distract them with comforting words or activities to help minimize distress. Teach Good Hygiene Habits: As part of first aid, emphasize the importance of good hygiene habits to your child. Encourage them to wash their hands thoroughly before and after touching a cut or scrape, and avoid picking at scabs to prevent infection. Seek Medical Attention for Severe Injuries: While most cuts, scrapes, and bruises can be effectively managed at home, some may require medical attention. If the injury is deep, long, or caused by a dirty or rusty object, or if your child experiences severe pain, excessive bleeding, or signs of infection, consult a healthcare professional.  In conclusion, knowing how to provide proper first aid for cuts, scrapes, and bruises is an essential skill for moms. By following these tips, you can effectively manage minor injuries and promote healing in your child. Remember to always seek professional medical advice for severe injuries or signs of infection. With prompt and appropriate first aid, you can help your child bounce back from minor injuries and continue to enjoy their active childhood adventures.

We hope that you and your family are staying safe and healthy during this coronavirus pandemic. We understand that many families have been directly affected by the drastic changes to everyday life, work and school. We hope the information in these newsletters have brought you some peace of mind and helped you get through this pandemic together. Since many children have switched to a hybrid school schedule (online and in-class learning) or maybe only online learning… children have been using computers, tablets, and/or other devices much more often. It is important to pay attention to how long your child is using these devices, or in other words… it is important to monitor their Screen Time! Our highly qualified physician, Dr. Linda Lukose, has created the acronym “S.M.A.R.T.E.R.” for parents to use & follow when monitoring their child’s screen time. The SMARTER Solution to Screen Time with Dr. Linda Lukose See the below for information from the video! S.M.A.R.T.E.R. SCHEDULE Be sure to schedule “play time” and “screen time” in your child’s routine. Be conscious of how much time they’re spending on their homework/classwork & the amount of time that they’ve spent on the computer. Try to schedule breaks in between screen usage! MOVE Movement is important! So make sure your child moves away from their screens regularly! Children may get up to go take a drink of water every 30 minutes to 1 hour to be sure they keep their body moving throughout the day! “Look away and do some stretches!” ALERTS (ON PHONE) You can use reminders on your phone to help you schedule breaks, and you can set an alert for when your child has had too much screen time! BUT… Alerts can also be distracting, so be sure to put phones out of reach and not to immediately look at it when it’s time for breaks. READ To minimize screen usage, you can print out worksheets & homework as often as possible so that they are able to read hard copies instead of using their screens. Read is also used to mean read a book instead of playing on devices and video games, etc. TURN OFF DEVICES Turn off those televisions and gaming systems. It is not healthy to go from one screen to another all day long. Encourage kids to gravitate towards screen-free interests like music, playing instruments, doing outdoor activities like taking walks and playing with pets! EAT REGULAR MEALS Eat 3 healthy meals regularly per day! Consider making kitchens and/or dining rooms “Screen-Free Zones!” Parents can model this behavior by putting their phones away as well. Kids will follow the good examples made by their parent(s). Cooking with your child is also great screen-free time and fun family activity as well! Just like how our phones and devices need recharging… human bodies need time to recharge as well! RECHARGE By placing your child’s device away from where they are sleeping, it will help reduce distractions in their sleep schedules. This may also include turning off alerts and notifications for the night. Thank you for choosing RBK Pediatrics and Urgent Care Center for all of your child’s medical needs! If you have any questions or need to schedule an appointment, feel free to contact our office with any of the contact methods provided below! Sincerely, RBK Pediatrics

