Day Night Reversal in Babies

happy-babyNewborns can sleep up to 20 hours a day, but most of them are born wanting to sleep more during the day. Who can blame them when an active mom rocked them to sleep with the her busy days? Once baby is born, who doesn’t want to come and hold the baby? Getting put down to sleep is like losing your seat warmer!

To help baby make the transition to a diurnal mammal, keep daytime bright and nighttime dim. Give your baby tummy time during the day to develop a strong back, neck and arms, but never let your baby sleep unattended on the tummy. Read more about day-night reversal from the AAP here.

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Essential Oils for Kids?

purple hyacinth in bloom

Photo by Peter Fazekas on

The short answer is well controlled studies do not show the benefits that many of these products claim. It’s important to know that the FDA doesn’t regulate over the counter supplements and herbs, and that they are allowed to claim health benefits as long as the seller doesn’t claim they treat disease. So you can see claims like “supports a healthy immune system.”

There’s a comprehensive article about essential oil in pediatrics here.

Pleasant scents like lavender may make you feel more relaxed. And the placebo effect is high–a third of people report improvement to many sugar pills and even sham surgery. An excellent book on complementary medicine is Snake Oil Science by R. Barker Bausell.

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Children Testing Positive for Marijuana


 A study in the December 2018 Pediatrics found that nearly half of hospitalized children in Colorado whose parents enrolled in a smoking cessation program tested positive for marijuana exposure. Authors of the study, “Marijuana and Tobacco Co-Exposure in Hospitalized Children” (published online Nov. 19), said findings suggest prevalent co-use of tobacco and marijuana in the state that could expose children to harmful effects of both. The research involved a secondary analysis of data and samples collected as part of a study to test the effectiveness of a tobacco smoking cessation program offered to parents.  All families were recruited after recreational marijuana use became legal in Colorado.  Parents in the study reported being current tobacco cigarette smokers, and some also reported using marijuana.  Among those who used both there was significantly variability- some primarily used tobacco with occasional marijuana use, while others reported more marijuana and less tobacco use.

Testing the participating children’s urine, the researchers discovered that 46 percent of them had detectable levels of the marijuana metabolite tetrahydrocannabinol carboxylic acid (COOH-THC). In addition, 11 percent of children had detectable levels of tetrahydrocannabinol (THC), which is used to test for active marijuana use, and suggests a higher level of exposure.

While 3 of the 9 study participants who tested positive for THC were adolescents, and potentially marijuana users themselves, 6 of the THC-positive children were ages 7 and under–most with parents who reported marijuana use “some” or “every day.” Study authors said they were not surprised that children with detectable levels of COOH-THC were more likely to have parents who reported smoking marijuana daily in the home, and in a different room if their child was there rather than outside.

They pointed out that tobacco smoke and marijuana smoke contain similar harmful chemicals, and smoking in the home–even in a different room–can result in significant exposures to children. Parents and caregivers should be encouraged to avoid smoking tobacco, marijuana, or both in the home, they said, to help reduce exposure to infants and children living there.

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Welcome Dr. Naho Taguchi

NahoTaguchiNaho Taguchi, MD will be working in the office to increase availability of afternoon appointments.

Dr. Naho Taguchi was born and raised in Tokyo, Japan and came to the US where she earned her B.A. at Vassar College. She went on to study Medicine at St George’s University School of Medicine in Grenada and did her Pediatric Residency at SUNY Downstate University Hospital in Brooklyn, NY. Dr. Taguchi spent a year as a chief resident in the pediatric department at Lenox Hill Hospital in Manhattan, NY. She joined a private practice in Brooklyn for 3 years and then moved to Orange County, CA where she was working in the pediatric urgent care at St Joseph’s medical group for 6 years. Dr. Taguchi and her family moved to San Francisco 2 years ago and she worked for Golden Gate Pediatrics until her recently move to Piedmont. She is excited to meet new people and learn more about the East Bay. She enjoys yoga, snowboarding, and traveling with her family in her spare time.

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Wild Fire Smoke and Kids


Do NOT rely on masks to filter contaminants, since masks do not work when not fitted correctly. Smaller sized masks may appear to fit a child’s face, but no manufacturers recommend their use for children. If your children are in an area with bad air quality, take them to an indoor environment with cleaner air, rather than give them a mask. Humidifiers or breathing through a wet washcloth do not prevent breathing in smoke.



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Antibiotics and Sick Kids


It’s the most wonderful time of the year, but the kids are more likely to be sick.

Some of the reasons why children are sicker from October through March include:

Close contact with classmates.

More indoor time with shorter days that increases the chance of coming in contact with someone sick.

Dry, heated air keeps viruses airborne longer.

