Tuesday, August 24, 2010

Does my child need 1 or 2 Flu vaccine doses?

Since the flu vaccine is starting to trickle in to many offices and pharmacies around the country (we don't have the injectable vaccine in stock yet in our office as of today), I thought I would take my first stab at answering this question.

Unfortunately, there is a complicated answer for the 2010-2011 season, especially since this season's vaccine has 2 seasonal flu strains and the 2009 H1N1 strain in it.

It is probably most easily explained in figure 3 at this link on the CDC website: http://www.cdc.gov/flu/professionals/acip/specificpopulations.htm#fig3

However, if you like words more than a diagram, this is how I summarize it:
1. Children who have already turned 9 years old only need one dose.
2. Infants aged less than 6 months cannot get the vaccine until they are 6mo.
3. Children 6mo-8yo who did not get (or it is unsure if they got) any 2009 H1N1 flu vaccine should get 2 doses of 2010-2011 vaccine at least 4 weeks apart.
4. Children 6mo-8yo who have never (or it is unsure if they ever) received seasonal flu vaccine should get 2 doses of 2010-2011 vaccine at least 4 weeks apart.
5. Children 6mo-8yo who got the seasonal flu vaccine for the 1st time during the 2009-2010 flu season AND did not get 2 doses of seasonal flu vaccine during the 2009-2010 should get 2 doses of the 2010-2011 vaccine at least 4 weeks apart.
6. Otherwise, only one dose of flu vaccine is recommended by the CDC during the 2010-2011 season to protect against both seasonal flu and 2009 H1N1 flu.

Lastly, to add a bit more confusion, according to the CDC "children who had laboratory-confirmed 2009 pandemic H1N1 virus infection... are likely to be immune to this virus". These children may not need 2 doses of the 2010-2011 flu vaccine. However, "laboratory-confirmed" H1N1 testing is not the same as the office, ER, or urgent care-based rapid flu swab. This term refers to a PCR or viral culture H1N1 positive result.

Monday, August 23, 2010

How to Eat for Good Health and Other Weight Control Tips

1. All in the Family
Approach food choices and exercise as a family project and set an example of healthy eating and exercise habits
-Read food labels looking for calorie, sugar and fiber content in particular.
-Avoid isolating or singling out the child (or children) with weight issues

2. Call a TV timeout and stay on the move
-Take the stairs, walk the dog, ride bike, and formal athletic activities (when possible)
-Keep total daily "screen time" to less than 2 hours/day

3. Eat more slowly and monitor portion size
- Take 20 minutes or more until second servings.
- Be aware of the USDA daily calorie recommendations for children. The recommended calorie intake in children depends on age, gender, and activity level. Summary of approximate calorie goals: 2-3yo 1000-1400; 4-8yo 1200-2000; 9-13yo girls 1400-2200/boys 1600-2600; 14-18yo girls 1800-2400/boys 2000-3200.

4. Limit sugar intake, in particular fructose
-Encourage your child to drink milk, water and max of 4-6 oz/day of fruit juice. Avoid or at least minimize soft drinks (12oz non-diet soda = 150cal & 10 tsp of sugar)
- High Fructose Corn Syrup (HFCS) was introduced to the U.S. market in the mid-1970’s. HFCS is used as a sweetener (cheaper than cane sugar) and preservative (extends shelf life) in processed foods, bread, condiments, and soft drinks.
-There is conflicting research on HFCS's health effects, but some of the research shows an association with obesity.
-Fructose acts biologically like fat and is toxic to the liver in large doses; it also delays satiety (feeling full).

5. Encourage a high fiber diet
-The fiber goal (> 2yo) in grams per day = age in years plus 5-10 grams per day (max of 30-35g/day).
-Promote fresh fruit, veggies, beans, and whole grains (see websites below to get list of high fiber foods).
-Fiber health benefits: slows the absorption of fructose (see above), helps control blood cholesterol levels, decreases the risk of type 2 diabetes and heart disease, and promotes general colon health.

6. Useful Internet Resources:
www.healthychildren.org; www.mypyramid.gov; www.uptodate.com/patients; www.mayoclinic.com

Sunday, August 15, 2010

Recommended pediatric health websites for parents

Includes office hours, patient forms, physician biographical information, and other office info.

TCPA Health Library
The TCPA health library is an excellent resource of health information on a variety of topics.

American Academy of Pediatrics' Website for Parents
The AAP’s parent-oriented webpage has up to date information on a variety of pediatric health topics.

TCH Center for Vaccine Awareness and Research
Includes info on vaccine education, safety and schedules for parents and health professionals.

Children’s Hospital of Philadelphia’s Vaccine Education Center
Includes informational videos and tear sheets. Parents can also sign up for a monthly email newsletter on vaccine science, safety and schedules.

UpToDate.com patient information
Includes free patient-level health information that is continually updated with evidence-based medical information on both pediatric and adult health topics.

Mayo Clinic
Includes comprehensive guides on hundreds of diseases and conditions.

Centers for Disease Control and Prevention- International Travel
Includes info to assist travelers and their health-care providers in deciding the vaccines, medications, and other measures necessary to prevent illness and injury during international travel.

Texas Department of State Health Services Immunization Branch
Includes info for the public on topics such as school and daycare minimum immunization requirements, schedules, and the Texas Vaccine for Children program (VFC).