How Breathing Secondhand Smoke Seriously Damages Your Child’s Health

Westchester Health Blog - Thu, 07/20/2017 - 23:57

Most people know that smoking is seriously harmful to their health, potentially even deadly. But what they often overlook are the dangers of secondhand smoke. Here at Westchester Health, what we find especially troubling is the fact that secondhand smoke is especially harmful to children, explains Rodd Stein, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, in a recent blog.

Millions of children breathe in secondhand smoke from their parents

Rodd Stein, MD

If you smoke around your children, or if they are continually exposed to secondhand smoke from other people or environments, their health, especially their still-developing lungs, are in danger. Even if you only smoke outside, your children are still exposed to the harmful chemicals found in secondhand smoke. The best way to eliminate this health danger? Quit smoking, as soon as possible.

Secondhand smoke is what a smoker breathes out after inhaling a cigarette, cigar, pipe or other smoking device

This inhaled/exhaled smoke typically contains around 4,000 chemicals, many of which are known to cause cancer. When children breathe in this secondhand smoke, they are exposed to these chemicals. Also, there are harmful toxins that remain on materials where people have smoked, such as car seat upholstery or even a child’s hair, these are also harmful.

How secondhand smoke hurts your baby

If you smoke while pregnant, you are exposing your unborn baby to the harmful chemicals contained in tobacco smoke. This can lead to many serious health problems, including:

  • Miscarriage
  • Premature birth
  • Low birth weight (possibly resulting in a less healthy baby)
  • Sudden infant death syndrome (SIDS)
  • Learning problems and attention-deficit/hyperactivity disorder (ADHD)

These health risks increase the more you smoke. Quitting anytime during pregnancy helps—the sooner the better.

How secondhand smoke hurts your children
  • Children who breathe in secondhand smoke have a higher risk of serious health problems, and existing health problems may become worse.
  • They typically have more:
    • Ear infections
    • Coughs and colds
    • Respiratory problems, such as bronchitis and pneumonia
    • Tooth decay
  • Children of smokers cough and wheeze more and have a harder time getting over colds.
  • They miss many more school days than those of non-smokers.
  • Secondhand smoke causes many other issues, including stuffy nose, headache, sore throat, eye irritation and hoarseness.
  • Children with asthma are especially sensitive to secondhand smoke. It may cause more and more severe asthma attacks, requiring trips to the hospital.
The long-term effects of secondhand smoke on children’s health

Kids who grow up with parents who smoke are themselves more likely to smoke. Furthermore, children who smoke are themselves affected by the same health problems that affect adults, including:

  • Lung cancer
  • Heart disease
  • Cataracts
  • Poor circulation
  • COPD
  • Vascular disease
If you smoke, one of the most important things you can do for your own health and the health of your children is to stop.

Quitting smoking is the best way to prevent your children from being exposed to secondhand smoke and safeguard their health. it’s also the best thing you can do for your own health. To help you on this journey, there are many OTC and prescription medicines that can help you quit. Also, every state has a QuitLine. Call 1-800-QUIT-NOW to be connected to the one in your area and for local resources to help you quit.

Additional information and resources: Concerned that your children are being exposed to secondhand smoke? Come see us.

If you smoke and are trying to quit, and are worried about how your smoking might be affecting your children’s health, please come in and see one of our Westchester Health pediatricians. Together, we’ll figure out the best way forward for everyone, and if needed, help you get help to stop smoking. Whenever, wherever you need us, we’re here for you.

To read Dr. Stein’s blog in full, click here.

Categories: Blog

Is It a Cold or Sinus Infection? How To Tell.

Westchester Health Blog - Mon, 07/17/2017 - 11:54

Even though we’re in the middle of summer, here at Westchester Health we still see a fair amount of colds and sinus infections (sinusitis). Patients come in sneezing and coughing with watery eyes and a stuffy nose, and want to know: is it a cold or a sinus infection? Our answer: the type of symptoms and long they last give us clues as to whether it’s a virus (cold) or an infection.

If it’s a cold

If what you have is a “common cold,” most of the time it will get better on its own. Typically, you’ll have a runny nose for 2-3 days, followed by a stuffy nose for 2-3 days. After that, most people begin to feel better. However, that’s little comfort when you’re suffering from the following symptoms and feeling pretty lousy:

  • Sore throat

    David T. Ennis, MD

  • Cough
  • Headache
  • Stuffy nose
  • Mucus buildup
  • Sneezing
  • Fatigue
  • Swollen sinuses
  • Fever (usually low-grade in adults but higher in children)
3 best ways to treat a cold
  1. Because a cold is a virus, antibiotics won’t help. But over-the-counter medications may make you feel better. Choose ones that target your specific symptoms, i.e., headache, cough, congestion and/or fever.
  2. Rest is still the best remedy but for many people, that’s hard. They don’t want to miss work, plus they may have a hard time sleeping because they can’t breathe through their nose.
  3. Sinus irrigation. A neti pot filled with a mix of distilled water and salt will help thin the mucus and flush out the sinuses. Studies show that people who irrigate when they have a cold usually feel better and get over it quicker.
If it’s a sinus infection

When your nasal passages become infected, that’s not a cold, that’s a sinus infection, which is harder to get over. Viruses, bacteria or even allergies can lead to sinus infections which will hang around for 7 days or more. Sinus infections are sometimes accompanied by a low-grade fever, while colds typically are not. Also, colds generally produce clear mucus, while bacterial infections tend to produce greenish or yellow mucus.

