Eliminating Gluten, Nuts and Dairy Photo

Brad Calkins | Dreamstime.com |Eliminating Foods Diet

With school starting soon, you’re probably busy with back-to-school activities, like buying clothes and school supplies, but is preparing your child’s school for his/her food allergies on the to-do list?

With a little organization, preparation and education, you can help keep your child safe from experiencing a food allergy reaction at school. We’ve created this list of tips to get you started.

Make an appointment with the allergist.
Discuss and update your child’s food allergy emergency plan for school, making sure the plan includes a photo of your child and your and the doctor’s contact information. Also, ask for any prescriptions that may need to be filled for the school.

Order a medical alert bracelet.
Along with your child’s name and allergy types, consider including that epinephrine should be given for a severe reaction.

Gather your child’s medical supplies.
Make sure all of your child’s medications are packed and ready to go to school. If it’s possible, provide the school with medications that will not expire; otherwise, make a note of the expiration date(s) on a calendar, so you’ll be ready to replace them before the expiration date.

If your child won’t have an epinephrine auto-injector on him/her at all times, provide one to the school nurse, your child’s teacher and any other school staff who will spend time with your child. The epinephrine container should be labeled with your child’s name, photo and emergency contact information.

Develop emergency plans with the school.
Speak with the school’s staff and make emergency plans for different scenarios, like snack time, lunchtime, classroom parties and field trips. Remind school staff they should give epinephrine immediately, then call 911 in the event of a severe allergic reaction.

Attend the school meeting.
Ask questions related to your child’s food allergy, including:

  • Where is the food kept, and where will your child eat?
  • Are tables cleaned with disposable disinfecting wipes? Sponges can spread allergens.
  • Which staff oversees snack and lunchtime, and do they discourage food sharing?
  • Can teachers give you several days’ notice of food-related events, including birthday parties?
  • Is food used as a reward in the classroom, and if so, can alternative rewards be given?
  • Are kids urged to wash their hands, instead of using hand sanitizer, before and after eating? Hand sanitizer gels do not remove allergens.
  • Is training provided to teachers on how kids describe allergic reactions (e.g. kids may say their food tastes spicy, tongue feels hot, mouth feels itchy or funny, or lips feel tight)?

Write a letter to other parents.
Your letter should include the allergies your child has, what can cause a reaction and the serious effects of a reaction. Explain cross contamination and how preventative measures can keep your child safe.

For year-long tips, read “Going to School With Food Allergies” at Johns Hopkins All Children’s Hospital website.


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Summer4827805659_9da7bd0ae7_b is all about having fun in the sun. We’ve all made plans to enjoy the beach, lake, and/or pool. Many of my friends are planning to lay on the beach and even out their tans for that perfect summer-kissed glow (due to all the up-coming weddings they are attending). Seems like no big deal, right? Well, it’s NBD until you have few moles removed from your back and your doctor is telling you that a sunburn you got 10-15 years ago is probably what made those moles a problem today. Listen, skin cancer is the most common type of cancer and accounts for about half of all cancers diagnosed. According to the American Academy of Dermatology nearly 145,000 Americans will be diagnosed with some form of melanoma this year. Moreover, 75% of skin cancer deaths are due to melanoma. It is a big deal.

My fiance just had a mole removed from his back two weeks ago. Today, he goes in to have the stitches removed. The doctor explained to us that on a scale of 1 – 5, where “1 is normal” and “5 is cancer” the previous biopsy of the mole was a “3” and that’s why the mole and the area around it needed to be excised. As a cancer survivor and liver transplant recipient, I understand the importance of protecting my skin because I am “100 times more likely than the general public to develop squamous cell carcinoma.” Despite the cautionary tales I’d shared and the “wear sunscreen” speech I’ve relayed from my doctors, friends, and fellow cancer survivors- it wasn’t until this happened to him that it “clicked.”

