Willows Pediatrics Blog - We Know Kids

We Know Kids

The Willows Pediatrics Blog

COVID-19 Vaccine for Under 5 Year Olds

We are thrilled to see that there is finally an option for children 6 months to 5 years to get vaccinated for COVID-19! On Saturday June 18, the CDC and FDA completed their review process and approved 2 vaccines for this age group.

Child getting a vaccine

How do the vaccines from Moderna and Pfizer differ?

The Moderna vaccine is two doses four weeks apart. The Pfizer vaccine is three doses, dose one and two are separated by three weeks and dose two to three need to be eight weeks apart. Both were found to be effective. The clinical trials showed that both vaccines produce adequate antibody responses in children in this age group. Moderna reported approximately 40% efficacy in this age group for preventing symptomatic COVID disease. Pfizer reported 80% efficacy after three doses. Please note that the efficacy for two doses of Pfizer was not good, it is important to get your child the third dose. Also, importantly, Moderna is currently testing an omicron-specific booster for the third dose in this age group, which would be great!

What side effects should I expect from these vaccines?

For both vaccines, the most common side effects for 6 month – 2 year olds were drowsiness and irritability. For 2 year – 4 year olds the most common side effects were pain at the injection site and fatigue. There were no serious side effects reported. There were no cases of myocarditis reported.

My child recently had COVID, when should he or she get the vaccine?

It is absolutely safe for your child to get the COVID vaccine as soon as they finish their isolation period. However, we rarely see repeat infections within a few months of infection so we do know that a recent COVID infection provides pretty good protection for a few months.

Where can we read more about this?

American Academy of Pediatrics: FAQs for Families

Your local epidemiologist: FDA meeting for <5 COVID vaccine: Q&A

Yale: What parents need to know

Where can we get our child vaccinated?

Willows will have limited availability of COVID vaccine clinics for this age group. We cannot rapidly vaccinate all of our patients, we’d love to but we don’t have the staff or space to do that while continuing to do all the summer check ups and sick visits. We encourage you to get your child the vaccine wherever is first available. We will update our website, Instagram and Facebook with more information, when we have it. Here are some local sites offering it:

Griffin Hospital, 10 Progress Drive, Shelton, vaccines for children 6 months and above: Griffin Health COVID Vaccine

CVS is giving vaccines to children 18 months and over: CVS COVID Vaccine

Walgreens is giving vaccines to children 3 years and over: Walgreens COVID Vaccine

Yale will be offering COVID vaccine clinics in the near future: Check here

 

 

Formula Shortage

The nationwide baby formula shortage is not getting any better. Willows Pediatrics hosted a visit from Congressman Jim Himes and News Channel 12 today to discuss this important issue. If you’d like to see News 12 coverage of this event, please click here.

News 12 coverage of baby formula shortage

News 12 coverage of baby formula shortage

A few important points based on questions we often get asked:

Can I switch formula brands?

Yes, if you have a healthy baby on a regular infant formula, then you can use any name or store brand infant formula. All infant formulas sold in the US are FDA approved to have the proper nutrition for normal growth and development. Here is a helpful list of equivalent formulas from North American Society For Pediatric Gastroenterology, Hepatology & Nutrition. This will give you more options when you go to the store.

The exceptions to this are:

– If your baby has a milk protein allergy, then you need to continue to use a hydrolyzed or extensively hydrolyzed formula. Please talk to your pediatrician if you aren’t sure which formula to use.

-If your baby is premature or has complex medical needs, please talk to your pediatrician before changing formulas.

Can I dilute formula?

Absolutely, not! This is not safe. Babies are fragile. They require a delicate balance of water, electrolytes, fat and protein. If you alter this, they can develop seizures.

Can I make my own baby formula?

Please do NOT do this. Baby kidneys are only capable of handling certain concentrations of fluid and electrolytes, making your own formula can harm your baby. Additionally, doing this carries serious risk of contamination, which could cause your baby to get sick.

If you are looking to read more on this, please reference this article from the American Academy of Pediatrics.

Please reach out to us if you have any questions about your baby!

Congressman Himes discussing formula shortage

Congressman Himes discusses baby formula shortage at Willows Pediatrics

 

CT Magazine Top Doctors

We are excited to announce that ALL 6 of our pediatricians have been named to Connecticut Magazine’s annual “Top Doctors List” for 2022!