Colds do not usually cause sinus infections but they do offer a breeding ground for them. You touch your nose a lot when you’re sick, and each time you do this, you bring more bacteria to the sinuses. Because your sinuses can’t drain, the bacteria stay there and grow. So yes, a cold can lead to a sinus infection.

Look for the following symptoms:
  • Sinus pressure behind the eyes and cheeks
  • A runny, stuffy nose that lasts more than a week
  • A headache that gets worse
  • Fever
  • Cough
  • Bad breath
  • Thick yellow or green mucus draining from your nose or down the back of your throat (postnasal drip)
  • Fatigue
  • Decreased sense of smell
3 best ways to treat a sinus infection

If you think you may have a sinus infection, see your doctor right away because you most likely need antibiotics, and the sooner you start, the sooner you’ll feel better.

Sinus irrigation is also recommended for sinus infections as well for colds. It can help ease your symptoms while you wait for the antibiotics to start working. Steroids, decongestants and over-the-counter mucus thinners can also ease your discomfort.

When to see a specialist

If your sinus infection does not go away after 1 or even 2 courses of antibiotics, you should see an ear, nose and throat (ENT) specialist.

Some people get sinus infections over and over (especially people who smoke or have allergies and smoking. If these cases, a recurring infection can become chronic if not treated successfully and sinus surgery may be needed.

Wondering whether you’ve got a cold or sinus infection? Come see us.

If you’re feeling lousy and think you have either a cold or sinus infection, please make an appointment with Westchester Health to see one of our Internal Medicine physicians. He/she will examine you, make a diagnosis and start treatment right away so you can soon start to feel better. Whenever, wherever you need us, we’re here for you.

By David T. Ennis, MD, an Internal Medicine specialist with Westchester Health.

Categories: Blog

Best Ways To Prevent Eczema Flare-Ups

Westchester Health Blog - Thu, 07/13/2017 - 11:30

Here at Westchester Health, we see a fair amount of eczema. Fortunately, it’s not contagious, but it does tend to run in families with a history of eczema or other conditions such as hay fever and asthma. Different triggers can make it worse, such as stress, allergies and sweating, which can cause itchy, painful flare-ups.

Eczema flare-ups can be especially problematic

Eczema is a condition which requires constant monitoring because excessive rubbing and scratching of the itchy areas can tear the skin, which in turn can lead to infection. A chronic skin problem, eczema can appear anywhere on the body or in just a few areas, and the symptoms are different with each person. Typically, eczema appears as a rash in the following places:

  • on the face and scalp
  • in the folds of the elbows and knees
  • on the hands, feet, arms and the backs of knees

    Jeffrey Sturza, MD, FAAD

Typical symptoms of eczema include:
  • Dry, scaly skin
  • Small bumps that “weep” when scratched
  • Redness and swelling of the skin
  • Thickening of the skin
Most effective ways to prevent eczema flare-ups

One of the best things you can do to manage flare-ups is to try to prevent them from happening. Here are some preventative steps you can take:

  1. Keep your skin moisturized. Thorough moisturizing should be a part of your daily routine.
  • Use fragrance-free moisturizers.
  • Cream or ointment is more moisturizing than lotion.
  • After a bath, gently pat the skin with a towel and then apply moisturizer to the damp skin.
  • Apply moisturizer at least once a day, more often if needed, applied to the face and entire body.
  1. Avoid irritants. People who are sensitive to scratchy fabrics or chemicals in soaps and detergents should:
  • Wear soft fabrics such as 100% cotton clothing.
  • Use mild, fragrance-free body cleansers.
  • Take short baths with room temperature water.
  • Take less frequent baths.
  • Use mild laundry detergent with no dyes or perfumes.
  • Skip using fabric softener in the dryer.
  1. Don’t scratch.
    Scratching can make the rash worse and lead to infection. Also, the more you scratch, the more the area will itch. To avoid this, keep fingernails short and smooth.
  2. Ask your doctor if allergies could be causing your eczema.
    Sometimes allergies such as food, pets, pollens or dust mites (in bedding) can trigger eczema or make it worse. If your eczema is caused by an allergy, avoid the trigger if possible. Also ask your doctor of other things could be causing flare-ups, such as overheating, sweating and stress.
You may need to treat your eczema with medication

Your physician may recommend medication to help keep the symptoms of your eczema under control. The type of medicine recommended will depend on how severe the eczema is and where it appears on your body. Treatments typically include OTC and/or prescription topical medications and oral ones.

Remember, eczema is a chronic skin problem, which means that it can come and go. It requires ongoing management by you and your doctor. If after several treatments your condition does not improve, you may need to see a dermatologist for severe or resistant eczema.

Additional resources to learn more If you have eczema and it’s becoming a problem, come see us

If you’re experiencing any of the symptoms mentioned above, please come see us at Westchester Health to see one of our Allergy and Immunology specialists. He/she will examine you, make a diagnosis and determine the best course of treatment so you can soon get relief and feel better. Whenever, wherever you need us, we’re here for you.

By Jeffrey Sturza, MD, FAAD, a dermatologist and dermatologic surgeon with Westchester Health.