AFTER SCHOOL HYGIENE HABITS” WITH DR. JENNIFER GALLUB 

Dealing with a child with an earache can make us parents feel helpless. Often, children can’t sleep and cry all night because of the intense pain. If your child has an earache, there are a few things you can do to help ease the pain, and it’s important to know the signs of when an earache gets serious. Symptoms of Earaches If it’s your child’s first ear infection, it’s difficult to figure out what’s wrong, and even more so if your child isn’t talking yet. However, there are several key symptoms to look for: Pain in the ear (amplified when chewing, sucking, or lying down) Pulling/rubbing ears Difficulty hearing Redness in the eardrum or outer ear Fluid leaking from ears Difficulty sleeping Fever Vomiting Headache Causes of Earaches The main causes of earaches are injury, infection, irritation in the ear, or referred pain (pain that is felt in the ear even though the ear is not the original source of the pain). The most common causes for earaches are: Ear infection Change in pressure (when traveling high distances) Buildup in earwax Allergies Cold Injury/trauma to the ear Water trapped in the ear Foreign object in the ear Soothing an Earache There are a couple different methods you can try to ease the pain of your child’s earache. Some of the ways to soothe an earache include: Ibuprofen or acetaminophen as needed A cold washcloth applied to the ear Sitting upright to relieve pressure Chewing gum to relieve pressure To prevent the pain from getting worse, do not get the ear wet (going in the pool, taking a bath). When to See a Doctor Earaches are common in children and usually are not serious. However, there are a few signs to watch out for when your child has an earache that can be indicators of an eardrum rupture. If he or she has a fever of 104ºF or higher, seek medical attention. If your child is an infant, seek medical attention immediately for a fever over 101ºF. If your child has any of these symptoms, it’s recommended that you make an appointment with your pediatrician: Severe ear pain An earache lasting longer than 24 hours Dizziness Migraine Swelling around the ear Blood or pus leaking from ear Drooping in the face For an ear infection, your pediatrician will prescribe ear drops or oral antibiotics. Like with all antibiotics, it’s extremely important you ensure that your child finishes their entire prescription, or the infection may return. If it’s a buildup of ear wax that’s causing the pain, your doctor will either prescribe wax-softening ear drops or flush the wax out using a vacuum or a water-based process. Neither of these options is painful. Preventing Earaches The way to treat earaches is prevention. The number one habit that helps is to dry the ears thoroughly after swimming or bathing. Also, always make sure to keep foreign objects, including q-tips, out of your child’s ears. Avoid exposure to cigarette smoke and allergy triggers. For more information on earaches or to make an appointment if your child has an earache, contact RBK pediatrics online or by phone at (631) 499-4114 .

Even though many associate warts with old age, kids actually get warts more often than adults do. Warts are contagious — it’s possible to get an infection that causes a wart by touching something that someone with a wart has just touched. However, it’s important to remember that even though warts are uncomfortable, they’re usually not medically problematic. If your child gets a wart, make sure he or she does not pick, rub, or scratch it. The best practice is to cover the wart, if possible. Here’s a quick parent’s guide to warts and wart care. What are Warts? A wart is non-cancerous skin growth. It appears as a small area (usually a round bump) that has hardened skin and an uneven surface. It can appear anywhere on the body, but the most common areas are the hands, feet, and face. Warts can occur in a variety of sizes, colors, or shapes, though most of the time they are round, skin-colored, gray or black, and have a rough texture. Why Do Kids Get Warts? Doctors aren’t exactly sure why children get warts more frequently than adults, but around 10-20% of children have gotten a wart. It’s somewhat more common for girls to get warts than boys. Warts are caused by the Human Papillomavirus (HPV). The virus acts like a germ seeking a warm place to call home, and enters through a cut, scratch, or wound. Once it enters, the virus causes the area to rapidly grow cells on the skin’s outer layer, resulting in the raised area. There isn’t a specific timeline for a wart to develop. Sometimes, it can take weeks to develop into a visible growth, and other times, it may take years. Because of this, it’s difficult to pinpoint when the infection happened. Different Types of Warts Some of the different type of warts include: Common warts: These warts are most often found on the hands, usually on the fingers or the backs of the hands. Palmer warts: As the name suggests, Palmer warts typically grow on the palms. Plantar warts: These warts usually grow on the feet, specifically the soles. Flat warts: Flat warts are most commonly found on the face, and can grow many at a time, as many as 20-100. Filiform warts: These warts are long, thin, flesh-colored warts that can grow on the face, eyelids, neck or lips. Genital warts: These warts don’t usually affect younger children because they are sexually transmitted. How Do You Remove Warts? Common treatments include over-the-counter wart removers that you can purchase at a drug store. Overall, these have about a 75% success rate, but may take 6-12 weeks to be effective. Though remember, these OTC treatments are not for warts on the face or lips.  One of the most popular home remedies for warts is to remove them with duct tape. The best way to do this is to place the duct tape over the wart, leave it on for 6 days, and soak in warm water to remove the tape. Repeat this process till the wart is gone, which could take from 28 days to a couple of months. In previous studies, this method has shown to be 85% successful. It’s best to speak with your doctor about the best path for treating your child’s wart, but if you decide to do nothing, that’s perfectly okay. In one study, researchers reported that warts spontaneously cleared in 40% of children within two years, without any treatment. If you’re struggling with a child with warts, contact RBK Pediatrics online for more information.

