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Tips of the Week for November, 2014

Holiday Safety & Mental Health Tips

The holidays are an exciting time of year for kids, and to help ensure they have a safe holiday season, here are some tips from the American Academy of Pediatrics (AAP). 


  • When purchasing an artificial tree, look for the label "Fire Resistant."
  • When purchasing a live tree, check for freshness. A fresh tree is green, needles are hard to pull from branches and needles do not break when bent between your fingers. The trunk butt of a fresh tree is sticky with resin, and when tapped on the ground, the tree should not lose many needles.
  • When setting up a tree at home, place it away from fireplaces, radiators or portable heaters. Place the tree out of the way of traffic and do not block doorways.
  • Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help keep your tree from drying out and becoming a fire hazard.
  • Be sure to keep the stand filled with water, because heated rooms can dry live trees out rapidly. 


  • Check all tree lights (even if you've just purchased them) before hanging them on your tree. Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.
  • Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could be electrocuted.
  • Some light stands may contain lead in the bulb sockets and wire coating, sometimes in high amounts. Make sure your lights are out of reach of young children who might try to mouth them, and wash your hands after handling them.
  • Before using lights outdoors, check labels to be sure they have been certified for outdoor use. To hold lights in place, string them through hooks or insulated staples, not nails or tacks. Never pull or tug lights to remove them.
  • Plug all outdoor electric decorations into circuits with ground fault circuit interrupters to avoid potential shocks.
  • Turn off all lights when you go to bed or leave the house. The lights could short out and start a fire.


  • Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals.
  • Never use lighted candles on a tree or near other evergreens. Always use non-flammable holders, and place candles where they will not be knocked over.
  • In homes with small children, take special care to avoid decorations that are sharp or breakable. Keep trimmings with small removable parts out of the reach of children to prevent them from swallowing or inhaling small pieces. Avoid trimmings that resemble candy or food that may tempt a young child to eat them.
  • Wear gloves to avoid eye and skin irritation while decorating with spun glass "angel hair." Follow container directions carefully to avoid lung irritation while decorating with artificial snow sprays.
  • Remove all wrapping papers, bags, paper, ribbons and bows from tree and fireplace areas after gifts are opened. These items can pose suffocation and choking hazards to a small child or can cause a fire if near flame. 
  • Keep potentially poisonous holiday plant decorations, including mistletoe berries, Jerusalem cherry, and holly berry, away from children.

Toy Safety

  • Select toys to suit the age, abilities, skills and interest level of the intended child. Toys too advanced may pose safety hazards for younger children.
  • Before buying a toy or allowing your child to play with a toy that he has received as a gift, read the instructions carefully.
  • To prevent both burns and electrical shocks, don’t give young children (under age 10) a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
  • Young children can choke on small parts contained in toys or games. Government regulations specify that toys for children under age three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long.
  • Children can have serious stomach and intestinal problems – including death -- after swallowing button batteries or magnets. In addition to toys, button batteries are often found in musical greeting cards, remote controls, hearing aids and other small electronics. Small, powerful magnets are present in many homes as part of building toy sets. Keep button batteries and magnets away from young children and call your health care provider immediately if your child swallows one.
  • Children can choke or suffocate on uninflated or broken balloons; do not allow children under age 8 to play with them.
  • Remove tags, strings, and ribbons from toys before giving them to young children.
  • Watch for pull toys with strings that are more than 12 inches in length. They could be a strangulation hazard for babies.
  • Parents should store toys in a designated location, such as on a shelf or in a toy chest, and keep older kids’ toys away from young children.

Food Safety

  • Bacteria are often present in raw foods. Fully cook meats and poultry, and thoroughly wash raw vegetables and fruits.
  • Be sure to keep hot liquids and food away from the edges of counters and tables, where they can be easily knocked over by a young child’s exploring hands. Be sure that young children cannot access microwave ovens.
  • Wash your hands frequently, and make sure your children do the same.
  • Never put a spoon used to taste food back into food without washing it.
  • Always keep raw foods and cooked foods separately, and use separate utensils when preparing them.
  • Always thaw meat in the refrigerator, never on the countertop.
  • Foods that require refrigeration should never be left at room temperature for more than two hours.                          

