TakeHomePediatrics Newsletter

As we grow, you will see our presentation of topics change, hopefully for the better. We thank you for allowing us to educate you while we experiment with our format. I want to thank Rena Upadhyay for being so instrumental in this newsletter. She is the editor, the IT supervisor, and topic reviewer.  Multi-talented and vital to this newsletter. Let's give a BIG SHOUT OUT to Rena!

Did you know...

Introducing solid foods to your infant can be exciting and nerve-racking!  This pivotal time has had many changing recommendations.  The latest recommendation is to introduce eggs and peanuts  early at 4-6 months of age.  More then 150 foods are known to cause allergies but 8 food groups constitutes 90% of the reactions. These are eggs, tree nuts, peanuts, fish, shellfish, cow's milk ,soy, and wheat.  Recommendations were much different 30 years ago when we would have high risk children avoid eggs until 2 yrs old and peanuts until the age of 3. Around 2008, researchers noted that children in Israel who were exposed to peanuts earlier actually had lower incidence of peanut allergies.  Thus evolved a large study known as the LEAP study which lead to the newer recommendations.

Have you seen this rash on your child [image1]  and [image 2] ? It stays for months to years, can spread from few spots to 100s.  It is a self resolving rash but there are many remedies discussed by healthcare providers. It is caused by a virus and spreads through fomites on towels or skin to skin contact.  Now, there may be a FDA approved device that delivers medication called cantharidin for molluscum.  This will provide relief to families dealing with  molluscum that seems to be there forever, sometimes itches, sometimes gets red and inflamed and even infected!

With the decrease in vaccination rates, there is an increase in prevalence of vaccine preventable diseases.  Along with vaccine refusal, COVID pandemic contributed to missing well visits and missing vaccines.  Now healthcare providers need to keep those diseases such as measles in their differential when seeing patients.  Many of us have never seen illnesses like measles and polio, since they was almost eradicated in the US. However, now we need to think about measles with a child with fever, rash, red eyes and cough.  Please make sure your child is up-to-date with vaccines as these diseases are preventable and many of them do not have antibiotics or antivirals to fight against them!

Finally seeing some positive financial decisions in healthcare. With increasing costs of medications and healthcare, one company has announced a price cap on its medication.  Eli Lilly will make insulin no more then $35/month.  While our senior population has the $35/month cap with Medicare, this move will help those with private insurances.  Will this open the way for more companies to help the general population?

Don't forget to check out these recalls. Just click on each to get more details... Infant Bodysuit Set,  Children's Bamboo Plate, Children's Pajamas, Kid's Bike Helmet

Dear Dr. Bhumi, can you discuss the pros and cons of delayed vaccine schedule?

Dear Reader,  while this is a very controversial topic, it is a very important one.  I will discuss the recommendations per American Academy of Pediatrics along with what I usually explain to our families. Childhood vaccines are recommended, as they have prevented many debilitating diseases. First, let's see why parents want to delay or are hesitant: fear of immune burden, fear of the discomfort, fear of neurological side effects, and the thought that vaccines are unnecessary.  As pediatricians, we cannot dismiss these concerns and should have a discussion with parents about the vaccines.   Vaccinations are considered the single greatest  advancement in public health. However, hesitancy has increased in last 2-3 decades.  Following an alternative schedule has quadrupled in the last few decades.  Vaccine hesitant families are not "pro" or "anti" vaccines. Most families I encounter, acknowledge the advantages of vaccines but just have the fear.  First, remember childhood vaccines have gone through years and years of studies both in public and private sectors, involving large subject groups.  Once the vaccine has received FDA licensure, it continues to be monitored post licensing even now.  Second, none of our childhood vaccines contain mercury.  Some do contain a very low amount of aluminum but no level of toxicity concerns.  I also like to explain that side effects are normal.  Whenever our body mounts an antibody response, we will have fever, aches, tiredness- this is a sign that our immune system is working.  If we split vaccines and have your child receive one at a time then remember, these side effects will occur each time even when one vaccine is given.  More severe reactions do occur but are very rare, just like severe reactions to any medication.  That risk is acknowledged but is not a reason for refusal.   Next, the immune load of the total number of vaccines given at once is actually not a concern.  The number of antigens/proteins in the newer vaccine formulations combined is less than number of antigens in just one vaccine 50 years ago.  Vaccines are necessary as the goal is to attain herd immunity as our newborns and infants and our immunocompromised children are not fully protected; so if all who can medically receive the vaccine get vaccinated, we will prevent the spread of the disease to the more susceptible population, leading to less disease complications and deaths. Eventually, there will be complete eradication of the disease.  Lastly, we can only recommend the schedule that has been extensively studied. Remember, the most efficacious and the best titer response schedule has been created from years of investigation of the vaccine.  If an alternate schedule is chosen, we cannot guarantee the same immune response as the recommended schedule. At the end, the only pros of delayed vaccine schedule is that we have convinced a family to do vaccines versus complete refusal and the reassurance of the family's comfort with receiving the vaccines.

Send your questions here!  Dear Dr. Bhumi

Click here to see a video on Screen Time with Dr. Bhumi.

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