My Blog

Posts for: May, 2019

May 26, 2019
Category: Healthy Kids
Tags: Vaccines   Books   family   sleep   Meals   Play   Thankfulness   friends   kindness  
Focus on 10 Things to Be Thankful For

November 2018 | Issue No. 175

I encourage all families to subscribe to this excellent website.    Dr. T

#1. Vaccines
Vaccines are one of medicine's greatest discoveries, saving an estimated 42,000 lives in the U.S. each year. We are fortunate to live in a country that makes vaccinations available. Here are 14 diseases you almost forgot about THANKS TO VACCINES! 
Also on our list:
#2. Kindness. Now more than ever, it's important to recognize kindness. Model it; children learn by watching. Be thankful when others show you that same respect.
#3. Our Village"It takes a village to raise a child." Hooray for grandparents, neighbors, teachers, friends, and others who touch your life directly or indirectly.
#4. Time to Play! Put down your smartphone. Play with your children. Be thankful for this magical age where fun and games help children thrive. 
#5. Our Differences. We live in a melting pot. Teach your children to honor those differences and celebrate the ways that make our country unique and awesome! 
#6. Our Children's Friends. They come into their lives for reason. Be grateful for the lessons each relationship brings, espeically about helping them feel secure outside the family. 
#7. Books. A really great book has the power to teach and inspire us, and that is a gift. Instill a love of books from a young age, and read with your child.
#8. Sleep. A good night's rest for everyone in the family is often what many parents are thankful for; we understand!   
#9. Family Meals. Eating at least three family meals together each week is associated with healthier kids. Give thanks each time you are able to sit down, talk, and eat together; not just on Thanksgiving.  
#10. Healthy Children. Here's a no brainer, right? By visiting, you know a reliable and trusted source when you see one. You've got this, and we appreciate your support!   



May 26, 2019
Category: Safety
Tags: Boating   Water Safety   Swimming   Pools   Life Jackets   Coast Guard  

Drowning is the leading injury-related cause of death for children age 1–4. It doesn’t only happen when you are by the pool or at the beach; drowning can happen anywhere, even in one inch of standing water. Among children under age 4, 70% of drownings happen during non-swim times. It is quick and it is silent, but it is preventable.

Memorial Day has come & gone, but summer is upon us and more families will be active around water. Join the American Academy of Pediatrics and be an advocate for Drowning Prevention. We all can reduce drowning and save children’s lives by working together to implement safety measures we know will protect children. 

Drowning can happen to any family. It’s quick, and it’s silent. Drowning is the No. 1 cause of death among children aged 1-4, and is a leading cause of death among teens. We can lower these rates if pediatricians, parents and policy-makers work together to implement the types of solutions we know will keep children safe. Please share these resources with parents and caregivers. 

An Important Message on Drowning from Grieving Parents:

Dear Doctors and Families, 
We write this from a place of grief, a sense of urgency, and a hope that no other family experiences what we have this summer. On June 10, 2018, we each lost a child to drowning during a non-swim time: Emmy Miller (19 months) and Levi Hughes (3). In the midst of our grief, we are honored to be partnering with the American Academy of Pediatrics on a National Drowning Prevention Awareness Project. We respect our own pediatricians tremendously and hope this message conveys to you that high level of respect as we ask for your partnership with us on this endeavor. 
Drowning is the #1 cause of preventable death between the ages 1-4 and the #2 cause in ages 5-14. Raising awareness of physicians, parents, and communities about this underrecognized killer is a shared responsibility that we must embrace. As health care providers, you are perfectly positioned to educate families about the importance of water safety and drowning prevention. We realize that well-child visits are busy, and there is much you must cover. However, you remain a deeply trusted source of information for parents.  We hope our stories can help spur you to action and prevent future tragedies.  
Over the last two months, we have been stunned to learn how often drownings occur during times when children are not swimming but slip away and drown in pools, ponds, streams, lakes, bathtubs, and even toilets. If you and your colleagues already share information on water safety, including drowning during non-swim times, we THANK YOU. If our stories inspire you to think about how you currently address water safety, we are grateful for your honest reflection.

