Pediatric News - July 2022
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Pediatric Newsletter

August 22: Volume 3, Episode 8

FDA & AAP Offer Reassurance on Infant Formulas

(From AAP News, July 14, 2022)

Image of baby formula.For the past few months, the country has been experiencing a supply shortage of infant formulas. We are now moving in the direction of having some alternative formulas available, including some from international suppliers.

Safety and Nutrition

The FDA (Food and Drug Administration) has confirmed that the imported formulas have been approved for use in the U.S. “Consumers can feel confident that the infant formula being imported to the U.S. through the FDA has gone through rigorous review of the information provided by the company, including details about the products’ nutritional adequacy and safety, microbiological testing results, labeling information, and details about the manufacturing facilities’ foods safety production practices and inspection history,” said Susan T. Mayne, Ph.D., director of the FDA’s Center for Food Safety and Applied Nutrition.

More About Imported Formula

  • Different imported formula options
  • Reading labels
  • Preparing these new formulas

This information and more is available to parents and caregivers in these FDA tip sheets and videos and on the AAP’s HealthyChildren.org website.

HealthyChildren.org FAQ has additional information about:

  • Understanding imported
    formula labels
  • Using goat milk formula
  • The dangers of importing your own formula
  • Benefit eligibility for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Because some labels have metric measurements, the FDA has created a tip sheet showing conversions from milliliters to fluid ounces and Celsius to Fahrenheit. They also offer videos that answer a variety of common questions.

Outlook on U.S.-Made Formula According to Dr. Mayne, U.S.

manufacturers have been ramping up production to make up for the shortage. The FDA also has plans to allow expanded access to
formula
 to avoid future shortages. 

References:

COVID-19 Update

Image of COVID disease.As of the time of writing (7/22/22), COVID-19 cases have risen to the point that Kalamazoo County is now considered HIGH risk by CDC standards. Cases reported to the county are around 200 per 7-days per 100,000 population.  Keep in mind that many positive cases are unreported because of at-home self testing kits. The hospital admission rate for COVID-19 is about 12 patients per 7-day per 100,000 population, and about 5% of hospital beds are occupied by patients infected with COVID-19.

St. Joseph County is at a MEDIUM risk with a rate of about 118 new cases per 7-day per 100,000 population.

Current safety recommendations include:

  • Wearing a mask indoors in
  • Staying up to date with your COVID-19 vaccine
  • Getting tested if you have cold symptoms or vomiting/diarrhea

 ** Covid-19 Vaccine now available for 6 months to 4 year olds. ***

References:

School Safety

Image of a little boy walking into schoolSeptember is around the corner, and that means kids are heading back to school. Here are some safety tips to keep in mind:

Walkers

  • Always use sidewalks. If there is no sidewalk and you must walk in the street, walk facing the traffic.
  • Always look both ways before crossing the street.  Do not enter the street  between objects that block your view, like parked cars, signs, trees or shrubbery.
  • Teach kids to recognize and obey the traffic signals, signs and pavement markings.
  • Never quickly move out in front of a parked car.
  • Practice walking to school with your child, being sure to cross the street at crosswalks when available.  Have a pre-established route.
  • Walk with a friend or parent. This is always safer then walking alone.
  • Review rules for talking with strangers. Make sure your kids know to never get into a car without your knowledge and permission.
  • Never text or talk on the phone while walking.
  • Do not use headphones while walking.

Bike Riders

  • Always wear a helmet that is properly fit.
  • Check with the school about what age kids are allowed to ride their bikes to school.
  • Children need to know the rules of the road. Ride single file on the right side of the road. Come to a complete stop before crossing the street. Walk bikes across the street.
  • Practice the route to and from school.
  • Ride bikes with friends or parents. Like walking, there’s safety in numbers.
  • Watch for opening car doors and other hazards.
  • Use hand signals when turning.
  • Wear bright-colored clothing.

 Bus Riders

  • Arrive early to the bus stop so your child is not tempted to cut corners or run across the street while trying to catch the bus.
  • Line up 6 feet away from the curb as the bus approaches. When riding the school bus, wait for the bus to stop completely before standing.  Make sure the bus comes to a complete stop before getting off the bus.
  • Do not shout or distract the driver.
  • Do not walk in the driver’s “blind spot.”  This is the area from the front of the bus to about 10 feet behind of the bus.

 Teen Drivers

  • No texting while driving!
  • Only talk on the phone in a car when it is completely necessary and using a hands-free option.
  • Don’t change the music on a phone while driving.
  • Plan to get to school early.  Accidents increase and defensive driving goes down when you are in a hurry to get to school.
  • Slow down for school zones.

Carpools This School Year

Image of three kids in the back of a car.Carpooling to school can be a simple and safe way to get your child to and from school.  They are very helpful, especially if you have multiple children and they are involved in several activities.

Some advantages to carpooling include:

  • Saving time and money
  • Added convenience and improved commuting option for both parents and children
  • Make new friends
  • A sustainable choice for the environment

Here are some points to consider when thinking about carpooling:

  • Check with your auto insurance and see if you need extra medical coverage for transporting passengers who are not family members.
  • Consider having a designated backup carpool of drivers who are available if the driver of the day cannot drive.
  • Have a plan in place in case your child is sick. Some carpools expect each family to drive on its day whether their child goes or not.
  • With our current pandemic, are you comfortable if all riders choose not to wear a mask?

