My name is Dr. Edna Tello, MD. I am a board certified pediatrician, wife, mother of two, and community health educator. I started this blog in response to questions and requests from many of my parents, friends, and family members.
April was Autism awareness month and I would like to take this opportunity to educate my families on this very prevalent developmental disorder. Autism Disorder is a brain condition that affects the development of social skills, speech and communication and the ability to interact with the outside world. It is best described as spectrum of developmental conditions that include the high functioning Asperger disorder, pervasive developmental disorder and Rett syndrome. It usually manifests between 2 and 3 years of age with the onset of speech problems, but sometimes it can be recognized earlier in more severe cases. According to recent research data the prevalence for Autistic Disorders continue to increase and now the new figure is 1 out of 88 live births will be affected. Males are more commonly affected than females and there is higher risk for siblings of affected children. Correct diagnosis and early detection are determining factors to initiate early intervention services. Referrals can be even if there is a suspicion while families are waiting for definitive diagnosis. It is believe that this a chronic condition that will extend to adult life however I firmly believe that positive outcomes in speech, behavior and social and adaptive skill are attained thanks to early intervention. Developmental screenings should take place every time a child is seen by the pediatrician. If there are consistent behaviors and speech issues that are concerning you as a parent please do not ignore and bring to your pediatrician’s attention. In the typical 10 minute office visit it is very difficult to attempt to diagnose such complex condition. The American Academy recommends two Autism specific screening by the age of 2 years old. The cause of Autism is believed to be multifactorial: there can be genetic predisposition and some environmental factors; however there is not one known cause. Research is currently undergoing on the causes and better treatment approaches. Recently some data suggest that advance maternal age as well as maternal obesity and gestational diabetes can have a relationship. Much more active research needs to be done as well as more support for pediatricians and families. In some place resources for speech and behavioral interventions are very limited. For more information about resources visit Autism Speaks website as well as the American Academy of Pediatrics official website. Or ask your pediatrician. Finally I like to clarify that the studies are very clear that MMR vaccines or thimerosol a mercury containing vaccine preservative are not the causes of autism. If you want a copy of the most comprehensive research please visit…or ask me. Dr. Tello
To all my readers happy Valentine’s month! This is the month of celebrating friendship and love. Since we celebrate with delicious chocolate, plenty of candy and pink and red hearts, I am dedicating this blog to the heart. Kids’ hearts that is!
The heart is an amazing muscle which pumps approximately 1.3 gallons per minute or 1872 gallons of blood in 24 hours! The heart starts beating at approximately the 6th week of gestation. For the pregnant mommies who want to ensure a healthy cardiovascular start for the baby, make sure you are eating a good healthy diet especially rich in folic acid and take your prenatal vitamins as recommended. All the major organs are formed by the first trimester. Always check with your doctor if taking any medications as some medications can cause birth defects and affect the development of the cardiovascular system which includes heart and vessels. If there is a family history of heart defects or unusual heart rhythms especially in first degree relatives like siblings or parents you need to tell your obstetrician as soon as possible. Usually a specialist called a perinatologist can do a very advance level 2 ultrasound which may be able to detect major heart structural abnormalities.
The American Academy of Pediatrics is now recommending heart screening for all newborns by doing a very simple test called pulse oxymetry. This consists in putting a small probe on the baby’s finger and matching the heart rate with oxygenation at room air. If there are any discrepancies further testing will be ordered. Since this is just a recommendation most hospitals are just starting to adopt it as a policy in most newborn nurseries. You can ask your pediatrician and request this very simple test.
Heart murmurs are a very common finding in perfectly healthy newborns and children. If any heart murmur is detected at birth it needs to be followed by the pediatrician who then will refer to the pediatric cardiologist or may order an ultrasound of the heart. A heart murmur is the sound of blood going through the different structures of the heart. If there is a structural abnormality the sound deviates from the usual sound that we appreciate with the stethoscope. In newborns and older children the majority of the murmurs are innocent but they always need to be investigated. If an infant is not gaining appropriate weight or he/she is having major difficulties feeding always asks your doctor as this can be a sign of heart trouble.
In school age children and adolescents signs and symptoms of heart disease are exercise intolerance, with extreme fatigue, weakness, almost passing out with or without exercise and syncope. Abnormal heart beats very rapid, skip beats or irregular heartbeats should always be investigated with the pediatrician and even may require a cardiology referral. For athletes with any of these symptoms competitive sports should be put on hold until cleared by a cardiologist and although not a universal requirement I would even recommend a screening EKG for any child playing competitive sports at the varsity level in high school and planning to play in college. Chest pain very rarely is related to heart problems more commonly maybe a sign of respiratory or musculoskeletal issues.
Childhood obesity increases the risk for early cardiovascular disease. We are starting to see many obese children with high cholesterol, high triglycerides, high blood pressure and diabetes.
For a healthy heart a well balanced diet, consisting of fruits and vegetables, lean meats, grains and legumes is essential. Avoid processed sugars, foods that come prepackaged with high levels of sodium, and preservatives, juices that are bottled or come in boxes, and sodas. A good diet, daily exercise and a good dose of laughter are the secrets for a healthy heart.