We will be working with the AAP to develop resources to help you promote awareness using evidence-based approaches at multiple levels, from individual interactions to community and policy interventions. Pediatricians are, by nature, child advocates. If we can help elevate the prevention of drowning, it could save many lives. We believe in the power of the medical community, which is why we are reaching out to you. 
Developing quality materials will take time, but we want to provide an action step that can be taken now, so we don’t lose valuable time in spreading awareness. We have developed a PDF flyer that we hope you will print out and hang in your clinics or include in your educational materials for families. Increasing parental awareness of the dangers of water can also lead to discussions of a “water safety plan” for all families. The development of these plans can be immediately implemented into well-child visits, without the need for any materials. 
If you would like to know more about the stories of Emmy and Levi, here are the links to the TODAY Show interviews: 

We are incredibly grateful for your time and attention to this urgent matter. 
With much respect,

The Hughes Family and the Miller Family 


Swim Lessons: When to Start & What Parents Should Know


Infant Water Safety: Protect Your New Baby from Drowning


Drowning Prevention for Curious Toddlers: What Parents Need to Know


Beach, Boating, and Lake Swimming Safety Tips


Pool and Swimming Safety Tips


Parents and Caregivers: What You Should Know

  1. Parents and caregivers should never (even for a moment) leave young children alone or in the care of another child while in or near bathtubs, pools, spas, or wading pools and when near irrigation ditches, ponds, or other open standing water.

  2. Parents and caregivers must be aware of drowning risks associated with hazards in the home.

    • Infant bath seats can tip over, and children can slip out of them and drown in even a few inches of water in the bathtub. Infants should always be with an adult when sitting in a bath seat in a bathtub.

    • Water should be emptied from containers, such as pails and buckets, immediately after use.

    • To prevent drowning in toilets, young children should not be left alone in the bathroom, and toilet locks may be helpful.

    • Parents and caregivers should prevent unsupervised access to the bathroom, swimming pool, or open water.

  3. Whenever infants and toddlers (or noncompetent swimmers) are in or around water, a supervising adult with swim skills should be within an arm’s length, providing constant touch supervision. Even with older children and better swimmers, the eyes and attention of the supervising adult should still be constantly focused on the child. This “water watcher” should not be engaged in other distracting activities that can compromise this attention, including using the telephone (eg, texting), socializing, tending chores, or drinking alcohol, and there needs to be a clear handoff of responsibility from one water watcher to the next. Supervision must be close, constant, and attentive. In case of an emergency, the supervising adult must be able to recognize a child in distress, safely perform a rescue, initiate CPR, and call for help. Parents need to recognize that lifeguards are only 1 layer of protection, and children in and near the water require constant caregiver supervision, even if a lifeguard is present.

  4. To prevent unintended access, families should install a 4-ft, 4-sided isolation fence that separates the pool from the house and the rest of the yard with a self-closing, self-latching gate. Detailed guidelines for safety barriers for home pools are available online from the CPSC. Families of children with Autistic Spectrum Disorder or other disabilities who are at risk for wandering off should identify local hazards and work with the community on pool fencing and mitigation of hazards.

  5. Although data are lacking, families may consider supplemental pool alarms and weight-bearing pool covers as additional layers of protection; however, neither alarms nor pool covers are a substitute for adequate fencing and adult supervision. Importantly, some types of pool covers, such as thin plastic solar covers, should not be used as a means of protection because they might increase risk of drowning.

  6. Parents, caregivers, and pool owners should learn CPR and keep a telephone and rescue equipment approved by the US Coast Guard (eg, life buoys, life jackets, and a reach tool such as a shepherd’s crook) poolside. Older children and adolescents should learn CPR. See See American Red Cross.

  7. Children and parents should learn to swim and learn water-safety skills. Because children develop at different rates, not all children will be ready to learn to swim at exactly the same age. There is evidence that swim lessons may reduce the risk of drowning, including for those 1 to 4 years of age. A parent’s decision about starting swim lessons or water-survival skills training at an early age must be individualized on the basis of the child’s frequency of exposure to water, emotional maturity, physical and cognitive limitations, and health concerns related to swimming pools. Parents should be reminded that swim lessons will not drown proof a child of any age. It is critical that swim instructors stress this message as well as the need for constant supervision around water. Swim ability must be considered as only 1 part of water competence and a multilayered protection plan that involves effective pool barriers; close, constant, and attentive supervision; life jacket use; training in CPR and the use of an automated external defibrillator; and lifeguards. Children need to be taught never to swim alone and never to swim without adult supervision.

