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Coping with Disasters

Posted on by Charish Barry, MD in ,

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

Posted on by Charish Barry, MD in

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.

http://countyofsb.org/thomasfire.sbc#update

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

http://awareandprepare.org/

Thomas Fire (wildfires) and the Health Risk to Children

Posted on by Charish Barry, MD in , ,

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

Posted on by Charish Barry, MD in

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

Posted on by Charish Barry, MD in

http://www.healthychildren.org/MediaUsePlan

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

Posted on by Charish Barry, MD in

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

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

California’s Law SB277 to End Vaccine Exemption PASSED.

Posted on by Charish Barry, MD in

The statement below is from the American Academy of Pediatrics’ (AAP) California chapter website. The AAP, whose members are pediatricians, supports the new law that ends personal belief exemptions for mandated vaccines. The new law signed by Governor Brown takes effect July 1st and impacts the 2016/2017 school year (Gov. Brown’s statement is attached). All children will need proof of vaccination for mandated vaccines to enter school and be unable to opt out of vaccination for personal or religious beliefs.

According to the website, https://www.aapca1.org/articles/california-governor-brown-signs-sb-277,

“California Governor Brown signs SB 277 to eliminate personal belief exemptions for school and child care entry in California. We applaud Senator Richard Pan, MD, and Senator Ben Allen, their co-authors and staff for this tremendous accomplishment – a landmark in public health legislation!

Thank you to the hundreds of AAP California member pediatricians who called and wrote in support of SB 277. Special thanks to Vaccinate California, the California Immunization Coalition, the California Medical Association, the Health Officers Association or California, the California Academy of Family Physicians and everyone who joined the effort to advocate, educate, and enact SB 277.

Children and the public health are the clear winners !

http://gov.ca.gov/docs/SB_277_Signing_Message.pdf”

Now is a good time to review your child’s vaccine records and discuss with your health care provider to make sure immunizations are up to date before the new school year.

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

ZIKA Virus

Posted on by Charish Barry, MD in

https://www.healthychildren.org/English/news/Pages/CDC-Outlines-Ways-to-Prevent-Diagnose-Treat-Children-with-Zika-Virus-Disease.aspx

CDC Outlines Ways to Prevent, Diagnose & Treat Children with Zika Virus Disease

​Noting the rapid spread of the Zika virus, an article to be published in the May 2016 edition of Pediatrics offers health care providers guidance on how to recognize, test and treat children who show signs of infection.

Diagnosis can be challenging, based on limited data that shows that most infants and children with Zika virus display mild symptoms that resemble common childhood illnesses, according to the report, “Zika Virus Disease: A CDC Update for Pediatric Health Care Providers,” by the U.S. Centers for Disease Control and Prevention, published early online March 23.

Zika virus has been identified in 37 countries and territories as of March 9, 2016. No vaccine is available to prevent infection with the virus, which is typically spread by mosquitoes and has also been reported to occur through sexual transmission from male partners.

The Zika virus has been associated with birth defects, including microcephaly, with warnings issued for pregnant women to postpone travel to areas where local Zika virus transmission has been reported. Children and adults who contract the virus may show symptoms of fever, rash, joint pain or conjunctivitis.

Health care providers should suspect mosquito-borne transmission of Zika virus infection in children who have traveled to or resided in an affected area within the past two weeks and exhibit at least two symptoms. Treatment consists of supportive care, including rest and fluids.

Published
3/23/2016 12:00 AM

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

ALLERGIES

Posted on by Charish Barry, MD in

Allergies

Allergies and asthma, which typically start in childhood, are by far the most common chronic diseases among children in the United States. Consider the following statistics:

Some 50 million Americans have allergies (about 1 in 5 people in this country).
The most common type of allergy is hay fever (allergic rhinitis); the medical cost of treating it, when direct and indirect costs are added up, now exceeds $7 billion a year.
More than 17 million Americans have asthma, and about one-fourth of these are younger than 18 years. Asthma accounts for about 4,000 deaths a year.
Seventy to 80% of school-aged children with asthma also have allergies, which are among the most common triggers for asthma, closely tied with viral respiratory infections.
If one parent has allergies, there’s a 25% chance that a child will also be allergic. The risk is more than doubled to 60% to 70% if both parents have allergies.
Many aspects of allergies, eczema, and asthma still are not fully understood. But advances in the diagnosis and treatment of these disorders are helping millions of sufferers.