As a mom, it’s almost inevitable that you’ll encounter cuts, scrapes, and bruises in your child’s active and adventurous life. While these minor injuries are a part of childhood, it’s crucial to know how to provide prompt and effective first aid to ensure proper healing and prevent infection. In this blog post, we’ll share essential first aid tips for moms to help them confidently manage cuts, scrapes, and bruises in their children. Cleanse the Wound: The first step in treating a cut or scrape is to gently cleanse the wound with clean, running water. Avoid using alcohol or hydrogen peroxide, as these can delay healing and damage healthy tissues. Pat the area dry with a clean towel or gauze. Apply an Antiseptic: After cleaning the wound, apply a mild antiseptic, such as hydrogen peroxide or povidone-iodine, to help prevent infection. Be sure to follow the instructions on the label and use it sparingly, as excessive use may delay healing. Cover with a Bandage: If the cut or scrape is small and not bleeding excessively, cover it with a sterile adhesive bandage or gauze pad to protect it from dirt and bacteria. Change the bandage and reapply antiseptic as needed. Elevate and Ice Bruises: For bruises, elevate the affected area and apply an ice pack wrapped in a towel to reduce swelling and relieve pain. Avoid placing ice directly on the skin to prevent frostbite. Monitor for Signs of Infection: Keep a close eye on the cut, scrape, or bruise for any signs of infection, such as increased redness, warmth, swelling, pus, or fever. If you notice any of these signs, seek medical attention promptly. Comfort and Reassure Your Child: It’s essential to provide comfort and reassurance to your child during the first aid process. Explain what happened in a calm and reassuring manner, and distract them with comforting words or activities to help minimize distress. Teach Good Hygiene Habits: As part of first aid, emphasize the importance of good hygiene habits to your child. Encourage them to wash their hands thoroughly before and after touching a cut or scrape, and avoid picking at scabs to prevent infection. Seek Medical Attention for Severe Injuries: While most cuts, scrapes, and bruises can be effectively managed at home, some may require medical attention. If the injury is deep, long, or caused by a dirty or rusty object, or if your child experiences severe pain, excessive bleeding, or signs of infection, consult a healthcare professional.  In conclusion, knowing how to provide proper first aid for cuts, scrapes, and bruises is an essential skill for moms. By following these tips, you can effectively manage minor injuries and promote healing in your child. Remember to always seek professional medical advice for severe injuries or signs of infection. With prompt and appropriate first aid, you can help your child bounce back from minor injuries and continue to enjoy their active childhood adventures.

Getting the kids fed and ready in time for school in the morning can be a struggle – even on the best of days. It’s no wonder that that the taste and convenience of a quick bowl of their favorite cereal is the go-to breakfast option for many. Unfortunately, this easy solution is contributing to children eating up to half of their daily recommended sugar intake before they even leave the house for school. How Much Sugar is Okay? The American Heart Association recommends that kids consume less than 25 grams of added sugar per day (which amounts to about 6 teaspoons), and cereals like Kellogg’s Honey Smacks or Quaker Oats Cap’n Crunch cereal contain half (or more) of that amount in one serving. Adding just one glass of apple or orange juice to the mix can double that amount, and easily take a child beyond the suggested added sugar threshold first thing in the morning. Effects of Too Much Sugar Not only do children who eat more added sugar tend to avoid healthier options in general, but they also are at a higher risk for an array of health issues like obesity, type 2 diabetes, high blood pressure, and heart disease. Another less obvious consequence of kids eating too much sugar is malnutrition. Filling up on the empty calories provided by sugar, kids are often missing out on essential nutrients like the vitamins and minerals provided by more nutrient dense food like fruit, vegetables, and proteins. Tips for Cutting Back and Some Lower Sugar Alternatives Since so many kid-friendly breakfast options are super sweet, it can be hard to get your child to accept other flavors and broaden his or her taste preferences. Here are a few tips for cutting back on the sugar overload at breakfast, and some alternatives to the worst high-sugar culprits: Choose a lower-sugar breakfast cereal: options like General Mill’s plain Cheerios or Kellogg’s Rice Krispies have a much lower sugar content than most others. Adding fresh bananas or strawberries can sweeten them just enough! Or if you want to try a less dramatic transition, you can even mix half a serving of the sugary stuff with a lower sugar alternative. Skip the juice: Apple juice has a whopping 24g of sugar per serving (which is more than a coca-cola). Swap out juice for a glass of milk or fruit-infused water, and serve a few slices of the fresh fruit alongside your child’s breakfast. Make your own breakfast: Check out these lower-sugar alternatives to breakfast cereal, like home-made yogurt parfaits, perfectly-poached eggs, or toast spread with avocado. Getting the kids involved in preparing them can help save time and get them excited about a lower sugar breakfast. At RBK, we are always available to answer any questions you may have about nutrition and healthy eating. Give us a call at one of our three locations to schedule an appointment.