Categories: Blog

The Best Ways To Treat Your Child’s Swimmer’s Ear

Westchester Health Blog - Mon, 07/10/2017 - 05:04

Summer is here, which means a lot of swimming and therefore, a lot of swimmer’s ear. Here at Westchester Health, we tend to see a lot of this condition and offer parents this information to help them know how to treat it and better yet, avoid it altogether, because it can be very painful.

Infancy and early childhood are the peak years for middle-ear infections like swimmer’s ear

Mason Gomberg, MD

As Mason Gomberg, MD, a pediatrician with our Westchester Health Pediatrics group, writes in a recent blog, swimmer’s ear is an inflammation of the outer ear canal and occurs when water gets into the ear, usually during swimming or bathing, and does not properly drain out. The stagnant water then causes the ear canal to become irritated and infected.

Children with this condition typically com­plain of itching or pain in the ear, particularly when the head or the ear itself is moved or pulled. As the canal swells, hearing might be affected and the infected ear may ooze yel­lowish pus.

Symptoms of swimmer’s ear
  • Severe ear pain that gets worse when the ear is touched or tugged
  • Jaw pain
  • Sore throat
  • Itching in the ear canal
  • Greenish-yellowish discharge
  • Temporary hearing loss in the affected ear, due to the canal’s becoming swollen or filled with pus
  • Redness around the ear canal opening
Best ways to treat swimmer’s ear

NOTE: Children under treatment for swimmer’s ear can still go into a pool/lake but should not get their head or ears wet while taking medicine for this condition.

From our years of experience, these are the 4 best ways to treat swimmer’s ear:

  1. Ear drops. After cleaning the infected ear, your pediatrician will begin treatment with medicated eardrops to kill bacteria and fungus, as well as reduce inflammation. The average course of treatment runs approximately one week. Note: It is not unusual for ear pain from swimmer’s ear to intensify for a day or two before the drops take effect.
  2. Antibiotics. Occasionally, the ear infection is severe enough to warrant the additional use of an oral antibiotic.
  3. Keep your child’s ears dry, and continue giving the medication for 2-3 weeks after the symptoms fade. When showering or washing your child’s hair, cover his/her head with a plastic cap or protect the ear canals with a soft earplug such as a cotton ball covered with Vaseline or OTB ear putty.
  4. A warm compress or heating pad against the ear will help reduce pain. Pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs will also help.
Preventing swimmer’s ear
  1. Once your child has had a swimmer’s ear in­fection, you should try to prevent future episodes. To do this, place drops in the ears after swimming—either a 70% alcohol solu­tion or a mixture of ½ alcohol, ½ white vinegar. Also, dry the ears with a towel immediately after swimming or bathing.
  2. It’s also recommended to dry out your child’s ears by having him/her sit out for 10-15 min for every 1-2 hours in the water.
  3. Never use a Q-tip to dry out the ear canal.
Come see us, we’re here to help

If you think your child might have swimmer’s ear, please make an appointment with Westchester Health. One of our pediatricians will diagnose whether or not your child does indeed have swimmer’s ear. If this is the case, together with you, we will decide on the best course of action to treat the infection so your child can feel better as quickly as possible. Whenever, wherever you need us, we’re here for you.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

At What Age Should You Have Your Child Evaluated For ADHD?

Westchester Health Blog - Thu, 07/06/2017 - 11:16

Here at Westchester Health, a lot of our parents want to know whether or not their child has ADHD (Attention Deficit Hyperactivity Disorder), what it means, and what to do about it. When a child is not doing well in school, finds it hard to sit still, is constantly restless and/or seems to have trouble concentrating, it’s understandable that parents become concerned.

Researchers say that 3-10% of all children in the U.S. have ADHD. Most often, the condition is recognized when a child starts school but for many, the signs and symptoms can appear at a younger age. Most experts agree that it’s hard to be sure whether a child has ADHD until he/she is 6 or 7 years old.

Lauren Adler, MD, FAAP

Evaluating a child for ADHD is not an exact science

Many children of all ages have trouble paying attention, but that doesn’t mean they have a disorder. Depression, anxiety, and learning disabilities can all be mistaken for ADHD. In some cases, a child may actually be suffering from both ADHD and depression, or ADHD and a learning disability (such as a speech and language delay).

At Westchester Health, if we feel your child might have ADHD, we will do a Vanderbilt screening (a psychological assessment tool for ADHD). If the results of the testing indicate that your child does have ADHD, we can refer your child to a psychologist or neurologist who can recommend medication.

An ADHD evaluation typically includes:
  • A thorough personal, family, and medical history. ADHD tends to run in families and it’s common for a brother or sister to have the disorder, or for parents to have symptoms even though they’ve never been diagnosed. For this reason, we will ask you a lot of questions about your child’s and your family’s health history, how long your child has been having ADHD symptoms (should be longer than 6 months) and whether he/she is having them in more than one setting, such as at school and home.
  • Interview with the patient. Often, kids will speak more freely when their parents are not in the room. To accurately determine the presence (or absence) of ADHD, we may ask your child age-appropriate questions without you present, such as, “What’s your favorite subject in school? Your least favorite? Why?”
  • Interview with the parents. We will also want to give you ample time (without your child present) to talk about your questions, concerns and frustrations with your child, such as short attention span, failure to follow through on homework or chores, non-stop activity or frequently losing his/her temper. Also, we might ask you to fill out a questionnaire about your child’s abilities and symptoms.
  • Interview with your child’s teacher(s). If your child is in school, we may want to speak with his/her teacher. Does your child have trouble waiting his/her turn, seems overly fidgety or restless, is easily distracted, or has a hard time following directions?
  • Physical examination. We will give your child a thorough physical exam, if his/her current one is out of date, to rule out any health issues that could be causing ADHD-like symptoms, such as vision or hearing problems.
  • Treatment options and follow-up. In addition to medication (if warranted), treatment options may include behavior therapy (changing your child’s environment to help improve behavior), working with you, the parents, to give you skills to deal with your child’s behavior, changes in the school environment, and a number of other alternative treatments. We will also want to see you and your child for follow-up visits to check on his/her progress.
Learn more about ADHD

To read American Academy of Pediatrics articles on causes of ADHD, common symptoms of hyperactivity, behavioral side effects of medication, and more, click here.

