Author: Charish Barry, MD

Practice Update COVID-19

Please review the following updates to our practice due to the COVID-19 pandemic.

OFFICE HOURS:

Shared daytime coverage with Dr. Iris Castaneda Van Wyk:

Mon & Wed – Dr. Iris

Tue, Thur & Fri – Dr. Barry

Nighttime: Dr. Barry on-call

Weekends: Dr. Barry & Dr. Iris alternate on-call coverage

TELEMEDICINE:

(All covered by and billed to insurance)

-Virtual Well-Visits:  Pre-visit surveys will be emailed in preparation for a virtual well-visit; vaccine plan of care to be determined with Dr. Barry at that time; will arrange for in-office or home-visit for vaccines, testing for vision/hearing or labs for screening iron, lead levels and urine tests as needed;
-Virtual Care-Visits: Non-emergent care visits set-up with Dr. Barry; May include Spruce-visits, direct  Spruce video visits, image or video transfers and/or text messages;
-Virtual Check-ins: Communication using voice call, text message, transfer of information via image or video; can be used for any concern about a child’s health;
-Virtual  E-Visits: Communication through our online patient portal. (We are launching our new patient portal called Passport. Stay tuned, as it will become available this month.)

SOCIAL MEDIA CONNECTION:

We want to stay connected with you!  Keep up-to-date via our website www.petitepediatrics.com, the hub for all practice updates and a great resource for parents. It’s also has our social media links including our newly launched instagram page. Follow us and share our links with your friends!

-Instagram:  @petitepediatricssb,
-Facebook:    PetitePediatrics,
-Twitter:         drbarry@petitepeds

COMMUNITY SUPPORT:

During this COVID19 crisis Petite Pediatrics will help offset the burden on the Emergency Departments by providing Telemedicine Virtual Visits for patients who aren’t established members of Petite Pediatrics. If you have family or friends who are in need of assistance with their child’s care, please direct them to our website to learn about our Virtual Peapod Membership Program that can provide as needed Telemedicine services.

HOME VISITS:

We are launching a Peapod Visiting NP Program as a separate home visit service that will allow us to provide vaccine visits or simple evaluations that require an in-person assessment. We believe this is  a safe way to deliver necessary care for children and protect families during the COVID19 health care crisis. Pediatric Nurse Practitioners will work directly with Dr. Barry to provide medical care for Petite Pediatric families.

SUPPORTING THE IMMUNE SYSTEM AND BODY:

We are strong supporters of staying healthy and active. Home exercises and finding ways to let kids get their wiggles out is always good for our response to stress both physically and emotionally.  Other ways to support our bodies is through a healthy diet. Supplements can benefit a balanced diet in unique ways as well. We offer supplements for our patients exclusively. The OrthoMolecular Products line called Springboard has products for overall immune health: D-Hist and D-Hist Jr., Buffered VitC, Reacted Zinc, Probiotics (Flora Bites and FloraBoost), Imu-Max, Natranix, Kid-D liquid and Vit K/Vit D and WholeImune immunity supplements for older kids, teens and adults.  Available on our website soon.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule a well-child visit at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Novel Coronavirus Update

2019 Novel Coronavirus (COVID-19)

Human Coronaviruses (https://www.cdc.gov /coronavirus/about/index.html) are a family of viruses that usually cause illnesses like the common cold. Almost everyone gets one of these viruses at some point in their lives. Most of the time the illness only lasts for a short time.

COVID-19: a new coronavirus

It was discovered in December 2019 and has now spread throughout the world. As the virus spreads, we are seeing some people with mild illness, some who get very sick, and some who have died. The reason health officials are concerned is because the virus is new, which makes it hard to predict how it will continue to affect people. Researchers and doctors are learning more about it every day, including exactly how it spreads and who is most at risk.

Symptoms of COVID-19

Symptoms can range from mild to severe and can include:

  • Fever
  • Cough
  • Shortness of breath

Who is at risk?