Dealing with a child with an earache can make us parents feel helpless. Often, children can’t sleep and cry all night because of the intense pain. If your child has an earache, there are a few things you can do to help ease the pain, and it’s important to know the signs of when an earache gets serious. Symptoms of Earaches If it’s your child’s first ear infection, it’s difficult to figure out what’s wrong, and even more so if your child isn’t talking yet. However, there are several key symptoms to look for: Pain in the ear (amplified when chewing, sucking, or lying down) Pulling/rubbing ears Difficulty hearing Redness in the eardrum or outer ear Fluid leaking from ears Difficulty sleeping Fever Vomiting Headache Causes of Earaches The main causes of earaches are injury, infection, irritation in the ear, or referred pain (pain that is felt in the ear even though the ear is not the original source of the pain). The most common causes for earaches are: Ear infection Change in pressure (when traveling high distances) Buildup in earwax Allergies Cold Injury/trauma to the ear Water trapped in the ear Foreign object in the ear Soothing an Earache There are a couple different methods you can try to ease the pain of your child’s earache. Some of the ways to soothe an earache include: Ibuprofen or acetaminophen as needed A cold washcloth applied to the ear Sitting upright to relieve pressure Chewing gum to relieve pressure To prevent the pain from getting worse, do not get the ear wet (going in the pool, taking a bath). When to See a Doctor Earaches are common in children and usually are not serious. However, there are a few signs to watch out for when your child has an earache that can be indicators of an eardrum rupture. If he or she has a fever of 104ºF or higher, seek medical attention. If your child is an infant, seek medical attention immediately for a fever over 101ºF. If your child has any of these symptoms, it’s recommended that you make an appointment with your pediatrician: Severe ear pain An earache lasting longer than 24 hours Dizziness Migraine Swelling around the ear Blood or pus leaking from ear Drooping in the face For an ear infection, your pediatrician will prescribe ear drops or oral antibiotics. Like with all antibiotics, it’s extremely important you ensure that your child finishes their entire prescription, or the infection may return. If it’s a buildup of ear wax that’s causing the pain, your doctor will either prescribe wax-softening ear drops or flush the wax out using a vacuum or a water-based process. Neither of these options is painful. Preventing Earaches The way to treat earaches is prevention. The number one habit that helps is to dry the ears thoroughly after swimming or bathing. Also, always make sure to keep foreign objects, including q-tips, out of your child’s ears. Avoid exposure to cigarette smoke and allergy triggers. For more information on earaches or to make an appointment if your child has an earache, contact RBK pediatrics online or by phone at (631) 499-4114 .

Even though many associate warts with old age, kids actually get warts more often than adults do. Warts are contagious — it’s possible to get an infection that causes a wart by touching something that someone with a wart has just touched. However, it’s important to remember that even though warts are uncomfortable, they’re usually not medically problematic. If your child gets a wart, make sure he or she does not pick, rub, or scratch it. The best practice is to cover the wart, if possible. Here’s a quick parent’s guide to warts and wart care. What are Warts? A wart is non-cancerous skin growth. It appears as a small area (usually a round bump) that has hardened skin and an uneven surface. It can appear anywhere on the body, but the most common areas are the hands, feet, and face. Warts can occur in a variety of sizes, colors, or shapes, though most of the time they are round, skin-colored, gray or black, and have a rough texture. Why Do Kids Get Warts? Doctors aren’t exactly sure why children get warts more frequently than adults, but around 10-20% of children have gotten a wart. It’s somewhat more common for girls to get warts than boys. Warts are caused by the Human Papillomavirus (HPV). The virus acts like a germ seeking a warm place to call home, and enters through a cut, scratch, or wound. Once it enters, the virus causes the area to rapidly grow cells on the skin’s outer layer, resulting in the raised area. There isn’t a specific timeline for a wart to develop. Sometimes, it can take weeks to develop into a visible growth, and other times, it may take years. Because of this, it’s difficult to pinpoint when the infection happened. Different Types of Warts Some of the different type of warts include: Common warts: These warts are most often found on the hands, usually on the fingers or the backs of the hands. Palmer warts: As the name suggests, Palmer warts typically grow on the palms. Plantar warts: These warts usually grow on the feet, specifically the soles. Flat warts: Flat warts are most commonly found on the face, and can grow many at a time, as many as 20-100. Filiform warts: These warts are long, thin, flesh-colored warts that can grow on the face, eyelids, neck or lips. Genital warts: These warts don’t usually affect younger children because they are sexually transmitted. How Do You Remove Warts? Common treatments include over-the-counter wart removers that you can purchase at a drug store. Overall, these have about a 75% success rate, but may take 6-12 weeks to be effective. Though remember, these OTC treatments are not for warts on the face or lips.  One of the most popular home remedies for warts is to remove them with duct tape. The best way to do this is to place the duct tape over the wart, leave it on for 6 days, and soak in warm water to remove the tape. Repeat this process till the wart is gone, which could take from 28 days to a couple of months. In previous studies, this method has shown to be 85% successful. It’s best to speak with your doctor about the best path for treating your child’s wart, but if you decide to do nothing, that’s perfectly okay. In one study, researchers reported that warts spontaneously cleared in 40% of children within two years, without any treatment. If you’re struggling with a child with warts, contact RBK Pediatrics online for more information.