This is an annual list compiled based on nominations from peer physicians and vetted to meet the criteria to earn Top Doc. The list is created with the national healthcare research firm Castle Connolly. If you’d like to see the entire list, click here.

We take pride in the care we provide and appreciate being recognized.

Formula Recall

FDA headline: FDA warns consumers not to use certain powdered infant formula produced in Abbott Nutrition's Facility in Sturgis, MichiganOn February 17, 2022, the FDA announced that it is investigating concerns about bacterial infections potentially related to Similac, Elecare and Alimentum powdered formulas. At this time, there are 4 cases of infants sickened with Cronobacter sakazakii and Salmonella Newport. This recall only related to powdered formula, not to liquid ready to feed. To read the full FDA announcement, please click here.

The FDA is advising consumers not to use Similac, Alimentum, or EleCare powdered infant formulas if:

  • the first two digits of the code are 22 through 37; and
  • the code on the container contains K8, SH or Z2; and
  • the expiration date is 4-1-2022 (APR 2022) or later

To check if formula you have at home is included in the recall please go to this website, where you can enter the lot number on the can and check if the recall applies.

What should I do if I was using the recalled formula for my infant?

Stop using that lot number and switch to a different infant formula. If you aren’t sure which formula to switch to, take a look at the chart below or contact your pediatrician. Monitor your child for illness, bacteria such as the ones involved in this recall can make children very ill with symptoms including fever, vomiting, diarrhea and lethargy.

What formula should I switch to?

Formula conversions

Willows welcomes two new providers!

We are thrilled to announce that we have added two new team members at Willows! We welcome Amanda Nederlof, APRN (left) Jessica Gonzalez, PA-C (right) to our team! Both are pediatric professionals with years of pediatric experience in Fairfield County before joining our practice.

As a Physician Assistant (PA) and Advance Practice Registered Nurses (APRN) both Jessica and Amanda are skilled professionals, qualified with academic and practical experience to provide complete medical care for infants, children, and adolescents.

Both Jessica and Amanda have a wealth of experience diagnosing and treating common and uncommon medical problems, responding to emergencies, and advising and communicating with families. When you see Jessica or Amanda with your child, you are in the care of an outstanding clinician who can either be your child’s primary medical provider or work with your physician. The physicians at Willows, together with our PAs, and APRN work together to ensure that we have flexible scheduling and can be responsive to urgent care and after-hours needs.

Amanda Nederlof, APRN’s Biography

Ever since I can remember I have wanted to work in pediatrics. Combining my love for education and childhood development, a career in pediatric medicine was an easy decision for me. After moving back home (Wellesley, MA) after college at Muhlenberg and working as a research assistant at Partners Healthcare (now Mass General Brigham), I was inspired to pursue a career in the field of nursing. I completed my training with a Master’s Program in Nursing in Pediatrics at the Yale University School of Nursing. This training allowed me to be exposed to many different settings where children receive health care. This included a Ear, Nose, and Throat specialty office, school-based and community health centers, and private practice pediatrics. After graduating, I worked in a pediatric office in Connecticut for a number of years, where I truly enjoyed watching my patients grow. As a new mother, I understand the anxiety that comes with being a parent. My goal is to provide patient centered care, where I make certain that I take into consideration both the patient and their family when I walk in a room. My aim is to make each visit with your family fun, interactive, and educational while providing the most up-to-date and evidence-based care possible. Click here to read Amanda’s full bio.

Jessica Gonzalez, PA’s Biography

As soon as I was accepted to Physician Assistant school, I knew that I wanted to work in pediatrics. I attended Hofstra University PA program in New York State. I was fortunate to do an extra elective rotation at a Children’s Hospital, which solidified my passion for pediatrics. When I graduated, I started work at Norwalk Hospital/CCMC, where I spent four years working in pediatric inpatient medicine, the neonatal ICU (NICU), and in the well-baby newborn nursery. I genuinely loved going to work every day.

When my daughter was born, I transitioned to outpatient pediatrics, which is what I have been doing for the past three years. I love working with all ages, from newborns to young adults. I have a special interest in pediatric asthma and teach pediatric clinical medicine at the University of Bridgeport PA program. I am so excited to be able to become a part of the Willows Pediatrics Family, and can’t wait to get to know all of the Willows families! Click here to read Jessica’s full bio.