Come see us, we’re here to help

If you think your child might have ADHD, please make an appointment with Westchester Health. One of our pediatricians will meet with you, diagnose whether or not your child does indeed have ADHD, and together with you, come up with a plan to help your child have the best opportunities for a happy, healthy life.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

How Nutritious Food And Plenty Of Exercise Help Create A Healthy Kid

Westchester Health Blog - Mon, 07/03/2017 - 11:13

At Westchester Health, we often get questions from our parents concerning their children’s exercise level or eating habits, and we’d like to share some of our knowledge here. We firmly believe that the health and well-being of your child to a large degree involves fitness and nutrition.

Physical activity should be a regular part of your child’s day

Rachel Managed, MD, FAAP

To help your child get more exercise and become more physically fit, suggest activities that he/she enjoys and can do regularly, advises Rachel Menaged, MD, a pediatrician in our Westchester Health Pediatrics group, writes in her recent blog. Fitting exercise into a daily routine doesn’t have to be a chore—almost anything that gets your son or daughter moving is beneficial.

Here are some exercise suggestions:
  • Dancing
  • Walking
  • Biking
  • Jogging
  • Rollerblading
  • Swimming
  • Basketball/football/soccer/baseball/track/gymnastics
  • Walking the dog
Activity levels per age

Preschoolers: Preschoolers need play and exercise to develop important motor skills, such as kicking or throwing a ball, playing tag or follow the leader, hopping on one foot, riding a tricycle or bike with training wheels, freeze dancing or running obstacle courses.

School-age: With elementary and middle school kids spending more time on sedentary pursuits like watching TV and playing computer games, the challenge for parents is to help them find physical activities they enjoy and feel successful doing. These can range from traditional sports like baseball and basketball to martial arts, biking, hiking and just playing outside.

Teenagers: Teens have many choices when it comes to being active, from school sports to after-school classes. It’s important to remember that physical activity must be planned and often has to be sandwiched between various responsibilities and commitments.

Healthy foods help build healthy kids

Your child should consume a variety of foods from the five major food groups that make up the U.S. Department of Agriculture’s “Choose My Plate” guidelines. Each food group supplies important nutrients, vitamins and minerals for your child’s growth and overall health.   

The USDA’s 5 recommended food groups and typical servings
  1. Vegetables: 3-5 servings per day.
  2. Fruits: 2-4 servings per day. Suggestions: ½ cup of sliced fruit or a medium-sized whole fruit, like an apple, banana or pear.
  3. Grains: 6-11 servings per day. Each serving should equal 1 slice of bread, ½ cup of rice or pasta or 1 ounce of cereal.
  4. Protein: 2-3 servings of 2-3 ounces of cooked lean meat, poultry, or fish per day. (Vegetarian alternatives: ½ cup of cooked dry beans, one egg or 2 tablespoons of peanut butter for each ounce of lean meat.)
  5. Dairy: 2-3 servings per day of 1 cup of low-fat milk or yogurt or 1½ ounces of cheese
Concerned that your child may not be eating well or exercising enough? Come see us.

If you’re concerned about your child’s diet, eating habits and/or fitness level, or if you have other questions relating to his/her health and well-being, please come in and see one of our Westchester Health pediatricians. He/she will provide guidance and advice on how to make healthy changes in your child’s life. Whenever, wherever you need us, we’re here for you.

To read Dr. Menaged’s blog in full, click here.

Categories: Blog

Why It’s So Important To Burp Your Newborn

Westchester Health Blog - Thu, 06/29/2017 - 11:16

Babies often swallow air when they feed, either from breast or bottle, which hurts their tummies and can make them fussy. This trapped air, or gas, needs to be released, and burping is the best way to help your baby get rid of that gas, writes Lauren Adler, MD, a pediatrician in our Westchester Health Pediatrics group, in a recent blog. By burping your baby frequently during and after each feeding, you can hopefully keep painful gas pains to a minimum.

For breastfeeding moms, we at Westchester Health recommend burping before switching breasts. For bottle-feeding moms, we recommend burping between every 2-3 ounces for newborns up to 6 months old.

The 4 best positions for burping your baby
  1. Hold your infant upright with his/her head on your shoulder. Support your baby’s head and back while gently patting him/her on the back with your other hand.
  2. Sit your baby on your lap. Support your infant’s chest and head with one hand by cradling his/her chin in the palm of your hand and resting the heel of your hand on your baby’s chest (be careful to grip your baby’s chin, not throat). Use the other hand to gently pat your baby’s back.
  3. Lay your newborn face-down on your lap. Support your baby’s head, making sure it’s higher than his/her chest, and gently pat or rub your baby’s back.
  4. If your baby doesn’t burp after a few minutes, change the position and try burping for another few minutes before feeding again. Always burp your baby when feeding time is over, then keep him/her in an upright position for at least 10-15 minutes to avoid spitting up.
There are many reasons why babies need to burp

Lauren Adler, MD, FAAP

When gas bubbles get stuck in your baby’s stomach, they can easily cause your baby to feel full and uncomfortable, which then most likely will cause him/her to squirm or cry.