According to the CDC (https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html), children do not seem to be at higher risk for getting COVID-19. However, some people are, including older adults and people who have serious chronic medical conditions like:

  • Heart disease
  • Diabetes
  • Lung disease
  • Suppressed immune systems

How to protect your family:

There is currently no vaccine to prevent COVID-19, but there are a few things you can do to keep your family healthy:

  • Wash your hands (/English/health-issues/conditions/prevention/Pages/Hand-Washing-A-Powerful-Antidote-to- Illness.aspx) often with soap and water for at least 20 seconds.
  • If soap and water are not available, use hand sanitizer (/English/safety-prevention/at-home/Pages/Keep-Hand-Sanitizer-Out-of-Childrens-Reach.aspx). Look for one that is 60% or higher alcohol-based.
  • Keep your kids away from others who are sick or keep them home if they are ill.
  • Teach kids to cough and sneeze into a tissue (make sure to throw it away after each use!) or to cough and sneeze into their arm or elbow, not their hands.
  • Clean and disinfect (/English/health-issues/conditions/prevention/Pages/Cleaners-Sanitizers-Disinfectants.aspx) your home as usual using regular household cleaning sprays or wipes.
  • Avoid touching your face; teach your children to do the same.
  • Avoid travel to highly infected areas (https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed- cases.html#map).

A note about facemasks:

The CDC only recommends facemasks for people who have symptoms of COVID-19, not for people who are healthy. Healthcare workers and anyone taking care of someone with COVID-19 should wear facemasks.

Preparing for School and Daycare Closures:

The COVID-19 outbreak in our community and many others has resulted in the temporarily closure of schools and childcare centers in order to help slow the spread of the virus. Many schools use email to update families. Be sure your child’s school knows how to get in touch with you.

Working parents can be prepared by having alternative childcare plans or talking with their employers about work from home options during school closings. If your child attends a college or university, encourage them to communicate with their school’s plan for the COVID-19 outbreak.

While your children are at home try to keep their days as routine and scheduled as possible. Here are a few tips that can help:

  • Read books with your child. It’s not only fun, but reading together strengthens your bond with your child AND helps their development.
  • Make time for active play. Bring out the blocks, balls, jump ropes and buckets and let the creativity go. Play games that kids of all ages can play, like tag or duck duck goose. Let your kids make up new games. Encourage older kids to make up a workout or dance to keep them moving.
  • Keep an eye on media time. Whenever possible, play video games or go online with your child to keep that time structured and limited. If kids are missing their school friends or other family, try video chats to stay in touch.

Talking to children about COVID-19

There’s a lot of news coverage about the outbreak of COVID-19 and it can be overwhelming for parents and frightening to kids. The American Academy of Pediatrics encourages parents and others who work closely with children to filter information and talk about it in a way that their child can understand. These tips can help:

Simple reassurance. Remind children that researchers and doctors are learning as much as they can, as quickly as they can, about the virus and are taking steps to keep everyone safe.

Give them control. It’s also a great time to remind your children of what they can do to help – washing their hands often, coughing into a tissue or their sleeves, and getting enough sleep.

Watch for signs of anxiety. Children may not have the words to express their worry, but you may see signs of it. They may get cranky, be more clingy, have trouble sleeping, or seem distracted. Keep the reassurance going and try to stick to your normal routines.

Monitor their media. Keep young children away from frightening images they may see on TV, social media, computers, etc. For older children, talk together about what they are hearing on the news and correct any misinformation or rumors you may hear.

Be a good role model. COVID-19 doesn’t discriminate and neither should we. While COVID-19 started in Wuhan, China, it doesn’t mean that having Asian ancestry – or any other ancestry – makes someone more susceptible to the virus or more contagious. Stigma and discrimination hurt everyone by creating fear or anger towards others. When you show empathy and support to those who are ill, your children will too.

Stay informed

Families are encouraged to stay up to date about this situation as we learn more about how to prevent this virus from spreading in homes and in communities. Your local and state public health department will have up-to-date information regarding your community and the most current health and safety recommendations.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule a well-child visit at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Spruce Telehealth: A Standard of Care

Petite Pediatrics has offered this technology as a standard of care for our patients since 2018.

The current COVID-19 global pandemic, requires families to remain home to minimize exposure to the novel corona virus.  We want to assure our families that this is the latest technology in the delivery of medical care and we are committed to ensuring confidentiality while maintaining the safety and well-being of our patients.

Spruce provides the following services:

● Direct text messaging with Petite Pediatrics
Virtual visits for pediatric rashes, allergies, cold/cough and flu symptoms, and newly added COVID-19 risk questionnaire to assist with care during the MERS Cov-2 global pandemic
● Secure Video Visit for complaints that need a live interaction
● Prescription refills and requests

How do I get started?

1. Navigate to Spruce.care/petitepediatrics on your iOS or Android phone.
2. Click on “Get the App & Connect” to download Spruce.
3. That’s it! You should be welcomed by Petite Pediatrics in the app.