Happy Visiting

  • Clean up immediately after a holiday party. A toddler could rise early and choke on leftover food or come in contact with alcohol or tobacco.
  • Remember that the homes you visit may not be childproofed. Keep an eye out for danger spots like unlocked cabinets, unattended purses, accessible cleaning or laundry products, stairways, or hot radiators.
  • Keep a list with all of the important phone numbers you or a baby-sitter are likely to need in case of an emergency. Include the police and fire department, your pediatrician and the national Poison Help Line, 1-800-222-1222. Laminating the list will prevent it from being torn or damaged by accidental spills.
  • Always make sure your child rides in an appropriate car seat, booster seat, or seat belt. In cold weather, children in car seats should wear thin layers with a blanket over the top of the harness straps if needed, not a thick coat or snowsuit. Adults should buckle up too, and drivers should never be under the influence of alcohol or drugs.
  • Traveling, visiting family members, getting presents, shopping, etc., can all increase your child's stress levels. Trying to stick to your child's usual routines, including sleep schedules and timing of naps, can help you and your child enjoy the holidays and reduce stress.


  • Before lighting any fire, remove all greens, boughs, papers, and other decorations from fireplace area. Check to see that the flue is open.
  • Use care with "fire salts," which produce colored flames when thrown on wood fires. They contain heavy metals that can cause intense gastrointestinal irritation and vomiting if eaten. Keep them away from children.
  • Do not burn gift wrap paper in the fireplace. A flash fire may result as wrappings ignite suddenly and burn intensely.
  • If a glass-fronted gas fireplace is used, keep children and others well away from it with a screen or gate. The glass doors can get hot enough to cause serious burns and stay hot long after the fire is out.

Holiday Mental Health Tips

  • Take care of yourselfJust like they say on the airplane, “In the event of an emergency, put your own oxygen mask on first, and then help children travelling with you to put theirs on.” Children respond to the emotional tone of their important adults, so managing your emotions successfully can help your children handle theirs better, too.
  • Make a plan to focus on one thing at a time. Try a few ideas from “mindfulness” as a strategy to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: stop and pay attention to what is happening at the moment, focus your attention on one thing about it, notice how you are feeling at the time, withhold immediate judgment, and instead be curious about the experience.
  • Give to othersMake a new holiday tradition to share your time with families who have less than you do, for example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter. Help your child write a letter to members of the armed forces stationed abroad who can’t be home with their own family during the holidays.
  • Keep routines the same. Stick to your child’s usual sleep and mealtime schedules when you can to reduce stress and help your child and you enjoy the holidays.
  • Keep your household rules in effect. Adults still have to pay the bills and kids still need to brush their teeth before bedtime​!
  • Teach the skills that children will need for the holidays in the weeks and months ahead. For example, if you plan to have a formal, sit-down dinner, practice in advance by having a formal sit-down dinner every Sunday night. 
  • Don’t feel pressured to “over-spend.” Think about making one or two gifts instead of buying everything. Help your child make a gift for his or her other parent, grandparents, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons that purchasing presents can’t.
  • Most important of all, enjoy the Holidays for what they are - time to enjoy with your family. So, be a family, do things together like sledding or playing board games, spend time visiting with relatives, neighbors and friends.​


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 All information provided by on 11/20/2014 12:00 AM


Flu -- Worse than Ebola for People Living in Our Community

If we had a vaccine for Ebola, our offices would be overrun with people clamoring for the vaccine.  Yet, it is unlikely that we will have significant numbers of people who die this winter in our community from Ebola.

However, there will be many deaths from flu, especially among those who are elderly, disabled, or who suffer with chronic disease such as congestive heart failure, asthma, or chronic obstructive pulmonary disease (COPD, emphysema).  Babies who are too young to receive the immunization are also at high risk to die if they become infected with the flu virus.

National medical authorities recommend that all of us who are over the age of 6 months of age should receive the flu vaccine, as soon as it becomes available in our communities.  At this time, flu vaccine is available in doctors' offices, the local health department, and local pharmacies.  The inactivated injectable vaccine can be given to all people.  The attenuated live viral nasal mist vaccine can be given to people between the ages of 2  and 49 years who do not have a chronic medical problem, like persistent asthma.  Ask your doctor about how you can receive flu vaccine.

As I interact with families every day in our practice, the most common reason that people refuse the vaccine is concern that the vaccine will make them get sick or come down with the flu.  I have never read a scientific report that showed that there is any way for the flu vaccine to cause one to come down with the flu.  I have never seen a patient who developed any serious complication from receiving the flu vaccine.  The reason people think the flu vaccine has made them sick, is that we do not start giving flu vaccine until the weather is cool and we are having lots of sickness in the community.  It seems that people want to blame the flu vaccine for anything that happens to them during the days to weeks after they receive flu vaccine.  So this is a "true-true, but unrelated" situation:  true, the person received flu vaccine, and true, the person became ill during the days to weeks after receiving the vaccine, but these two events are unrelated.  

I have been practicing medicine long enough to see patients develop life-threatening and disabling complications from flu.  My adult medicine colleagues have seen many of their elderly, disabled, and chronically ill patients die from flu. 