Getting the kids fed and ready in time for school in the morning can be a struggle – even on the best of days. It’s no wonder that that the taste and convenience of a quick bowl of their favorite cereal is the go-to breakfast option for many. Unfortunately, this easy solution is contributing to children eating up to half of their daily recommended sugar intake before they even leave the house for school. How Much Sugar is Okay? The American Heart Association recommends that kids consume less than 25 grams of added sugar per day (which amounts to about 6 teaspoons), and cereals like Kellogg’s Honey Smacks or Quaker Oats Cap’n Crunch cereal contain half (or more) of that amount in one serving. Adding just one glass of apple or orange juice to the mix can double that amount, and easily take a child beyond the suggested added sugar threshold first thing in the morning. Effects of Too Much Sugar Not only do children who eat more added sugar tend to avoid healthier options in general, but they also are at a higher risk for an array of health issues like obesity, type 2 diabetes, high blood pressure, and heart disease. Another less obvious consequence of kids eating too much sugar is malnutrition. Filling up on the empty calories provided by sugar, kids are often missing out on essential nutrients like the vitamins and minerals provided by more nutrient dense food like fruit, vegetables, and proteins. Tips for Cutting Back and Some Lower Sugar Alternatives Since so many kid-friendly breakfast options are super sweet, it can be hard to get your child to accept other flavors and broaden his or her taste preferences. Here are a few tips for cutting back on the sugar overload at breakfast, and some alternatives to the worst high-sugar culprits: Choose a lower-sugar breakfast cereal: options like General Mill’s plain Cheerios or Kellogg’s Rice Krispies have a much lower sugar content than most others. Adding fresh bananas or strawberries can sweeten them just enough! Or if you want to try a less dramatic transition, you can even mix half a serving of the sugary stuff with a lower sugar alternative. Skip the juice: Apple juice has a whopping 24g of sugar per serving (which is more than a coca-cola). Swap out juice for a glass of milk or fruit-infused water, and serve a few slices of the fresh fruit alongside your child’s breakfast. Make your own breakfast: Check out these lower-sugar alternatives to breakfast cereal, like home-made yogurt parfaits, perfectly-poached eggs, or toast spread with avocado. Getting the kids involved in preparing them can help save time and get them excited about a lower sugar breakfast. At RBK, we are always available to answer any questions you may have about nutrition and healthy eating. Give us a call at one of our three locations to schedule an appointment.

Many adults jokingly blame ADHD for their own occasional daydreaming or moments of inattention, but for some children, Attention Deficit Hyperactivity Disorder is far from a laughing matter. The National Institute of Mental Health defines ADHD as a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. More specifically, ADHD affects the executive functioning skills of the brain – functions like concentration, organizational skills, and impulsivity. Some hold the controversial opinion that ADHD doesn’t exist, or that it’s a result of bad parenting or modern-age information overload. However, research has shown that ADHD is a genetic disease, and brain studies have linked ADHD to changes in the production of the neurotransmitter dopamine. In addition, cases of ADHD have been found both throughout history and in developing countries. What has changed recently is the number of people diagnosed with it. According to the Center for Disease Control, one in every eleven children is diagnosed with ADHD. What are the Subtypes of ADHD? ADHD is broken down into three subtypes: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined. Children with a Predominantly Inattentive ADHD have trouble paying attention for extended periods of time, but don’t show symptoms of hyperactivity. Hyperactive-Impulsive ADHD involves excessive activity and an inability to control immediate impulses, especially those which have a potential for harm. This subtype is less common. The Combined ADHD subtype combines the other two subtypes. It is the one people most commonly associate with the disorder. What Are The Symptoms? Most, if not all, children are hyperactive or inattentive from time to time, but at what point to these behaviors signal a possible ADHD diagnosis? If your child shows some of the following behaviors for prolonged periods of time (more than 6 months), it may be time to consult your pediatrician: Constant daydreaming Excessive fidgeting Excessive talking Excessive forgetfulness Taking unnecessary risks Inability to get along with peers Inability to concentrate You can find the specific set of criteria used to diagnose ADHD on the Center for Disease Control (CDC) website. My Child Has Been Diagnosed With ADHD – What Are Our Treatment Options? The most important thing to remember is that ADHD is treatable and can be well managed. It is treated with either medication or therapy, and research shows that the most effective treatment method involves a combination of both . The medications that are generally prescribed for ADHD are classified as either stimulant or nonstimulant . Both have specific benefits and side-effects to consider, and your pediatrician will make appropriate recommendations based on the specifics of your child’s diagnosis. Combining prescriptions with Cognitive Behavioral therapy and mindfulness-based therapy not only help with the physical symptoms of the disorder, but also in the management of its emotional aspects. Here is a list of additional resources for learning about ADHD. At RBK, we are also always available to answer any questions you may have about the disorder. Give us a call at one of our three locations to schedule an appointment.

