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During the cold months, a common illness is strep throat. Strep throat is caused by a bacteria and is most common in children aged two years and older. Don’t be fooled though: Strep can happen anytime of the year and at any age. It is spread through coughing, sneezing and close contact, such as sharing cups, utensils, etc.

Symptoms of strep are fever, chills, painful/swollen/red tonsils and throat, pain with difficulty in swallowing, swollen glands of the neck or under the jaw, headache, stomach ache, nausea/vomiting. Seeing pus or white dots doesn’t mean that it is strep; that can be seen with viruses as well. If you see red dots (petechiae) on the roof of the mouth, it almost always is strep.

Some kids never have a sore throat; they just complain of headache, stomach ache, etc. Others may have a red, rough rash that may itch. This is scarlet fever. It is essentially strep of the skin. The rash feels like fine-grain sandpaper and looks like a sunburn.

We recommend that strep be treated with antibiotics. In rare instances, strep may affect other parts of the body, such as the kidneys. Penicillin is the recommended antibiotic, though we may prescribe amoxicillin (it tastes better!). Zithromax and Omnicef are good choices for those allergic to penicillin.

It is a good idea to replace your toothbrush in one to two days after starting the antibiotic, so your child is not reinfected. Your child can return to school after being on the antibiotic for 24 hours and fever free for 24 hours.

Learn more about strep at http://www.rushcopley.com/health/healthwise/document-viewer/?id=hw54745

Eva Alessia, D.O.

Binky, paci, pluggie, nuk, dummy…no matter what you call it, there has been some controversy over using pacifiers. Probably the major concerns are nipple confusion for breastfed babies and dental issues in the future.

Let’s face it – babies love to suck. It is their primary way of getting food in the first 4 to 6 months of life. It is also a soothing, comforting mechanism. Here are some tips and info regarding pacifier usage:

• If, for no other reason, pacifiers actually decrease the risk of SIDS by keeping the baby’s airway open.
• Offer the pacifier at naps and bedtime.
• Do not offer the pacifier when the baby may be truly hungry.
• If baby is nursing, consider waiting until baby is 3 to 4 weeks of age before offering pacifier, to diminish “nipple confusion” (though in my experience, this is rare).
• Look for a pacifier that is one molded and solid piece. The shield should have ventilation holes.
• It may take several different pacifiers to find the one baby likes.
• Keep extras on hand, in case one is lost!
• Wean off the pacifier by age 2, if possible, to decrease risk of dental issues.
• If your baby does not want a pacifier, no big deal.
• NEVER tie the pacifier to baby’s crib, hand or neck!

Here’s a Monty Python video about pacifiers. Some babies are truly like this!

For more information, check out www.healthychildren.org.

Nicole Keller, D.O.

It is 12:31 a.m. I just finished nursing my son and I can’t turn my racing mind off. All I can think about are the families who tonight are “nursing” their children who have contracted measles. I can’t imagine the fear and sadness they are feeling as their child battles this preventable illness. I’m thinking about how I work in healthcare and could potentially expose my beautiful little boy to a preventable and sometimes deadly disease if the measles cases continue to spread – which they will.  I’m also thinking how to help all my patients and how to protect them all during this time. In light of this, I thought I’d make my sleeplessness worthwhile and write this blog.

Measles is here. On January 27, 2015, we had a case confirmed in Cook County and now there are two confirmed cases of children less than one year old having the illness who attend the same daycare in Palatine. We are awaiting another three blood tests from kids at that same daycare. Let me put this in perspective: in the last five years in Illinois we have had 10 total confirmed measles cases. Pending the lab results of the other three daycare children, we are over half-way to 10 cases within one week. Measles is extremely contagious and is a virus that has a mortality rate of one to three in 1,000 cases (majority in kids less than five years old) with more than that experiencing serious lifelong complications of the illness.

Parents, with tears in my eyes, I urge you to make sure your children are vaccinated. Not only with the measles vaccine (aka the MMR vaccine) but with all the vaccines we have available. Please follow the recommended schedule to allow your child to receive as much immunity as possible as soon as possible. These vaccines, given at intervals suggested by the CDC’s recommended schedule, save children’s lives. Vaccines are safe. Vaccines are effective. Please make sure to protect your child, your family and everyone around you by choosing to vaccinate.

In addition, educate yourself and others with the following information about measles. If you have been exposed to a confirmed case or are showing the worrisome symptoms (fevers >101F, cough, red eyes, runny nose, with or without rash), you should contact your local health department. Do NOT go to the ER or your provider’s office without calling first if you fear you may have been exposed or are showing symptoms. As always, please call your physician’s office if you have any questions or concerns.

Below are the facts about measles:

Measles (aka Rubeola) is a highly contagious virus. It will infect nine out of 10 non-immunized who get exposed. It typically affects children. The illness begins on average 14 days after exposure.

Symptoms: cough, runny nose, red eyes, spots in the mouth along with a rash that spreads from head to toe and includes the palms and soles. Fever associated with illness starts 10 to 14 days after exposure, is 101 degrees F or higher, lasts for three to five days, then improves along with the rash improving at a similar time.

