Your Partners in Health Through the Seasons of Life.


Carseat Safety

March 9th, 2020

We all know that car seats play a vital role in the safety of our children. During pregnancy, we obsess over finding the perfect car seat that provides safety and functionality. Once the baby arrives, one of the prerequisites for leaving the hospital is knowing how to properly install the car seat and safely buckle in the newborn. All that being said, there is a lot of confusion about car seats. However, we are here to help you! Here’s the latest information to keep your child safe while in the car.

Rear-facing Car Seats

One of the biggest questions parents have about car seats is how long should a child be in a rear-facing seat? Since 2018, the American Academy of Pediatrics (AAP) recommends that children stay in a rear-facing seat as long as possible. Thus, a child should remain rear-facing until they exceed the weight or height requirement by the car seat manufacturer. For example, most convertible car seats have height and weight limits that will permit children to ride rear-facing past their second birthday. As car seat manufacturers increase these limits, more children can stay in rear-facing car seats well into their toddler years. 

This recommendation by the AAP was based on the anatomy of young children. Since young children have large heads, when compared to their body, they have a higher center of gravity. Also, the vertebrae in their spine are shallow and ligaments are looser. These aspects of a child’s anatomy increase a child’s risk of a spinal injury during a car crash. A rear-facing car seat will protect a child’s back and spread out the force of a sudden stop or a car crash.  This will reduce the risk of neck and spinal injuries. 

Forward-facing Car Seats

If your child has outgrown a rear-facing seat based on his or her height and weight, it’s time to consider moving the convertible car seat to forward-facing. It’s important for all children 4years and under to remain in a harness style car seat for optimal safety. There are two main types of car seats that are safe in forward-facing mode: convertible seats, such as 3-in-1 seats, that will transition with your child from rear-facing to forward-facing and combination seats with a harness buckle that can be used for children who weigh up to 90 pounds, depending on the model. When installing your convertible car seat to forward-facing after being used as a rear-facing seat, it’s important to remember to move the shoulder straps.  Make sure they are at or just above your child’s shoulder. If you are using a seat belt to safely buckle your child, make sure that it runs through the belt path of the car seat correctly.  It also should be locked and tightened to ensure your child’s safety. Additionally, make sure you check the car seat safety instructions for height and weight requirements. 

Booster Seats

Your child has officially outgrown their forward-facing car seat once certain criteria are met.  These include the following: that they reach the weight or height limit for their forward-facing car seat with a harness; their shoulders are above the top harness slots or the tops of their ears have reached the top of their seat. Once these requirements are met, they can start riding in a booster seat. The booster seat is to make sure that the car’s seat belt fits the child properly. Typically, a standard vehicle seat belt will fit a child once they are 4 feet and 9 inches. Most children will require a booster seat until they are 10 or 11 years. It’s also important to note that all children under 13 years should ride in the back seat. 

Keeping your child safe is always on your mind as a parent. We are happy to provide you with information to help you with this. If you have specific questions about your car seat and its suitability for your child, please come visit our office. 


There are plenty of things worse than vomiting and diarrhea, but when it hits it can be so inconvenient. Most parents can testify that these two symptoms seem to strike at the worst possible times – the middle of the night, in the car, or when you’re already running late for work. This month we want to take a minute to shed some light on three causes of vomiting and diarrhea in children:




Rotavirus is the most common cause of severe diarrhea in children under 2. This infection is so common that virtually all children have rotavirus at some point before they turn 3. We are in the middle of the rotavirus season. (Most infections between November and March.) 

Children suffering from rotavirus can experience diarrhea, vomiting, stomach pain, and a fever. It is the most common cause of admission to the hospital for dehydration in children under one year of age. Thus, parents should watch for signs and symptoms of dehydration— decreased oral intake, thirst, dry mouth, decreased urine output, weight loss, and lethargy. 

Prevention can be simple. Two oral rotavirus vaccines are available. They can be given at 2 and 4 months or at 2, 4, and 6 months. If your child does contract rotavirus, it has to run its course with supportive care and diligent supervision of hydration. It is highly contagious so diligent handwashing and antibacterial surveillance can help keep other family members safe. Anti-vomiting drugs can be given but we never use anti-diarrheal drugs in children. They have been proven only to prolong the course of an illness that just needs to get out of their bodies.




Salmonella bacteria most commonly manifests in diarrhea and is caused by eating food that is contaminated. Most often children under 4 contract salmonella infections. The typical food products that result in salmonella infection are poultry, beef, eggs, and dairy products, but sometimes fruits and vegetables can be contaminated by coming in contact with an animal product. Finally, water contaminated by animals and contact with contaminated pets can also result in infection. Pet turtles and lizards are common carriers. 

