Tag Archive for: pediatrics

Know the Facts about Children and Diabetes

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The Defeat Diabetes Foundation (DDF) has named April Defeat Diabetes Month. Defeat Diabetes Month is a time to raise awareness about diabetes prevention, management, and treatment throughout our communities. At NOAH, we are here to help you through all aspects of defeating diabetes, from awareness to treatment.

There are multiple forms of diabetes, but the two most common forms are called type 1 and type 2 diabetes mellitus. Both forms can occur at any age, but a child is typically more likely to be diagnosed with type 1 diabetes. However, with childhood obesity rates on the rise, the number of children diagnosed with type 2 diabetes or who are at risk of developing type 2 diabetes later in life is also increasing. According to the DDF, 1 in 3 US children is overweight or obese. 75% of these children will become overweight or obese adults, and 87.5% of adults diagnosed with type 2 diabetes in the US are overweight or obese.

The DDF has created three different steps to help win the fight to defeat diabetes. The three steps include awareness, action, and prevention.

  • Awareness – creating awareness of the risk factors, warning signs, and complications.

Diabetes is a chronic disease that is characterized by high levels of glucose (sugar) in the blood. Insulin is needed to help lower the levels of sugar and maintain normal blood sugar levels. Diabetes occurs when insulin is not produced in sufficient amounts or the cells of the body are unable to use the insulin properly. Over time, high blood sugar levels may lead to serious complications such as diseases of the eyes (retinopathy), kidneys (nephropathy), nerves (diabetic neuropathy), and blood vessels (that can eventually lead to poor circulation in the extremities). Diet and lifestyle changes can help decrease the risk of these complications.

Type 1 diabetes is a chronic disease that is almost exclusively based on genetics, and it cannot be prevented. With type 1, the pancreas produces very little or no insulin, leading to high blood sugars. Symptoms include increased urination, excessive thirst, increased appetite, and weight loss.

Type 2 diabetes is highly preventable and can be characterized by insulin resistance, decreased insulin production, or a combination of both. Some of the modifiable risk factors for type 2 diabetes include diet, physical activity, and weight management.

  • Action – taking action and providing individuals with the information they need to make the right dietary, lifestyle, and treatment choices to ensure their optimal health.

It’s important to talk with your child’s doctor to find the best treatment plan. Your child’s doctor will talk you through the importance of lifestyle, diet, and medication in order to keep your child’s blood sugar under control. Eating healthy and maintaining an active lifestyle can help manage BOTH type 1 and type 2 diabetes. As mentioned, Type 2 diabetes is highly preventable, so it is even more important to start creating healthy nutrition and lifestyle habits at a young age.

Children who are at risk or are diagnosed with diabetes can live a happy, healthy life through self-management and with an integrative team approach with various medical professionals. An integrated approach with your child’s doctor, a registered dietitian, and a behavioral health specialist can help develop a nutrition, physical activity, and medication plan that can help.

Here are some healthy nutrition tips from The American Academy of Pediatrics:

  • Eat at least 5 servings of fruits and vegetables each day.
  • Stick with water, avoiding juices and other drinks high in sugars.
  • 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 soups that 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.
  • Prevention – take a personal pledge to prevent diabetes in your family and your community.

Feel free to reach out to one of your NOAH Health Centers with any questions you may have. NOAH offers a full range of primary and preventable health services for all ages!

To learn more about the DDF and the prevention and management of diabetes, visit their website at https://defeatdiabetes.org/

To read more about Type 1 Diabetes in children visit https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Diabetes.aspx

To learn more about type 2 diabetes and tips for healthy living check out https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Type-2-Diabetes-A-Manageable-Epidemic.aspx

Halloween Safety Tips by Amit Jain, MD, FAAP, MBA

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It’s that time of year again! Halloween is right around the corner. With it comes lots of fun, elaborate costumes, tricks, and treats! Have your children thought of the costume they’d like to wear this year? We here at NOAH want to make sure they stay safe while out trick or treating this year. With assistance from the American Academy of Pediatrics, have provided some great safety tips below to keep them safe while they’re out.

Fun / elaborate costumes can be an exciting part of Halloween. One of the most effective but most easily forgotten ways to help make your child’s Halloween a safe one is with costume safety.