  1. Digestion. The bacterial breakdown of certain foods in the large intestine can naturally create gas. This includes food that the baby consumes as well as what the mother eats or drinks and passes on in her breast milk.
  2. Allergic reaction or food intolerance. If your baby is breastfeeding and has an intolerance to certain foods from your diet or to a type of formula, his/her body may react by creating more gas. Dairy intolerance is the most common culprit in this instance.
  3. Your diet. If you’re breastfeeding it is possible that something in your diet could be causing your baby’s discomfort. According to the National Institutes of Health, foods that contain carbohydrates are more likely to cause gas, as well as dairy (milk, cheese, ice cream), beans, certain vegetables (broccoli, cauliflower, cabbage, Brussels sprouts), sugar-free candies and gum, soda and fruit drinks. Changing your diet can help but it can be hard to pinpoint which food or drink is causing the gas because some foods take weeks to get out of your system. Plus, foods that produce gas in one person may not cause gas in another.
  4. Allowing too much air to enter your baby’s formula. Shaking vigorously after adding water to formula actually adds lots of air to the liquid, which then can lead to excess gas. Instead, try premixed formula, or let the bottle settle before giving it to your baby.
  5. Nipple flow. Bottle nipples come in a variety of flow options that are usually classified by age (preemie, newborn, 3-6 months, 6+ months, etc.). If you’re using a nipple that is too advanced for your baby, it may be releasing the milk or formula too fast, making the baby gulp, sputter and swallow a lot of air in the process. At the same time, if you are using a nipple that is too slow for your baby, it may cause your baby to suck too hard to get the milk out faster, thus swallowing a lot of air. Instead, choose an age-appropriate nipple to try to limit the amount of air swallowed during feedings.
Want more advice about burping your baby? Come see us.

If you’re wondering whether you’re burping your baby properly, if your baby seems overly gassy and you want some advice on what to do, or if you have other questions relating to your baby’s health and well-being, please come in and see one of our Westchester Health pediatricians. He/she will help you work out solutions that will bring relief to both you and your baby.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

Having A Baby Over Age 35 Has Its Own Special Joys and Risks

Westchester Health Blog - Tue, 06/27/2017 - 00:59

If you’re 35 or older and expecting a baby, you have many advantages over younger moms, such as being more financially secure and having years of life experiences to draw upon when raising your child. As the average age at marriage rises in the U.S., so does the average age of new mothers. We can attest to that: many of our moms-to-be are in their late 30s and early to mid-40s.

Mason Gomberg, MD

As Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group, writes in his recent blog, the majority of older moms have perfectly normal pregnancies and deliver healthy babies, but it’s very important for you to take extra special care of yourself because your chances of developing certain health problems are greater when you’re 35 or older.

Being an older mom-to-be carries some risks

Over age 35, the risks for you and your baby are a little higher than average, but still very low. Some of these risks include:

  1. Birth defects. Older women are more likely to have a baby with a chromosome disorder such as Down syndrome. If you are 25, the chance of Down syndrome is about 1 in 1,250. If you are 35, the risk increases to 1 in 400. By age 45, it is 1 in 30.
  2. Miscarriage. Most miscarriages happen in the first 13 weeks of pregnancy. As you get older, your risk of early miscarriage rises. At age 35, the chance is about 20% and by age 45, it’s 80%.
  3. High blood pressure and diabetes. You may be more likely to develop high blood pressure
    or diabetes during pregnancy, which can cause problems including miscarriage, growth problems in your baby or complications during birth.
  4. Placenta problems. Placenta previa happens when the placenta covers all or part of your cervix. This can lead to risky bleeding during delivery. If you’re in your 40s, you’re three times more likely to have placenta problems than a woman in her 20s. Even so, this problem is rare.
  5. Premature birth and low birth weight. Older women are more likely to deliver their babies prematurely, before 37 weeks. As a result, they are at risk of having babies weighing less than 5.5 pounds at birth.

With good prenatal care, you can control many of these risks. Routine prenatal screenings and testing will usually reveal if your baby has a problem before birth.

7 things that can help you have a healthy pregnancy over 35 1. Take a prenatal vitamin before getting pregnant.

We recommend one that contains ARA and DHA, 2 substances that promote good eye and neurological development. Your prenatal vitamin should also contain folic acid to help prevent neural tube birth defects such as spina bifida.

2. See your doctor regularly.

If you’re planning to become pregnant, get a pre-pregnancy checkup. Your healthcare provider will answer all your questions about your pregnancy, your diet, what exercises are safe, any environmental factors you should avoid for the next nine months, and a host of other topics. He/she will also review any medications you are taking. If you are planning on breastfeeding (breast is best, for you and your baby), there are certain preparations you can do ahead of time to help ensure a successful experience.

3. Manage pre-existing and chronic conditions.

Be sure you’re aware of any existing health problems such as high blood pressure or diabetes.