I don’t want you to have to end up with a cancer diagnosis to realize and practice the simple steps you can take to avoid getting sunburned. Sunburns today could be skin cancer in a year or 10 years. Trust me. Cancer is expensive and interrupts your life significantly. Below are some questions and answers to help make the case for protecting your skin this summer.

Q: If the sun is so scary, are you expecting me to stay inside all summer?

A: Please don’t hide in your closet all summer. Go outside, be active! It’s essential to your health in countless ways. I’m just asking that you be smart about it. Avoid going outside during the hottest part of the day when the sun is at its highest peak. If you can’t avoid being outside during that time, limit your time in the sun, find shade, wear broad spectrum protective clothing, hats, sunglasses, etc. Think about it this way, one hour of sun at 9 A.M. is nearly equivalent to 15 minutes of sun at 1 P.M. Your goal is to stay safe in the sun. As my fiance says regularly, “Fun ends when safety ends.”

Q: So, how much sunscreen do you really need? 

A: You need to apply at least one oz. of sunscreen every two hours in order for it to really be effective. Truly! If you’ve spent 4-5 hours at the beach and a quarter of your 8 0z. tube of sunscreen isn’t gone, you didn’t use enough. If you went with a group and you still have any sunscreen left- clearly, you all didn’t use enough. Rule of thumb: apply sunscreen 30 minutes prior to being out in the sun and reapply often. Even if your sunscreen is labeled as “water-resistant” or “water-proof” you still need to reapply. Efficacy of these kinds of sunscreens means about 40-80 minutes of SPF coverage when wet.

Q: Fine! I’ll wear sunscreen. What SPF (Sunburn Protection Factor) should I use? 

A: There is some debate over this. Many believe that the higher the SPF number is, the greater it is at protecting you from UVA/UVB rays. Actually, it’s pretty negligible; but for someone who has a history of or susceptibility for skin cancer, the marketing of SPF numbers could mean peace of mind. Truth is, no matter the SPF you put on, it’s ineffective after a couple hours. Which means, it’s not necessarily the SPF number that counts, it’s how often you reapply. Effectively, you should reapply after you do anything that could make the sunscreen slough off. Be sure to purchase a quality sunscreen with “broad spectrum” protection. An everyday SPF of 15 (blocks 93% of harmful rays) for your daily commute through life, in and out of buildings, etc. should be sufficient (reapply religiously). Thankfully, many lotions and make up products include SPF 15 already. However, if you’re playing in a sporting event, or near water (which is reflective) in directly sunlight, etc. you’re probably better off with a thicker, higher SPF of 30+ (blocks 97%+ harmful rays) which is the recommendation found on hopkinsmedicine.org.

Q: Sunscreen is gross. Couldn’t I just use a tanning bed?

A: If you want to jump from the frying pan and into the fire, that’s your decision as an adult. However, there’s a reason why Howard County, Maryland does not allow tanning for minors. If you read the report and its findings, I expect that you’ll see how important your skin is too. Perhaps you’ll decide tanning beds aren’t for you and that wearing sunscreen isn’t such a bad idea after all.

Clearly, I’m not a doctor or medical professional. Please consult with your primary care physician or your dermatologist for your skin health needs. Take these questions and answers as what they are: another way to hear the “wear sunscreen” speech.

Remember: use high quality, broad spectrum sunscreen, and reapply religiously!

JP is the HCLS Editor & Blog Coordinator for Well & Wise. She is also a Children’s Instructor & Research Specialist at the Savage Branch & STEM Education Center. She is a storyteller, wannabe triathlete, myriad hobbyist, cancer survivor, and liver transplant recipient.

 

 

 


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choose a pediatrician

[Credit: michaeljung]/[iStock]/Thinkstock

“Parenthood is a long and wonderful journey and having a medical professional who is caring and understanding from the beginning is an important part of this experience,” says Edisa Padder, M.D., a pediatrician on staff at HCGH. “Every parent should feel their pediatrician cares about their child as if they are their own. Your pediatrician’s office should be your medical home, where all your child’s medical needs are met.”

