2605 Blue Ridge Road, Suite 100 Raleigh, NC 27607(919) 881-9009

Carolina Kids Blog

By Carolina Kids Pediatrics
August 01, 2018
Category: Children's Health
Tags: nutrition  

Age 1 to 5 has been described as the “Age of Beige.”
 
Beige and bland - the color and taste of foods eaten by picky toddlers and preschoolers.
 
So, how can you win the Battle of the Plate with your toddler or preschooler? At Carolina Kids Pediatrics in Raleigh, our pediatricians offer these ideas for vanquishing your picky eater:
 
RULE #1: AVOID SHORT-ORDER COOKING. So, what can you do if your toddler rejects the pasta and broccoli you have just worked so nutritionhard to prepare? Do you fix the peanut butter and jelly sandwich (with the crust cut off) that you know they will eat? Don’t. Do you force your toddler to eat the food you just spent 30 minutes cooking? Again, don’t. Instead, force a smile, and say, “Not hungry? That’s OK, I’ll save your food for you in case you get hungry later.” Then, leave the food out - the top of a chair works well, as a toddler can change their mind, come back, and the food is available at eye level. Just remember to put the dog outside first, or he’ll think that food you left out on the chair is all for him!
 
RULE #2: SAYING “NO” TO EATING IS OK.  By allowing young kids to say “no” to the meal we prepared, we are supporting their sense of autonomy. However, by not short-order cooking their favorite meal instead (or getting out the packaged snack foods), we avoid giving them more choices than they can handle. A child who gets chicken nuggets and fries every time they reject a meal will end up eating…nuggets and fries, and very little else. By providing a child access to the rejected meal until it’s time for another meal, we are insuring they don’t go hungry and can reconsider their choice when they do get hungry. The hardest part? Don’t suggest your child go back and eat it. Let them figure that part out themselves, and let it be their choice. Kids almost never lose weight or become malnourished when we allow them to say “no” to a meal this way.
 
RULE #3: ABANDON THE 3-MEAL-2-SNACK MYTH. Many toddlers and young children eat a mid-morning snack, a mid-afternoon snack, and even an after-dinner snack. Often these snacks are packages of processed food – cheese sticks, goldfish, crackers, etc. Remember that your toddler or preschooler may only need about 1200 calories a day – if they have 3 snacks with 300 calories each, it’s no wonder they don’t want to eat that nutritious meal we cook for them at breakfast, lunch or dinner. Skip the packaged snack foods. Instead, allow kids access to the previous unfinished meal if they get hungry before the next one – or just offer some sliced fresh fruits or veggies.
 
RULE #4: DUMP THE LIQUID SUGAR. Many young kids become juice-a- holics quickly if given the opportunity. Juices, sodas, and other sweetened drinks offer sugar and very little nutritional benefit – and they often fill kids up, which leads to the “hunger strike” at mealtimes. A cup of milk with each meal is great – but stick to water in between. 
 
RULE #5: WHAT’S GOOD FOR THE GOOSE IS GOOD FOR THE GANDER. THIS MEANS YOU. The most powerful motivator for healthy eating habits is watching a parent or an older sibling eat well. Even if life gets too busy to swing family meals every night, make sure at least one adult is eating at least a small meal with your young child – and that you are eating the same thing. If you are planning a meal at a different time, just have a small plate of what your toddler is eating and take a few well-timed bites. It also takes the pressure off – there’s nothing that gets a toddler to reject food as much as an adult staring at them and not eating themselves.
 
RULE #6: TODDLERS ARE NOT SMALL ADULTS. We routinely over-estimate portion sizes for toddlers. Try the “palm of the hand” rule – a portion of food for a child should roughly equal the size of the palm of their hand – not your big, grownup hand. Use smaller plates for little people to remind yourself of this rule. And never ask kids to clean their plate. If they learn to eat to please you instead of eating until they are full, we risk excessive weight gain, and all the health risks that come with it. Remember that toddlers and preschoolers naturally have a lower body mass index than they do at any other time in life – it’s probably OK if you can see and count their ribs!

RULE #7: WE’RE HERE TO HELP. Although most young picky eaters can be well-managed with these rules, real health problems are out there also. If you think your child is underweight, has chronic abdominal pain, chronic diarrhea or constipation, or signs of food allergy, please contact your Raleigh pediatricians – contact us here at Carolina Kids Pediatrics by calling (919) 881-9009 or sending us a message through our patient portal.