The reason we all need to receive flu vaccine every year is to protect the less fortunate among us from getting infected with the flu virus.  If we all receive the vaccine, then we are unlikely to have a significant flu epidemic in our community, and those at-risk people in our families and community are less likely to die from coming down with the flu.  This is all about public health, and our commitment to having the healthiest community possible.

So, as we read the daily reports about the Ebola epidemic in Africa, and fret about the possibility that Ebola will invade the US, we must remember that flu is an immediate threat to the health of our community. 

Thanks for making sure that you and all your loved ones receive the flu vaccine as soon as possible.


Dave Tayloe, Jr., MD, FAAP

Goldsboro Pediatrics, PA

Type 2 Diabetes: Tips for Healthy Living

Children with type 2 diabetes can live a healthy life. If your child has been diagnosed with type 2 diabetes, your child's doctor will talk with you about the importance of lifestyle and medication in keeping your child's blood glucose (blood sugar) levels under control.

About Blood Glucose

Glucose is found in the blood and is the body's main source of energy. The food your child eats is broken down by the body into glucose. Glucose is a type of sugar that gives energy to the cells in the body.

The cells need the help of insulin to take the glucose from the blood to the cells. Insulin is made by an organ called the pancreas.

In children with type 2 diabetes, the pancreas does not make enough insulin and the cells don't use the insulin very well.

Managing Blood Glucose Levels

Glucose will build up in the blood if it cannot be used by the cells. High blood glucose levels can damage many parts of the body, such as the eyes, kidneys, nerves, and heart.

Your child's blood glucose levels may need to be checked on a regular schedule to make sure the levels do not get too high. Your child's doctor will tell you what your child's blood glucose level should be. You and your child will need to learn how to use a glucose meter. Blood glucose levels can be quickly and easily measured using a glucose meter. First, a lancet is used to prick the skin; then a drop of blood from your child's finger is placed on a test strip that is inserted into the meter.

Medicines for Type 2 Diabetes

Insulin in a shot or another medicine by mouth may be prescribed by your child's doctor if needed to help control your child's blood glucose levels. If your child's doctor has prescribed a medicine, it's important that your child take it as directed. Side effects from certain medicines may include bloating or gassiness. Check with your child's doctor if you have questions.

Along with medicines, your child's doctor will suggest changes to your child's diet and encourage your child to be physically active.

Tips for Healthy Living

A healthy diet and staying active are especially important for children with type 2 diabetes. Your child's blood glucose levels are easier to manage when you child is at a healthy weight.

Create a Plan for Eating Healthy

Talk with your child's doctor and registered dietitian about a meal plan that meets the needs of your child. The following tips can help you select foods that are healthy and contain a high content of nutrients (protein, vitamins, and minerals):

  • Eat at least 5 servings of fruits and vegetables each day.
  • Include high-fiber, whole-grain foods such as brown rice, whole-grain pasta, corns, peas, and breads and cereals at meals. Sweet potatoes are also a good choice.
  • Choose lower-fat or fat-free toppings like grated low-fat parmesan cheese, salsa, herbed cottage cheese, nonfat/low-fat gravy, low-fat sour cream, low-fat salad dressing, or yogurt. 
  • Select lean meats such as skinless chicken and turkey, fish, lean beef cuts (round, sirloin, chuck, loin, lean ground beef—no more than 15% fat content), and lean pork cuts (tenderloin, chops, ham). Trim off all visible fat. Remove skin from cooked poultry before eating.
  • Include healthy oils such as canola or olive oil in your diet. Choose margarine and vegetable oils without trans fats made from canola, corn, sunflower, soybean, or olive oils.
  • Use nonstick vegetable sprays when cooking.
  • Use fat-free cooking methods such as baking, broiling, grilling, poaching, or steaming when cooking meat, poultry, or fish.
  • Serve vegetable and broth-based soups, or use nonfat (skim) or low-fat (1%) milk or evaporated skim milk when making cream soups. 
  • Use the Nutrition Facts label on food packages to find foods with less saturated fat per serving. Pay attention to the serving size as you make choices. Remember that the percent daily values on food labels are based on portion sizes and calorie levels for adults.

Create a Plan for Physical Activity

Physical activity, along with proper nutrition, promotes lifelong health. Following are some ideas on how to get fit:

  • Encourage your child to be active at least 1 hour a day. Active play is the best exercise for younger children! Parents can join their children and have fun while being active too. School-aged child should participate every day in 1 hour or more of moderate to vigorous physical activity that is right for their age, is enjoyable, and involves a variety of activities.
  • Limit television watching and computer use. The AAP discourages TV and other media use by children younger than 2 years and encourages interactive play. For older children, total entertainment screen time should be limited to less than 1 to 2 hours per day.
  • Keep an activity log. The use of activity logs can help children and teens keep track of their exercise programs and physical activity. Online tools can be helpful.
  • Get the whole family involved. It is a great way to spend time together. Also, children who regularly see their parents enjoying sports and physical activity are more likely to do so themselves.
  • Provide a safe environment. Make sure your child's equipment and chosen site for the sport or activity are safe. Make sure your child's clothing is comfortable and appropriate.

