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Nearly every parent can recount the experience: their child is unwell, awake late at night with a sore throat, fever, maybe a persistent cough, or any combination of symptoms. No one is sleeping well, and they’ve exhausted their over-the-counter remedies. When you make a sick visit appointment for symptoms like those listed, it’s understandable to hope for quick relief in the form of a prescription. Antibiotics are a wonderful treatment for bacterial illness or infection, but they’re ineffective against viruses and can actually cause more problems if used incorrectly. While your physician will ultimately determine treatment for illness, below are some general guidelines for antibiotic treatment. Viruses are not cured with antibiotics. If you’re ever unsure if an illness is viral or bacterial, it’s perfectly acceptable to ask. Examples of prevalent viruses include flu, Covid-19, and common cold. Pneumonia can be viral or bacterial. Strep throat describes an infection with streptococcal bacteria; most sore throats, however, are a symptom of viral illness. Antibiotics should not be prescribed without confirming the presence of bacteria, if possible. This is why your physician will typically request a test or culture of areas where bacterial infection is suspected. Ear and sinus infections are more likely to be confirmed by sight and treated appropriately. If you or a family member have ever received a prescription such as Tamiflu, note that it is an antiviral and not an antibiotic. Antiviral drugs exist for certain viral illnesses, and they are usually most effective when the virus is detected early. Usually, the best treatment for viral illness is rest, fluids, and OTC symptom relief medication for fever or discomfort such as Tylenol (acetaminophen) or Advil (ibuprofen). That said… Viruses can lead to bacterial illness. When a person’s immune system is compromised, their body becomes vulnerable to further infections. Influenza can trigger viral or bacterial pneumonia; colds can lead to ear infections. In these cases, antibiotics may be prescribed to treat the complications. If this occurs, rest assured that your doctor did not prolong or worsen your child’s illness by not prescribing antibiotics immediately. In fact… Antibiotics can cause more problems if used prematurely or inappropriately. There are many types of antibiotics, each designed to eradicate specific harmful bacteria. The body also uses helpful bacteria to function normally. “Using antibiotics without clear physician guidance can eradicate good bacteria, not treat the original problem at all, or make bacteria more resistant and therefore harder to treat. This is why physicians want to see patients in person before giving prescriptions: so they can treat illness the right way at the right time. Speaking of using medications appropriately… Use all medications, including antibiotics, as directed. If your pediatrician says to administer an antibiotic for 10 days, but the child’s symptoms “clear up” after five days, finish the course of treatment anyway. Even if a patient is feeling much better, bacteria may persist in the body. Not finishing treatment can cause infection to recur, possibly with more antibiotic-resistant bacteria. Medication should also be stored and administered as directed. Some antibiotics must be refrigerated and/or given with food. Antibiotics are usually given with clear directions and amounts so there is none left over. If you do have leftover antibiotic, it should be disposed of safely. Do NOT give a person leftover antibiotic from previous illness or medication that was prescribed for someone else. If anything should happen to a prescription medication, such as a spill or forgetting it when you go out of town, call your prescriber’s office for further guidance rather than skipping doses or using alternate medication. Accidents happen, and your physician can make a judgment call on refilling missing doses. Which reminds us… Communicate with your pediatrician. When kids are seen for illness, their physician will always encourage parents to call if symptoms get worse, don’t resolve, or other concerns arise. This is sincere advice, whether the illness is viral or bacterial, medicated or not. Your pediatrician wants to know if a patient is not getting better. This includes poor reactions to any medication, such as upset stomach or new symptoms. Some individuals are intolerant or allergic to medication, including certain antibiotics. If a child in your care shows signs of allergic reaction, including but not limited to coughing, wheezing, shortness of breath, itching, sneezing, runny nose, hives, watery eyes, or swelling, seek emergency treatment right away. If you know or suspect a child in your care has ingested too much of a medication, whether prescribed to them or not, contact Poison Control at 800-222-1222 and/or seek emergency treatment.