Asthma affects people of all ages, but it often begins in childhood. Asthma is the leading cause of illness of children – around 7 million children have asthma in the US alone, and for unknown reasons that number is on a steady rise. As a parent, it’s important to be aware of the signs, symptoms, and treatment options for this common affliction. What is Asthma? Asthma is a condition in which the airways, the tubes that bring air in and out of the lungs, periodically become sore and swollen. This makes it more difficult to breathe, and because children’s airways are smaller than the airways of adults, asthma is a more serious issue for kids. What Causes Asthma? The main cause of asthma is inflammation, which can be triggered by a variety of irritants or allergens. When inflamed, the airways get very swollen and sensitive, kind of like how allergies in your nose can make you feel congested and stuffy. When the airways react, the muscles tighten and cells in the airways create more mucus, reducing the airflow. Asthma Symptoms Some asthma symptoms can mimic a cold or bronchitis. In addition, symptoms can get worse when your child is around their asthma triggers, like air irritants (smoke or strong odors, for example) or allergens such as pollen, pet dander and dust mites. Asthma triggers are individual, and it’s important to determine your child’s particular asthma triggers. Asthma symptoms can include: Frequent coughing spells or chronic cough Drained energy while playing Rapid breathing A wheezing or whistling sound, especially when breathing out Tightness in chest Weakness or tiredness Asthma sufferers can also suffer from asthma attacks. This is when the muscles around the airways suddenly tighten in a bronchospasm, and asthma symptoms worsen. Asthma attacks create more mucus and the airways become swollen and inflamed more so than usual. When to Go to the Doctor Any asthma symptom is serious, as even mild symptoms can lead to a life-threatening situation. So if you’re child is exhibiting any of the symptoms, and especially if they’re recurring, take your child to a doctor. During an asthma attack, symptoms are exacerbated. Without an inhaler or the appropriate asthma medication, it may be necessary to call 911 or take your child to the hospital for emergency medical care. Managing and Treating Asthma There are two main types of treatment that doctors prescribe for asthma, depending on how severe the asthma is and how frequent the child has symptoms. For instant relief for a child who has bouts of coughing, wheezing, or shortness of breath, an inhaler is usually prescribed. Doctors advise that the child have this inhaler on him or her at all times in case symptoms flare up or an asthma attack occurs.  For long-term control and management, doctors prescribe medication to prevent the inflammation of the airways – usually corticosteroids. This can also be administered through an inhaler, or through a nebulizer. When used as directed, asthma medicines are very safe and can be extremely effective. RBK’s Asthma Care Program If your child has asthma, RBK Pediatrics is 100% ready to guide you through the diagnosis and treatment. We have a specific asthma care program designed to make the process as easy as possible on both children and parents. For more information on our asthma care program, visit our webpage on asthma.

As a parent, you’ve probably been asked “Are they walking yet?” dozens of times. Learning to walk is a major milestone in your baby’s life and many parents feel frustration and worry over when their baby will take her very first step. First off, it’s important to remember that there’s little a parent can do to speed up the timetable of walking. Secondly, there’s a large variation between babies on what age they learn to walk. Another baby the same age may learn to walk 3-4 months earlier than your child, and both babies could still be in the normal age range for learning to walk. The timing of the first steps depends on a variety of factors and delayed walking isn’t necessarily an indicator of a problem. Learning-to-Walk Milestones Milestones for your baby’s walking aren’t set in stone. However, there is a general sequence of events that leads up to your baby’s first steps: 6-10 months: Baby will learn to pull her body up and stand up alone. 7-13 months: Baby will “cruise,” meaning walk while using something for support, such as outstretched hands on furniture. 11-14 months: Babies will start to walk alone. By 14 months, most babies use some degree of walking. When to Talk to Your Pediatrician About Delayed Walking Your pediatrician will regularly be examining your child and performing developmental screening at your well-baby check up visits. Legs, feet, and motor skills should be checked during these appointments. However, if you have a specific concern about your child’s delayed walking, you can schedule an appointment with your doctor to address these concerns. If your baby hasn’t started walking or isn’t showings sign of starting to walk by 18 months, talk to your pediatrician to see why there may be a delay. As a parent, the age your baby starts walking isn’t the only thing to keep an eye on. If your baby is over 2 and only walks on his or hers toes, make sure to tell your pediatrician as it could be a sign of a central nervous system problem and should be evaluated. Any differences between how your child moves one side of the body as compared to the other, for example favoring one leg, should also be evaluated by your pediatrician.

