What Milestones Should My One-year-old Toddler Be Passing?

Depending on how old your toddler is, she should be passing certain developmental milestones. As you watch your toddler play, you may see her intensely focusing on what she is doing, and that is because everything she does is an opportunity to learn.

At one-year-old, your toddler will be able to gather and recall some information to find answers to problems she may face when playing. One-year-olds are usually attracted to toys with buttons, levers, switches, and knobs, but your toddler may ignore the toy if she is not quite ready to play with it yet. Once your child turns one, she will begin imitating what she sees everyday and will display this in how she plays. For example, she may “drink” from a cup or “knock” on a door, and therefore it is extremely important to monitor your own behavior because she will most likely imitate it. Your child will initially imitate by herself, but as she develops, she will gradually include others in her imitation play.

As she nears two years old, your toddler will begin to shine at hide-and-seek type games, and will remember where hidden items are even after you hide it from her. Your toddler knows she is in control, and she will let you know what role she wants you to play in her games. She will occasionally bring you a toy so you can play with her, but sometimes she will pull her toys away from you so she can play by herself. When she does something she thinks as special, she will pause and wait for your praise. And giving her this affirmation gives her the encouragement and support she needs to continue learning. If your child is not quite at these stages of development, don’t worry, just talk to your doctor to see what steps you can take to get your child on track.

Measles in the U.S.

By Elizabeth Chea, M.D.

As the number of cases of measles in the U.S. has reached over 100 people, this is the time to make sure that your child is protected. Most of these cases can be traced back to an exposure in Disneyland in December but now 17 states and Mexico have confirmed measles. 

Measles is a very contagious virus that can be passed into the air when an infected person coughs, sneezes, or talks and can be inhaled for up to 2 hours after leaving the infected individual.  Symptoms of measles include fever, cough, runny nose, red eyes, and rash.  If contracted, measles can cause pneumonia, encephalitis, and even death. 

Due to the rise in measles cases, the CDC is now recommending that infants 6 to 11 months old who are in an outbreak area or traveling internationally receive the MMR vaccine.  The CDC recommends that children receive their first MMR vaccine at 12 to 15 months and the second vaccine at 4 to 6 years old.  There are instances when the MMR vaccine should not be administered to include pregnant women, anyone immune compromised, or anyone with a history of an allergic reaction to the MMR vaccine.  Please discuss with your pediatrician any concerns with your child receiving the vaccine. The American Academy of Pediatrics just released a statement to encourage MMR vaccination.

Click on this link to read a letter from the AAP: http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-President-Urges-Parents-to-Vaccinate-Their-Children-Against-Measles.aspx

This is the time to make sure that your child is adequately vaccinated and protected from the disease. Please talk to your CMC pediatrician if you have any questions about measles or vaccines so we can keep your child protected and healthy.

Antibiotics – Are They Necessary?

Help, my kid’s nose is running and it’s green like a Martian!

It’s that time of year again, the time of year when the leaves begin to turn, there is coolness in the air in the mornings, homework begins to pile up and the noses start to produce amazing amounts of mucus!! Fall, back to school, ragweed season, cold and flu season-they all mean the same thing: your child is likely going to be coming home with a stuffy, runny nose.  With all of these things going on, you may feel like you are constantly running to the doctor’s office, and you may become frustrated when you hear, “It’s a virus!”  Antibiotics have become increasingly overused over the past several years. And with this overuse comes increased bacterial resistance. This means that when bacteria do infect, it is more difficult to clear the infection. Therefore, judicious use of antibiotics is necessary! I hope to dispel some myths, to help you to know when you need to make an appointment for your child, and to help you know when you need to let it run its course.
 

Myth 1: If it is green, it needs antibiotics.

Truth-Mucus produced by the cells lining the respiratory tract can be any color at all, ranging from clear to green, and may mean nothing more than the body is fighting off an infection. As our immune system gets the message that an “enemy” has invaded, white blood cells are recruited to the sight of the infection. Their job is to kill viruses or bacteria that are foreign to our body. When that happens, mucus becomes thicker and will often turn yellow or green, especially as it sits around in the nose overnight. THIS DOES NOT MEAN IT IS TIME FOR AN ANTIBIOTIC!!
 

MYTH 2: If there is a fever, an antibiotic is necessary.

TRUTH: Most viruses cause at least a low grade fever during the first several days of the illness. Even colds in babies are often associated with fevers of 101-102 degrees. Many viruses are known to cause fever in the 104-105 range-with no associated bacterial infection. While we would certainly want you to call our office if your baby under 3 months has any fever or if your baby or child has a fever of 104-105, usually these are indicative of a healthy immune system doing its job to fight infection. Whenever a fever lasts more than 5 days or if your child has cold symptoms that seem to be getting better then a fever recurs, we need to see her in the office. Just having a fever at the beginning of an illness, however, does not mean an automatic need for antibiotics.
 

Myth 3: If the cough sounds “wet”, an antibiotic is necessary.

Truth: Most viruses produce wet sounding coughs. As the virus invades the respiratory tract, the normal lining cells are sloughed off. The normal function of these cells, the respiratory cilia, is to clear mucus and debris from our respiratory tract and thereby prevent these from entering the lungs. When these cells are infected with a virus, they do not work properly and therefore, mucus builds up. Our body’s next defense for clearing this mucus is to cough.
 
There are many reasons you may want to bring your child in to be seen for a cold. These may include, among others, ear pain, fever, or perceived shortness of breath. Please know that we are always happy to see your child and would want to anytime you are concerned. We will assess his symptoms and decide whether an antibiotic is necessary. Sometimes knowing that nothing more than your love and care is needed is worth your time to come in! After all, chicken soup is still the best treatment for a cold!
 
Michelle Lynch, MD