As soon as daylight saving time begins and we enjoy more sunshine, many families eagerly anticipate their spring break and summer vacation. It’s never too early to plan for water safety, and some practices are crucial for babies and toddlers year-round. As awful as it is to consider, drowning is the leading cause of death for children ages 1 to 4 according to the Centers for Disease Control and Prevention. Swimming pools are especially dangerous, but bathtubs, kiddie pools, filled buckets or basins, fish ponds, and natural bodies of water all deserve extreme caution. Many of us expect drowning to be theatrical with shouting and flapping arms, but it’s actually much more subtle. Signs of drowning include: Body vertical Head tilted up with mouth at water level Hair over the forehead/face Very quiet- not talking, shouting or waving Ladder-climbing motion “These quiet behaviors are an instinctive response,” says Dr. Kara Murphy Schmidt at One Pediatrics at Simpsonville. “Even children who know how to swim can become exhausted and struggle to stay afloat. Drowning happens quickly, and the lungs don’t have to completely fill with water for an incident to be dangerous or even fatal." If your child has a near-drowning experience, it’s best to halt water play for the day. “Dry-drowning” occurs when water causes a person’s vocal chords to spasm and close. “Delayed drowning” happens when a small amount of water is inhaled and irritates the airways. Children should be monitored for fatigue, respiratory distress, and coughing or congestion after any incident. Pools themselves should have a fence around them with a gate closed at all times. The American Academy of Pediatrics recommends pools be completely separate from the house, a fence at least four feet tall on all sides, and the gate latch at least 54 inches off the ground. Alarms that chirp when someone opens a door are also recommended in homes with pools. If your child is visiting a home with a pool, ensure that adults will be enforcing water safety and know life-saving procedures. Enrolling kids in age-appropriate swimming lessons as soon as possible is strongly recommended. Kids who don’t know how to swim should wear a flotation device at all times near pools or other bodies of water, and make sure it’s approved for their weight. Novelty inflatables, especially inner tubes, can become dangerous if a child flips upside down so their head is in the water and they can’t swim out. The opening should be wide enough in diameter that the widest part of the user’s body can slip through. Supervise children closely as all times in pools, even if they have flotation devices and/or can swim. In addition to pools, families should practice bath time safety. Babies can drown in just an inch or two of water, so keep hands on them at all times. Have your soap and towel nearby before they enter the water, and monitor toddlers at all times in the tub. Check water temperature with your wrist or elbow before bathing. Baby-proofing measures including toilet latches and doorknob covers can protect curious little ones from the bathroom as a whole. Your pediatrician can recommend water safety measures, both in general and for your home’s particular features. Don’t hesitate to share concerns and maintain age-appropriate safety.  *** If a child in your care becomes unconscious in water, remove them from the water immediately, call 911, and administer CPR.

Most contemporary parents are at least familiar with the notion of self-harm, and increasing numbers of families are dealing with it firsthand. Non-suicidal self-injury, or NSSI, refers to a person hurting themself on purpose without the intent to die. While frightening to consider or address, some basic knowledge of these behaviors can only help if it affects your child or one of their friends. The most common form of self-harm is cutting, but self-injury can take other forms including hitting oneself, head banging, hair pulling, burns, excessive scratching to the point of drawing blood, and ingesting harmful substances. Cutting can manifest as single deep cuts, numerous smaller ones, or some combination. The American Academy of Pediatrics states that NSSI is most prevalent among teens, and females are more likely to self-harm through cutting and males through hitting. However, adolescents of any age ranging from pre-puberty through early 20s and gender–including non-binary or transgender individuals–are equally capable of self-harming behaviors. Parents or caregivers who have identified NSSI often struggle to understand why their loved one feels the need to self-harm. This confusion, combined with sadness, fear, and perhaps some anger, can lead to unhelpful (if