  8. Parents should monitor their child’s progress during swim lessons and continue their lessons at least until basic water competence is achieved. Basic swim skills include ability to enter the water, surface, turn around, propel oneself for at least 25 yards, float on or tread water, and exit the water.

  9. Any time a young child visits a home or business where access to water exists (eg, pool, hot tub, open water), parents and/or guardians should carefully assess the premises to ensure that basic barriers are in place, such as sliding door locks and pool fences with closed gates in good working order, and ensure that supervision will be consistent with the preceding recommendations.

  10. All children and adolescents should be required to wear US Coast Guard–approved life jackets whenever they are in or on watercraft, and all adults should wear life jackets when boating to model safe behavior and to facilitate their ability to help their child in case of emergency. Small children and nonswimmers should wear life jackets when they are near water and when swimming. Parents and caregivers should ensure that any life jacket is approved by the US Coast Guard because many do not meet safety requirements. Information about fitting and choosing US Coast Guard–approved life jackets is available at the US Coast Guard Web site. Parents should not use air-filled swimming aids (such as inflatable arm bands, neck rings, or “floaties”) in place of life jackets. These aids can deflate and are not designed to keep swimmers safe.

  11. Jumping or diving into water can result in devastating spinal injury. Parents and children should know the depth of the water and the location of underwater hazards before jumping or diving or permitting children to jump or dive. The first entry into any body of water should be feet first.

  12. When selecting an open body of water in which their children will swim, parents should select sites with lifeguards and designated areas for swimming. Even for the strongest of swimmers, it is important to consider weather, tides, waves, and water currents in selecting a safe location for recreational swimming. Swimmers should know what to do in case of rip currents: swim where there is a lifeguard, and if caught in a rip current, remain calm and either swim out of the rip current parallel to the shore (do not try to swim against the current) or tread water until safely out of the current and able to return to shore or signal for help.

  13. Parents and children should recognize drowning risks in cold seasons. Children should refrain from walking, skating, or riding on weak or thawing ice on any body of water.

May 26, 2019
Category: Infectious Disease
Tags: immunizations   measles   update   2019   Vaccinations   Public Health  

Measles – 2019 Outbreaks


Total Number Of Measles Cases In US Climbs To 25-Year High Of 971, CDC Reports

The Washington Post (5/30) reports there have been 971 cases of measles in the US so far this year, “the greatest number since 1994, when 963 cases were reported for the entire year,” according to the Centers for Disease Control and Prevention (CDC). The agency announced the new total on Thursday, rather than waiting for Monday when it typically updates the count, “because it had reached this new milestone.”


The New York Times (5/30) reports CDC Director Robert Redfield said, “Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated.” Redfield added, “Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease that vaccination prevents.” The Times adds that the “measles was eliminated as an endemic disease in the United States in 2000,” but if the current outbreak continues then the US could lose that status, “meaning the disease would be considered endemic in the country for the first time in a generation.”


Updated 5/22/2019 

Pediatricians are monitoring multiple outbreaks of measles across several U.S. states.


  • Current outbreak locations:
  • Number of infections: 880 cases in 24 states (from 1/1/19 through 5/17/19)
  • Pediatric population affected: All pediatric populations at risk. Patients 19 years or younger have accounted for 77% of the cases so far; 48% have been younger than 5 years old.
  • The main outbreaks have been associated with travelers who brought measles back from Israel, Ukraine, and the Philippines.
  • Cases have been reported in Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Pennsylvania, Oklahoma, Oregon, Texas, Tennessee, and Washington.