What Are Allergies?
Many people mistakenly use the word allergy to refer to a disease or almost any unpleasant or adverse reaction. We often hear someone say, “I have allergies,” “He’s allergic to hard work,” or “She’s allergic to anything that’s green.” In reality, allergies are reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema.

Your immune system is made up of a number of different cells that come from organs throughout the body—principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose).

Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens.

Who Is at Risk?
Although allergies can develop at any age, they most commonly show up during childhood or early adulthood. A search of family medical histories of a child with allergies will usually turn up a close relative who also has allergies. If one parent, brother, or sister has allergies, there is a 25% chance that a child will also have allergies. The risk is much higher if both parents are allergic. But the child will not necessarily be allergic to the same substances as the parents or always show the same type of allergic disease (eg, hay fever, asthma, eczema).

Symptoms Associated With Allergies
Eyes, Ears, Nose, Mouth
Red, teary, or itchy eyes
Puffiness around the eyes
Sneezing
Runny nose
Itchy nose, nose rubbing
Postnasal drip
Nasal swelling and congestion
Itchy ear canals
Itching of the mouth and throat

Lungs
Hacking dry cough or cough that produces clear mucus
Wheezing (noisy breathing)
Feeling of tightness in the chest
Low exercise tolerance
Rapid breathing; shortness of breath

Skin
Eczema (patches of itchy, red skin rash)
Hives (welts)

Intestines
Cramps and intestinal discomfort
Diarrhea
Nausea or vomiting

Miscellaneous
Headache
Feelings of restlessness, irritability
Excessive fatigue

When to Suspect an Allergy
Allergies can result in various types of conditions. Some are easy to identify by the pattern of symptoms that invariably follows exposure to a particular substance; others are more subtle and may masquerade as other conditions. Here are some common clues that should lead you to suspect your child may have an allergy.

Patches of bumps or itchy, red skin that won’t go away
Development of hives—intensely itchy skin eruptions that usually last for a few hours and move from one part of the body to another
Repeated or chronic cold-like symptoms, such as a runny nose, nasal stuffiness, sneezing, and throat clearing, that last more than a week or two, or develop at about the same time every year
Nose rubbing, sniffling, snorting, sneezing, or drippy nose
Itchy, runny eyes
Itching or tingling sensations in the mouth and throat
Coughing, wheezing, difficulty breathing, and other respiratory symptoms
Unexplained bouts of diarrhea, abdominal cramps, and other intestinal symptoms.

Where does ASTHMA fit in?
Although allergies can trigger asthma and asthma is often associated with allergies, they are actually 2 different things. In simple terms, asthma is a chronic condition originating in the lungs, whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs. Many different substances and circumstances can trigger an asthma attack—exercise, exposure to cold air, a viral infection, air pollution, noxious fumes, tobacco smoke, and for many asthma sufferers, a host of allergens. In fact, about 80% of children with asthma also have allergies. Although allergies are important in triggering asthma, severe asthma exacerbations are often set off by the good old common cold virus, totally unrelated to allergy.
Last Updated
11/21/2015
Source
Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)

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.

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Ear Infections

Posted on by Charish Barry, MD in

Ear Infection Information

When is it an Ear Infection?
A typical middle ear infection in a child begins with either a viral infection (such as a common cold) or unhealthy bacterial growth. Sometimes the middle ear becomes inflamed and causes fluid buildup behind the eardrum. In other cases, the eustachian tubes — the narrow passageways connecting the middle ear to the back of the nose — become swollen.