Spruce won’t replace all in-office visits.  This service has been offered to enhance our member’s patient-care experience so that we can extend care on occasions when coming to the office is not available, can be efficiently handled remotely, or as a way to better decide that in-person care is needed. We will continue to work with families to deliver excellent pediatric care and will update families via Spruce regarding the latest developments related to COVID-19 and how we can continue to provide pediatric care to our community.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule a well-child visit at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Flu Update for 2018

 A Message for Caregivers & Teachers

Get Vaccinated for Seasonal Flu Now!
Flu activity is quite elevated in the US. Getting vaccinated is still the single best way to protect against influenza and reduce the risk of becoming sick from it. Annual influenza vaccination is recommended for everyone 6 months of age and older, including all child care staff. It is recommended that everyone get vaccinated NOW if you have not already had the vaccine this season. Because young children pass on infections to others in the community, vaccination of every person in a child care setting is an incredibly valuable step in protecting the public’s health.

Prevent the Spread of Germs
With flu activity increasing during the winter months, as it does every year, the challenge is to keep these flu germs from spreading. Staff members and children should be taught to cover their mouths and noses with a tissue when they cough or sneeze (and then put the tissue in the trash right away) or cough/sneeze into their elbow or upper arm.
Everyone should be encouraged to wash their hands with soap and water or use an alcohol-based hand sanitizer. Consider displaying educational materials in Head Start or early education and child care programs to encourage proper hand hygiene and cough/sneeze etiquette. “The Flu: A Guide for Parents”, “Everyday Preventive Actions that can Help Fight Germs, Like Flu”, and “Teaching Children About the Flu” are examples of free materials available on the CDC Print Materials Web page.

If You Get the Flu, Antiviral Drugs May Be an Option
Antiviral drugs are prescription medicines that are used to treat the flu. They can shorten a person’s flu illness, make it milder, and can prevent serious complications. Antivirals can be given anytime during the illness, but they work best when started during the first 2 days. Antiviral drugs are recommended to treat flu, especially those who are at high risk of serious flu complications, are very sick, or are hospitalized. Antivirals can be given to children and pregnant women.
Ready Wrigley and Preparedness for Flu Season

The American Academy of Pediatrics (AAP) worked with the Centers for Disease Control and Prevention (CDC) to develop a Ready Wrigley Activity Booklet on influenza. This book includes tips, activities, and stories to help families prepare for influenza. The book is designed for children 2 to 8 years of age. The Ready Wrigley Activity Book series is produced by the CDC Children’s Preparedness Unit and CDC communication specialists. Child care professionals can print copies of the book for their center or share a link to the book with families.
Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide (4th Edition)
This AAP manual provides child care directors, teachers, and caregivers with important information about the prevention and management of influenza and other infectious diseases that circulate in group care settings. The guide contains helpful reference guides, including quick reference sheets on specific conditions or diseases. Detailed chapters address infection control measures, immunizations, and inclusion/exclusion criteria. Information within this manual can be used to implement new strategies within the center.

Archived Webinar
In January 2018, the AAP collaborated with CDC to conduct a webinar titled, “Preparing Head Start/Child Care and Communities for Seasonal and Pandemic Influenza.” By watching this archived webinar, the viewer can learn about the recommendations for this flu season and find out why everyone who works in Head Start and child care programs should get the vaccine each year. The webinar also shares strategies to prevent and control the spread of influenza in child care settings and explores ways to prepare for an unlikely but dangerous flu pandemic. The webinar is available online.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule a well-child visit at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Coping with Disasters

How Families Can Cope with Relocation Stress After a Disaster

​Unplanned evacuations during a disaster can cause great stress on a community and on the individuals in that community.

First Steps of Recovery
Recovering from a disaster occurs in phases over days, weeks, and months. Soon after being uprooted by a disaster, families can start the recovery process. Right now, there are three general steps to take to improve the mental and emotional strength of the family.

The following steps will help everyone to begin to retake control over life:

Step 1: Rebuild physical strength and health. Once everyone is in a safe and secure place, whether a shelter, a new apartment, or a place with relatives or friends, make sure to tend to their immediate medical needs, if any. Be sure everyone has enough to eat and drink to regain their physical strength. Make sure everyone gets some restful sleep in as private a space as possible. Rebuilding physical strength is a good first step to calm shattered emotions.