4. Lose weight if you’re overweight.

Women who are overweight when they get pregnant are more likely to develop problems during pregnancy (and often have more issues with labor and delivery).

5. Eat healthy and avoid certain foods.

Include a wide variety of nutritious foods in your diet, especially ones that contain folic acid such as spinach, beans, lentils and sunflower seeds. Avoid shark, tilefish, king mackerel, swordfish and more than 6 oz. of albacore tuna per week.

6. Exercise regularly.

Join a workout class, start walking or jogging, try some at-home exercise DVDs…anything that gets you moving. Note: make sure you work out on a regular basis, not intermittently.

7. Make sure you’re getting enough sleep.

It’s very important to get lots of sleep during a pregnancy. Not only does your body need the rest and the chance to recharge, the growing baby benefits from your hours of sleep.

If you’re expecting a baby over 35 and pregnant, come see us.

If you’re pregnant and over 35, and have questions relating to your pregnancy, please come in and see one of our Westchester Health OB/GYNs. He/she will give you tips and guidance to help you have a healthy pregnancy, labor and delivery. Whenever, wherever you need us, we’re here for you.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

Is Fruit Juice Good Or Bad For Your Child?

Westchester Health Blog - Fri, 06/23/2017 - 00:40

At Westchester Health, we were pleased to learn that the American Academy of Pediatrics recently issued new guidelines limiting the recommended amount of 100% fruit juice that should be given to children AND recommending no fruit juice in a child’s first year of life. In fact, this is what we have been recommending to our patients for years. Why? Because juice offers no nutritional benefits early in life and can actually take the place of what babies need most: breast milk (or formula), protein, fat and minerals like calcium.

Lauren Adler, MD, FAAP

Lauren Adler, MD, a pediatrician in our Westchester Health Pediatrics group, explains in a recent blog that this might come as a surprise to parents who thought that 100% fruit juice was healthy for babies. The new guidelines also limit the amount of juice recommended for older children as well as for babies, now saying that four ounces for children ages 1-3, six ounces for children 4-6 and only 8 ounces (down from 12) for children 6-18 is best.

Believe it or not, fruit juice is nutritionally not much better than soda

Four ounces of apple juice has no fiber, 60 calories and 13 grams of sugar. By comparison, a half cup of apple slices has 1.5 grams of fiber, 30 calories and 5.5 grams of sugar. That’s a big difference. While whole fruit offers fiber, calories and sugar, while fruit juice has no fiber, only sugar and empty calories. Nutritionally, the two are not even close.

100% fruit juice is also bad for your child’s teeth

Not only is fruit juice not nutritious for babies and children, its high levels of sugar can promote tooth decay. That’s why at Westchester Health, we strongly believe that the healthiest beverages for your child are water and milk (cow’s milk or otherwise). Water is important for adequate hydration and milk offers fat and calcium, both important for growing children.

Questions about your child and fruit juice? Come see us, we’re here to help

If you’d like more information about how much fruit juice is recommended for your child’s particular stage of development, please make an appointment with Westchester Health to see one of our pediatricians. He/she will meet with you and give you the information, advice and guidance you need. Whenever, wherever you need us, we’re here for you.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

How Much Should You Exercise While Pregnant?

Westchester Health Blog - Mon, 06/19/2017 - 23:52

At Westchester Health, here’s what we advise pregnant women who ask us if it’s safe to exercise while they’re expecting: if they were physically active before their pregnancy, they can continue their activity in moderation. We firmly believe that maintaining a regular exercise routine throughout a pregnancy can help both the mom-to-be and her baby stay healthy.

Lauren Adler, MD, FAAP

As Lauren Adler, MD, a pediatrician in our Westchester Health Pediatrics group, writes in her recent blog, exercising while pregnancy not only helps a woman stay in shape but also helps relieve stress, builds the stamina she’ll need for labor and delivery, and may even prevent gestational diabetes (diabetes that develops during pregnancy).

Recommended: 30-60 minutes or more of moderate exercise per day

The American College of Obstetrics and Gynecology recommends 30-60 minutes or more of moderate exercise per day while you’re pregnant, unless you have a medical or pregnancy complication (asthma, heart disease, diabetes, low placenta, history of miscarriage or early labor, weak cervix). However, if you haven’t exercised regularly before getting pregnant, you can still follow an exercise program while you’re expecting after consulting with your OB/GYN.

Be careful: underdoing it is actually riskier than overdoing  it

It is actually more hazardous to your health not to exercise while pregnant. This contributes to excess weight gain, high blood pressure, aches and pains, and a higher risk for Cesarean section and gestational diabetes. Approximately 70-80% of women with gestational diabetes develop type 2 diabetes later in life, and their babies are themselves more likely to become overweight and develop diabetes.

8 exercises you can safely do until delivering

Most exercises are safe to perform during pregnancy, as long as you are careful not to overdo it. We recommend the following:

  1. swimming
  2. brisk walking
  3. yoga
  4. indoor stationary cycling
  5. step or elliptical machines
  6. low-impact aerobics (taught by a certified aerobics instructor)
  7. jogging (in moderation, especially if you were doing this before your pregnancy)
  8. strength and toning exercises, such as Pilates
11 exercises you should avoid during your pregnancy
  1. Be aware that there are certain exercises and activities that can be harmful if performed during pregnancy, including:
  2. holding your breath during any activity
  3. sports where falling is likely (such as skiing, ice skating or horseback riding)
  4. contact sports such as softball, football, basketball and volleyball
  5. any exercise that may cause even mild abdominal trauma, jarring motions or rapid changes in direction
  6. activities that require extensive jumping, hopping, skipping, bouncing or running
  7. deep knee bends, full sit-ups, double leg raises and straight-leg toe touches
  8. bouncing while stretching
  9. waist-twisting movements while standing
  10. heavy exercise spurts followed by long periods of no activity
  11. exercising in hot, humid weather
Want to know more about exercising while pregnant? Come see us.