One way to get started finding a pediatrician is to ask for referrals from family and friends. Your next step should be visiting the pediatrician’s office and meeting with the doctor, even before your baby is born. “A few issues to consider when choosing a pediatrician are the willingness of the pediatrician to listen and hear your concerns about your child, whether a simple question or complex medical issue,” explains Dr. Padder. “If you have a trusting relationship with your pediatrician, even a difficult situation becomes more manageable.”

Understand whether your pediatrician works full- or part-time and who you talk to or see after hours. “You want to talk to a physician who knows your family so he/she can give you proper guidance and advice,” explains Dr. Padder. “When your child gets sick after office hours, you should call your pediatrician’s answering service for guidance — if you know it is truly an emergency, go to the emergency room. If you are not sure whether your concern requires an urgent evaluation, please contact your pediatrician on call immediately. Additionally, you want to know how easy it is to get an appointment if your child is sick or for a well-child visit.”

Choose a doctor who shares your parenting philosophy and style and sees eye-to-eye with you on issues such as feeding, antibiotics, colic and sleep problems. Decide whether you want a solo practitioner or group practice and check the pediatrician’s training and credentials. “Know your initials,” says Dr. Padder. An M.D. attended medical school, did three years of residency and passed American Board of Pediatrics examinations. FAAP after a doctor’s name signifies a fellow of the American Academy of Pediatrics. Also trained to work with children are medical doctors who are family practitioners, nurse practitioners (NPs) and physician’s assistants (PAs).

In addition to family and friends, other sources for finding a pediatrician include the Howard County General Hospital Find A Doctor, your insurance’s website and the American Academy of Pediatrics .

Visiting the Office
When visiting potential pediatrician offices, ask questions:

  1. Is the doctor in a group practice?
  2. Does another physician cover for the doctor at times?
  3. Is there a nurse in the office who can answer routine questions?
  4. Who handles phone calls when the office is closed?
  5. Is your insurance accepted?
  6. What is the office policy on taking and returning phone calls?
  7. A question to ask yourself: Are the physician and office staff courteous? Do they show compassion and patience or did you feel rushed?
Edisa Padder, M.D., is a pediatrician with Padder Health Services in Columbia. Call for an appointment, 301-560-4747

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trio booksAs you may already know, the Central Branch of HCLS closed its doors for an exciting three-month renovation (it’s going to be so cool when it reopens!). Central team members have been temporarily relocated to the East Columbia and Miller Branches during this time. Both East Columbia and Miller have been welcoming and accommodating beyond belief. Moving, however, is never without stress, confusion, and a bit of nerves. It occurred to me, as an adult woman, that if a temporary move into a more-than-friendly territory gives me the jitters, then a young person encountering his or her first move into a new home must be completely freaked out.

So if you’re getting ready to move and you’ve lost your mind (as well as your keys and match to every other sock) in a slew of boxes, and you haven’t accidentally packed the kids, then they may be just as stressed out, if not more so, than you. The first thing you can do is head to the library and pick up some books that might ameliorate your kids’ unease.

peanut butter and cupcakeOne of my favorites out of the gate is one from our Summer Reading 2015 picks, Peanut Butter & Cupcake by Terry Border. A simple tale about newly transplanted Peanut Butter who wanders around his new town with a soccer ball looking for a new friend to play with. Don’t be fooled by the simplicity and humor of this story; one of the biggest fears of a child who is moving is finding new friends.

lenny and lucyContinuing with the theme of friendship, but also focusing on the anxiety caused by how “scary” a new place can be, is the charming Lenny & Lucy by Phillip C. Stead. This American Library Association Notable Books for Children pick and Publishers Weekly Best Book of the Year for 2015 will reassure your kids that their feelings are perfectly normal and that things will get easier.

