Is Snacking Good?

Good news, snacking is good for you….as long as they are healthy snacks! During adolescence, the body needs more nutrients to grow which is why teenagers feel hungry a lot throughout the day. This is why snacks are a great way to satisfy that hunger and give the body the nutrients it needs to grow. Although it may be tempting for every teen to have a soda and candy bar after school, the temporary sugar boost it gives will slow them down in the long run. In order to keep energy levels going and to avoid weight gain, choose snacks that are full of fiber and protein such as peanut butter, fruits, or yogurts. However, you have to beware of claims that snack manufacturers make on their products. Just because something is “all natural” or “pure” does not mean that it is nutritious, such as fruit juices which can be filled with sugar which makes it extremely high in calories. Similarly, watch out for snacks with “low-fat” claims, because usually the fat is replaced with large amounts of sugar which is just as unhealthy. In order to judge how healthy a product is for you, look at the nutrition information on the food label.

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:

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.

Controlling Media Violence Exposures

As parents, we must take action in reducing our children’s exposure to media violence. Not only is this a children’s health issue but, unfortunately, also a public health issue. After a school shooting, politicians will examine gun control, mental health support, and media violence among other areas.  Extensive research has shown that media violence can contribute to aggression and real life violence.


What are some steps we can take as parents?


1.  Remove televisions, Internet, and video games from bedrooms and move them to common areas.

2.  Preview or coview media of concern with our children. Discuss what is inappropriate, why it is inappropriate, and what an alternative would be to the action if there are any exposures.

3.  Review music lyrics prior to purchase for both sexual and violent content.

4.  Limit screen time to no more than 1-2 hours day.

5.  Don’t allow video games with human targets or games in which points are awarded for killing. Kids will understand if you explain to them why these games don’t need to be purchased or played.

6.  Remember that we, as parents, are role models for our children of appropriate media and music use. 

7.  Avoid media in children less than 2 years old- not for violence but to prevent possible language delay.


It is time to take control of our children’s exposure to media violence. Speak up to our politicians. Tell the entertainment industry. There needs to be a more responsible way to portray violence and a simplified rating system to guide parents. We want to prevent any further gun tragedies against children in the future.



Elizabeth Chea MD

Ingestions, Exposures and Other Holiday Hazards

As we enter into the Holiday season, it is important to remember a few things to keep your children healthy.



Unfortunately our favorite times of year to gather together with family members fall right in the middle of the peaks of cold and flu season. This year especially, Type A Influenza is circulating widely in our area. Along with that are many common cold viruses and RSV, a virus which causes wheezing in infants and young children. Most of these viruses are airborne illnesses. With that in mind, there are a few things you can do to increase your child’s chances of staying healthy.

1) Don’t take your baby under 2months old to large family gatherings. Aunt Betty might be fine today but have flu tomorrow and could expose your infant without knowing she is a carrier. Unfortunately, many common, relatively mild illnesses for adults could be devastating for a young infant.

 2) Get a flu vaccine and immunize your child over 6months of age.

 3) If you are not feeling well, STAY HOME!! Epidemics are typically caused by well meaning individuals who feel they must go to work or must go to a social function.



Most parents are very careful about child proofing the house, but around the holidays, chances are your curious little “George” will have the opportunity to explore many houses other than their own.

1) While you can’t be certain that all of your relatives will have safety plugs, you can ask them to make sure they don’t leave medications within reach. Many adults who don’t have young children will put medicine into daily pill dispensers so they will remember to take it. Unfortunately these are not child proof and look like a fun toy with which to play.

2) Household cleaners pose another common risk. While you may have locks on your cabinets or have them put up high, many homes do not have this safety feature unless there are other young children there. Just make sure your child is not given too much free roaming room.

3) Choking is a common cause of injury in young children. While most of us would not give a toy to a baby that is a choking hazard, we will thoughtlessly hang small ornaments well within a baby’s reach. Try to place smaller ornaments high on the tree and put up a barrier around the tree to keep baby away.

4) Burns-most parents think to put a barrier around fireplaces, but many relatives may not. In addition, they may heat with a wood stove or kerosene heater that can be hot to touch and pose a burn risk for your baby or toddler.

5) New foods- Everybody is always anxious to give babies their first bite of food x-Whether it is Grandma’s sweet potato casserole or a taste of Whipped Cream, it could be a risk for an allergic reaction. Many of the holiday foods we enjoy traditionally have nuts. While most people are perfectly fine with that, children under two should not be exposed to nuts due to an increased likelihood of an allergic reaction.  For the child with a known allergy, let your relatives know to please only feed your child what you have prepared or approved.


Other Hazards

When I was a Resident, the ER census always started to increase around 1-2pm on Christmas Day. It seemed as the toys were opened and kids had time to play, accidents began to occur. Make sure if your child gets a new bike or skateboard, that she also gets –AND USES-a helmet and other protective gear like elbow pads. Older children receiving BB guns or other firearms need to be instructed in safety features. They should also be made aware of the importance of protecting younger siblings or cousins who may not be as safety conscious.

The Holiday Season, from Thanksgiving to New Year’s, is a time of celebration and fun. We hope you also make it a safe and healthy time!!


Healthy Holidays!!


Michelle Lynch, MD

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


What to do About Sleep Problems

Sleep is important for both children and parents. With inadequate sleep, children can be moody, fatigued, have inattention, poor school performance, increased daytime sleepiness, or even depression.

In current society, our kids have high homework loads, extensive after school activities and parents with increased work demands. These demands are causing our kids to get to bed later and are adversely affecting our kids. In addition, when our kids get to bed later, so do we.

Sleep requirements vary for different kids but typical requirements are:

  • 11-13 hours a day for toddlers
  • 10-11 hours a night for school age children
  • 9-9.5 hours a night for teenagers

There are ways we can help to facilitate a good night’s sleep. It is important to establish a relaxing bedtime routine and a regular bedtime. Children should sleep in a cool, dark, quiet room. The room should have no distractions or activities. That means no TV, computer, video games, or cell phone. Children should have regular afternoon physical activity but not right before bed. They should have no caffeine after lunch. They should also turn off all video stimulation at 7 o’clock to allow their brain to rest before bed. Teenagers should not have cell phones in their room so they cannot be woken by texts or calls.

If your child takes more than 30 minutes to fall asleep or has trouble staying asleep talk to your child’s pediatrician. Also, if you have noticed loud snoring or trouble breathing at night, they could have a medical problem affecting their sleep so call our office so we can evaluate the sleep problem further.

Elizabeth Chea, MD