Contagious period: four days before rash appears until four days after rash appearance

Transmission route: secretions from the mouth/throat or nose usually spread by coughing or sneezing. The virus can also remain airborne for up to two hours in a closed space.

Diagnosis: usually clinical (by symptoms and patient history), but, to confirm the disease a blood test must be drawn.

Treatment: supportive care. This means fluids, fever reducers, pain control, rest and TLC.

Prevention: vaccination. First vaccine (confers approximately 94 to 98% immunity) given at 12 months old, booster (confers 99% immunity) given at four years old.

Possible exposure: A person who was potentially exposed and is experiencing symptoms a fever of 101 F or higher, cough, runny nose and red eyes with or without rash, should call the Department of Public Health as well as their healthcare provider. These individuals should not go to their doctor’s office or the emergency room as they could infect others around them.

Nicole Keller, D.O.

Hello parents! Has anyone seen The Mother ‘Hood Official Video being circulated on social media? It is a really heartwarming ‘welcome to parenthood’ skit expressed in a unique way.

In the video it shows groups of moms (and dads) who have different beliefs all meeting on a playground getting ready to “brawl” over their different beliefs (breast feeding moms vs. formula feeding moms, stay at home moms vs. working moms, dads vs. moms, etc!). In the end while everyone is focusing on their own “superior” way of parenting, a mom accidentally lets go of her stroller and it goes rolling down the hill. At this point you would think that each opposing group might not go to rescue the runaway baby, but, instead, all the groups come together and chase after the stroller ultimately saving the stroller and keeping the baby out of harm’s way.

I think it is a really good example of how each family and parenting style is different, but, in the end we are all parents trying to raise our kids in the best way possible. No matter your beliefs, we can all agree that what we want is what is best for our kids.

I hope you all know that that is also true of your pediatricians! We all do this because we love kids and want to help families grow in a safe, happy and healthy environment. Our recommendations are our best effort to achieve that goal. In the end, what works for one family/child may not work for another and that’s ok! There are a lot of right ways to do things and we as parents and as pediatricians hope to continue to help you all find the “right way” for you and your family. Please know we are always here for you to answer your questions about your child’s overall health, growth and development. I fully appreciate this now as a new mom and have a new understanding of making things work for each individual family and child.

Happy parenting to you all!

Nicole Keller, D.O.

Happy New Year everyone! I know we are well into 2015, but, I am still feeling the aftershocks of the holiday season. Boy can all those holiday gatherings impact your life! I don’t know about you all, but my little guy (who is now just over 4 months old) had a hard time sleeping after all the excitement and my husband and I are still recovering from the sugar overload induced by every type of bread, cheese and candy we consumed over the last month or so. As we try to return to our everyday schedule we are also trying to remind our bodies (and our minds) what healthy eating is. So for this blog post, I want to talk about an important part of a healthy diet that often goes overlooked…your drinks!

The Illinois Chapter for the American Academy of Pediatrics (ICAAP) has recently launched a campaign to “Rethink your Drink.” Here’s what ICAAP is recommending (and what I would have to agree with!):

• “Red light” drinks – drink RARELY: regular soda, energy/sports drinks, sweetened coffee/tea, fruit drinks
• “Yellow light” drinks – drink OCCASIONALLY : diet soda, low-calorie/low-sugar drinks, 100% juice
• “Green light” drinks – drink PLENTY: water, seltzer water, skim or 1% milk

This got me thinking about how much my liquid consumption is part of my diet – and a part of all my patient’s diets! Fluids are one of the best ways to keep your body hydrated and healthy if you are choosing the right ones. In our grocery stores today, the juice and pop aisles take up a huge amount of space which points to how much we consume these items as a society. While juice and pop may seem like a good option to drink (they are fizzy, fruity and sweet of course!), they are some of the most common culprits for a lot of medical problems. Obesity, dental cavities, diabetes and other medical conditions can be brought on or worsened by what we drink.

Here are some tips to make sure your kids and your family are on the right track for choosing healthy drinks throughout the year:

• Water should be the primary drink you and your kids consume. You can offer water to infants starting at six months of age (in a bottle or preferably a sippy cup). Water should be available at all times of the day.
• Pop and juice should be reserved for special occasions. Holidays, birthdays, or other family celebrations (for example) should really be the only time these are offered to your kids.
• When offering juice, water it down. Cut the juice in half with water to make it less sugary.
• When you choose a juice, look for the 100% fruit juice label. This is still a very sugary drink and still should only be offered on occasion, but, if you are going to give it, this option would be best.
• Offer water or milk only with each meal. Remember infants one to two years old should be on whole milk (the extra fat helps their brain development) but milk in general should be limited to no more than 24 ounces in a day.
• Stay away from sports drinks. While those drinks are great for athletes who are exerting lots of energy during practices and games, they are not meant to be used on a regular basis. There are way too many carbs and sugars for frequent consumption.
• If you follow these guidelines you can easily make sure the beverage portion of your family’s healthy diet stays on track. As always, let your pediatrician know if you have any questions about healthy eating and drinking – we are always here to help!