Step 2: Restore daily activities. Restoring daily routines helps build a sense of being home mentally and emotionally, even in the absence of a physical home. Simple routines normally done together, such as family walks, watching television, and bedtime stories, help pull the pieces of daily life back together even in a new place. Restoring daily activities rebuilds the normal sense of morning, afternoon, evening, and night. Even though you are away from home and in a strange place, try to resume the daily routines as much as possible.

Step 3: Provide comfort. Family members are better able to deal with the stress of relocation when they are comfortable and informed. Comfort can be increased by

Providing family with information about other family members, friends, and news of home.

Expressing affection for family members, in the ways the family normally shows affection.

Discussing, when ready, the emotions associated with the disaster and relocation feelings of loss, missing home, and worry about family members, friends, and pets.

Rebuilding Family Life
After the initial emergency has passed and the shock and confusion from disaster relocation have subsided, the physical rebuilding and long-term emotional recovery phase begins.

This longer recovery phase has two steps:
Assess all physical and emotional losses your family has experienced. This inventory can help identify practical actions to take in rebuilding the physical losses the family has experienced.

Develop an emotional understanding of the disaster experience and relocation situation to help rebuild family life. Working through emotions takes time. There is no set timeframe or stages for it.

Resolving emotions is a natural healing process that relies on talking to friends about feelings, mental sorting of emotions, and receiving practical and emotional help from family, friends, your place of worship, or other organized support groups in the community.

About Disaster-Related Stress in Children
Disaster-related stress affects young people in several ways:

Damage, injuries, and deaths that result from an unexpected or uncontrollable event are difficult for most children to understand.

Following a disaster, a child’s view of the world as safe and predictable is temporarily lost. This is true of adults as well.

Children express their feelings and reactions in various ways, especially in different age groups.

Many are confused about what has happened and about their feelings. Not every child has immediate reactions; some can have delayed reactions that show up days, weeks, or even months later, and some may never have a reaction. Children’s reactions are strongly affected by the emotional reactions of their parents and the adults around them. In addition, children can easily become afraid that a similar event will happen again and that they or their family will be injured or killed.

How Children Show Disaster-Related Stress
It is normal for young people to show signs of stress after a disaster. Young people show signs of stress differently at different ages or school levels.

  • Signs of stress in preschoolers:

Waking confused and frightened from bad dreams

Being reluctant to going to bed or refusing to sleep alone

Acting and showing behaviors younger than their actual age, such as whining, thumb sucking, bedwetting, baby talk or fear of darkness

Clinging to adults more than normal

Complaining often about illnesses such as stomachaches

Not having fun doing things they normally enjoyed

Being irritable

  • Signs of stress in elementary or middle school age:

    Ongoing concern over their own safety and the safety of others in their school or family

Irrational fears

Becoming extremely upset for little or no reason

Having nightmares and sleep problems

Experiencing problems in school, such as skipping school or misbehavior (e.g., loss of interest, withdrawal, and excessive need for attention)

Complaining of headaches or stomachaches without cause

Not having fun doing things they normally enjoyed

Disruptive behaviors-outbursts of anger and fighting

Being numb to their emotions

Experiencing guilt or shame about what they did or did not do during the disaster

  • Signs of stress in high school age:

Feeling self-conscious about their feelings concerning the disaster

Feeling fearful, helpless, and concerned about being labeled “abnormal” or different from their friends or classmates (this may lead to social withdrawal)

Experiencing shame or guilt about the disaster

Expressing fantasies about retribution concerning people connected to disaster events

Not having fun doing things they normally enjoyed

Difficulty concentrating

Impulsive behaviors

Emotional numbing

Seeing the world as an unsafe place

When Children May Need Additional Help
Situations may develop when children need additional help dealing with emotional after-effects of the disaster. They may benefit from help from a healthcare professional if the emotional stress associated with the disaster does not get better in a few weeks or when they:

Display continual and aggressive emotional outbursts

Show serious problems at school (e.g., fighting, skipping school, arguments with teachers, or food fights)

Withdraw completely from family and friends

Cannot cope with routine problems or daily activities

Engage in vandalism or juvenile law-breaking activities

Express suicidal ideas

Reaching out for help is not a sign of weakness. People have limits and sometimes need help when stretched beyond their limits. Seeking help from others can offer solutions that may not be known to you.