In the United States, around 80 million people carry the Human Papillomavirus (HPV), and every year around 14 million people become infected. If you have a pre-teen child, chances are you’ve already heard about the HPV vaccine. You may be apprehensive about whether it’s the right choice because of recent debates about vaccination. If you have a son, you may be wondering whether he even needs the vaccine. We’re ready to set the record straight. What is Human Papilloma Virus? HPV is a sexually transmitted infection that both men and women can carry. It can cause genital warts and cervical cancer, as well as other cancers including cancers of the vulva, vagina, anus, penis, and throat. Why Does My Child Need the HPV Vaccine? The vaccine is an important measure in a child’s life to prevent infection and help curb the spread of HPV. Many of the cancers mentioned above caused by HPV can be prevented by the vaccine. The vaccine works best when given before someone is sexually active so that if exposure happens later on, your child will already has antibodies to the virus. The HPV vaccines cover 4 strains of the virus — the ones that cover 70% of cervical cancer-causing HPV and 90% of genital warts-causing HPV. Though the vaccine used to be solely for girls, intended to reduce the risk of cervical cancer, it has recently been extended to boys as well. The HPV vaccine can prevent some cancers, such as anal or prostate cancer, and genital warts in men. The vaccine also prevents the spread of HPV to women, who are at risk for developing cervical cancer. Both girls and boys should get the vaccine around 11 or 12 years of age. If your child is already a little older than 11 or 12, he or she can still get the vaccine; contact your pediatrician for more information. Are There Any Risks? There are very few risks associated with the HPV vaccine, and the chance of being allergic is extremely slim. The CDC’s Immunization Safety Office has said that the HPV vaccine has been shown to be as safe as meningitis and Tdap vaccines. The CDC has a rigorous process for determining if a vaccine is safe, and they have created a handy infographic for parents that explains how it works. The most common side effects of the HPV vaccine that have been reported to the Vaccine Adverse Events Reporting System (VAERS) were fainting while having the shot administered and pain at the injection sites for a few days. Both side effects are very rare. Information About Getting the Vaccine: Doctors recommend HPV vaccination around ages 11 or 12, for both boys and girls. If you’d like your child to receive the HPV vaccine, contact the RBK Pediatrics office today by phone or online to schedule an appointment.

It’s well-documented that obesity can cause serious and chronic medical conditions. With childhood obesity rates increasing globally, parents have started asking what steps they can take to instill healthy habits into their kids, and to help an overweight or obese child grow into a healthy weight. Though it’s easy to blame fast food as the primary culprit in our nation’s obesity epidemic, burgers and fries may not be the only thing causing kids to be overweight. It’s important to understand what the main factors are in your child’s lifestyle that are affecting his or her weight, and commit to taking steps as a family to correct them. How Can I Tell Whether My Child Is Overweight? Both the WHO (World Health Organization) and CDC (Centers for Disease Control) have developed growth charts that physicians in the US use when assessing a child’s weight. However, the easiest way for a parent to check whether their child is overweight at home is by using an online BMI calculator. This tool from the CDC is easy to use. If your child is overweight, start by talking to your pediatrician. Children shouldn’t be placed on a calorie-restricted diet plan, and especially not on a fad diet (like Atkins or the SlimFast diet). Instead, kids should be encouraged to eat healthy meals, get lots of exercise, and cut out unhealthy junk foods. Change #1: Be a Positive Role Model. Your children pick up a huge number of habits from you, so be their healthy role model. If your children watch you eat high-sugar snacks while foregoing fruit and vegetables, they’re considerably more likely to mimic that behavior. Eat healthy in front of your son or daughter, and try trading in a few nights per week on the couch for an evening walk as a family. Involving the whole family in this healthier lifestyle prevents your child from feeling singled out or embarrassed, which could cause them to resent you and push back at your efforts. Change #2: Make Better Food Choices Together. Many busy families find it hard to eat healthy, but some simple changes can have big results. We encourage the following habits for the families of our young patients: Provide plenty of vegetables, fruits, and whole-grain products. Choose lean meats, poultry, fish, lentils, and beans for protein. Juices are usually very high in sugar. Encourage low-fat milk or just plain water. Serve reasonably-sized portions, and eat one portion per meal. If your family has a tendency to take unnecessary second or third helpings, try leaving pans of food out of reach of the table. This will help prevent everyone from mindlessly grabbing another portion. Limit consumption of sugar-containing foods, as well as saturated fats (like butter and chocolate). Don’t use food as a prize for good work or good grades. Food shouldn’t be a reward. Replace junk food with healthy alternatives. Get creative and look for ways to make your family’s favorite foods healthier (such as swapping out sour cream for plain yogurt, or serving leaner cuts of beef). Change #3: Encourage Exercise. Moderate-intensity exercise a few times per week is a great way to keep your kids healthy. Encourage your child to join an after-school sport, or just to get out and play with his or her friends. If your child isn’t interested in team sports, get creative: rollerblading, walking, or video games like Wii fit, Pokemon Go, or Dance Dance Revolution are fun ways to “trick” kids into exercise. Kids love toys and technology. If a wearable fitness tracking device is in your budget (such as a FitBit), that’s another way to keep them invested in exercise. Wearables will be much more appreciated by a child who’s interested in getting healthier, and needs some motivation to stay on-track. Childhood obesity can lead to a number of health-related consequences, but there are plenty of things you can do as a parent to fight unhealthy habits. Always keep in mind that small daily changes are what make up the recipe for a healthy body.

