Measles 1991: My Philadelphia Flashback

Shot TimeIn 1991, Philadelphia experienced a measles outbreak. I was in medical school in the city, and I remember how difficult it was to control. Children—some of whom had never been immunized—died. Babies received measles vaccines at 6 months of age and again at 12 months. Countless measles vaccines boosters were given. Living through a measles epidemic and seeing its grave consequences only confirmed the need to immunize against vaccine-preventable diseases.

There is a short radio piece on that time here.

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Pediatric Practices in the United States

BabyMoving and need to find a new pediatrician for your family?

The map link here will show you pediatric practices affiliated with the American Academy of Pediatrics Section on Practice Administration.

A more general link for finding a pediatrician from the American Academy of Pediatrics is here.

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Baby Measles

MeaslesThis article from SFGate about a 4 month old from SoCal who caught measles at Disneyland has good pictures of the rash. Scroll through to image #4 here. This baby was up to date on all his vaccines: he measles vaccine is given at 12 months. See more about measles from our office here.


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Resolution 4: Green and Yellow

Green and Yellow Vegetables


Can you eat a green and a yellow vegetable each day?

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How Do I Protect my Baby and Child from Measles?

First Aid Neon

Babies have some protective antibodies that cross the placenta from their mother if she was immunized or had measles. These antibodies wear off over time and can’t always be depended upon.

A person with measles can be contagious 4 days before the rash starts and for four more days afterwards. Measles is spread by coming in contact with an infected person who is sneezing or coughing. The virus can be present in the air for 2 hours after the infected person leaves the room. Shaking hands, kissing, touching surfaces or door handles or anything that an infected person has come in contact with can also spread measles.

Babies under 8 weeks should not be exposed to crowds or sick people. Their immune systems are not well developed. For the first two years, the immune system does not work well against infection. Babies and toddlers can become sick with influenza and other illnesses besides measles. Avoid close, crowded indoor spaces, and small children, who are sick frequently, and can be contagious before showing signs of infection.

If you must visit a public space with a young infant, consider going when it firsts opens or is less likely to be crowded. Wash your hands and your child’s hands. Running water and soap are best. Use sanitizers when these are not available.

Babies and children who are not immunized present a risk to your child. Those children may come in contact with someone infected with measles, get sick and infect your child. Ask if other children are vaccinated.

The simplest way to protect babies and children from measles is to vaccinate. The vaccine is safe and effective.

The first dose of the measles vaccine (abbreviated as MMR for measles, mumps and rubella) is given after the first birthday and the second dose is given between the ages of 4 and 6 years.

If your baby is 6 months of age or older and you are traveling outside of the US, your baby should be immunized against measles early to avoid catching measles outside of the US and bringing it back.

Measles begins with high fever, cough, runny nose and red, watery eyes. After that a rash begins at the hairline and spread down the face to the rest of the body. There are pictures of a baby with the measles rash from the recent Disneyland outbreak here.

If you think your child has been exposed to measles or may have measles, please call the office. Know that our office believes in protecting babies and children and vaccinates them!

If the CDC issues additional health advisories with recommendations to immunize and/or reimmunize children against measles, I will tweet that information and post it on the office web site and Facebook page.

The measles vaccine is very effective in preventing disease, but vaccines protect best when everyone who can be vaccinated is vaccinated. This is called herd immunity. When vaccine protection rates are high in the “herd” and a case of measles is imported from outside the US, the herd stays well. The problem is that people have forgotten how bad measles is and why babies and children should be protected. The Disneyland measles outbreak is a sad lesson. Too many people have chosen not to immunize their children based on misinformation. Their children have been hiding in the herd—and not getting their shots—and now the herd is so poorly immunized that epidemic measles can take hold like it’s the 1950s. Measles is not a benign infection: it can cause pneumonia, encephalitis (brain inflammation), deafness, and death.

Read more about measles from the CDC here.

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What Color is your Snot?




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Resolution 3: Hungry Enough to Eat an Apple?

Apple PearI’m hungry!

Wait, are you really?

Try this: pick a food for the family that’s healthy and good in it’s own right like a pear or an apple.

When someone is hungry, do a gut check: are you hungry enough to eat an apple?

If the answer is yes, and it’s midway between breakfast and lunch or lunch and dinner, have the apple (or pear or carrots).

If the answer is no, you’re not that hungry, have a list of things to do instead. When the hungry feeling comes, distraction and redirection can make it goes away. Not every sensation of hunger needs to be obeyed. Children will not perish. Healthy kids can even practice this.

One definition of a snack is a food that has no added sugar, less than 500 milligrams of sodium and less than 100 calories. That’s basically fruits and vegetables. 100 calorie packets of processed crackers, chips or bars are gone in an instant without being filling.

Foods without a lot of calories—an apple has 95—that take time to eat make excellent snacks.

Read more about how to think about food and behavior in The Beck Diet Solution.

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Resolution 2: Small Plates

small plateMake it fun. Pick a new food for the family (or revisit a healthy one that never got traction). Have the kids find the smallest plates in the house to serve this food on—this could be a doll plate or a plate for a fashion doll or action figure. Everyone can pop a serving from their tiny plate into their mouth and try. Praise everyone who laughs and plays along for trying. Award points for bravery and gusto.Work up to slightly bigger plates. For trouble with healthy drinks like milk, try this with toy-sized cups.

Common sense: avoid very small toys and cups for children under 4 years of age since they are a choking hazard.

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Resolution: 1

ResolutionResolutions are great. The problem is we almost always set our expectations too high.

We are going to eat right, get active, straighten up and fly right.

And as soon as we fail, we feel terrible. We give up.

Instead, resolve small. And easy.

It takes months for adults to change a habit and weeks for kids.

Pick something that isn’t hard to do at all—remember you want everyone to feel like a winner.

Here’s one to try from the 5210 Let’s Go program.

To start easy, go for the 0!

0 is for no sugary drinks.

Kids do best with milk or water.

If your kids get juice, soda or sugary drinks more than once a day, reduce the number of times they drink them. Fruit, with its fiber and nutrients, is best eaten.

If 0 sugary drinks is too hard, pick something that’s easy for you and your kids.

Check back for more and let us know what you’re doing at your house.

Go slow to to win and then keep going!



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First Aid NeonHumidifier or Vaporizer?

Humidifier, hands-down.

A cool mist humidifier is what you want to sooth irritated airways.

Vaporizers heat water into steam and they can burn or scald children who are naturally curious and active.

It’s unclear whether adding anything like Vic’s to the humidifier helps or harms. One study showed that these types of products causes airway tissue to swell; another thought it might help.

The most important thing to remember is to clean your humidifier so it doesn’t spread mold or bacteria.

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