Additional Information & Resources:
Responding to Children’s Emotional Needs During Times of Crisis

Talking to Children about Disasters

How Children of Different Ages Respond to Disasters

Taking Care of Yourself during Disasters: Info for Parents

Helping Children Adjust to a Move

National Mental Health Association

Crisis Helpline – Dial 1-800-273-TALK (1-800-273-8255) to be connected to a network of local crisis centers across the country.

Last Updated 9/27/2017

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Thomas Fire: Stay UP-TO-DATE

Thomas Fire Resources

  • Families can stay updated on the local conditions by checking the Count of Santa Barbara Website. There is also helpful information regarding the use of masks for safe breathing. N95 masks provide protection from small particles in smoke and should be fitted for proper usage.

If they cant reach you, they can’t alert you….Register for Santa Barbara County alerts!

Thomas Fire (wildfires) and the Health Risk to Children

The Thomas Fire has been devastating and poses a major health concern for the young and old, alike.  Here are some guidelines that can be helpful during the acute phase of this fire:

The Pediatric Environmental Health Specialty Units (PEHSU) Network encourage families, pediatricians, and communities to work together to ensure that children are protected from exposure to environmental hazards. Wildfires expose children to a number of environmental hazards, e.g., fire, smoke, psychological stress, and the byproducts of combustion of wood, plastics, and other chemicals released from burning structures and furnishings. During the acute phase of wildfire activity, the major hazards to children are fire and smoke. Acute stress from fire activity and response to the fires and the emotional responses of those around them can also impact children during this time.

Children, individuals with pre-existing lung or cardiovascular problems, pregnant women, elderly, and smokers are especially vulnerable to environmental hazards such as smoke. Children are in a critical period of development when toxic exposures can have profound negative effects, and their exploratory behavior often places them in direct contact with materials that adults would avoid.

The acute phase environmental hazards for children and their family are highlighted below.

SMOKE consists of very small organic particles, liquid droplets, and gases such as CO, CO2, and other volatile organic compounds, such as formaldehyde and acrolein. The actual content of smoke depends upon the fuel source.

HEALTH EFFECTS OF SMOKE: Symptoms from smoke inhalation can include chest tightness, shortness of breath, wheezing, coughing, respiratory tract and eye burning, chest pain, dizziness or lightheadedness, and other symptoms. Asthma symptoms may flare up. The risk of developing cancer from short-term exposures to smoke is vanishingly small.

RECOMMENDATIONS

Stay indoors with windows and doors closed and any gaps in the building envelope sealed. Avoid strenuous activity.
If available and if needed for comfort, run an air-conditioner on the “recirculate” setting. Be sure to change the filter at appropriate intervals. Other types of room or central air filtration systems may help remove airborne particles, but they need to be selected to adequately filter the area in which they serve. Some electronic air cleaners and ozone generating “filters” can generate dangerous amounts of ozone indoors (see the Wildfire Smoke – A Guide for Public Health Officials resource). These ozone filtration systems do not remove harmful contaminants from the air and are not recommended.

Never operate gasoline powered generators indoors – they produce dangerous carbon monoxide. Avoid smoking, using wood stoves, and other activities that add to indoor air contamination.
If there is a period of improved air quality, open up (air out) the house and clean to remove dust particles that have accumulated inside.

Humidifiers or breathing through a wet washcloth may be useful in dry climates to keep mucous membranes moist, although this does nothing to prevent inhalation of contaminants.

When riding in a car, keep the windows and vents closed. If comfort requires air circulation, turn the air-conditioning on “re-circulate” to reduce the amount of outside air drawn into the car.

Children with asthma, heart disease, and others considered at high risk from health effects from contaminant inhalation should be moved to an adequate “clean air” shelter, which may be in their home, in the home of a friend or relative, or in a publicly-provided “clean air” shelter.

Use of Masks

Paint, dust, and surgical masks are not effective obstacles to inhalation of the fine airborne particles generated by wildfires. For information on use of respiratory protection for adults see “Wildfire Smoke – A Guide for Public Health Officials.”  [See local Neighborhood Clinics for distribution of masks]

Although smaller sized masks may appear to fit a child’s face, none of the manufacturers of masks recommend their use in children. If a child is in air quality severe enough to warrant wearing a mask, they should be removed to an indoor environment with cleaner air.