well-intentioned) reactions. While each case is unique, a few principles can help parent and child navigate this challenge: KNOW WHAT TO LOOK FOR Active kids are naturally more prone to small wounds, but those engaging in self-harm will almost always hide their marks. Long clothing (even in warm weather), bandages repeatedly placed in the same area(s), frequent bruises, or other recurring marks may be cause for concern. Symptoms of depression, such as overwhelming feelings of hopelessness or worthlessness, sleep disturbances, and persistent fatigue, should also be noted. Young people suffering from depression are more likely to engage in NSSI. APPROACH A DIFFICULT CONVERSATION WITH LOVE Your internal thoughts may be screaming, “How could you do this?!” or “What could you possibly be so miserable about?!” It’s important to foster a safe space for the adolescent to discuss what is real to them. While there is no clear explanation for self-harming habits, many teens report a need to escape feelings of agony or feel better for even a moment. The AAP explains that when human bodies are injured, the brain releases endorphins and other natural painkillers to cope. This may suggest a connection between self-harm and temporarily “feeling better” when other solutions are unclear. Regardless of the reason, remind your loved one that you’re concerned for their well-being and want them to feel safe. While it’s ok to acknowledge your sadness, do so in a way that does not impose more shame on the sufferer. Explain your concerns gently, and be open to hearing what they have to say even if it doesn’t make sense to you right away. TALK TO THEIR DOCTOR Since people who engage in NSSI are likely to hide it, they might have a strong or negative reaction when you address it. Let them know that you plan to talk to their doctor and hope they will participate in the conversation. “Remember that incidents of threatened or confirmed self-harm do not make you a bad parent,” says Dr. Eleanor Braun at South Louisville Pediatrics. “This is a challenging, murky topic that pediatricians are addressing in a wide spectrum of patients and families. Neither you nor your child need feel stigmatized. Help is available.” Follow through on your doctor’s recommendations, including any follow-up appointments, specialist referral, and/or safety plan. If you need help, ask! Behavioral healthcare is in high demand and not always straightforward in the billing department. Your pediatrician’s office will strive to help. NURTURE A HEALTHY HOME ENVIRONMENT If your child is confirmed to self-harm, you can make your home safer by limiting access to dangerous implements. Beyond stashing sharp objects–and just as important–you can: Maintain open communication and regularly check in on their emotional state Prioritize mental health for the whole family through self-care and downtime Set a healthy example of limiting social media exposure Never overshare about a person’s private struggles, or write them off as a ply for attention 24/7 Crisis Support Options: https://www.crisistextline.org/ | Text HOME to 741741 to connect with a volunteer Crisis Counselor The National Suicide Prevention Lifeline: DIAL 988. When people call, text, or chat 988, they will be connected to trained counselors that are part of the existing Lifeline network. These trained counselors will listen, understand how their problems are affecting them, provide support, and connect them to resources if necessary. The previous Lifeline phone number (1-800-273-8255) will always remain available to people in emotional distress or suicidal crisis.

When used properly, medications are an invaluable asset to our daily lives. As families grow and medicine cabinets expand, however, we must be extremely cautious in how they’re used. Just this year, the FDA released a warning about the dangers of using Nyquil—which many families have in their homes—to perform a social media stunt. Both over-the-counter and prescription medications can be harmful, and accidents happen. To help with safe medication use, we’re sharing some advice and reassurance: PROTECT SMALL CHILDREN FROM ALL MEDICATIONS The most obvious advice is to keep all medications away from young children. Flavorings added to children’s antibiotics, fever reducers, and vitamins to make them more palatable also make them more enticing. Data from the Poison Control Center shows that nearly half of all poison exposure calls in 2019 involved children younger than age 6, who are simply more likely to consume things on impulse. All medicines and supplements should be kept out of reach, including nicotine substitutes which are extremely dangerous to kids. Protection also requires careful dosing when