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Type 2 Diabetes: Tips for Healthy Living (Copyright © American Academy of Pediatrics 2013)

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.


Health Issues of Premature Babies

Because premature babies are born before they are physically ready to leave the womb, they often have health problems. These newborns have higher rates of disabilities (such as cerebral palsy) and even death. African Americans and Native Americans have the highest neonatal death rate associated with prematurity.

Because of these health concerns, premature babies are given extra medical attention and assistance immediately after delivery. Depending on how early the baby has arrived, your pediatrician or obstetrician may call in a neonatologist (a pediatrician who specializes in the care of premature or very ill babies) to help determine what, if any, special treatment the infant needs.

Here are some of the most common conditions that occur in premature infants:

Respiratory Distress Syndrome (RDS) 

What It Is:

RDS is a breathing disorder related to the baby’s immature lungs. It occurs because the lungs of preterm babies often lack surfactant, a liquid substance that allows the lungs to remain expanded.


Artificial surfactants can be used to treat these babies, along with a ventilator to help them breathe better and maintain adequate oxygen levels in their blood. Sometimes, extremely preterm babies may need long term oxygen treatment and occasionally may go home on supportive oxygen therapy.

Chronic Lung Disease/Bronchopulmonary Dysplasia (BPD)

What It Is:

BPD, or chronic lung disease, is a term used to describe babies who require oxygen for several weeks or months. They tend to outgrow this uncommon condition, which varies in severity, as their lungs grow and mature.

Apnea and Bradycardia

What It Is:

Apnea is a temporary pause (more than fifteen seconds) in breathing that is common in preterm infants. It often is associated with a decline in the heart rate, called bradycardia. A drop in oxygen saturation as measured by a machine called pulse oximetry is called desaturation. Most infants outgrow the condition by the time they leave the hospital for home.

Retinopathy of Prematurity (ROP)

What It Is:

ROP is an eye disease in which the retina is not fully developed.


Most cases resolve without treatment, although serious cases may need treatment, including laser surgery in the most severe instances. Your infant may be examined by a pediatric ophthalmologist or retina specialist to diagnose and, if needed, recommend treatment for this condition.


What It Is:

Jaundice happens when a chemical called bilirubin builds up in the baby’s blood. As a result, the skin may develop a yellowish color. Jaundice can occur in babies of any race or color.


Treating it involves placing the undressed baby under special lights (while her eyes are covered to protect them).

Other Health Problems

Other conditions sometimes seen in preterm babies include anemia of prematurity (a low red blood cell count) and heart murmurs.

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Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

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.


Developmental Milestones of Early Literacy

In the spirit of making both good eating and reading a part of every healthy childhood, the following is a quick book-related look at the well-defined developmental milestones of early literacy.

Younger Than 6 Months: Never Too Young

Unlike solid foods, it is never too early to start reading with your baby. Who cares if it’s the sports page or Elmo—it will be the time you share together that counts, so have fun with it!

6–12 Months: Developing a Taste for Books

Whatever babies are interested in at this age, they predictably put straight in their mouths. Books are no exception. Now that your baby can sit in your lap; grab for a book; and show her interest by batting at, turning, or gumming the pages, you’ll find yourself especially appreciative of board books for their drool-proof nature.

1–2 Years: Becoming Routine

As with food, your child will now figure out there’s a lot more she can do with books than just put them in her mouth. As she makes a point of holding them, turning them right-side up, and carrying them to you to read time after time, you can start relating what’s in her books to her real-life experiences—pointing to pictures and asking simple yet pointed questions like, “Where’s the pea? Can you find the pea?” Before you know it, she’ll be answering your questions, filling in the ends of each sentence, and reciting her VeggieTales back to you. As with meals, don’t expect a long attention span, since it’s the quality of the time spent that really matters, not the quantity.

2–3 Years: Read, Read, and Read Again

Two-year-olds thrive on routine and love to master the power of predictability, so don’t be surprised if yours is less than willing to try something new and instead wants to read the same story over and over (and over) again. If bedtime books have now become a habit—great! This is one habit you’ll never need to break. 

Additional Resources:



Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP


Last Updated 10/29/2014


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Heading Home With Your Newborn, 2nd Edition (Copyright © 2010 American Academy of Pediatrics)

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.


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