Air Quality Index

The Air Quality Index indicates how dangerous the air is to breathe based upon the measurement of various pollutants such as ozone and small particles (PM2.5). The smoke from wildfires contains large amounts of these hazardous particles. In areas where the Air Quality Index is not determined, measuring PM2.5 is a good substitute for determining the air quality.
Recommended actions for each level of air quality can be found in the Wildfire Smoke – A Guide for Public Health Officials and Air Quality Index – A Guide to Air Quality and Your Health resources cited below. The current air quality index can be found at http://www.airnow.gov.

CLOSING OF SCHOOLS AND BUSINESSES may become necessary because of smoke exposure risk when air quality is so poor that even traveling between indoor locations places people at risk. However, in some situations the school may be a relatively protected indoor environment with better air quality and where children’s activity can be monitored.

CONSIDERATION OF EVACUATION because of smoke should weigh the effects of smoke exposure during the evacuation versus what the exposure would be while resting quietly inside one’s home. A disorderly evacuation can unnecessarily increase the duration and extent of smoke exposure. Remember to pack at least 5 days of any medications taken by family members.
ASH: Recent fires may have deposited large amounts of ash on indoor and outdoor surfaces in areas near the fire. This ash may be irritating to the skin and may be irritating to the nose and throat and may cause coughing. The following steps are recommended:
Do not allow children or animals to play in ash.
Wear gloves, long sleeved shirts, and long pants when handling
ash, and avoid skin contact.
Wash any home-grown fruits or vegetables before eating.
Avoid spreading the ash in the air; wet down the ash before
attempting removal; do not use leaf blowers or shop vacuums.

PSYCHOLOGICAL EFFECTS ON CHILDREN: During the acute phase, parents and caregivers should also be alert to children’s emotional health and psychological wellbeing. It is important to keep in mind the youngest members of our society may easily become saturated with graphic pictorial images and incessant talk of smoke, flames and destruction. Resulting stress and anxiety may be manifested in a variety of ways, depending upon the developmental stage of an individual child:
Clinging, fears
Uncooperative behaviors, irritability
Nightmares
Physical complaints
Changes in eating or sleeping patterns
Regression
Indifference
Parents and caregivers can support children in a number of ways:
Maintain previously established routines and structures as much as possible.
Provide an open door and a listening ear for children; encourage the expression of feelings through a variety of pathways, e.g.,music, art, journaling, talking.
Answer questions openly and honestly, remaining mindful of the age of the child will determine how information is shared.
Reassure and hug when hugs are wanted; practice patience and adopt a peaceful demeanor, as children take their cues from the clues given by their parents and the environment.
To contact your local Pediatric Environmental Health Specialty Unit with any questions about this fact sheet please visit http://www.pehsu.net.

New Medical Home

510 West Pueblo Street

Dr. Barry and the staff at Petite Pediatrics are excited to announce the move of our medical office this fall. We will be relocating to a free-standing medical home that will provide our signature care of personalized medicine for infants, children and adolescents.  We look forward to welcoming you to our new space!

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

MAKE A PLAN for Media Use in School Aged Children and Adolescents

The AAP has created an interactive tool to help families create a Media Use Plan. Media can create frustration for both parents and children, for example, both parties can feel ignored, or be concerned about excessive use.  Both parents and children can lose moments to connect emotionally if devices take the place of face-to-face conversations and interactions.  This tool can help set ground rules, and clear expectations around media use (TV, internet and social media) condusive to a healthy home environment and family relationships.  Check out today and see if it can help your family. Use the link above.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Back to School Tips

Summer is ending soon and the new school year will be starting up. Healthychildren.org has some great Back-to-School tips.

This is a good time to organize and prepare your paperwork for immunizations, sports physicals, learning issues etc. and/or schedule necessary appointments to be ready for the school year.

Back-to-School Tips

The following health and safety tips are from the American Academy of Pediatrics (AAP).

Making the First Day Easier
If your child seems nervous, remind him or her that there are probably a lot of students who are uneasy about the first day of school. This may be at any age. Teachers know that students are nervous and will make an extra effort to make sure everyone feels as comfortable as possible.

Point out the positive aspects of starting school to create positive anticipation about the first day. Your child will see old friends and meet new ones. Refresh his or her positive memories about previous years, when he or she may have returned home after the first day with high spirits because of a good time.

Find another child in the neighborhood with whom your student can walk to school or ride on the bus.

If it is a new school for your child, attend any available orientations and take an opportunity to tour the school before the first day.

If you feel it is needed, drive your child (or walk with him or her) to school and pick him or her up on the first day.