using pediatric products as advised. Remember that similar bottles, like name-brand and generic Tylenol for example, can have differing amounts of active ingredient per dose. Always check the dosing instructions on the bottle before giving. ENSURE PROPER USE FOR OLDER KIDS As children become adolescents, the challenge often transitions to making sure they don’t skip medications when needed! Even after your child is old enough to take medicine on their own, whether prescription or OTC, it’s not a bad idea to help them use it correctly. You can assist in establishing a routine for daily prescriptions, and make sure they use the correct medicines when they’re feeling unwell. Teenagers in particular don’t always want to share every headache or stomach upset, and they may conceal fevers or other problems so their lives aren’t interrupted. Give your attention to any symptoms requiring more than a single dose of relief. AVOID KEEPING UNNECESSARY MEDICATIONS Not every prescription is taken until it’s gone, and many adults stash away unused medicines “just in case.” This simple, common scenario explains how many drugs end up in the wrong hands. Perhaps an adult in your household had surgery and received opioid painkillers during recovery, or maybe your teenager changed their dose of ADHD medication and now you have leftovers of the old prescription. Whatever the case, it’s best to dispose of unused drugs safely. To find a drop-off location for unused or expired prescriptions, visit the DEA’s convenient Controlled Substance Public Disposal Location search utility. SHARE ALL CURRENT INFORMATION (AND CONCERNS) WITH YOUR PEDIATRICIAN “If your child was given a prescription by their physician, but you’re concerned about dosage or side effects, don’t hesitate to contact their office,” says Dr. Greg Robson at Oldham County Pediatrics. “Likewise, we want to know about any over-the-counter medications or vitamins our patients are using, whether daily or as needed, including holistic remedies. We won’t use this information to chastise parents. Rather, we want to make the best and safest recommendations for our patients.” Don’t forget to update your primary care physician about: New medications from a specialist, including dermatology prescriptions Allergy relievers Probiotics or immune support supplements Sleep aids, such as melatonin Medicines used during illness, including fever reducers, cough suppressants, and “rescue” medications for asthmatics FINALLY, GET HELP IF NEEDED  The benefits of medication should always outweigh their hazards. If any medicine has been used inappropriately under your supervision, whether on purpose or by accident, get help. The Poison Control Center is a fantastic resource available 24/7/365, and any information they collect is to give proper advice and record important statistics. Contact your doctor for monitoring use of routine products, and always call 911 for any signs of harmful ingestion.

Anthem Blue Cross & Blue Shield is one of the most commonly-seen insurance providers across One Pediatrics practices. We work closely with Anthem (and other insurers) to make sure patients receive all age-appropriate preventive care covered, including routine well visits, sports physicals, immunizations, preventive screenings and surveys, and chronic condition management. Insurers communicate with pediatricians to best facilitate each child receiving the routine care they’re entitled to. With this in mind, it’s very important that patients have the correct primary care physician on file with their insurance company. Sometimes, their records are incorrect due to changes that take time to update. The best and easiest way to make sure your insurance provider’s records are correct is to select your PCP yourself. This is an easy process. Anthem subscribers just need to log in to the Anthem member portal . You can also create an account if you don’t already have one. Then… Select the stethoscope icon under Quick Tasks on the home page Click Select or Change Primary Care Physician Choose the member/dependent Click Change on the right side of the page Enter your zip code Enter the name of your child’s physician, then click Search Click Choose my PCP next to your chosen provider’s name Click Confirm to verify the change, then Done By following these easy steps, your insurance company will make any changes in 30 days or less. It can take much longer for their records to update on their own. You can also designate your child’s primary care physician by calling the phone number for Member Services on the back of your insurance card.  We thank you for managing this step with your insurance so we can focus on providing the best care to our patients!