Bacterial meningitis is a disease in which the protective lining around the spinal cord and brain – called the meninges – becomes inflamed. This inflammation is usually caused by an infection, which could be caused by a virus (viral meningitis) or bacteria (bacterial meningitis). Bacterial meningitis has been a very hot topic in the news the past few years, as several college campuses have experienced outbreaks among students in the dorms. If you’re a parent, you may be wondering whether your children should be vaccinated. What’s the Difference Between Bacterial and Viral Meningitis? Viral meningitis is the more common of the two, and can be caused by a number of different viruses (including the mumps and measles viruses). Most cases of viral meningitis resolve themselves within seven to ten days, with no need for medical intervention. Bacterial meningitis is much rarer, but can be life-threatening without immediate medical attention. Without treatment, the case-fatality rate (the percentage of patients who die as a result of the disease) can be as high as 70 percent, and one in five survivors of bacterial meningitis may be left with permanent complications like hearing loss, neurologic disability, or loss of a limb. Because of their constant and close social contact, kids and teenagers are generally at a higher risk of contracting bacterial meningitis. Full-scale outbreaks usually occur in places where people are in close contact with each other – such as in college dormitories, boarding schools, or on military bases. Someone suffering from bacterial meningitis may experience symptoms like: Fever Stiffness in the neck Headache Nausea or vomiting Confused mental state Increased sensitivity to light If you suspect your child has bacterial meningitis, it’s important to get him or her to the doctor immediately. What to Know About the Vaccines Available Because preventing a disease is always much easier and safer than treating one, meningitis vaccines are in high demand. However, it can sometimes be a bit complicated for parents to research the vaccinations available, because there are 12 types of bacterial meningitis. These 12 types are divided into 12 “serogroups,” which are groups of bacteria that contain a common antigen (a particular substance that causes an immune response). A meningitis vaccine will usually cover one or more serogroups, and subsequent vaccines should be administered at different points in your child’s life. The CDC (Centers for Disease Control) has developed a recommended schedule for meningococcal vaccines. Starting at 11 or 12, children should be vaccinated with a single dose of a meningococcal conjugate vaccine, which protects against multiple serogroups. A booster (an additional dose) is recommended around age 16. Brand names of this vaccine include Menveo®, Menactra®, and MenHibrix®. Last year, the FDA licensed two serogroup B meningococcal vaccines: Bexsero® and Trumenba®. It’s now recommended to also be vaccinated with one of these serogroup B vaccines between age 16 and 23. Your child’s pediatrician will discuss with you how many doses of the vaccine are needed. Despite the age recommendations listed above, any child (or adult!) at an increased risk of contracting bacterial meningitis should be vaccinated. Ask your doctor if you think this may be you. Talk to Your Child’s Doctor About Meningitis Vaccination The best source of information about vaccination for bacterial meningitis is your pediatrician. Ask your child’s doctor which vaccinations they should receive and when. If you’ve ever changed pediatricians, be sure to bring your child’s immunization history and medical records with you to the appointment. And if you have college-aged children or kids living in close quarters away from home, be sure that they know the symptoms of meningitis and to get themselves to urgent care if they start to experience them.