If you want more information on how exercising while pregnant benefits you and your baby, or if you have questions about labor and delivery or any other aspects of having a baby, please make an appointment with Westchester Health to see one of our OB/GYNs. We’re here for you with years of experience, advice and guidance.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

How Much Weight Should I Gain While I’m Pregnant?

Westchester Health Blog - Thu, 06/15/2017 - 10:29

Here at Westchester Health, we get this question a lot from our moms who are expecting. Our answer? Yes, of course, you do need to eat extra calories for your growing baby, but it’s really not necessary to “eat for two.” In actual fact, the average pregnant woman needs only about 300 healthy calories more a day than she did before she was pregnant in order to gain the right amount of weight.

As well as gaining weight, there are a number of important steps you need to take in order to have a healthy pregnancy, including eating a balanced diet, exercising regularly, taking a vitamin and mineral supplement if recommended by your physician, and avoiding alcohol, tobacco and other harmful substances.

How much you should gain while pregnant, based on your body type

Dennis McGroary, MD, FACOG

In general, you should gain about 2-4 pounds during the first three months (1st trimester) of the pregnancy and 1 pound a week during the rest of your pregnancy. Here’s what we recommend:

  • A woman who was average weight before getting pregnant should gain 25-35 pounds
  • Underweight women should gain 28-40 pounds
  • Overweight women should gain only 15-25 pounds
  • If you are expecting twins, you should gain 35-45 pounds

For twins, weight gain increases to 1½ pounds per week after the first three months. It’s particularly important to gain enough weight when you’re carrying twins because your weight directly affects the babies’ weight. In addition, because twins are often born before their due date, a higher birth weight is important for their health. With twins, you may need between 3,000 and 3,500 calories a day.

Where your extra weight goes during pregnancy

As well as asking how weight they should gain, our pregnant patients often ask us, “Where does all the weight I’m gaining actually go?” Here’s a general breakdown:

  • Baby: 8 pounds
  • Placenta: 2-3 pounds
  • Amniotic fluid: 2-3 pounds
  • Breast tissue: 2-3 pounds
  • Blood supply: 4 pounds
  • Stored fat for delivery and breastfeeding: 5-9 pounds
  • Larger uterus: 2-5 pounds
  • Total: 25-35 pounds
It’s not just eating more, it’s eating the right things

A balanced diet containing a variety of foods can provide pregnant women with enough nutrients for themselves and their developing baby. These should include:

  • Whole grains: Bread, cereals, pastas and brown rice.
  • Fruits: All types of fruits without added sugars.
  • Vegetables: A variety of colorful vegetables with no added salt. Raw sprouts should be avoided.
  • Lean protein: Choose lean protein from meat, poultry, fish, eggs, beans and peas, peanut butter, soy products and nuts. Avoid eating tilefish, shark, swordfish and king mackerel, and limit white (albacore) tuna to 6 ounces per week. Deli, luncheon meats and hot dogs should be reheated before eating, avoided altogether.
  • Dairy: This includes milk, cheese, ice cream and yogurt. Unpasteurized milk and some soft cheeses that are made from unpasteurized milk should be avoided.
  • Healthy fats: You can get these from foods such as avocados, nuts and seeds as well as vegetable oils including canola and olive oil.
  • Folic Acid: Folic acid reduces the risk of birth defects that affect the spinal cord. That’s why pregnant women should consume at least 400 micrograms of folic acid each day. Sources of folate include legumes, green leafy vegetables and citrus fruits. Folate also can be obtained through fortified foods such as cereals, pastas and bread, as well as vitamin supplements.
  • Iron: Maternal iron deficiency is the most common nutritional deficiency during pregnancy. Pregnant women need at least 27 milligrams of iron each day. Good sources of iron include red meat, chicken and fish, fortified cereals, spinach, beans and some leafy greens.
  • Calcium: During pregnancy, it’s important to get enough calcium for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. When a pregnant woman does not consume enough calcium, her body will take it from her bones for the baby. The recommended amount of calcium during pregnancy is 1,300 milligrams per day for adolescents 14-18 years old and 1,000 milligrams per day for women 19-50 years old. That equals at least 3 daily servings of calcium-rich foods such as milk, yogurt, cheese, broccoli or fortified cereals and juices.
5 tips for sensibly gaining weight while pregnant
  1. Eat 5-6 small meals a day rather than 3 large ones.
  2. Keep quick, easy snacks on hand, such as nuts, raisins, cheese and crackers, dried fruit, peanut butter and ice cream or yogurt.
  3. Spread peanut butter on toast, crackers, apples, bananas or celery. One tablespoon of peanut butter gives you about 100 calories and 7 grams of protein.
  4. Add healthy extras to your meal, such as butter, cheese, gravy, beans, tofu, sour cream, bananas or nuts.
  5. Avoid empty calories and added sugar from soda, candy, chips and fried snacks.
If you gain too much weight during pregnancy

