Peanut Allergy Prevention – Dr. Paul Miller

The incidence of peanut allergy has been rising , as many parents know. Like its allergic cousins eczema and asthma, food allergy has been something to be managed rather than prevented. But a recent study suggests perhaps some help in our goal of prevention of food allergy.
Most food allergies are related to 6 foods: wheat, soy, egg, fish/shellfish, peanuts/tree nuts and cow’s milk. Medical wisdom had up until now recommended avoidance of allergenic foods within the first year of age.
The recent LEAP study through the National Institutes of Allergy and Infectious Disease (NIAID) suggests that early testing and introduction of peanut protein in those with high risk for peanut allergy is associated with 81% lower rates of allergy at 5 years of age.
Peanut allergy is particularly important because of its capacity to induce severe, anaphylactic reactions.
High risk groups include infants with moderate to severe eczema or known/documented egg allergy. Determining whether a child has an egg or existing peanut allergy will require either blood or skin testing.
Here’s a link to the new information for parents.
This is exciting news and we look forward to helping manage this aspect of your child’s diet with you.
In good health,
Paul A. Miller, MD
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Travel Tips – Dr Mina Kim

Summer in Chicago is my favorite time of year, but for those of you planning travel in the upcoming months, here are a few travel tips from the American Academy of Pediatrics:
  • Avoid feeling rushed by giving yourself plenty of time to get through airport security.  Moms traveling with breast milk or formula should notify a TSA official that they are carrying on liquids greater than 3.4 oz so it can be tested separately, if necessary
  • Pack snacks and toys to keep your child occupied during the flight
  • Small babies can benefit from feeding at take off and landing to help with ear pressure pain from the change in elevation.  Older children can receive the same benefit from drinking through a straw, or chewing gum.
  • Arrange a car safety seat at your destination or bring your own.  Children should be safely restrained while in a car on vacation as they would be when traveling locally.  Most car rentals offer this as an option.
 With all that in mind, don’t forget to have fun and take lots of pictures; they only stay this young for so long!
Dr Mina

Zika Virus Update – Paul Miller, M.D., F.A.A.P.

This week’s post is an update on Zika virus. Since my initial post there have been more developments leading to a better understanding of the condition although the problem of Zika spread remains to play out. Some new information will be highlighted below:

  1. Zika virus is spread through the mosquito bites of Aedes Aegyptii (African) and Aedes Albopictus (Asian) species. They prefer warm climates and do not survive at altitudes > 6500 ft. They are both present in the US, primarily along the Gulf coast.

    NEW: Zika spread between humans has also been confirmed through unprotected sexual contact (Vaginal, anal). Women are recommended to avoid pregnancy for 8 weeks after returning from areas of disease activity regardless of symptoms. Men returning from endemic areas are recommended to avoid unprotected sexual contact (Vaginal, anal and oral) for 8 weeks if no symptoms and for 6 months if symptoms are experienced. Men returning from endemic areas with symptoms should avoid unprotected sex for the entire term of their partner’s pregnancy.

  2. Only 1:5 people have symptoms due to infection. Nevertheless a pregnant woman can have fetal effects with an asymptomatic infection.

    NEW: The risk of microcephaly due to infection during pregnancy is estimated at 1:100. This data comes from the recent spread of Zika through French Polynesia (Oct. 2013 -Apr 2014). The greatest risk of microcephaly is still thought to be due to infection during  the first trimester. This is good news. However there is also some concern raised about the fetal effects of Zika infection during the 2nd or 3rd trimester related to deafness, visual problems, mental retardation and stillbirth. Not such good news.

  3. What should a pregnant woman do?

    As of March 2016 US officials have recommended all pregnant women who visited a Zika endemic area to get blood test for the virus regardless of symptoms. An Ultrasound looking at fetal head size and presence of calcification so is also recommended. (See link -MMWR) Any questions regarding testing during pregnancy should be directed to your OB-GYN or Infectious Disease specialist.

    Overall the spread of Zika is a scary proposition, but one that should be approached with sound scientific knowledge and public health measures. Like the hitchhiker’s guide says: ‘Don’t Panic!’ It is likely that this outbreak will continue and even reach mainland US, perhaps as early as this summer. Below is a map of some of the most likely places to be infected first.

    nytimes.com – the most vulnerable predicted locations – interactive map

Scientists are working on a vaccine and a mouse model of disease has recently been discovered which should help in testing any candidate vaccines.

I am happy to answer any questions regarding Zika that you may have. Questions of testing during pregnancy should be directed to your OB-GYN or Infectious Disease specialist.

The NY Times posted a good article last week if you’d like additional information; nytimes.com – Short Answers to Hard Questions About Zika Virus

In good health!

Paul Miller, MD

Back to School Tips! – Dr Diana Metropulos

It’s that time of year again! As we gear up for the start of the school year here are a couple tips to make sure your kids are fully prepared!

back to school - wordpress blog

1. Sleep hygiene:

Summer is often a time when bedtimes become more relaxed. At least 1 week prior to the start of the school year get your children back into the habit of an early bedtime and getting up earlier in the day. Even during the school year it’s recommended to keep a consistent bedtime on weekends in order to prevent sluggish Mondays!

2. Kindergarten readiness:

If you haven’t already it’s good to start practicing writing letters especially your child’s name at home. Also learning their numbers and letters is a good way to get a head start prior to the school year. Make it a fun game throwing a ball outside, etc. Make sure the TV, IPAD’s, etc are off during this time in order to help them with concentration!

3. After School Activities:

It’s a fun time to look ahead to the school year and find after school activities that fits your child’s interests. Music, sports, an extra language, etc is a good way to stimulate other areas of their brain and help for success in the future! Take advantage of Fall and Spring in Chicago to get them out of the house and some exercise!

Just a few things to think about! Don’t forget, school year forms are due very soon! Make your appointment at the office for your child’s annual school physical!

Dr. Diana

Get rid of your baby monitor!

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Oftentimes parents who are struggling to teach their children self-soothing techniques will have a baby monitor.  They admit that they can “hear them anyway”  but they insist that the monitor helps reduce overnight anxiety.  The monitor sabotages parents who are sleep training in three ways:

1.  The monitor has an LED power light that provides artificial light in the nursery that can disrupt sleep.

2.  If there is a video feed, one or both the parents stays up at night watching the their child on a backlit screen (furthering their own exhaustion)

3.  Most importantly, the monitor lowers the threshold for which one of the parents thinks that their child needs them.  Little sounds, movements, squeaks, noises are misinterpreted as the child being more hungry or more in pain than they actually are.  This misinterpretation causes the parents to rush in too early before the child can soothe themselves.  Or it can make the parents think that their child is ready to start the day before that truly is the case.

Except for certain specific medical cases, there is no indication that monitors prevent SIDS in otherwise healthy term infants.  The AAP wrote a policy statement in 2011 that outlines a safe sleep environment and the fallacy that commercial monitors provide extra safety.

If you live in Chicago, come by our office and we will put your monitor in the thresher (below) by our coffee maker.  Call first: we only use the thresher on tuesdays and thursdays 🙂  Have a great weekend Chicago and enjoy Lollapalooza!

-Dan Weissbluth Weissbluth Pediatrics

thresher