July 2022: Volume 3, Episode 7

July 4th Safety

Image of fireworks over the water.Fireworks are part of our American tradition to celebrate the Independence Day. And while the events and the array of sparkles and beautiful lightings in sky can bring joy to our hearts, they can also create some dangers that we need to be careful with. 

Here are some tips from the American Academy of Pediatrics web site, HealthyChildren.org:

  • Fireworks can result in severe burns, blindness and scars.  Children should never play with fireworks
  • Sparklers can reach temperatures above 1,000 degree Fahrenheit, and can burn bystanders
  • Families should attend community firework displays run by professionals rather than setting off their own firework show at home.
  • The AAP has recommended prohibiting public sale of all fireworks, including those by mail or by the internet.

Here are other recommendations by other organizations (acknowledging that you may do some fireworks at your home):

  • Never disassemble or try to make your own fireworks.
  • Don’t point sparklers or fireworks at yourself or others, especially while they’re being lit.
  • Only light fireworks on the ground and in areas that are dry and fire resistant.
  • Don’t attempt to light multiple devices at the same time.
  • Never allow young children to handle fireworks or sparklers.
  • Always keep a portable fire extinguisher close by. Also, keep a water hose or buckets of water nearby to put out fires.

 References:

COVID-19 Update

Image of COVID disease.As of the time of this writing (6/27/22), COVID-19 cases have risen slightly.  We also continue to see other viruses that can give upper respiratory infections, such as rhinoviruses.  There have been some severe vomiting and diarrhea cases from Norovirus.

As an aside, most viruses can be killed with alcohol-based gels and hand sanitizers. You must wash your hands with soap and water to get rid of Norovirus.

In Kalamazoo County, the positivity rate for COVID-19 is about 136 new cases per week per 100,000 population.  In St. Joseph County, the rate is about 50 new cases per week per 100,000 population.  Both counties are currently rated as “Low Risk” by CDC standards.

We are slowly making progress with immunization rates against COVID-19 in Kalamazoo County. The percentage of people who are fully vaccinated is:

  • 5-11 years: 43%
  • 12-15 years: 58%
  • 16-64 years: 66%
  • > 65 years: 91%

The FDA has analyzed data for children 6 months to 5 years for the Pfizer and Moderna vaccines, and has granted  EUA (Emergency Use Authorization) of the vaccine for this group.

References:

Summer Water Safety

An excerpt from an AAP website, HealthyChildren.org

Image of three happy kids at the pool.We are heading into that time of year when kids want to be in the lake or pool all the time. Here are some tips to minimize the risk of drowning: 

  • All children older than 1 year of age should learn how to swim. Basic water skills include entering the water, coming to the surface, turning around, propelling through the water for 25 yards and exiting the water.
  • Swim lessons can be found at local parks, recreation facilities and they YMCA.
  • Have safety barriers around pools. This includes four-sided fencing around water, US Coast Guard-approved life jackets, active supervision, life buoys, reach tools likes a shepherd’s crook and lifeguards.
  • Child supervision in and around the water is a must! Be close, constant and attentive.
  • Parents and caregivers should know CPR.
  • The risk for drowning is higher for children on the Autism Spectrum, as they can be prone to wandering.  Download an emergency plan at http://bit.ly/WanderingPlanAutism (case sensitive).

Other drowning risks at home include  infant bath seats, toilets and buckets filled with water. If you have a swimming pool at home, have a thorough inspection to check for safety, including the operation of the water drain. The pumps in the drain can be pretty strong to keep a child submerged before help can arrive.

References:

Melatonin Overdoses

Image of a melatonin pill.In June 2022, the U.S. Poison Control Centers reported a 530% increase in children overdosing on melatonin over the past decade. Melatonin is a dietary supplement most often used as a sleep aid. The biggest spike came at the start of the COVID-19 pandemic, with an increase of 38% from 2019 to 2020.

Researchers analyzed 2012-’21 data from the American Association of Poison Control Centers’ National Poison Data System and found reports of 260,435 melatonin ingestions among children and teens. Annual calls for these ingestions jumped from 8,337 in 2012 to 52,563 in 2021, an increase of 530% over that decade.

Most were unintentional, and 84% involved children under 6 years. About 17% of all children in the study had clinical effects from the ingestion, most commonly involving the central nervous system. About 15% of those treated at a healthcare facility, and 1% required intensive care. Five children required mechanical ventilation and two died. Children under 6 years had the largest increase in hospitalizations due to melatonin ingestion, according to the study.

The authors of the Morbidity and Mortality Weekly Report (MMWR) believe the poisonings may have been related to melatonin being more available to families as they coped with the pandemic and dealt with sleep difficulties. 

References:

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    About the Author

    Dr. John Spitzer is a pediatrician at Bronson Primary Care Partners in Texas Corners. He is accepting new patients now.

    “I am thankful every day to be a pediatrician. I enjoy being able to work with kids. They are honest, sometimes silly, and always bring pure sweetness. They are deserving of the best care and compassion that I can provide.”

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