To support continuity of care, One Pediatrics practices routinely follow up with patients seen in a hospital setting. In recent months, we’ve noted an increase in the number of pediatric patients treated for dehydration in the emergency room. With this data in mind, we hope to reduce the frequency of children needing urgent treatment. While dehydration isn’t uncommon as a symptom of other illnesses, it’s not usually an ailment by itself. Kids become dehydrated after prolonged fevers, vomiting, diarrhea, or even simply from not taking in enough fluids while they feel unwell, over-exercise, or overheat. PREVENTING DEHYDRATION On a normal daily basis, children are more susceptible to dehydration than adults. They have faster metabolisms and a higher ratio of body surface area to weight, are often on the move, and don’t regularly think about their fluid needs. Kids should have water always accessible during the day, even if they’re relaxed. Consistent intake will help prevent an imbalance once they’re active. The American Academy of Pediatrics says children ages 1-3 years need approximately 4 cups of beverages per day, including water or milk. During ages 4-8, increase the amount to about 5 cups, and 7-8 cups for older kids. During exercise, kids should hydrate at least every 20 minutes. When illness strikes, especially gastrointestinal viruses, children may not be interested in fluids or struggle to keep them down. If the child is vomiting, offer small sips of water or ice cubes until they can tolerate an ounce of fluid in one hour, then increase to 2 ounces the following hour, 3 ounces the next, etc. Be careful with sports drinks like Gatorade—they contain electrolytes but also lots of sugar that can make diarrhea worse. Sugar in general should be limited, but you can offer a 1:1 mix of juice and water if necessary. Artificial sweeteners are also known to cause further stomach upset. Any illness can lead to dehydration if a child isn’t taking in enough fluids. Kids with sore throats, for example, may avoid consuming anything because it’s uncomfortable. Flu, Covid-19, or even a common cold may simply cause so much fatigue that a child misses water breaks because they’re sleepy. You can offer fruit-based popsicles for raw throats, or water-heavy foods like soup, applesauce, melon, etc. RECOGNIZING DEHYDRATION By knowing the signs of dehydration, you can address it before it becomes severe. The most common signs in babies are fewer wet diapers (normally 6-8 per day), extra sleepiness, sunken soft spot (fontanelle) on top of their head, and no tears when crying. Even after a child can communicate their needs and/or recognize thirst, they might be easily distracted from taking a water break or picky about what they want to drink. Symptoms of dehydration include dry/sticky lips and mouth, irritability, dark urine, and flushed skin. Older kids and adolescents will experience these same symptoms, plus headaches, lightheadedness, and cramps. Severe dehydration can trigger a rapid heart rate, extreme fatigue, confusion, and unresponsiveness. If your child is experiencing these symptoms, seek immediate medical attention. Heat stroke, when the body’s core temperature is dangerously high, will cause these symptoms. TREATING DEHYDRATION On a typical day, make sure all kids over age 1 have consistent access to water. Ideally, kids should have a water bottle at school every day and on family outings. Babies under 6 months should drink breast milk or formula only, and 6 months to 1 year should have one cup of water per day in addition to their milk/formula intake. If your child is sick and dehydration is a concern, contact your pediatrician’s office right away. Do not give kids any medication (like anti-nausea or anti-diarrhea medicines) unless directed or prescribed. Your doctor can also provide guidance on proper amounts of electrolyte solution (Pedialyte) and fever management. Severe dehydration is treated with IV fluids in a hospital setting, bypassing the need to take in liquids by mouth, and may also require prescription medication to treat the cause.  If you’re ever concerned about your child’s hydration level, whether they’re well or sick, let your pediatrician know. Dehydration is highly manageable until it becomes a serious problem, and our providers have years of experience treating habitual or illness-based symptoms. We will also help with next steps if it’s time to seek hospital-level treatment.