By Carolina Kids Pediatrics
March 23, 2018
Category: Children's Health
Tags: Prenatal Education  

For years, the pediatricians at Carolina Kids Pediatrics in Raleigh, NC have taught free prenatal education classes at Babies R Us locally.prenatal education This week, we were saddened to hear that Babies R Us stores will be closing nationally. We will continue to look for ways to reach out to our community to provide prenatal education classes and resources for future parents. 

What can you expect from a Prenatal Education Class?
We cover a range of topics, including what to expect as you initiate feeding (breast or formula), what to have at home, and what to expect in a newborn’s first few weeks of life. For a list of more prenatal education topics, check out the page:
https://www.healthychildren.org/english/ages-stages/prenatal/Pages/default.aspx

Our lactation consultant, Jerrianne Webb, also joins our prenatal education class periodically to provide additional guidance on preparing for breastfeeding. Our prenatal education classes are held every 2 weeks at Carolina Kids Pediatrics in Raleigh, NC. A few other reminders about your prenatal care:

  • Take a prenatal vitamin with at least 400 mcg folic acid as soon as possible in pregnancy. Early supplementation is critical for decreasing your baby’s risk for a number of birth defects, including spina bifida
  • Avoid cat litter, pet rodents, lizards and turtles during pregnancy: all can pose a risk for infections that are particularly concerning during pregnancy
  • Let your obstetrician know if you are traveling to the Caribbean, Latin America, or other areas where Zika virus is transmitted
  • Talk to your obstetrician about prenatal vaccination, especially against pertussis and influenza
  • Avoid undercooked meat, unpasteurized dairy, and certain fish with potentially high mercury levels (including swordfish, shark, tuna, tilefish, orange roughy and mackerel)

Take advantage of Prenatal Education opportunities and prenatal classes not just at Carolina Kids Pediatrics, but throughout the Raleigh area – remember that local hospitals also provide prenatal classes on various topics. If you are part of an organization which provides resources for new parents, we are always happy to provide community outreach education for parents!

Dr. Nechyba
Carolina Kids Pediatrics
Raleigh, N

By Carolina Kids Pediatrics
January 26, 2018
Category: Children's Health
Tags: breastfeeding  

Should a mother continue to breastfeed if she has been exposed to influenza?

What if she has tested positive for the flu, or has other children that have it? Should she temporarily wean the baby to protect him? breastfeeding

These questions have been frequently asked by many mothers of breastfeeding newborns over the last few weeks. As the lactation consultant at Carolina Kids Pediatrics in Raleigh, NC, I have been asked these questions several times in the last few days alone.

Breastfeeding mothers SHOULD continue to breastfeed even if they have influenza, or have been exposed to it. Breastfeeding protects the newborn from infections, as antibodies from the mother’s body are passed to the newborn through the milk. The flu virus, as with any virus, has an incubation period. This is the time before the onset of symptoms. Since breastfeeding mothers and babies share the same environment, the mother and baby are likely exposed to the virus at the same time. During this incubation period, the mother’s body begins to produce these protective antibodies for the baby. Breastfeeding (and handwashing!) is the best protection for the newborn.

In the case where a mother is receiving anti-viral medications, such as Tamiflu, breastfeeding is still not contraindicated.  The mother should continue to breastfeed as desired.

Please do not hesitate to contact your pediatrician in Raleigh, NC, to discuss any concerns you have about flu symptoms, or breastfeeding.

You may call Carolina Kids Pediatrics at (919) 881-9009 to schedule an appointment with me. I’ll be glad to help with any of your breastfeeding concerns. 
Jerrianne Webb, RN, IBCLC
 
For more information:
https://ibconline.ca/maternal-illness1

By Carolina Kids Pediatrics
October 05, 2017
Category: Children's Health

A new report released from the American Academy of Pediatrics this month addresses the topic of preventing the spread of infectious school sports physicaldisease in organized sports. This is a hot topic for pediatricians in Raleigh who do lots of sports physicals, including those of us here at Carolina Kids Pediatrics. 