Here are some great safety tips:

  • As most of the trick or treating happens after dusk, make sure costumes are bright and colorful and / or have some reflective surfaces that can be easily seen by drivers and others. You can even consider adding some reflective tape or striping to the costumes and trick-or-treat bags with such tape. It can even help for a cool effect the children would love.
  • Make sure the costumes are short enough to prevent tripping, and are clearly labeled as flame-resistant.
  • Along with this, make sure your children have shoes that fit well and are comfortable for walking long distances.
  • Masks can obscure a child’s vision, especially to the sides (peripheral vision) as the mask moves around their face. Consider non-toxic makeup and decorative hats as fun and safe alternatives to masks.
  • Any swords or other sticks / canes that are a part of the costume should not be sharp or too long that they could hurt your child if they trip and stumble over these objects.
  • Make sure all children and their escorts have flashlights with a fresh set of batteries.
  • Before leaving for trick or treating, make sure your children know how to call 9-1-1 or their local police department in case they get lost or separated or in an emergency. Have a safety plan in place for the chance that a child gets separated from the group, which should include having the child stay where they are in a safe location if they do get separated from the group. The non-emergency number for the Phoenix Police Department is: 602-262-6151.
  • Also, make sure they have a good meal prior to going trick or treating, and bring a water bottle for each child and the children’s escorts to stay hydrated while out.
  • A parent or responsible adult should be with and watching children at all times while out. Instruct children to always stay in a group and close to the parent / responsible adult. Also instruct them to remain on well-lit streets, always use the sidewalks (or as close to the edge of the road as safe if no sidewalk is available, facing traffic), and use designated crosswalks to cross the street.  Don’t assume you have the right of way – it is much more difficult to see the road and pedestrians at night! While out trick-or-treating, only go to homes with a porch light that is on. Remember to never enter homes or cars for a treat.
  • If your older children are going alone, plan and review a route that is acceptable to you beforehand – and ensure they will stay on that route. Plan and agree upon a time that they should arrive home by. Remember curfews – Phoenix juvenile curfew hours are 10 p.m. for children 15 and younger and midnight for 16- and 17-year-old children. If possible, give them a cell phone for emergency contact use.
  • Finally, after the fun night of trick-or-treating, sort and check all treats before the child eats any of them (including ones they eat while still out trick-or-treating). Throw away any spoiled, unwrapped, or suspicious looking treats. Ration out treats for the weeks and months following Halloween. They should not eat any of these treats immediately before bedtime. Along with this, remind your children that the rules don’t change from a normal day – remember to have your children brush their teeth before bedtime to get all of that stuck-on candy out of their teeth.
  • Also, don’t forget to have regular check-ups with our wonderful Pediatric Dentists here at NOAH!

Please check the American Academy of Pediatrics website for some more awesome safety tips here:

https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Halloween-Safety-Tips.aspx

Have a fun, safe, and Happy Halloween from your friends at NOAH!

Car Seat Safety by Dr. Amit Jain, Pediatrician

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We here at NOAH care about your child’s health and safety not only at the clinic, but at home and on the go too. One very important part of this is Car Seat Safety.  We would like to remind you about the importance of Car Seats, and how to keep your child safe when on the go.

Especially for a new parent, the variety of car seats available today can be overwhelming! And it makes it more difficult to make sure your child is buckled in appropriately. We would like to help alleviate some of the confusion! Thinking about a car seat starts before your child is born. Most hospitals require an appropriate car seat for you to take your baby home and do car seat checks when your new baby is first allowed to go home from the hospital.

Unintentional injuries (including car accidents) are the leading cause of death in children and teens. Courtesy of the National Highway Traffic Safety Administration (NHTSA), we know that on average, 3 children were killed every day in traffic accidents. Of those, more than a third of the children were unrestrained. More than half of injuries and deaths were cases in which car seats and seatbelts were incorrectly used.

There are various types of car seats to consider based upon your child’s age, weight, and height including rear-facing, convertible (rear-facing that can become forward-facing), forward-facing, and booster seats (with or without back support). Below is a chart explaining the various car seats, separated by age group. To securely install these various car seats, you can either use the available seatbelts or the LATCH system. Nearly all vehicles and car seats built after September 1, 2002 include this LATCH system (Lower Anchors and Tethers for Children) which consists of a lower anchor where the seat cushions meet, and a tether which can be located on the panel behind the seat, on the back of the seat, the ceiling, or the floor.

Some important points when using these systems:

  • Most rear-facing car seats do not use the tether for installation, just the lower anchor and/or seatbelt.
  • You should not use both the lower anchor and seat belt together unless specifically instructed in the car seat installation instructions. However, the tether can and oftentimes will be used along with the seatbelt to securely install the seat.
  • To get a tight fit using the seatbelt, the seatbelt should lock. For most modern cars, the seatbelt can be locked by pulling it out all the way, and then letting it retract as it clicks.
  • When possible, the middle back seat is the safest. However, the middle seat often doesn’t have a LATCH system, or is too small, or uneven to safely support a child. It is most important that wherever the child may be seated, that the seat is securely and tightly installed in the vehicle.
  • Infants and children should wear thinner clothes when buckled into car seats as bulky clothing such as jackets can leave the straps too loose, increasing the risk for injury. 
  • The American Academy of Pediatrics recommends that all infants be placed in rear-facing car seats starting from their first ride home from the hospital.
  • All infants and toddlers should ride rear-facing as long as possible (even if their legs are bent), until the highest weight or height allowed by their car seat.
  • When children outgrow their rear-facing only car seat, a convertible car seat installed rear-facing should be used.
  • A forward-facing car seat should be used only once a child has reached the weight or height limit for their convertible rear-facing car seat. Similarly, a forward-facing car seat should be used until the weight or height limit for that specific car seat has been reached (this is usually listed on the label of the car seat).
  • A belt-positioning booster seat is the next step and should be used until a child’s seatbelt fits properly across their shoulder (without riding up to their neck), which is typically at a height of 4 feet, 9 inches or taller, and 8-12 years of age.
  • The safest place for all children younger than 13 years old is the backseat.
  • Do NOT use the car seat after it has been in a moderate to severe crash, such as if any of the following are true (according to the NHTSA):
    • The vehicle could NOT be driven away from the crash
    • The vehicle door closest to the car seat was damaged
    • Anyone in the vehicle was injured
    • The airbags went off
    • There is any significant damage to the car

And remember, always be a good role model by buckling your own seatbelt every time you’re in the vehicle! Set a reminder whenever you buckle your child’s car seat to help you remember never to leave your child in or around your car when you leave.

If you need help installing your child’s car seat, or just want to make sure it is secure, below are some great options for you to reach out to:

  • Your local fire department
  • Parent partners plus
  • Phoenix Children’s Hospital car seat safety program

For more information, please visit:

Why Get Your Child a Flu Shot by Dr. Amit Jain, Pediatrician

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It’s that time of year again! The fall and winter seasons are approaching. Along with exchanging presents during the holiday season, everyone, especially children, are passing around germs and illnesses between each other. We here at NOAH want to inform you about the flu and why it is important to protect your child against the flu with the flu vaccine.

The Flu is short for Influenza – a virus that most often causes an illness that affects our breathing and airways. There are many different viruses that can cause common cold symptoms, but influenza is different in that it is more contagious, and often causes worse symptoms, lasts longer (a week or more) and has more severe problems that it can cause compared to other common cold viruses including pneumonia (an infection of the lungs), and a bacterial infection.

The flu is highly contagious, and most often spread via droplets, meaning it is most often caught from being near when a person with flu coughs or sneezes. It can also be caught when a child touches something contaminated with the flu virus, then touches their eyes, nose, or mouth.

The symptoms of the flu include:

  • Sudden, often high fever
  • Chills
  • Body shakes
  • Muscle aches
  • Headache
  • Being more tired than usual
  • Runny or stuffy nose
  • Sore throat
  • Dry cough
  • Some children may even throw-up (vomit) and have diarrhea

Although the likelihood of getting the flu is high, the children who would suffer the greatest problems from getting the flu are:

  • Those with chronic medical conditions – especially respiratory conditions including Asthma and chronic lung disease
  • Heart problems
  • Diabetes
  • Sickle cell disease
  • Weakened immune system
  • Disorders of the brain or nervous system

How can you prevent or decrease the risk of your child getting this scary flu virus? The best way to protect against the flu is the influenza vaccine. All infants and children 6 months old and older can get the flu vaccine every year. Since babies younger than 6 months cannot get the influenza vaccine, the best way to protect them is that everyone around and taking care of the baby get the flu vaccine. Along with this, frequent, good hand washing with soap and water is especially important. If you cough or sneeze, be sure to do so into your elbow (like a vampire holding their cape!) or into a tissue, but not directly into your hands. Teach your children these good habits from a young age as well! Sanitize toys that your children play with frequently as well.

Along with this, it may be a good idea to keep your child home from daycare or school if they are having the following symptoms:

  • Fevers (usually a temperature greater than 101F)
  • Chills and shaking of the body
  • Headaches
  • Body aches
  • Tiredness / sleepiness
  • Sore throat
  • Runny nose / congestion
  • Dry cough

Do not hesitate to bring your child in to your NOAH clinic to evaluate your child and determine if any treatment would be helpful. 

The side effects from the flu vaccine are few, and generally much less severe than getting infected with the flu. These include:

  • A low-grade fever
  • Some redness and soreness around the site that the injection was given.
  • The flu vaccine is made using eggs. Those who have a severe allergy to egg (anaphylactic reaction) should have a discussion with their doctor before getting the flu vaccine.

At NOAH, we are here to help you and your child get through the cold and flu season safely and healthily. Please call today to make an appointment to get you and your child the flu vaccine!

For more information, please visit:

  1. https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/The-Flu.aspx
  2. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Prepare-Your-Family-for-Flu-Season.aspx
  3. https://www.cdc.gov/flu/index.htm
  4. https://www.cdc.gov/flu/prevent/vaccinations.htm