Children are more prone to both of these problems for several reasons. The passages in their ears are narrower, shorter, and more horizontal than the adult versions. Because it’s easier for germs to reach the middle ear, it’s also easier for fluid to get trapped there. And just as children are still developing, so are their immune systems. Once the infection takes hold, it’s harder for a child’s body to fight it than it is for a healthy adult’s.

The symptoms of an ear infection may be hard to detect. A child who constantly tugs or pulls at the ear could simply be exploring, or simply showing a self-soothing reflex — even though that tops the list of signals listed in many books and Web sites.

Other symptoms can include:
More crying than usual, especially when lying down
Trouble sleeping or hearing
Fever or headache
Fluid coming out of the ears
Doctors can use special instruments to see if an infection is present.

Treatment: Less May Be More
Perhaps the most surprising news is that common ear infections rarely require medication or any other action, except when severe or in young infants. “The body’s immune system can usually resolve them,” says Dr. Robert M. Jacobson, chair of the Mayo Clinic’s Department of Pediatric and Adolescent Medicine. “More and more studies show that children treated or untreated are at the same place 10 days out. We are constantly amazed at how many ear infections resolve on their own.”

It’s true: Fewer doctors are relying on antibiotics. As Dr. Jacobson points out, it’s important to understand that taking antibiotics might or might not speed recovery, and overusing them can lead to bacteria developing resistance to the drugs, as the germs mutate to defend themselves against medicine. As a result, many pediatricians have adopted a wait-and-see approach, rather than prescribing antibiotics at the first sign of infection.

Asking the parents to observe the child for 48 to 72 hours is becoming the most common first step among pediatricians. That doesn’t mean that an office visit isn’t a good idea, however. Doctors can prescribe numbing drops and suggest over-the-counter pain relievers to treat symptoms, which can help the child feel better as she recovers.

Along with getting away from prescriptions, pediatricians are also shying away from ear tubes, a procedure in which a small tube is surgically inserted in the ear to drain fluid. According to Dr. Jacobson, tube placement is best used with those children who have recurring hearing problems caused by multiple infections.

“Tubes don’t actually stop ear infections, just symptoms and fluid retention,” says Dr. Jacobson. “We don’t want to do it too often because there is an increased risk of damage to the eardrum.”

According to Dr. Jacobson, diagnosis and treatment should be a three-step process:
First, the pediatrician determines whether or not an ear infection is present.
Second, the pediatrician and parent discuss risk factors and how to reduce them.
Finally, observation and treatment of symptoms ensure the child is recovering without pain.
Reducing the Risks for Ear Infection
While parents can’t head off every germ that’s headed for their children, they can take steps to reduce their children’s risks.

Avoid Secondhand Smoke Exposure
Smoking is a huge contributor to childhood illness. Ear infections are no exception to that rule. Smoking is addictive and hard to quit, but not every smoker realizes the harmful effects that secondhand smoke could have on his or her child. Quitting is just as important for your child’s health as your own.

Proper Hygiene
Bad hygiene habits are another major problem. Children in child care are more exposed to widespread bacteria, as are those who drink from a bottle as opposed to asippy cup, says Dr. Jacobson. That’s because bottles have more surface area for germs to live on. Teach children to wash their hands frequently to prevent the spread of germs that spread illness.

Keep Your Child Up-To-Date with Vaccines
Talk with your child’s doctor about the vaccines that protect against pneumonia and meningitis. Studies show that vaccinated children experience fewer ear infections.

Breastfeed Your Baby
Breastfeed infants for the first year. Breast milk has many substances that protect your baby from a variety of diseases and infections. Because of these protective substances, breastfed children are less likely to have bacterial or viral infections, such as ear infections.

Get A Flu Shot
Consider getting immunized against influenza. Aside from protecting against this yearly disease, it can help prevent ear infections.
Last Updated
11/21/2015
Source
Adapted from Healthy Children Magazine, Summer 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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

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