before i leaveBefore I Leave by Jessixa Bagley takes a different tack. This sweetly sad picture book focuses on the fear of leaving behind a beloved friend with a new move. And the heartwarming Ice in the Jungle by Ariane Hofmann-Maniyar touches on the loss of the familiar and how alien a new place can seem. While Eve Bunting’s Yard Sale explores the theme of loss even more deeply as the main character must watch her family sell off some of their possessions to move from a house to an apartment. And if you want a book that that’s less of a story and more of an aid to help you start a conversation about the fears your child may be having about the move, then a nonfiction book such as Moving by Caitie McAneney might be what’s needed.

trio books 2This is just a drop in the bucket of books covering this topic (a catalog search on moving, household will give you many more options). We even have some books for the older kids such as Seven Dead Pirates by Linda Bailey for middle grade readers (if you think moving is hard, try moving into a house occupied by the ghosts of seven pirates). There’s also Tell Me Three Things by Julie Buxbaum for teens (about a teen grappling with grief, navigating a new school and step-family, and corresponding online with a mysterious new “friend”). Or maybe a graphic novel such as Lost in NYC: A Subway Adventure by Nadja Speigelman will provide some comfort.

Moving, at any age, can be a trying experience. A book might bring a sense of peace (or at least help alleviate some of the loneliness and anxiety) for a kid. Even adults need support and comfort during a move. That being said, if you get a chance, I hope you’ll swing by the East Columbia Branch and say hi to me sometime during the next three months.

Joanne Sobieck-Lingg is glad to blog about her many, disparate interests (though expert in none, except maybe parenthetical asides). In past lives, she was a writer, proofreader, editor, project manager, teacher, and even co-coordinator of a certain health blog. She has been happily ensconced among the fiction and teen books at the Central Branch of HCLS since 2003.

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mask-157574_640By the time you read this, I will be in Costa Rica on an exciting vacation with the hubby and our two cheeky monkeys…or possibly rocking back and forth while curled in a ball alternating between laughter and tears, having just traveled several hours on a plane with the aforementioned cheeky monkeys. This, of course, is an exaggeration (as you may have noticed, I am sometimes prone to exaggeration). The monkeys, though still only in elementary school, have become quite the seasoned travelers, having already traipsed all over the United States many times, and even to Ireland once. This, however, is their first trip where English is not the primary language, and I’d be a liar if I didn’t admit to being a bit nervous.

Though the hubby and I have been doing a lot to get our ducks in a row (everything from organizing travel documents, to making sure that there will be things our one very picky eater will eat, to arranging accommodations, to making sure we’ve purchased1 some reading material to distract the kids en route), we know and accept that, inevitably, something unplanned for will come up. Parenting is definitely not an exact science, and all the preparation in the world is still sometimes not enough.

This is RidiculousThat seems to be at the heart of a delightful little book I recently came across at HCLS: This Is Ridiculous This Is Amazing: Parenthood in 71 Lists by Jason Good. Full of lists with titles such as “How to Defend Yourself Against a Toddler Attack,” “What We’ve Googled,” “Signs That You’re a Bad Parent,” and, one of my personal favorites, “Reasons Your Toddler May be Freaking Out,” this book reminded me of some of the very frustrating and very funny early days of parenting. Even now that my kids are a bit older, there’s still plenty of humor, but the frustration factor has definitely gone down as we’ve learned to just roll with it.2

The book is mainly made up of these light-hearted lists, with the occasional mini-lesson, such as “The Arithmetic of Parenting”–apparently there are formulas for parenting that include variables such as “LI” (likelihood of injury) and CSC (current state of comfort), and “How to Threaten Your Child Effectively”–self explanatory. Remembering to laugh along the way is sometimes, I feel, the best way to get though the trickier times of family life.

Jason Good’s little book certainly brought plenty of smiles and a much-needed reminder that I’m not the only parent out there that thinks less than motherly thoughts on occasion. If you need such a reminder, a sanity check, or just a good laugh, you may also want to check out Someone Could Get Hurt: A Memoir of Twenty-First Century Parenting, Naptime Is the New Happy Hour: And Other Ways Toddlers Turn Your Life Upside Down, The Three-Martini Playdate: A Practical Guide to Happy Parenting, The Sweet Potato Queens’ Guide to Raising Children for Fun and Profit, and I Heart My Little A-Holes: A Bunch of Holy-Crap Moments No One Ever Told You about Parenting.