The vast majority of teenagers experience some degree of acne. Many families seek the help of dermatologists, who begin treatment with skincare regimens, topical medications and/or antibiotics. Severe and persistent forms, however, may be unresponsive to these treatments and lead to debilitating physical and emotional scars alike. When nothing else works, dermatologists consider a prescription for isotretinoin. Often still referred to as “Accutane” despite the brand’s discontinuation in 2009 as generic forms became available, isotretinoin is a vitamin A derivative that can permanently clear severe acne in 4-7 months. “If you are a parent considering isotretinoin for your child, there are pros and cons to consider,” says Dr. Eleanor Braun at South Louisville Pediatrics. “The most obvious benefit is clear skin and a boost in self-esteem during crucial years of social and personal development. As a caregiver, however, remember that treatment will be demanding for you as well.” CONSIDERING ISOTRETINOIN? PLEASE READ THE FOLLOWING: It is not a first resort. If your child has never received professional treatment for acne, do not expect an isotretinoin prescription right away. Due to the possible side effects and responsibility required to take it, dermatologists will nearly always start with less severe options, especially if the patient is 14 or under. The possible side effects are numerous and may be severe. Most people already know that the #1 risk of taking isotretinoin is pregnancy. If a patient taking isotretinoin becomes pregnant, severe birth defects are extremely likely. Beyond this risk, new or worsening depression has been linked to isotretinoin treatment, so patients taking it should monitor their mental well-being and be prepared to answer questions during check-in appointments. They must also complete monthly fasting blood tests to monitor liver function and metabolism. If results come back abnormal, your doctor may want to repeat the test, adjust or halt treatment. Less severe but common side effects include: skin dryness/itching; chapped lips (nearly guaranteed); increased susceptibility to sunburn; headaches; joint, muscle or back aches; dry or irritated eyes; nose bleeds. The commitment is strenuous. A number of steps are required before your dermatologist can administer the first dose. Patients of any age and gender must be enrolled in the mandatory iPledge program, completing requirements which vary according to whether the patient is capable of pregnancy. No one using isotretinoin may donate blood during treatment or for one month afterward. Don’t forget the monthly blood tests. Patients who are capable of getting pregnant: Must have two negative pregnancy tests at least 19 days apart (if not 30 depending on menstrual cycle and/or birth control) prior to receiving their initial prescription. They must also attest to using two forms of birth control each month of their treatment, and these forms must match what is reported to the prescribing physician. This may be frustrating for patients who are not sexually active or don’t identify as female, but your prescriber and pharmacist are bound by the FDA to follow these rules. The prescriber must continue to run and report a monthly pregnancy test regardless of the patient’s age, stage of development, sexual activity, or gender identity. Once iPledge requirements and monthly blood work are complete, the prescription must be obtained within 7 days. Patients who are NOT capable of getting pregnant: Once iPledge requirements and monthly blood work are complete, the prescription must be obtained within 30 days. If they are sexually active with an isotretinoin-using partner who is capable of pregnancy, they should adhere to that person’s chosen forms of birth control. Beyond these medical requirements, there are time and financial demands to consider. The monthly appointments are time-sensitive, must be completed in person, and may incur co-pays for office visits. The cost of the drug itself may also vary depending on brand, insurance coverage, and pharmacy. There are downsides. A teen suffering from acne may welcome the side effects or risks as long as their skin clears up, but they should consider a few stipulations: It may not be curative. Despite isotretinoin’s success record, it doesn’t work permanently for everyone. Female patients in particular may experience hormone fluctuations later in life that cause acne to return. Some side effects may linger after treatment concludes. Temporary hair loss has been reported after taking isotretinoin. Hair density typically returns with time, but patients should be prepared for extra shedding and regrowth of “baby hairs.” Needles are part of the program. If your teen is averse to needles, they should know that monthly blood draws are required for isotretinoin prescriptions. If the blood work isn’t completed, they can’t get a refill. IPledge requirements are subject to gender at birth. Patients and caregivers should maintain open communication about the demands, which may be uncomfortable if you’ve never talked about birth control or your child doesn’t identify with their birth gender.  “If isotretinoin is the right choice for your teen, please inform your pediatrician of treatment and any hormonal birth control they may be starting,” says Dr. Braun. “This lets us know which drugs not to prescribe, including some antibiotics, and whether we should look out for any red flags during or after treatment. Our priority is to be a supportive partner in your child’s health and well-being.”

