Common Concerns

Expecting

If you are looking at this page, chances are that congratulations are in order.
So, congratulations!

Becoming a parent is one of the most exciting and terrifying times in a person’s life. Before we say anything else, it’s going to be okay.

You probably have so many questions that you do not know where to begin. Like most things, keeping it simple is probably the best way to get to a good place.

As a mother-to-be, take care of your own health. Make sure you see your doctor regularly to optimize your condition. Quit smoking if you do.

Find a local prenatal class to get a detailed introduction to what you have to expect.

A good instructor can be a great source of information and reassurance. Many people make lasting friendships with others who are just as excited and nervous as you.

Try not to have “too many cooks” managing your pregnancy. Information overload is never more present than during parenthood, and we have been known to joke that the reason pregnancy is nine months long is to get used to all the unsolicited advice you will get. Your care provider, prenatal instructor, partner, and one or two family members or friends should suffice. Most people like to have a book, such as What to Expect When You’re Expecting

Talk a lot to your partner about your plans and concerns. It is easy to take certain things for granted because you were raised a certain way, but he/she may have had a totally different experience. The more you talk about in advance, the more prepared you will be. Having said that, you are never really prepared! Starting parenthood is like opening a door to room you barely knew existed. And don’t forget that the most important person, the baby, will have his or her own plans about when to come, how to act, sleep, eat and everything else. In the end, accepting the cards that pregnancy and labor deal you and knowing that all plans in life are tentative will help you to roll with any unexpected situations.

At Falmouth Pediatrics, we are happy to meet with you before the baby is born if you would like. Give the office a call and we can set up a meeting. There you can ask all your questions, or let us know about any special situations and concerns in your life.

Despite the challenges, pregnancy is a really exciting time. We hope that you really have a chance to look forward to this most exciting change in your life. It is worth the effort- one look at your newborn and you will know that is true.

Medications

At Falmouth Pediatrics, we recommend the same medications we would use for our own children. Sometimes that means admitting that the best thing to give is nothing.

Here are some common over-the-counter medications

Fever, pain

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are the two medications that are used really often. If you ask 100 pediatricians how and when they should be given for fever, you will get 110 different answers. In other words, some say give acetaminophen, some say ibuprofen and others say alternate the two medications. As a rule of thumb, aim for comfort rather than a certain timeframe or number on the thermometer. If acetaminophen is working, great. If not, ibuprofen may work better. At FPA, we tend to use both medicines only when one alone is not working.

 

Here are some important that doctors do agree on:

 

For babies under three months of age, any fever of 100.5 degrees F (rectal) or over requires a call to the doctor, even at night.

 

Acetaminophen can be given up to every 4 hours. It is safe at any age. Here is the dosing chart for Acetaminophen. It can also be given as a rectal suppository if vomiting is an issue.

 

With ibuprofen, remember infant drops are stronger (more concentrated) than syrup for toddlers. For example, more medicine is in 5 mL of infant drops than in 5 mL of syrup for toddlers. Never give the same amount of infant drops as you would syrup. Here is the ibuprofen dosage table

 

Also, acetaminophen and ibuprofen can be ingredients in many OTC and prescription medicines (eg, pain relievers, fever reducers, cough/cold medicines). If your child is taking more than one medicine, read the ingredient list to prevent double dosing.

 

Note: Never give aspirin to your child unless your child’s doctor tells you to. Children who take aspirin may get a serious illness called Reye syndrome.

Cold and cough

The American Academy of Pediatrics recommends cough and cold medicines not be given to infants and small children under 6 years because they have not been proven effective and can be harmful. Saline nose drops can be used for congestion. For older children (over 2 years), lemon and honey is sometimes good for cough at night.

Allergy, itching

Antihistamines can be used to treat your child’s runny nose, itchy eyes, and sneezing due to allergies. Cetirizine (Zyrtec) is probably the best non-sedating general allergy medicine for hay fever etc. For hives, we recommend dimenhydrinate (Benadryl). Here is the dosage table

Rash, itching

Hydrocortisone cream or ointment is used for itching from bug bites, and eczema. It takes a couple of days to work.

Wound, cuts, and scrapes

Antibiotic ointment is used to prevent or control infection in wounds, cuts, and scrapes.

Constipation

Remember that constipation is a state of poop (=hard), not a state of calendar. Some breastfed babies go over a week between bowel movements.
For infants with hard bowel movements, the best first approach is to change the diet to include more fruit such as peaches, pears and prunes, and less bananas and apples. If juice is given, then give it in one sitting (not spread out over the day, which can hurt the teeth). If that is not enough, infants often do well with a glycerin suppository. Older children usually are better to take something by mouth. The most common medicine we recommend is glycolax (Miralax).

Immunizations

One of the topics that parents want to discuss the most is immunizations. This is good, because getting your children immunized is also one of the best things you can do for your child’s health. We like to say that in the winter storm of life, immunizations are your child’s hat, boots and mittens. We also want you to know that we give our children all their vaccines.

1. General Info

Immunizations (also known as vaccines) give protection from some of the most serious infections that can affect children. When the immunization is given, the body responds to it in a way that protects your child in the event that he or she is ever exposed to the actual infection later on. It takes about two to four weeks for the body to respond. Some immunizations have to be given on 2 or more occasions to get a full response from the body. Some, like tetanus, need “booster” doses later to maintain the protection. Others, like influenza, have to be given every year. Every one is different, and is given in a way to provide the best protection.

2. Why so many, so soon?

Newborn babies are the most prone to getting serious infection, and need the most protection. Vaccines against infections which threaten babies are introduced as soon as the baby is old enough to respond to the vaccine. The first dose of hepatitis B vaccine is given at birth, because this infection can be passed from mother to baby. Many other immunizations are introduced at 2 months and 1 year.

3. Vaccine Schedule.

Falmouth Pediatric Associates follows an immunization schedule which fits with the recommendations of the American Academy of Pediatrics and other major health bodies.

Here is our schedule:

In addition to immunizations, children are tested for hemoglobin (red blood cell count) and lead level at 9 months, 18 months and 3 years. Tuberculosis testing is done for children who are at risk.

4. Vaccine Safety

Immunizations are the most successful public health medicine ever invented.
Immunization safety is of paramount concern to everyone. While every effort must be taken to ensure safety, we must also remember that unfounded fears put young lives at risk. Vaccines are extensively tested prior to approval, and there is continuous surveillance for problems after marketing.

We do not recommend dividing the immunization schedule into more steps, or “splitting up shots” as it is commonly known. This results in delays for children receiving important immunizations, and increases the potential for missed doses.
There is no evidence to suggest that the current schedule exposes kids to “too many proteins”.

For you as a parent, it is very important that the information you review is from reliable sources. Unscientific, unsubstantiated information is not only misleading, it is harmful to our community.

We recommend the following:

Immunizations

Vaccines & Immunizations

Vaccine Education Center

Vaccine information sheets are available at this link

If you are interested in specific vaccine ingredients, you can find a list here

None of the regularly used immunizations at Falmouth Pediatric Associates contain mercury.

Remember, immunizations protect your child. Let’s keep all our kids fully immunized!