The highlights of this report: Skin infections spread by direct contact with other athletes account for 10-15% of time lost from sports. At Carolina Kids Pediatrics, we see kids from around Raleigh for sports physicals on a regular basis who have acquired skin infections through direct contact with other athletes or contaminated sports equipment. A general rule we can review during sports physicals is never to share equipment, towels or clothing, and make sure that wrestling mats and protective sports equipment are cleaned regularly – a dilute bleach solution works quite well to kill many bacteria, viruses and fungi which cause skin infection. Some additional advice about common sports-related infections:

  1. Strep and staph (including MRSA): Resistant, aggressive staph infections often cause skin infections and abscesses (which look like hard, red painful lumps) on skin. If a team member is infected, up to 10 to 23% of fellow athletes on football teams and wrestling teams can develop MRSA skin infections. If there is a team outbreak, athletes with eczema or skin scrapes are at higher risk for infection. Having kids take a bath in a tub of water with 1 cup of bleach twice weekly can help decrease the risk of infection, especially during a team outbreak. Infected athletes should not return until they have been treated for at least 24 hours, and sites of infection should be covered during sports.
     
  2. Tinea (ringworm): Ringworm can appear in the scalp (often causing patches of flaky skin with hair loss), the body (often causing scaly, raised rings), or the feet (athlete’s foot - often causing peeling and redness that most commonly starts between toes. Prevent ringworm of the scalp by avoiding sharing of hats, combs and brushes among athletes, and using an antifungal dandruff shampoo (like Nizoral) once or twice a week. Prevent spreading ringworm on the body by avoiding shared towels and cleaning equipment regularly as described above. Studies have shown that use of foot powder after bathing can decrease risk of athlete’s foot by 75%.  Ringworm on the body or athlete’s foot can be treated with over the counter creams and sprays, including terbinafine (Lamisil) and clotrimazole (Lotrimin) twice daily for 3-4 weeks – but ringworm on the scalp requires oral prescription medications.
     
  3. Herpes: This refers not just to genital herpes, but also to the herpes virus which causes fever blisters. This can cause painful, blistering skin infections (called herpes gladiatorum), sometimes with fevers, in contact sports. Up to 34% of wrestling team contacts can be infected during a team outbreak. Athletes with active skin blisters should be excluded from contact sports for about a week, and the blisters should be covered until healed. Herpes skin infections are treatable with acyclovir and other prescription medications – and earlier treatment, within a day or two of symptom onset, works better. Athletes with frequent outbreaks can be treated with preventative medication during the sports season.
     
  4. Molluscum & warts: Kids who come in for a sports physical often have these. Both are viral skin infections, which cause single or clustered skin bumps. Bumps from molluscum are usually smooth with a dot in the middle, while warts are usually rougher and scalier. Both molluscum and warts can be spread by direct contact in sports, and covering them is the best way to prevent spread. Plantar warts (warts on the bottom of the feet) are easily spread in communal showers – in fact up to 25% of athletes who use communal showers are affected, so it might be worth coming in to treat plantar warts if your athlete uses a communal shower in sports (or wear pool shoes in the shower if they don’t want to treat their warts). We can treat both molluscum and warts in the office with treatments such as liquid nitrogen and cantharidin extract, but treatment is not always necessary for bumps which can be easily covered in sports.

Every organized sports team, whether school-based or not, requires that children be cleared by their Raleigh pediatrician through a sports physical. When your child gets their sports physical at Carolina Kids Pediatrics, please talk to us not only about injury and concussion prevention, but also the prevention of infectious disease from sports participation.
For more information on these guidelines on preventing infections in sports, check out this article before you come in for this year’s sports physical:

https://www.nytimes.com/2017/09/25/well/family/when-athletes-share-infections.html
 
Christian Nechyba, MD
Carolina Kids Pediatrics
Your Pediatrician in Raleigh, North Carolina

By Carolina Kids Pediatrics
August 10, 2017
Category: Children's Helath
Tags: ear infections  

Perk up your ears, kids! Did you hear the good news about ear infections?

A new study of 615 kids showed that the rate of ear infections in kids under 3 years has dropped 3-fold over the past 10 years compared to ear infectionsthe 1980's. This dramatic decrease in ear infections seems to be due to the pneumococcal conjugate vaccine, which your kids get at 2, 4, 6 and 15 months when they come to Carolina Kids Pediatrics. Pneumococcal bacteria used to be the most common cause of ear infections, but we didn't start immunizing against pneumococcus until the 1990s. Although the vaccine was primarily designed to prevent meningitis and blood stream infections (which it has done beautifully), this seems to be a nice side benefit of the pneumococcal vaccine.

Less ear infections not only means less pain, fever, and night fussing for the kids, it also means less doctor visits, antibiotic prescriptions and antibiotic resistance!





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