Measles Outbreak and Vaccination Information

NOTE: People exposed to measles who have not been vaccinated almost always get measles

Measles is one of the most contagious diseases known. It is a virus that mainly spreads by direct contact with airborne respiratory droplets. For example, if someone who is contagious coughs or sneezes near someone who is susceptible, the susceptible person is very likely to get measles. You can catch measles just by being in a room where a person with measles has been—even if the person is gone!

SYMPTOMS

The symptoms of measles generally appear about seven to 14 days after a person is infected.

Measles typically begins with:

       high fever

       cough

       runny nose

       red, watery eyes

Two or three days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth.

Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may spike to more than 104° Fahrenheit.

After a few days, the fever subsides and the rash fades.

All reputable studies have found no link between MMR vaccine and autism.

Sellwood is our home and a wonderful place to grow up. To protect our children and our neighbors children we are advising that ALL our age appropriate patients  (One year and up) receive a dose of MMR, and we are recommending a second dose for those over the age of 4 years unless unable to do so due to medical concerns.


Enjoying Our Sunny Days Safely

Healthy Family Tips from Dr. Meyrowitz

Summer in Oregon may be a fading memory, but the sun can burn in fall and winter, too. Whether they're outside skiing, doing yard work, or playing soccer, we want to make sure your children are protected with sunscreen. The most recent guidelines released by the FDA recommend using broad spectrum sunscreen with a sun protection factor (SPF) between 15-50 for children greater than six months of age. Sunblock should be applied 30 minutes before sun exposure and at least every two hours thereafter. There is no such thing as waterproof sunscreen, therefore sunscreen should be reapplied every 40-80 minutes if swimming. In addition, more frequent application is needed when also wearing bug spray.

When choosing a sunblock for your child, we recommend either zinc oxide or titanium dioxide based products. These compounds block against both UVB and UVA radiation, both of which are harmful for our skin. In addition, these ingredients are minimally absorbed across the skin barrier and are less likely to cause irritation for children with sensitive skin. Further, we recommend avoiding sunblocks containing oxybenzone, which is more likely to cause adverse skin reactions.

Here are some sunscreen brands we recommend:

All Terrain

Badger

Burt’s Bees

CeraVe

TruKid

Cotz

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Probiotics: The cure for infant colic?

Healthy Family Tips from Dr. Meyrowitz

Only when I became a parent did I realize how frustrating it can be to hear the words, “it will go away with time." Yet this is exactly what families are most often told regarding their colicky infant.

Infantile colic is generally defined as excessive crying in an otherwise healthy baby lasting more than three hours per day, occurring more than three days in any week for a three week period, between the ages of two weeks and four months. And, while colic does typically resolve by four months of age, this can seem like an eternity to a family with a fussy infant. 

So, what can you do to help your colicky infant? While many treatment techniques have been suggested, the most consistently successful intervention has remained the “5 S's” approach introduced by pediatrician Harvey Karp, author of “Happiest Baby on the Block”:

1.  Safe swaddling: Avoid overheating, covering the head and use of loose or bulky blankets, and allow for the hips to be flexed.

2.  Side or stomach: To soothe a crying baby, the sidelying position or placing the baby on his/her stomach can provide relief and comfort. Remember, however, the back is recommended as the safest position for sleep.

3.  Shhh’ing: A strong shhh’ing sound is used to emulate the baby’s environment while in the womb.

4.  Swaying: Tiny jiggling movements while supporting the head and neck can be soothing.

5.  Sucking: Feeding at the breast or sucking on a clean finger or pacifier can also provide relief.

Depending on the irritability of your infant, you can try one or all of these steps.

While the underlying cause of infantile colic has yet to be determined, recent interest has focused on microbiota (the bugs that hang out in our intestine). Thus far, probiotics have shown promising effects in the treatment of colic, potentially by favorably shifting an infant’s microbiome. In one review, the use of probiotics (Lactobacillus reuteri) showed a decrease in crying time by seven days into therapy and was sustained at three weeks follow up, compared to either simethicone (an over-the-counter medication directed at decreasing gas) or placebo1. Further, an almost one-hour reduction in crying time was reported in those taking probiotics. Another study released in March of this year showed that the daily use of Lactobacillus reuteri in infants from birth to three months of age decreased the overall crying time by nearly half. Infants in this study also experienced decreased episodes of regurgitation and were less likely to suffer from functional constipation. 

While probiotics have yet to provide consistent results for reducing crying time in colicky infants, mounting evidence is showing probiotics to be a safe and beneficial option in decreasing infant crying time. And yes, without any treatment, colic will fade with time. But, if a little probiotics a day can keep the crying away, I say, “why not?” 

For more information about infant colic and its potential treatments, please ask your provider.

1.     Sung, V et al. Probiotics to Prevent or Treat Excessive Infant Crying: Systematic Review and Meta-analysisJAMA Pediatr, 2013; 167(12):1150-1157.

2.     Indrio, F et al. Prophylactic Use of a Probiotic in the Prevention of Colic, Regurgitation and Functional Constipation: A Randomized Clinical Trial.  JAMA Pediatr. 2014; 168(3):228-233.