 

Pacifier Recall

This week a recall on pacifiers was announced:

From CNN:

More than 333,000 silicone pacifiers available for purchase on Amazon have been voluntarily recalled by the distributor due to reports that the nipple can detach and cause a chocking hazard for infants.

The recalled pacifiers, made by Frigg in Denmark, come in two types: The “Classic” version has a silicone nipple attached to a round plastic shield; in a version called “Daisy,” the nipple is attached to a round, scalloped plastic shield. Each design comes in 40 colors and two sizes, 0 to 6 months and 6 to 18 months. Each pacifier has the name “Frigg” in raised letters on the handle of the pacifier shield.

A few thoughts:

– We prefer pacifiers that are one solid piece for this exact reason.

– If your child’s pacifier shows signs of wear or damage, please replace it immediately.

 

photo from CNN

Covid-19: Update

Who is eligible for a Covid-19 vaccine booster?

There have been some changes to COVID vaccine & booster eligibility guidelines.

  1. Booster eligibility now begins 5 months after your primary series for Pfizer and Moderna.
  2. 12-15 year olds are now eligible for boosters with Pfizer, 5 months after they complete the primary series.
  3. Anyone who received J&J for the primary vaccine, is eligible for a booster of any vaccine 2 months after the primary shot.

I just had COVID, when can I get my vaccine?

You can get your primary COVID vaccine or your booster as soon as you have met the criteria to leave isolation: 5 days, fever free for 24 hours and symptoms improved.

My child tested positive for COVID, what do I do?

First of all, don’t panic! For the vast majority of children, COVID is a mild illness. Just monitor and manage symptoms as they come.

There have also been some changes to isolation recommendations.

If You Test Positive for COVID-19: Everyone, regardless of vaccination status.

  • Stay home for 5 days. If your child cannot wear a mask, then they should stay home for 10 days.
  • If you have no symptoms or your symptoms are resolving after 5 days, you can leave your house.
  • Continue to wear a mask (ideally a good mask such as N95, KN95- since you are likely still contagious) around others for 5 additional days. Again, if your child cannot wear a mask, then 10 days of isolation.

If you have any symptoms, continue to stay home until your symptoms resolve.

My child was exposed to COVID, what do I do?

Again, don’t panic!

If they: have been boosted or completed the primary series of a vaccine and are not due for a booster yet:

  • Wear a mask around others for 10 days.
  • Test on day 5, if possible.
  • If you develop symptoms get a test and stay home.

If they: are overdue for a booster or unvaccinated or too young to be eligible for a vaccine

  • Stay home for 5 days. After that continue to wear a mask around others for 5 additional days. If your child cannot wear a mask, then they should isolate for 10 days.
  • Test on day 5 if possible.
  • If you develop symptoms get a test and stay home.

Overarching guidelines– stay home if sick, wear a (high-quality) mask, and get tested if possible

Should I trust a Covid rapid test?

We have become increasingly aware that rapid tests have some limitations. The rapid tests may provide false negatives with Omicron, early in the course of illness, and in asymptomatic people. This is because rapid tests are less sensitive.

What do we mean by sensitive? Sensitivity statistically means the likelihood that the test will give you a positive result when you actually have the disease. If a test has a lot of false negatives, then the sensitivity is low. For example, what do we see if we test 10 patients in the office with a rapid test, some asymptomatic but exposed, some with 1 day of mild symptoms, some with 3 days of symptoms and then also do a PCR these patients and compare the results? Anecdotally, we will get a few negative results on the rapid test that then come back positive on the PCR (when we get the PCR back 2-4 days later).

What does this mean practically?

If you are symptomatic and your rapid test ends up being positive, you have COVID. If your test is negative, we don’t know if you have COVID or not based on the rapid alone, although most likely you have a non-COVID illness or virus. In these cases, parents can go back to things we know are effective – getting children vaccinated, stay home if sick, and wear a high-quality mask.

What type of mask is best?

The Omicron variant is more contagious than prior variants. Consider using a more effective mask while we have such a high community caseload. Consider an effective mask particularly when you are in crowded settings, if it is not possible to maintain distance, or if you are indoors for long periods of time.

In order of increasing protection: least protective are cloth masks, then surgical masks then KN95s, KF94s and N95s.