In addition to diarrhea, a child suffering from a salmonella infection will experience abdominal cramps and a fever. The incubation period for salmonella infections is typically 6-72 hours but can range from 6 hours to 60 days. The health department is very vigilant in surveillance. If there isn’t an improvement in your child’s symptoms within 2 or 3 days, if there is blood in her stool, or if he has symptoms of dehydration, it’s important to contact our office. We can then test your child for salmonella organisms through a stool sample. Treatment includes fluids, rest, fever reducers, and rarely an antibiotic. To avoid salmonella infections, make sure to practice good hygiene while prepping food. For example, wash your hands thoroughly before and after cooking and eating; make sure to cook eggs, poultry, and ground beef thoroughly; and, make sure to wash hands after playing with pets and before eating always.


Stomach Bug


What is commonly called the stomach bug is medically called viral gastroenteritis. It is incredibly common in school-age children due to the high number of germs passed around between kids. The vomiting, diarrhea, and overall icky feelings associated with the stomach bug make life hard for parents and kids, especially since this illness can be passed between family members. In order to avoid the stomach bug during the school year, it’s important to remember a few things: 

• Wash hands, wash hands, and wash hands! Reinforce at every opportunity with children to never touch your face or eat without washing hands. 

• Vomiting is scary for kids! Being there despite the gross parts of the stomach bug exposes you to a lot, so while you are there for your kids, make sure you wash your hands often to avoid catching it yourself. 

• Teaching your child to share is a good idea, but we don’t share everything. Illness is always a good opportunity to reinforce good boundaries to children when they are approached by their friends to share things they shouldn’t be sharing. Sharing food and drinks is risky because they can also be sharing germs! Make sure your child knows that sharing drinks and food can expose them to germs that can lead to the stomach bug. And when they are sharing toys, make sure they wash their hands before eating or before moving on to the next activity.


Illnesses that involve diarrhea and vomiting are TOUGH! We are here for you to help by diagnosing the illness, making sure your child stays hydrated, and provide encouragement for you as a caregiver. If your child is suffering from a gastrointestinal illness, give our office a call or text during the day. We can often call in medications that can help with the symptoms. When the stomach bug strikes at night, our night clinic is open 5-11 p.m. during the week and 12 to 8 on Sundays.

How to Avoid Skin Irritation

January 7th, 2020

How to Avoid Skin Irritation


Sensitive skin is incredibly common in children, and skin sensitivity for children often manifests itself as eczema.  The cold winter weather combined with the dryness of indoor heat can be tough on kids’ skin, causing it to feel dry, irritated, and scratchy, especially if your child already suffers from eczema. 

Eczema affects approximately 17% of children, and most children develop eczema before their fifth birthday.  Children that suffer from eczema have a problem with their skin barrier that causes sensitivity.  The skin barrier, also known as stratum corneum, protects your child from the outside world – bacteria, chemicals, sun, etc.  Eczema sufferers have a skin barrier that doesn’t function correctly; their skin is less likely to stay hydrated, more prone to irritation, and unable to fight off microbes that can cause infection.  These symptoms are often magnified by the dryness of winter, which makes the skin barrier’s ability to function difficult, causing eczema flare-ups.  

Here are 5 tips for helping your child’s skin stay healthy and keep eczema flare-ups at bay:  

  1. Check water temperatures:  Before your child gets in their bath, make sure to check the water temperature.  Water that is too hot, even if it is a safe temperature for your child, can make itchiness and dryness worse because it stimulates nerve endings. 
  2. Pat skin dry:  After your child finishes their bath, pat skin dry instead of rubbing it dry with a towel.  The rubbing motion often used when drying off from the bath can irritate a child’s compromised and weakened skin barrier.  
  3. Moisturize:  Fragrance-free creams can help combat dryness and decrease eczema flare-i[s by protecting your child’s skin barrier.  Skin can benefit the most from lotion when it’s applied within 3 minutes after getting out of the bath because damp skin seals in moisture better.  Vasoline and Aquaphor are great examples of moisturizers that can be used after the bath. 
  4. Avoid irritants:  Make sure the products you use daily, such as laundry detergent, cleaning products, and fabric softeners, are mild and preferable fragrance-free or made for sensitive skin.  The chemicals often used in fragrance can cause irritation and make your child scratch, leading to further irritation. 
  5. Talk to us!:  We are here to help you and your child through dry skin and eczema this winter.  If you think your child may have eczema but hasn’t been diagnosed previously, come in to see us to confirm a diagnosis and discuss how to best care for your child’s sensitive skin.  We can also talk through some things that might trigger eczema, as well as any allergies that might lead to skin irritation. 

We are always here for you and your children!  To schedule an appointment to talk about your child’s irritated skin or other winter illness, or to ask any questions you may have about your child’s skin, you can call, text or message us!