Backpack Safety
Choose a backpack with wide, padded shoulder straps and a padded back.

Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of your child’s body weight. Go through the pack with your child weekly, and remove unneeded items to keep it light.

Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles.

Adjust the pack so that the bottom sits at the waist.

If your school allows, consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs, they may be difficult to roll in snow, and they may not fit in some lockers.

Traveling To and From School
Review the basic rules with your child.

School Bus
Children should always board and exit the bus at locations that provide safe access to the bus or to the school building.

Remind your child to wait for the bus to stop before approaching it from the curb.

Make sure your child walks where he or she can see the bus driver (which means the driver will be able to see him or her, too).

Remind your child to look both ways to see that no other traffic is coming before crossing the street, just in case traffic does not stop as required.

Your child should not move around on the bus.

If your child’s school bus has lap/shoulder seat belts, make sure your child uses one at all times when in the bus. (If your child’s school bus does not have lap/shoulder belts, encourage the school system to buy or lease buses with lap/shoulder belts). See Where We Stand: Safety Restraints on the School Bus for more information.

Check on the school’s policy regarding food on the bus. Eating on the bus can present a problem for students with food allergies and can also lead to infestations of insects and vermin on the vehicles.

If your child has a chronic condition that could result in an emergency on the bus, make sure you work with the school nurse or other school health personnel to have a bus emergency plan.

Car
All passengers should wear a seat belt and/or an age- and size-appropriate car seat or booster seat.

Your child should ride in a car seat with a harness as long as possible and then ride in a belt-positioning booster seat. Your child is ready for a booster seat when he or she has reached the top weight or height allowed for his or her seat, his or her shoulders are above the top harness slots, or his or her ears have reached the top of the seat.

Your child should ride in a belt-positioning booster seat until the vehicle’s seat belt fits properly (usually when the child reaches about 4′ 9″ in height and is between 8 to 12 years of age). This means that the child is tall enough to sit against the vehicle seat back with her legs bent at the knees and feet hanging down and the shoulder belt lies across the middle of the chest and shoulder, not the neck or throat; the lap belt is low and snug across the thighs, and not the stomach.

All children younger than 13 years of age should ride in the rear seat of vehicles. If you must drive more children than can fit in the rear seat (when carpooling, for example), move the front-seat passenger’s seat as far back as possible and have the child ride in a booster seat if the seat belts do not fit properly without it.

Remember that many crashes occur while novice teen drivers are going to and from school. You should require seat belt use, limit the number of teen passengers, and do not allow eating, drinking, cell phone conversations (even when using hands-free devices or speakerphone), texting, or other mobile device use to prevent driver distraction. Limit nighttime driving and driving in inclement weather. Familiarize yourself with your state’s graduated driver’s license law and consider the use of a parent-teen driver agreement to facilitate the early driving learning process. For a sample parent-teen driver agreement, click here.

Bike
Always wear a bicycle helmet, no matter how short or long the ride.

Ride on the right, in the same direction as auto traffic and ride in bake lanes if they are present.

Use appropriate hand signals.

Respect traffic lights and stop signs.

Wear bright-colored clothing to increase visibility. White or light-colored clothing and reflective gear is especially important after dark.

Know the “rules of the road.”

Walking to School
Make sure your child’s walk to school is a safe route with well-trained adult crossing guards at every intersection.

Identify other children in the neighborhood with whom your child can walk to school. In neighborhoods with higher levels of traffic, consider organizing a “walking school bus,” in which an adult accompanies a group of neighborhood children walking to school.

Be realistic about your child’s pedestrian skills. Because small children are impulsive and less cautious around traffic, carefully consider whether or not your child is ready to walk to school without adult supervision.

If your children are young or are walking to a new school, walk with them or have another adult walk with them the first week or until you are sure they know the route and can do it safely.

Bright-colored clothing will make your child more visible to drivers.

Eating During the School Day
Studies show that children who eat a nutritious breakfast function better. They do better in school, and have better concentration and more energy.

Most schools regularly send schedules of cafeteria menus home and/or have them posted on the school’s website. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat.

Many school districts have plans which allow you to pay for meals through an online account. Your child will get a card to “swipe” at the register. This is a convenient way to handle school meal accounts.

