Daylight Saving Time ending! Helping kids adjust to the upcoming time change so they don't start waking up at 5am.

 My favorite sleep expert, Dr Craig Canapari of the Yale Pediatric Sleep Center, has a great article on this. 

"Falling Back"

 Affected by the infant formula shortage or just wondering about the differences in brands?  

Substitute formula recommendations during the shortage

Everything you wanted to know about choosing a baby formula

Looks like we should all be getting blackout curtains...

 Small but fascinating study suggesting that even low levels of light when we are sleeping can activate our sympathetic ("fight-or-flight") nervous system and adversely affect our blood sugar regulation and cardiac health.  

Original article in Proceedings of National Academy of Sciences

And the NPR summary

COVID vaccines now recommended by CDC for ages 12 & up

 Today's announcement from the LACDPH:

Starting tomorrow, Los Angeles County vaccination providers may begin offering the Pfizer vaccine for 12 to 15-year-olds at vaccination sites that offer the Pfizer vaccine. All eight county run sites will be open tomorrow and able to vaccinate children 12-17; teens should be accompanied by a parent, guardian or responsible adult, and present a photo ID and verification of age.  For a full list of sites across the county offering Pfizer vaccines, please visit http://bit.ly/PfizerSites . To schedule an appointment, visit www.VaccinateLACounty.com beginning this evening; walk-ins are welcome at all 8 county-run sites.  Parents or teens with questions about the vaccine should contact their healthcare provider or visit the Public Health website for more information on vaccine safety and efficacy.

From the American Academy of Pediatrics:

Safety

Pfizer and CDC officials reviewed data on safety and efficacy of the vaccine during Wednesday’s ACIP meeting. Pfizer and BioNTech conducted trials in more than 2,000 adolescents ages 12-15 with half randomized to receive the vaccine and half to receive a placebo.

The most common side effects in adolescents were pain at the injection site, fatigue, headache, chills, muscle pain, fever and joint pain, consistent with trials in older teens and adults.

About 6% of vaccine recipients experienced an adverse event, including seven cases of swollen lymph nodes. There were five serious adverse events in the vaccine group (0.4%) including one person with abdominal pain, constipation and neuralgia and others with depression, anxiety and suicidal ideation. None of the serious events were determined to be related to the vaccine and no deaths were reported. There also were no reports of blood clots, serious allergic reactions or Bell’s palsy.

Efficacy

Vaccine efficacy for this age group was 100%. Among just over 1,000 vaccine recipients, there were no cases of COVID-19, while 16 were reported among more than 970 placebo recipients. An immunogenicity analysis in 190 participants also showed their response was even better than the response for those ages 16-25 years.

I do recommend vaccinating kids 12-17. I think this Washington Post piece summarized the data well:

https://www.washingtonpost.com/opinions/2021/03/24/case-vaccinating-children-covid-19/

I am sorry that I am unable to offer the vaccine in my office yet.  Pfizer's vaccine requires a special, ultra-cold freezer and also only comes in shipments of 1200 doses.  Both of these are expected to change in the coming months. My website will be updated with all news. 

Stop the ice for sore muscles?

It is important to me that the advice we give as doctors is based on evidence, but sometimes when we don't have that, we rely on tradition.  I am glad when "the way we've always done it" is given a fresh look.  In this article, the author discusses new studies that suggest that the common practice of applying ice after muscle injuries may do more harm than good...

No ice for sore muscles?

Is coronavirus still a big deal? YES.

Just because we are tired of this doesn't mean it is going away. The virus doesn't care how we feel about it.

I continue to get calls EVERY DAY from families in my practice who have been exposed to or caught coronavirus.  Some family members have become seriously ill,  fortunately none of them children.  As studies have shown, symptoms in kids range from nothing at all to mild congestion and runny nose, or low-grade fever, to high fevers, coughing, vomiting, and loss of taste or smell.  So potentially any sign of illness could be coronavirus.  Please continue to wear masks and socially distance to prevent spread and stay home for 10 days if your child has any sign of illness.  1500 people died from the flu in L.A. County in all of 2019, but 5381 people have died from COVID in L.A. County as of today, only 6 months after it started. See publichealth.lacounty.gov/media/Coronavirus/data/index.htm

Back-to-school time

Because kids themselves (and people under 40 with no risk factors) are at low risk of serious illness (death rate about 0.1%), many kids may be able to return to school under careful protocols.  Each family has to consider their individual situation and risk to family members, however.  Every exposure to another person increases risk and many families have made the decision to keep their kids at home.  For those who are sending their kids to school and daycare I am concerned about exposure to grandparents, whose risk is much higher.  The risk  in people over 60 was 10% and over 75 20-30%.  Fatalities currently are going down in Los Angeles, but this is partially because there are fewer cases among the elderly, where nursing homes were hit hard at the beginning, and more among younger people, who are more likely to have mild cases. 

For more information here is a SUPER HELPFUL website!

explaincovid.org

Stay safe!

Updates from our office!

It is very quiet now in the office so we can open up to more well visits.  We are now seeing 0-4 year olds and 11 year olds for checkups. In addition, any child who is overdue for a vaccine may have a nurse-only visit at any time. Please call for an appointment. 

For everyone's safety:

We have only one patient in the office at a time.

Morning and early afternoons are reserved for well visits only.

Only one parent may attend and no siblings.

There is no check-in; you can go straight to your room upon arrival.

Only the minimum in-office is done: Maggie does the measurements and screenings and Dr. Schramm's exam, then shots.

In the afternoon a separate 15-minute video chat from home with Dr. Schramm gives you plenty of time for discussion and questions.  You can download the sprucecare app on your phone from the top of my website.

We all wear masks and we ask that you and your child do too (if they are 2 or older.) Dr. Schramm is in full PPE + n95 for every visit, but kids don't seem to mind.

We thoroughly clean & sanitize after every patient. Donations of Lysol or other EPA-registered disinfectants are gratefully accepted.

If it stays quiet, we should be able to add other ages.  

Hope to see you soon!