Last updated 9 months ago
New York City Mayor Michael Bloomberg just unveiled a health initiative that he hopes will encourage new moms to breastfeed. The plan? Ask hospitals to treat formula like any other regulated substance, keeping it locked up and given out only under certain conditions.
I applaud NYC Mayor Michael Bloomberg for taking this bold step forward. For too many years, mothers who wanted to breast feed have gotten mixed messages and inadequate support from hospitals. This has come about by having the same practice standards for 2 very different types of moms, the standard of giving all moms formula at delivery and formula plus promotional products at the time of discharge.
When a mother expresses a desire to breastfeed, she needs the hospital and perinatal staff to support her decision. Having that same staff put bottles of formula in the baby’s crib is a mixed message. It says “we don’t believe you can do this, so we’ll have this formula at your bedside.” It then becomes much easier to give the baby a bottle when mom’s milk has not yet come in or the baby is having difficulty latching on. This is an inappropriate response to the problem. These moms need encouragement and information. They need to be told that it is normal for it to take 2-3 days for your milk to come in. Meanwhile, baby gets good nutrition from your colostrum. If you bottle feed your Infant during this time, it will take longer for your body to produce a good milk supply. If baby has an improper latch, nursing staff or a lactation consultant need to be available to help teach appropriate latching methods, rather than popping a bottle into the baby’s mouth.
In a few days the breastfeeding mom is discharged to home with her little one. Why does she need samples of formula? Why does she need a baby bag advertising that company’s product? How is that more important than a timely follow up appointment with her baby’s physician or a lactation specialist?
Locked up formula is not unavailable formula. The mom who chooses to give her baby formula will still have adequate access to formula. It may be under lock and key, but it will still be on the ward. The baby formula supplied to hospitals comes in 6 packs of ready to feed bottles. Mom will be given at least 6 bottles at a time. These mothers’ needs and their babies’ needs will be met. Furthermore, the program is voluntary. This means that hospitals that do not have the necessary staff will not be forced to participate.
~Dr Nan N~
Last updated 9 months ago
Robert West, an associate professor in the Department of Biochemistry and Molecular Biology at SUNY Upstate Medical University, recently put together a list of 25 socially-active female doctors to give a “starting point in discovering the participation of female physicians in social media.” I was honored to be included on this list with 24 other wonderful female physicians.
West gave his reasoning for the list:
“I delivered a keynote presentation a few weeks ago entitled “Personalized Medicine: Tailoring Healthcare in the Information Age” to a group of parents who had taken their kids to the Bristol-Myers Squibb Science Horizons summer science camp.
That conversation prompted the question of how commonplace an occurrence it was for docs to engage in social media, particularly female docs? I have had many Twitter exchanges with various female docs, but naming a group of individuals on the spur of the moment was more challenging. To this end, I deemed it advantageous to specifically identify various female physicians engaged in social media, creating a short list that could be made readily available in a situation like that above.”
The link to the list of socially active female physicians can be found here. I want to thank Robert West for including me! Are there any other female docs that you would put on the list? Let me know in the comments below!
~Dr. Nan
Last updated 9 months ago
Independence, Kansas is home to a number of venomous creatures, including brown recluses, black widows, yellow sack spiders, scorpions, and a number of snakes, such as the cottonmouth, copperhead, and rattlesnake. Learn how to identify symptoms of a venomous bite and when it may be necessary to contact a pediatrician by reading this helpful overview:
Identify the Type of Bite
When your child suffers from a bite or sting, try to confirm whether the snake, insect, or spider that caused the injury is in fact venomous—there tend to be more non-venomous critters than harmful ones. A good way to determine if the bite is venomous is to watch your child closely for certain symptoms. For example, venomous bites can often cause nausea, vomiting, increased sweating, and muscle weakness, whereas non-venomous bites will usually cause redness, pain, swelling, and itching. Of course, if you witnessed the injury occur and were able to identify the animal or insect that caused it, you may know to seek medical treatment right away.
Avoid Using a Tourniquet
Once you have determined that the bite is likely from a venomous insect, spider, or snake, you can begin at-home first aid treatment until emergency medical care can be obtained. It is important not to put a tourniquet around your child’s bite, apply ice, or suction the area in an attempt to remove the poison or venom, as these measures can often cause more damage to soft tissues.
Contact a Pediatrician
Contact a pediatric physician as soon as possible so that your child can obtain medical care; venomous bites can often lead to clotting abnormalities and other life-threatening conditions. An experienced pediatrician or general pediatrics clinic will provide an anti-venom serum or injection to your child, which is most effective if administered within four hours of the bite. This medication will continue to be given until your child shows improvement in his or her systemic symptoms.
If your child has suffered a bite, sting, or other injury, pediatric physician Dr. Nan Nuessle is here to help. Call our office in Independence at (620) 330-8188 for more information on our telemedical services.
Last updated 9 months ago
Acne is a common trial of adolescence. There are many approaches to the management of acne. Mine focuses on good skin care habits. It's not particularly expensive or fast, but it is effective and fulfilling. When a teen learns good skin care, it is a habit that serves them for life.
