Published 9/17/2023

CDC Announcement [1]:

• CDC recommends everyone 6 months and older get an updated COVID-19 vaccine to protect against the potentially serious outcomes of COVID-19 illness this fall and winter. 
• Vaccination remains the best protection against COVID-19-related hospitalization and death. Vaccination also reduces your chance of suffering the effects of Long COVID.
• The virus that causes COVID-19 is always changing, and protection from COVID-19 vaccines declines over time. Receiving an updated COVID-19 vaccine can restore protection and provide enhanced protection against the variants currently responsible for most infections and hospitalizations in the United States.

Staying Up to Date with Vaccines [2]:

• Everyone aged 6 years and older should get 1 updated Pfizer-BioNTech or Moderna COVID-19 vaccine to be up to date.
• People who are moderately or severely immunocompromised may get additional doses of updated Pfizer-BioNTech or Moderna COVID-19 vaccine.
• Children aged 6 months–5 years may need multiple doses of COVID-19 vaccine to be up to date, including at least 1 dose of updated Pfizer-BioNTech or Moderna COVID-19 vaccine, depending on the number of doses they’ve previously received and their age. 
• COVID-19 vaccine recommendations will be updated as needed.

Updated (Bivalent) COVID-19 Vaccines
The updated vaccines are called “updated” because they protect against both the original virus that causes COVID-19 and the Omicron variant BA.4 and BA.5. Two COVID-19 vaccine manufacturers, Pfizer-BioNTech and Moderna, have developed updated COVID-19 vaccines.

When Are You Up to Date? 
Everyone aged 6 years and older
You are up to date when you get 1 updated Pfzer-BioNTech or Moderna COVID-19 vaccine.

Children aged 6 months—5 years who got the Pfzer-BioNTech COVID-19 vaccine
You are up to date if you are:

• Aged 6 Months—4 years and you get 3 COVID-19 vaccine doses, including at least 1 updated COVID-19 dose.
• Aged 5 years and you get at least 1 updated COVID-19 vaccine dose.

Children aged 6 months—5 years who got the Moderna COVID-19 vaccine
You are up to date when you get 2 Moderna COVID-19 vaccine doses, including at least 1 updated COVID-19 vaccine dose.

Sources:
[1] https://www.cdc.gov/media/releases/2023/p0912-COVID-19-Vaccine.html
[2] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

Published 11/30/2020

We are taking precautions to prevent the spread of COVID-19, caused by the novel Coronavirus.

• We are implementing more frequent cleaning using disinfectant on doorknobs and other high-touch surfaces.
• We are encouraging our patients to get their flu shot (it's never too late!) to avoid unnecessary visits for similar symptoms.
• As a reminder, we have separate sick and well waiting rooms, and separate exam rooms for sick patients. If you suspect that you or your child has been exposed to COVID-19, please call in advance so we can take appropriate precautions to prevent additional spread of the illness.
• In-office testing is not yet available but we will share an update as soon as possible. To ensure care of the most vulnerable populations, the CDC has recommended testing only for those presenting with symptoms of the illness who have also had exposure to someone who has tested positive for or been exposed to COVID-19. Patients should be screened for strep and flu first. Until testing is available at commercial laboratories, specimens will be processed by the Health Department.

Information about the novel Coronavirus and COVID-19:

• COVID-19 spreads by droplets, meaning it transmits person to person as well as through surface contact. We are advising patients to avoid touching their faces, noses, eyes, and mouths and to engage in frequent hand washing.
• There are many other Coronaviruses that merely cause the common cold, but COVID-19 spreads more quickly and causes more severe respiratory symptoms.
• Presenting symptoms of COVID-19 are fever and a dry cough. If you have interacted with someone who has COVID-19 and you have these symptoms, please call the office for advice.
• The virus is most dangerous for people over 60 years old, and who have other pre-existing conditions. If you or a family member is in a high-risk group, consider taking extra precautions.
• Social distancing is recommended if possible. This means staying home from large group activities and trying to maintain at least six feet of distance from other people if you need to go out.

For Everyone
General tips to keep you feeling good.

1. Remember to wear plenty of layers and keep your child's feet warm and dry.
2. A warm pair of gloves is essential and can be clipped on to your child's jacket
3. Drink plenty of fluids. Hot cocoa and herbal teas are great
4. A moisturizer with sunscreen will protect your child from winter glare.
5. Use a lip moisturizer daily.

Mental Health
Mental health is important too! Here are some tips to keep you feeling good mentally as well.

1. Stay active during the dark winter months
   
2. Consider a sunlamp
   
3. Try to keep involved with plenty of social activities

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For Babies
For you parents of little ones, keep this in mind!

• Make sure to put Vaseline or Aquaphor on your baby's cheeks to prevent chapping

An abrasion is an area of superficial skin that has been scraped off during a fall, such as a skinned knee. Wash the wound for at least 5 minutes with warm water and soap. The area will probably need to be gently scrubbed several times to get out all the dirt. You may have to remove some dirt particles with a pair of tweezers. Pieces of loose skin may be cut off with clean scissors. Apply an antibiotic ointment and cover the scrape with a bandaid or gauze dressing. Cleanse the area once a day with warm water and then reapply the ointment and dressing until the scrape is healed. Give acetaminophen (Tylenol) or Ibuprofen (Motrin) for pain relief.
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Call our office immediately if:                             

• There is dirt or grime in the wound that you can’t get out.
• Skin loss involves a very large area.
• The wound looks infected (yellowish or foul smelling discharge, foul odor, spreading redness or streaking).