The baby product industry is worth tens of billions of dollars annually. With countless goods on the retail and secondhand markets, it’s impossible for new or experienced parents to sift through every option. We often rely on reviews, recommendations, and the wisdom of others. Factor into that wisdom the experience of your pediatrician. Beyond years of education, training, and daily practice, your child’s doctor maintains awareness of ever-evolving product safety. Unfortunately, many have also treated negative effects of unsafe items firsthand. “Just because a product is manufactured for children doesn’t guarantee its safety,” says Dr. M.K. Allgeier at All Star Pediatrics. “Tragically, items aren’t usually recalled or changed until something terrible happens, and even then, the process can be slow.” Listed below are several products with a history of risk to babies, plus guidance on alternatives: INCLINED LOUNGERS : Arguably one of the most popular baby registry items as they promise to give exhausted parents a break, inclined loungers include many products marketed as “rockers,” or “sleepers.” Used correctly, they’re meant to entertain or relax infants under constant supervision. Far too often, however, babies drift to sleep in them and stay there. Loungers with an incline over 10 degrees are hazardous to sleeping babies for a couple reasons. Baby heads are heavy, and the incline can bring their chin to rest against their chest while they sleep. This position restricts the airway, which can be further suppressed by a seat buckle. They also usually include plenty of cushioning, a suffocation hazard if baby turns their face to the side. For these same reasons, breastfeeding pillows like the famed Boppy should never be used to hold sleeping babies. If you plan to use a lounger or swing, make sure baby is always supervised in it and transfer them to a flat sleeping surface if they doze off. Safe places for sleep include cribs, portable playards (Pack n’ Play) or bassinets for babies who cannot roll over yet, all of which should be bare inside. If your baby attends daycare or spends extended time with relatives, ensure they also follow these rules. CRIB ACCESSORIES : By now, most parents have heard the dangers of crib bumpers. They’re a known suffocation hazard responsible for dozens of preventable infant deaths. Cushioning is an obvious danger, but even mesh bumpers can be a strangulation hazard if a baby wedges their head/neck between the bumper and the mattress. Older babies may also be tempted to climb or pull up on a bumper. Sleep spaces should be kept bare, especially for babies under 1 year old. No bumpers, blankets, pillows, stuffed animals, toys, or bottles should be present, and a fitted sheet should fit the mattress precisely so there is no excess fabric. New federal safety standards passed by the U.S. Consumer Product Safety Commission in 2022 ban the sale of unsafe crib bumpers and inclined sleepers, holding them to the same rigorous safety standards as other sleep furniture. Even so, suppliers have until later this year to fully comply, and the secondhand market is difficult to regulate. Again, make sure other caregivers follow safe sleep rules. AMBER TEETHING NECKLACES : Unlike the products above, amber teething necklaces are relatively new to the industry. Claiming to relieve teething pain by transferring succinic acid to the bloodstream as it’s absorbed through the skin, these necklaces are generally a small strand of golden-brown beads with various types of closures. Over the last several years, they’ve become widely available from boutiques, big box stores, and online retailers alike. First and foremost, any necklace on a baby is a strangulation hazard. They can constrict a child’s airway while they’re sleeping or get caught on something while they play. A broken strand is a choking hazard the same as any beads. Further, there is no scientific evidence whatsoever that they’re effective against teething pain. Succinic acid is not released from (real) amber until it reaches a dangerously high temperature, and these necklaces are not regulated for authenticity of the amber anyway. Teething pain is best relieved by durable, safe, single-piece teethers and rest. Your pediatrician can also clarify the appropriate dose of acetaminophen for teething-related fever and discomfort. USED CAR SEATS : Car seats, like vehicles themselves, are intensely scrutinized and tested for safety. Even so, parents should abide by a few cautions: Car seats should not be used if they are more than 6 years old or have surpassed the manufacturer’s expiration date. Purchasing or accepting a used car seat is not recommended as you don’t know its history. If it was involved in a wreck or improperly stored, it should not be used again. Car seats are made with plastic, which weakens over time in extreme/uncontrolled temperatures like hot attics. If your child has outgrown their seat and you want to use it for a sibling before the expiration date, store it in a temperature-regulated space. Many stores offer trade-in programs where you can turn in an old car seat for a coupon to purchase a new one. Share the coupon with someone else if you don’t need it! UNSECURED FURNITURE : We cannot stress enough that any furniture taller than it is wide—namely, shelves and dressers—should be secured to the wall before your child is crawling. Do not