Look into what is offered inside and outside of the cafeteria, including vending machines, a la carte, school stores, snack carts, and fundraisers held during the school day. All foods sold during the school day must meet nutrition standards established by the US Department of Agriculture (USDA). They should stock healthy choices such as fresh fruit, low-fat dairy products, water, and 100% fruit juice. Learn about your child’s school wellness policy and get involved in school groups to put it into effect.

Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Choose healthier options (such as water and appropriately sized juice and low-fat dairy products) to send in your child’s lunch.

Bullying
Bullying or cyberbullying is when one child picks on another child repeatedly. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood, over the Internet, or through mobile devices like cell phones.

When Your Child Is Bullied
Alert school officials to the problems and work with them on solutions.

Teach your child when and how to ask a trusted adult for help.

Recognize the serious nature of bullying and acknowledge your child’s feelings about being bullied.

Help your child learn how to respond by teaching your child how to:

Look the bully in the eye.

Stand tall and stay calm in a difficult situation.

Walk away.

Teach your child how to say in a firm voice.

“I don’t like what you are doing.”

“Please do NOT talk to me like that.”

“Why would you say that?”

Encourage your child to make friends with other children.

Support activities that interest your child.

Make sure an adult who knows about the bullying can watch out for your child’s safety and well-being when you cannot be there.

Monitor your child’s social media or texting interactions so you can identify problems before they get out of hand.

When Your Child Is the Bully
Be sure your child knows that bullying is never OK.

Set firm and consistent limits on your child’s aggressive behavior.

Be a positive role model. Show children they can get what they want without teasing, threatening, or hurting someone.

Use effective, non-physical discipline, such as loss of privileges.

Develop practical solutions with the school principal, teachers, school social workers or psychologists, and parents of the children your child has bullied.

When Your Child Is a Bystander
Encourage your child to tell a trusted adult about the bullying. Encourage your child to join with others in telling bullies to stop.

Help your child support other children who may be bullied. Encourage your child to include these children in activities.

Before and After School Child Care
During early and middle childhood, children need supervision. A responsible adult should be available to get them ready and off to school in the morning and supervise them after school until you return home from work.

If a family member will care for your child, communicate the need to follow consistent rules set by the parent regarding discipline and homework.

Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.

If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone.

If you choose a commercial after-school program, inquire about the training of the staff. There should be a high staff-to-child ratio, trained persons to address health issues and emergencies, and the rooms and the playground should be safe.

Developing Good Homework & Study Habits
Create an environment that is conducive to doing homework starting at a young age. Children need a consistent work space in their bedroom or another part of the home that is quiet, without distractions, and promotes study.

Schedule ample time for homework; build this time into choices about participation in after school activities.

Establish a household rule that the TV and other electronic distractions stay off during homework time.

Supervise computer and Internet use.

By high school, it’s not uncommon for teachers to ask students to submit homework electronically and perform other tasks on a computer. If your child doesn’t have access to a computer or the Internet at home, work with teachers and school administration to develop appropriate accommodations.

Be available to answer questions and offer assistance, but never do your child’s homework for him or her.

Take steps to help alleviate eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch, and take a break periodically when it will not be too disruptive.

If your child is struggling with a particular subject, speak with your child’s teacher for recommendations on how you or another person can help your child at home or at school. If you have concerns about the assignments your child is receiving, talk with his or her teacher.

If your child is having difficulty focusing on or completing homework, discuss this with your child’s teacher, school counselor, or health care provider.

For general homework problems that cannot be worked out with the teacher, a tutor may be considered.

Some children need help organizing their homework. Checklists, timers, and parental supervision can help overcome homework problems.

Some children may need help remembering their assignments. Work with your child and his or her teacher to develop an appropriate way to keep track of his or her assignments–such as an assignment notebook.

Establish a good sleep routine. Insufficient sleep is associated with lower academic achievement in middle school, high school and college, as well as higher rates of absenteeism and tardiness. The optimal amount of sleep for most adolescents (13 to 18 years of age) is in the range of 8 to 10 hours per night. See Healthy Sleep Habits: How Many Hours Does Your Child Need? for more information.

Additional Information from HealthyChildren.org:
Ten Tips for Your Child’s Success in School

Administering Medication at School: Tips for Parents

Snacks & Sugary Foods in School: AAP Policy Explained

How You Can Help Your Child Avoid & Address Bullying

Back to School, Back to the Doctor

The Healthy Children Show: Energy Balance for School-Age Kids (Video)

Published 8/8/2016 12:00 AM

https://www.healthychildren.org/English/news/Pages/Back-to-School-Tips.aspx

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