Whatever the cause–here are some excellent links about sick kids from the American Academy of Pediatrics.

Antibiotic Prescriptions for Children: 10 Common Questions Answered

10 Common Childhood Illnesses and Their Treatments 

Why Most Sore Throats, Coughs & Runny Noses Don’t Need Antibiotics

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Traveling Abroad for the Holidays?

ChristmasTeddy.2017The Centers for Disease control has ways to enjoy your stay here.

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Tetanus: Wounds and Shots

TetanusBlogPostI like to walk my dogs at the Bulb in Albany.

If you’ve never been to the Bulb, it’s a former landfill on the San Francisco Bay that’s making the transition to natural, open space.

It’s also a tetanus-prone wound paradise, as you can see from the rusted fitting on this old telephone pole.

Tetanus shots are good for 10 years, however, if you get an injury that’s penetrating, dirty or contaminated, you should get a tetanus shot if it’s been more than 5 years since your last one.

Children get immunized against tetanus at 2, 4 and 6 months. There is a booster for toddlers and kindergarten and again at age 10-11 years old. That’s the Tdap required for 7th grade. I immunize high school seniors so they are protected for wherever life takes them after graduation. After that, tetanus shots are every 10 years.

The technical Guidelines for the management of tetanus-prone wounds is here.

If you think you might be due for a tetanus shot, call the office.

Enjoy your rambling!

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Raising Safe Drivers

Have a rising teen or young adult driver?

Car safety tips for parents as here.

Teen driving agreement is here.

More from the American Academy of Pediatrics:

The Teen Driver


​Teen driving fatalities appear to be on the rise after years of decline, prompting the American Academy of Pediatrics (AAP) to update recommendations for physicians and parents to address risks that include inexperience, speed and distracted driving.

Despite a nearly 50-percent reduction in crash-related teen deaths over the last decade, teen drivers are more likely to be involved in a motor vehicle crash that causes injury or death than any other age group in the United States. Data from 2014-2016 showed an increase in teen driving deaths and crash-related injuries that suggest a need for renewed attention.

In its policy statement, “The Teen Driver,” the AAP observes that while vehicle safety advances, graduated licensing laws, improvements in seat belt use and impaired driving enforcement have helped lower the fatality rate over the long term, much work needs to be done to make driving safer for adolescents and the community.

The policy statement will be published in the October 2018 issue of Pediatrics (published online Sept. 24), and reflect new research on the risks faced by teen drivers. The previous AAP policy statement on teen driving was published in 2006.

“We all know how easy it is to become distracted while driving, particularly in the age of texting and technology,” said Elizabeth M. Alderman, MD, FAAP, FSAHM, member of the AAP Committee on Adolescence and a lead author of the statement. “Parents can set a powerful example with their own driving habits, from using a seatbelt regularly to avoiding cell phone use or speeding.”

In 2015, 1,886 young drivers died in motor vehicle crashes, an increase of 9 percent from 2014. Another 195,000 teen drivers were injured in vehicle crashes in 2015, up 14 percent from the prior year.

Teen drivers with fewer than 18 months of driving experience have four times the risk of a crash or near-crash event, with risk factors that include inexperience, speed, teen passengers, distraction and use of alcohol, drugs or medication.

The crash risks increase for teen drivers who transport young passengers. More than half of children age 8 to 17 who die in vehicle crashes are killed as passengers of drivers younger than age 20.

“Every state has some form of graduated driver’s licensing regulations, which have helped improve safety by limiting the number of passengers or restricting night-time driving, for instance,” said Brian D. Johnston, MD, MPH, FAAP, a lead author of the report and member of the Council on Injury, Violence, and Poison Prevention. “Yet more can be done. One step that could make a difference is for communities to more consistently enforce laws on seat belts and use of cell phones while driving.”

AAP recommends that pediatricians:

  • Counsel teens on seat belt use and the risks of driving while impaired by alcohol, illicit substances and medication.
  • Encourage parents to practice driving with their teenagers in a variety of environments and for more than the state-required minimum of hours.
  • Promote the use of safe alternative routes to school to lessen driving time.
  • Support later school start times to ensure teens have adequate sleep.
  • Study whether the graduated driver’s licensing provisions should be expanded to include novice drivers who are 18 or 19 years old.

The policy statement also notes that adolescents with medical concerns such as attention-deficit/hyperactivity disorder, concussions or sleep apnea may be at higher risk if their driving ability is affected.

“For many teenagers, driving is an important rite of passage,” Dr. Alderman said. “We want to help them navigate this new privilege safely. Families can ask their pediatrician to share in a conversation with their new driver to set expectations and decrease risks.”



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