Call our office during regular hours if:

• Your child hasn’t had a tetanus booster in more than 10 years.
• The wound doesn’t heal by 2 weeks.
• You have other questions or concerns.

Diarrhea consists in frequent, loose bowel movements. The best indicator of the severity of the diarrhea is its frequency. The main complication of diarrhea is dehydration from excessive loss of body fluids. Symptoms of dehydration include a dry mouth, the absence of tears, a reduction in urine production (i.e., none in 12 hours), and a darker, concentrated urine. It is the dehydration you need to worry about, not the presence of diarrhea.

​Diarrhea is usually caused by a viral infection of the intestines. Occasionally, it is caused by bacteria or parasites. It also can be due to drinking too much fruit juice or to a food allergy. Diarrhea usually lasts from several days to a week, regardless of the treatment. The main goal of therapy is to prevent dehydration. Don’t expect a quick return to solid stools. Since one loose stool can mean nothing, don’t start dietary changes until there have been at least two. Infectious diarrhea is very contagious. Good hand washing is essential for preventing everyone in the family from getting diarrhea.
For a child of any age with mild diarrhea (a few loose or mushy stools), continue a regular diet
with a few simple changes:

• Continue full-strength formula or milk and encourage an increased intake of these fluids and extra water.
• Reduce the intake of fruit juices—if given, make them half strength with water or Infalyte.
• Avoid raw fruits and vegetables, beans, spicy foods, and any foods that cause loose stools.

For bottle-fed infants with frequent, watery diarrhea:

• Use oral rehydration solutions (ORS) such as Pedialyte or Infalyte for the first 6 to 24 hours. Give as much ORS as your baby wants. Diarrhea makes children thirsty, and your job is to satisfy that thirst and prevent dehydration. Never restrict fluids when your child has diarrhea without vomiting.
• You may continue with your regular formula after 6 to 24 hours, starting when your baby becomes hungry. If the diarrhea persists for more than a week or if your child is suspected of having rotavirus, you may switch to a soy based formula or a lactose-free formula. When the stools are watery, green and foul smelling, your child may have rotavirus. This virus isespecially prevalent during the winter months and in the daycare setting. It is extremely contagious. The stool may be tested for rotavirus. No special treatment or diet is required. Plan to keep your baby on the soy formula until 4 days after the diarrhea is gone.
• Solid foods that contain a lot of starch are most easily digested when your child has diarrhea. If your baby is over 4 months old, has had diarrhea for over 24 hours, and wants to eat solid food, give him/her the following starchy foods until the diarrhea is gone: any cereal, mashed potatoes, apple-sauce, strained bananas, strained carrots, and other highfiber foods(if the baby has already been on these foods).

For breast-fed infants with frequent, watery diarrhea:

• No matter how they look, the stools of breast-fed infants are considered normal unless they contain mucus or blood or develop a foul odor. The normal number of stools in breast-fed infants may vary from as few as one every seven days to as frequent as one after each feeding. Diarrhea in breast-fed infants can be diagnosed if your baby’s stools abruptly increase in number. Additional clues are if your baby feeds poorly, acts sick, or develops a fever.
• Continue breast-feeding, but at more frequent intervals. Breast-feeding should never be discontinued because of diarrhea.
• If urine production is decreased, offer ORS between breast-feedings for the next 6 to 24 hours.

For children over 1 year of age with frequent, watery diarrhea:

• The choice of solids is the key factor – starchy foods are absorbed best. Give cereals (especially rice cereal), oatmeal, bread, noodles, mashed potatoes, carrots, applesauce, etc. Pretzels or salty crackers can help meet your child’s sodium needs.
• For fluids, use Pedialyte, Infalyte, Gatorade, flat sodas, or herbal or decaffeinated tea. If solids are not being consumed, encourage a high fluid intake.
• Avoid all fruit juice or other drinks containing fructose because they usually make diarrhea worse.
• You may give milk if desired. Active culture yogurt is fine for babies over 9 months of age.
• If your child has rotavirus, you may switch to soy milk until four days after the symptoms have resolved.
  
  

Call our office immediately if:

• Blood appears in the diarrhea.
• Signs of dehydration occur (no urine in more than 12 hours, very dry mouth, no tears).
• Diarrhea is associated with severe abdominal pain.
• The diarrhea is frequent and watery and your child also vomits the clear fluids four or more times. (Note: If your child has vomited more than once, treatment of the vomiting has priority over the treatment of diarrhea until your child has gone 6 hours without vomiting).
• Your child starts acting very sick.

Call our office during regular hours if your child has:

• A fever lasting more than 3 days.
• Mild diarrhea lasting more than 2 weeks.
• You have other questions or concerns.