procrastinate on this baby-proofing step. Only one incident can be catastrophic. If your furniture did not come with a securing mechanism, you can purchase kits to get the job done from hardware stores or online. Note that if you move homes or purchase new furniture after your child has outgrown toddlerhood, it’s still not a bad idea to secure it. Climbing is not the only hazard. Dressers can tip if multiple drawers are pulled out at once, and narrow shelves are risky on even slightly-uneven floors. You also won’t have to worry about guests with a baby or young child. What harm is a little added safety? “If you’ve used one of the above products during your parenting journey, we are absolutely not shaming you as a caregiver,” Dr. Allgeier emphasizes. “Our only ‘dog in the fight’ is your child’s wellness. We understand how marketing works, how hard parents try to find budget-friendly, efficient products, and how challenging it is to keep up with recalls. If you’re not sure about a baby item you’re using, ask us!” For more information on products to avoid and safe sleep guidance from the American Academy of Pediatrics, visit https://healthychildren.org/English/ages-stages/baby/sleep/Pages/Inclined-Sleepers-and-Other-Baby-Registry-Items-to-Avoid.aspx To view lists of baby product recalls by year and sign up for email notifications of new recalls, visit https://www.safekids.org/product-recalls

Covid-19 has been a defining catastrophe for countless childhoods. Even so, the endless news cycle of tragic events never stops, and parents are left to wonder how any number of upsetting circumstances are affecting their kids. As pediatricians dedicate more and more of their working lives to emotional and behavioral wellness in their patients, we would like to offer some advice for discussing tragedies—such as war, weather-related disasters, crime/violence, or accidents—with children and adolescents. ASK WHAT YOUR CHILD ALREADY THINKS AND FEELS. For parents, the most stressful part of addressing disasters is the uncertainty about how much their child already knows. We don’t want to overshare and risk further upset. Simply ask. Let them know there is no right or wrong answer, you just want to see how much information they already have and how they’re feeling. From there, you have an opportunity to answer questions or possibly correct false/exaggerated statements they’ve picked up. ACKNOWLEDGE THAT ADULTS ARE CONFUSED TOO. Young children in particular may see adults as all-knowing, but this is a recipe for confusion as adults are constantly sharing conflicting views or news that’s still unfolding. Adults usually don’t know exactly how or why something has happened, and reminding kids of this fact can alleviate some anxiety that they’re “in the dark.” PROVIDE HONEST REASSURANCE. Depending on the topic, provide age-appropriate facts and comfort. If your child is upset by conflict abroad, talk about the people providing emergency relief. Perhaps there was a recent break-in in your community—let your child know that you double-check the locks every night and your neighbors are looking out for one another. Try not to worry about the “perfect” response OR assigning blame to a particular person, group, or cause. There may be a responsible party, but fixating on an enemy can be counterproductive to stress relief. AVOID GRAPHIC AND REPEAT EXPOSURE. It’s probably obvious that young children don’t need to see frightening images or hear repetitive news coverage. Around older kids, allow peaceful moments to be exactly that. Even though most teens have unfettered access to news, a family dinner may not be the time to bring up current events (unless they want to talk about a particular issue). Make an effort to let serious discussions and relaxing quality time exist separately. SEEK ADDITIONAL SUPPORT IF NEEDED. If you suspect your child is feeling especially anxious, depressed, or obsessive, there’s nothing wrong with getting a professional opinion. “Every clinician at One Pediatrics has stepped up to the plate to address our patients’ emotional well-being, more than ever in the last couple years,” says Dr. Eliot Thompson at Springs Pediatrics. “We see and hear the same news as you, and worry for how it reaches our loved ones. We’re here to listen and find next steps without judgment.” Take note of changes that may indicate higher levels of stress, including sleep issues (nightmares, insomnia, excessive tiredness), changes in appetite, headaches, clinginess or regressive behavior in small children, irritability, obsessiveness, or unhealthy coping/“distractions” in adolescents. Each of these behaviors could have a clear developmental explanation, but your pediatrician can look at the complete picture and monitor these changes for red flags. PREPARE FOR FEELINGS TO CHANGE. Remember that these conversations will evolve because the news changes rapidly and each day is a new opportunity for kids to be exposed. Children can seem naïve or uncaring one day and feel affected the next as they learn and contemplate, even by events that don’t directly affect them. Your own feelings may fluctuate too—talking to kids about catastrophic events is an emotional step for many caregivers.  For more information on emotional wellness from the American Academy of Pediatrics, visit https://www.healthychildren.org/English/healthy-living/emotional-wellness/Pages/default.aspx