  • Infants and children aged less than 5 years, adults aged more than 20 years, pregnant women, and people with compromised immune systems, such as from cancer, chemotherapy, or HIV infection, are at high risk for severe illness and complications from measles.
  • Measles can cause serious illness requiring hospitalization, even in previously healthy children.
  • Consider measles in patients with fever and rash and ask about recent international travel, exposure to international travelers, or exposure to people with measles
  • During an outbreak, MMR vaccine should be offered to all people exposed or in the outbreak setting who lack evidence of measles immunity. During a community-wide outbreak that affects infants, MMR vaccine has been shown to be effective in preventing symptoms after exposure and may be recommended for infants 6 through 11 months of age.
  • Involvement of state and local health departments is often advisable for any diagnosis of measles, as there may be specific ways these departments wish to receive specimens and manage patients.

Actions as recommended by the American Academy of Pediatrics and the U.S. Public Health Service


10 Things You Should Know about Measles:

Backyard Poultry – Salmonella Infections

Updated 5/24/2019

Officials are currently investigating multistate outbreaks of Salmonella infections linked to contact with backyard poultry.


  • Location: U.S. Multistate (case count map)
  • Description: Salmonella infections, linked to contact with backyard poultry (such as chicks and ducklings) from multiple hatcheries
  • Number of infections: 52 (as of 5/10/19)
  • Pediatric population affected: All pediatric populations at risk, especially children who live in homes with backyard poultry.


  • Fifty-two people infected with the outbreak strains of Salmonella have been reported from 21 states. Cases began on dates from January 12, 2019 to April 29, 2019.
  • Epidemiologic and laboratory evidence indicate that contact with backyard poultry (such as chicks and ducklings) from multiple hatcheries is the likely source of these outbreaks.
  • People reported obtaining chicks and ducklings from several sources, including agricultural stores, websites, and hatcheries.
  • Nineteen percent of ill people have been hospitalized. No deaths have been reported.
  • Twenty-eight percent of ill people were children younger than 5 years.
  • Children younger than 5 years, immunocompromised individuals and people with hemaglobinopathies, pregnant women, the elderly, and those with chronic gastrointestinal tract disease are more likely to have a severe Salmonella illness.

Action (also applicable when visiting Petting Zoos or having residential backyard farm animal/reptile parties)

  • Prevention
    • People should always wash their hands with soap and water right after touching backyard poultry or anything in the area where they live and roam.
    • Adults should supervise handwashing by young children.
    • Use hand sanitizer if soap and water are not readily available.


  • What you should know:
    • People can get sick with Salmonella from touching backyard poultry & residential party farm animals/reptiles, and visiting petting zoos or their environment. These birds, animals & reptiles can be carrying Salmonella bacteria but appear healthy and clean and show no signs of illness.
    • If you have backyard poultry or attend backyard parties with farm animals and/or reptiles or visit petting zoos, follow these tips to stay healthy:
      • Always wash your hands with soap and water right after touching these backyard animals, petting zoos or anything in the area where they live and roam.
        • Adults should supervise handwashing by young children.
        • Use hand sanitizer if soap and water are not readily available.
      • Don’t let backyard poultry or party animals inside the house, especially in areas where food or drink are prepared, served, or stored.
      • Set aside a pair of shoes to wear while taking care of poultry, backyard animals or visiting petting zoos and keep those shoes outside of the house.
      • Children younger than 5, adults over 65, and people with weakened immune systems should not handle or touch chicks, ducklings, or other poultry or the visiting animals at residential parties or those at petting zoos.
      • Don’t eat or drink where poultry, farm animals or petting zoo animals live or roam.
      • Don’t kiss backyard poultry or snuggle with them and then do not touch your face or mouth. Also true for petting zoos and residential farm animal/reptile paties.
      • Stay outdoors when cleaning any equipment or materials used to raise or care for poultry, such as cages, or feed or water containers.
    • Contact your health care professional if you think you may have become ill from contacting backyard poultry. Most people infected with Salmonella develop the following signs and symptoms 12 to 72 hours after eating a contaminated product:
      • Diarrhea
      • Fever
      • Abdominal cramps

May 14, 2019
Category: Immunizations
Tags: immunizations   Vaccines   Autism   Sc ience  

Blume is living proof that the antidote to misinformation about vaccines is science. "I was relieved," she said, "because I didn't hurt him. His autism wasn't my fault."

The current outbreaks of measles around the country are largely a result of parents being afraid to vaccinate their children against the virus. The number one concern? Autism.

This is a show worth watching!