1 As a dedicated employee of HCLS and a member of a family that consumes books pretty rapidly, I am a firm believer in getting most of our reading materials from the library. However, I am not foolish enough to think that books will not get misplaced, damaged, or completely obliterated during world travel with children. We make the purchase to help mitigate another one of those unforeseen, unplanned for events that seems to come with parenthood.

2 Many of our friends with older kids have warned us that the frustration factor will come back into play in the teen years–let’s hope the humor also increases during these years.

Joanne Sobieck-Lingg is glad to blog about her many, disparate interests (though expert in none, except maybe parenthetical asides). In past lives, she was a writer, proofreader, editor, project manager, teacher, and even co-coordinator of a certain health blog. She has been happily ensconced among the fiction and teen books at the Central Branch of HCLS since 2003.

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breastfeeding tips

Dr. Natalia Colón Guzmán is an OB/GYN on staff at Howard County General Hospital. Also a mother of two, she shares her struggles with breastfeeding and the reasons she persisted until breastfeeding became a success. (Dr. Colón Guzmán with husband Eduardo Guzmán and daughters Susana and Ana Lucía.)

Breastfeeding may require some hard work, but it’s worth the effort says this OB/GYN and breastfeeding mom

In addition to being a mom of two, I am an obstetrician. So, I know how beneficial breastfeeding is to both mother and baby. When I had my firstborn, I was determined to breastfeed. Although it was more difficult than I expected, with assistance, I was able to be successful. If I can do it, anyone can.

Breastfeeding has long proven to be quite beneficial for both mother and infant. There is good evidence that it can influence many aspects of an infant’s life, including overall health, risk of infections, risk of obesity in the future and many others. Breast milk helps strengthen infants’ immune systems, which is why infants who are exclusively breastfed have fewer visits to doctors and hospitals for illnesses. Some studies even suggest that the longer a baby is breastfeed, the higher the child’s IQ could be later in life.

There are also many benefits to the mother, including helping to achieve a quicker recovery from delivery and reducing her levels of stress. It can enhance weight loss for many mothers and can be a method of birth control, although not quite perfect. Breastfeeding can reduce the risks of maternal ovarian and breast cancer and it is also good for the household economy as it is free (it is estimated it can save $1,000 in one year).

While it has many benefits, breastfeeding can, unfortunately, be challenging for many mothers. Sometimes the infant has issues, such as a tongue tie or congenital deformities, and sometimes the mother can have problems, such as flat nipples and low milk supply. Some women have to work very hard to achieve their breastfeeding goals.

When I had my first child, my milk came in a bit later than expected and the baby was not gaining as much weight as the pediatrician wanted. It was very hard work for me; I had to pump and supplement feedings with my own milk, but perseverance is one of my personality traits and I sought support and was able to pull through. Now I am breastfeeding my second child, and it is so natural to me that it feels as if I have been doing it my whole life.

In order to be successful at breastfeeding, I think it is important to take care of yourself. Eat well, stay hydrated by drinking lots of fluids/water, take your vitamins, and rest as much as you can. It is important to be persistent, even if the breastfeeding is not going as planned. In my practice, I find many women give up easily. I know how they feel…I almost gave up myself. But, a good lactation consultant, pediatrician and/or a lactation support group, will help women pull through and allow them many months of successful breastfeeding.

Howard County General Hospital hosts a Breastfeeding Support Group every Wednesday, 12:30-2:30 p.m. in our Wellness Center. No appointment is needed.

Natalia Colón Guzmán, M.D., FACOG, is an OB/GYN on staff at Howard County General Hospital. She and her husband, Eduardo Guzmán, are the proud parents of two little girls, Susana and Ana Lucía.

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