In honor of National Eye Care Month, I will be dedicating this month’s posts to vision care tips. In the spirit of the New Year, there is no better time to schedule a new eye exam for the entire family.
As a part of the health screening before school entry, I recommend having your children’s vision formally checked. Between the ages of 3 and 4 all children should have their vision screened. Your child should have his/her eyes check by the pediatrician with every well visit. However, I recommend a more detailed exam and it should be performed by a pediatric ophthalmologist or by an optometrist who is comfortable evaluating young children.
These are some red flags that should be immediately investigated in regards to your children’s vision:
- A severe headache that is persistent; Children should not have headaches. Mark a calendar for everyday he/she complains of headache and make note of the time of the day. This could be a sign of a vision or a more serious problem. If the headache is associated with other symptoms always contact your pediatrician immediately.
- Watching TV, playing video games or computer games too close as if unable to see clearly
- Needing to read books too close
- Squinting frequently
- Lazy eye
- Family history of refractory eye problems like astigmatism, far sightedness or near sightedness
- History of Prematurity
Eye exams are as important as your dental exams. Have your eyes checked once a year. And kids remember to eat your carrots: Vitamin A is good for your EYES.
Stay tuned for my next post on Vision Nutrition!
The Flu Season has already begun are you and your little ones prepared? I am sure that you are all seeing and hearing the commercials to come and get “The Flu Shot.” They are giving them at your local pharmacy, at the health department, and in your primary care physician’s office. Before you make your decision about receiving this vaccine, I’m sure you have several questions.
What exactly is this “Flu Shot?”
There are two types of influenza vaccines: a live and non live. The live means an actual viral particle is given to the patient, this vaccine is popular because is non injectable and given through a nasal spray. The live vaccine should never be given to children under age 2 years, children who have asthma or recent history of wheezing or anybody who is immunocompromised. The non live is injectable but it contains the inactivated virus as the main component of the vaccine. There are also a preservative free or with preservative version of the vaccine. In this case the preservative is thimerosol which contains small traces of mercury. I never like to give my children or my patients anything with mercury preservative if I can prevent it. Ask your provider which version they have so you can make the best decision for you and your child(ren).
Why is there a new vaccine every year?
There are different influenza strands and every year the virus mutates or changes. Therefore a new vaccine is made using a combination of strands from the most recent outbreaks worldwide. Once the vaccine is given to a patient it will start working in the immune system at day three of vaccination, but it is not until after day 7 that you will have full immunity. If during that period you are exposed you will still get the flu.
Who is more susceptible to the flu?
I recommend the flu vaccine every year for all children who are six months and up especially for little ones with chronic conditions like asthma, diabetes, history of extreme prematurity, and heart disease.
What are the possible side-effects?
All vaccines have potential side effects. The possible side effects of the flu vaccine can range from nothing, to minor redness and swelling at the site of the vaccine, to pain and soreness of the site for several days after the vaccine; to the most unusual but possible fever, body aches and headaches. Other possible side effects may present if the child is allergic to any components of the vaccines, then the child should not receive the vaccine: the possible side effect can be hives, wheezing, difficulty breathing which are signs of severe allergy called anaphylaxis. The vaccine contains some chicken egg component therefore if a child is allergic to eggs he/she should not receive the vaccine. Thankfully the most severe side effects are very rare.
As I stated in my previous posting the best preventions for the Flu are hand washing and the vaccine. I arm myself, my family, and my patients with the flu vaccine every year.
For more information on the flu vaccine visit http://www.cdc.gov/vaccines/pubs/vis/#flu .
Two years ago, my daughter Sarah woke up feeling extremely weak, with terrible chills and an uncontrollable fever of over 103. It took me less than two minutes to realize what she had, “The dreaded FLU!” The flu is a contagious illness caused by the influenza virus which symptoms include: fever, body aches, sore throat, severe cough, and in some cases abdominal pain, vomiting and diarrhea. I’m sure these all sound familiar, so how can you tell that your little one has more than just a cold? Look for these main differences:
- Body Aches
- Constellation of all the symptoms
- Unbreakable fever
- The duration of the symptoms- the fever can last up to 7 days and the cough can stay for 2 more weeks!
The treatment for the flu is usually supportive. In the most uncomplicated cases physicians will recommend plenty of fluids, rest and ibuprofen or acetominophen for the fever and body aches. In cases where the patient may be at risk for complications he/she may be prescribed antiviral medications to shorten the duration of symptoms. If you or your little ones are experiencing these symptoms be sure to consult with your primary care physician right away.
According to the CDC and the Journal of the American Medical Association, every year in the US approximately 36,000 people die from complications of influenza, especially very young children, the elderly and those with weakened immune systems. The US influenza season starts in September, ending in May with a peak in January-February. The best prevention for any infection other than vaccination is hand washing. This can protect you and your little ones from “the flu,” and all other viruses that can cause severe infections. I give myself and my entire family the vaccine every year, and I recommend for children six months and up to prevent yearly infections.