When can my child return to sports after a COVID infection?

After a COVID infection, there is a very small risk of myocarditis, which is inflammation of the heart muscle. Children who play organized sports are required to get a clearance from their physician to return to playing sports. Please make an appointment with us when your child has completed their required isolation time (5 days and symptoms improved including fever resolved for 72 hours). Younger children are at lower risk since their sports are less competitive, and they are allowed to simply self-regulate their activity. If your child had mild symptoms: minimal fever, no severe cough or shortness of breath and total COVID symptoms for less than a week, then the risk of myocarditis is very low, so don’t worry! If at any point, your child develops: chest pain, shortness of breath, new heart palpitations, or near-fainting/fainting, stop exercise and call us.

Other FAQs:

My family recently all had COVID, do we still need to be careful?

Most likely you have a few months of protection from COVID. That is unless a new variant comes around in the meantime. However, we urge caution; don’t forget about the other viral illnesses that are around in the winter. If you have an infant, an immunocompromised family member, or a child with asthma then consider that RSV, influenza, and other viruses are also circulating, so please don’t throw all caution to the wind!

I completed my 5 day isolation after COVID, can I go see my kids now? How do I know if I am still contagious?

The short answer is, you could be still contagious on Day 6. Some people use a rapid test as a proxy for contagiousness, but there is no solid evidence for this. We recommend wearing a high quality mask (KN95, KF94, N95) for days 5-10 of your isolation when around others.

I completed my 5-day isolation but I still feel really awful with ongoing symptoms. What should I do?

Please stay home. You are still sick and need to continue to isolate.

What are you seeing clinically in children who have COVID?

Common symptoms in young children with Omicron have been fever, a croupy (barky) cough, sometimes diarrhea and vomiting. In older children, school-aged kids, we often hear about a headache, sore throat, body aches, and occasional vomiting. We are also seeing some influenza cases; these patients often have fever, vomiting, and body aches. This is not an exhaustive list of symptoms, just our general perspective in the office.

Please do not hesitate to call your doctor, PA, or nurse if you have any questions!

Fall Highlights 2021

We wanted to share some of the activities taking place at Willows and surrounding towns. The physicians, PAs and nurses at Willows are on the go supporting our patients and keeping them healthy!

Covid-19 Vaccine Clinic For Children 5-11 Years At Willows

Dr. Allison - Pfizer Covid19 Vaccine at Willows Pediatrics

We are excited to announce our Pfizer COVID-19 vaccines have shipped!

We will be holding vaccination clinics for dose 1 and 2 on the following evenings from 5:30 pm – 7:30 pm.

The choices are:

Dose 1: Tuesday Nov 16 AND Dose 2: Tuesday Dec 7

Dose 1: Thursday Nov 18 AND Dose 2: Thursday Dec 9 

Please call our office to schedule both dose 1 and dose 2 appointments. Also, please note to ensure all patients receive both doses, we cannot accommodate families who only want their child to receive one Covid-19 vaccine dose at our office.

Please print this Covid-19 vaccine administration form to complete and bring with you for each child. Forms will be available at our office for families who are unable to print the form out ahead of time.

Children must be observed for 15 minutes in our office after receiving the vaccine. We are happy to answer any questions, please don’t hesitate to call us!

 

Covid-19 Vaccine for Children 5-11 Years at Willows

We are thrilled the Pfizer Covid-19 vaccine has been approved for children ages 5-11 years. We are also aware that many families have been anticipating this and want to vaccinate their children as soon as possible.

We look forward to administering the Covid-19 vaccine to our patients ages 5 through 11 years in our office. Unfortunately, we do not have an expected ship date yet from the State of Connecticut. As soon as we are confirmed on when the vaccine will arrive at our office, we will post dates for vaccine clinics at Willows.

There are also other opportunities to get the vaccine locally, including local pharmacies and hospital sponsored clinics. You can locate other sites giving the Covid-19 vaccine to children ages 5-11 though the CT Vaccine portal.

Our advice at this time is to get the vaccine at your first available opportunity wherever you and your child are comfortable.

Please do not hesitate to call your doctor, PA, or nurse if you have any questions!

Helpful Link: The CT Vaccine Portal

https://portal.ct.gov/vaccine-portal?language=en_US

Covid19 update from Willows Pediatrics - 5 to 11 year olds