When a teen comes to me with concerns about acne, the first thing I do is ask what they are currently doing for skin care. I also ask how much their acne bothers them. Then, I share what I have learned about good skin care. It starts with washing. I recommend you wash your face with a non-soap cleanser. There are hundreds on the market. Pick one you like and use it twice daily. Washing removes a large portion of the dirt and oil from your skin. However, it doesn't get it all. Adding a toner helps tremendously. Witch hazel is a toner that has been around for ages, is inexpensive and works very well. Put some on a cotton ball and use that on your freshly washed face. The toner also helps keep pores small. Then, even for the young, oily skin of a teen, hydrate with a lotion or cream.
This is a 3 step process. Wash, then tone, and finally hydrate. These 3 steps need to be done twice a day, every day. If your teen does this for 3-4 months, most will see a dramatic improvement in their acne. It is that simple. This works very well for the common acne that consists of open comedones (pimples) and closed comedones (black heads). For individuals with cystic acne, I recommend getting a Dermatologist involved. Salicylic acid is a component of many acne washes and lotions. It helps reduce the redness and swelling associated with closed comedones. This can be used daily. There are many masks that help draw out open comedones. These are best used only once a week.
If your teen has followed these recommendations for 4 months or more and still has significant acne (or acne that bothers him or her), then adding benzoyl peroxide can be quite beneficial. Benzoyl peroxide comes in many forms. It is only effective an a form that is left on your skin. I recommend a gel, cream or lotion form of benzoyl peroxide. This can be used once or twice daily, but benzoyl peroxide should be left on the skin for at least 8 hours. I don't recommend using a benzoyl peroxide wash, as this will not be left on the skin. Also, remember, this is a peroxide. It can bleach towels and pillow cases if not used sparingly, rubbed in well, or not rinsed off your hands.
If your teen continues to have concerns about acne after using these steps, then talk with your pediatrician. A referral to a Dermatologist may be in order. While this problem may not be life threatening or chronic, acne can effect your teen's self esteem and warrants attention.
Yours always,
~Dr Nan N~
Last updated 9 months ago
This past weekend, we had "feels like" temperatures of 103 degrees. Rumor has it, temperatures were even warmer on Monday. It doesn't look like this is going to go away before the dog days of August.
I spent Sunday sitting outdoors at a local sporting event. A 21 year old young man who was a member of our party developed signs of heat exhaustion after 2 hours. He had headache, fatigue and muscle cramps. Even though I am much older, I didn't start feeling the effects of the heat until I had been out for 4-5 hours. I was tired, and starting to fall asleep in my chair. Okay, I was also starting to get irritable. However, I was drinking 12 oz of water (and other fluids) every hour, and I may be in better shape than the young man.
This weather can be particularly dangerous for athletes who are practicing outdoors. We need to keep this in mind as we send our youngsters off to sports camps. Heatstroke is dangerous and can kill. Heat exhaustion is the early stage of heatstroke. Risk factors for heatstroke are dehydration, fatigue, poor fitness and lack of acclimatization to the weather. Once the temperature is over 98 degrees (and humidity is over 55%), children should rest 5-10 minutes after every 25-30 minutes of activity. I strongly recommend encouraging them to drink water during these breaks.
Your children may not get heatstroke if they are swimming. However, they can still get dehydrated. This puts them at risk for developing heatstroke during later activities. It is easy to forget this risk, since they are wet and less hot while in the pool. They have less evaporative water loss through their skin, but their bodies still use more water than on a cool day. Also, they are exercising in that water, even when they are just playing. Have them stop hourly for something to drink.
Football seems to have the highest risk of heatstroke, with 27 deaths over the last 10 years. Much of that increase in risk is due to their need to wear protective equipment. If temperatures are over 98 degrees and the humidity is over 55%, these kids should be in only shorts and t-shirts with helmet and shoulder pads. As the humidity rises over 80%, they should remove all safety equipment to continue activity. This also means they have to alter their activity, as they are not wearing safety equipment. There are differing recommendations about when to stop activity, with some references saying you don't need to stop until humidity is 100%. I wouldn't wait that long.
If a child or teen is having headaches or muscle cramps, these could be signs of heatstroke. Move the individual to a cool place and give plenty of fluids. Water is best. Juice can also help, but avoid caffeinated beverages. This is one of the few times when I recommend a sports drink with electrolytes. (However, the majority of their fluid intake should be water). If their body temperature is 102 degrees or more, immerse them in cold water (and consider calling 911). A great way to do this is with a plastic wading pool, ice and lots of water. You want to immerse the person in cold water, except for their face. Nausea, vomiting and dizziness can also be signs of heatstroke. If the child is also dehydrated, they may have difficulty sweating. The skin will be red, hot and dry. If the person has rapid breathing, a rapid pulse, seems confused, disoriented or is hallucinating, call 911 while you are cooling them in the wading pool.
Let's keep our kids safe while they enjoy the activities they love!
Dr Nan N
May your day bring you delight and the eyes of a child.