If you have gained more weight than your doctor recommends, you’ll probably have to wait until after the delivery to lose the added weight. Here are some suggestions to slow your weight gain:

  • Avoid fried foods such as french fries, onion rings, mozzarella sticks or breaded chicken patties.
  • Cut out sweet or sugary drinks such as soft drinks, fruit punch, fruit drinks, sweetened iced tea, lemonade or powdered drink mixes. Choose water — it’s healthier and it contains no extra calories.
  • Don’t add salt to foods when cooking. Salt causes you to retain water.
  • Limit sweets and high-calorie snacks. Cookies, candies, candy bars, donuts, cakes, syrup, honey and potato chips have a lot of calories and little nutrition. Instead, choose lower-calorie snacks and desserts such as fresh fruit, yogurt, angel food cake with strawberries, or pretzels.
  • Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream and cream cheese.
  • Cook food in a healthy way. Frying foods in oil or butter will add calories and fat. Baking, broiling, grilling and boiling are healthier preparation methods.
  • Exercise. Moderate exercise can help burn excess calories. Walking, biking or swimming is usually safe for pregnant women. Ask your healthcare provider what exercise would be right for you before getting started.
Concerned about your pregnancy weight gain? Please come see us.

If you are expecting a baby and have concerns about the amount of weight you’re gaining (or not gaining), please make an appointment with Westchester Health to see one of our OB/GYNs. We will help make sure you are neither overdoing nor underdoing it, and that your baby is getting the optimal amount of nutrients he/she needs to grow at a healthy rate.

By Dennis McGroary, MD, FACOG, Department of OB/GYN, Westchester Health

Categories: Blog

“Do I Need Glasses?” 10 Ways to Know For Sure.

Westchester Health Blog - Mon, 06/12/2017 - 11:03

Ironically, one of the clearest signs that you might need glasses is the inability to read an actual sign. However, there are many other clues that can reveal if your eyesight needs correcting with glasses (or contact lenses). As I frequently tell my patients who aren’t thrilled to be needing glasses, roughly 60% of the world’s population requires vision correction and 80% of all visual impairment can be avoided or corrected.

Two main types of vision problems

William B. Dieck, MD, FAAO

Nearsighted: Difficulty seeing far away. People with myopia (nearsightedness) can see close objects clearly but objects farther away appear blurred. Myopia occurs if the eyeball is too long or the cornea (the clear front cover of the eye) is too curved. As a result, the light entering the eye isn’t focused correctly, and distant objects look blurred.

Farsighted: Difficulty seeing close up. People with hyperopia (farsightedness) can see distant objects very well but have difficulty focusing on objects up close. The eyes have to work harder in order to focus which can result in headaches, eye fatigue and long-term effects.

Many symptoms can signal you need glasses

The following 10 symptoms may reveal that it’s time to get glasses. Keep in mind, though, that the only way to accurately diagnose a vision problem is to see an eye care professional.

  1. Trouble seeing up close or far away. If you can’t recognize an object, person or sign that’s 20 feet away, or if you are having trouble reading newspaper or magazine print, you may be developing farsightedness or nearsightedness. If you find it difficult to see objects both near and far, that may be astigmatism, a common condition involving a curvature of the eye lens or cornea.
  2. Difficulty seeing at night. If your night vision is deteriorating to the point where you really can’t see things accurately at night, you may be experiencing signs of early cataracts, which should be examined as soon as possible.
  3. Trouble adjusting from dark to light. If it takes your eyes a long time to adjust after seeing bright lights on the highway, it likely means the muscles that help your iris contract and expand are weakening, most likely due to age.
  4. Difficulty seeing computer screen images clearly. This may signal farsightedness. Try this test: start each day looking at the same page and see if your vision worsens. Also, sitting too close to the screen may signal nearsightedness.
  5.  Eye strain or fatigue. Do your eyes feel tired after 20 minutes of reading? Eye fatigue results from blurry vision or constantly squinting or blinking to bring items into focus. It can also occur from frequent driving, writing or reading/typing/interacting with a mobile phone. If possible, try taking regular breaks from this activities but if the eye fatigue persists, see your eye doctor.
  6. Frequent headaches. Sometimes the mechanism fails that helps the cornea and lens focus on images, forcing the small muscles in the eye to work harder. The result is eye strain, which can lead to headaches. In other words, when you squint, it can cause headaches, and you may need glasses.
  7.  Double vision. Seeing double may indicate problems with your cornea or eye muscles. It can also be a symptom of cataracts. If you’re experiencing double vision, see your eye care professional immediately.
  8.  Wavy vision. Are objects starting to look like they are under water? When straight lines appear distorted, or colors look faded, it may be a sign of macular degeneration, the deterioration of the central portion of the retina and a leading cause of vision loss.
  9. Seeing halos. Seeing halos around objects (usually more pronounced in the dark) may signal that you are developing cataracts or night vision problems.
  10.  Eye pressure. If you feel pressure behind the eye, it may be a sign of glaucoma, which is highly treatable. Pressure buildup can damage the optic nerve that transmits images to your brain, but not everyone who experiences eye pressure has glaucoma. If this pertains to you, it’s important to get it checked.
The importance of regular eye exams

While the presence of one or more of these symptoms doesn’t mean a guaranteed vision problem, an eye exam is recommended as a precaution. It is essential to have a qualified eye doctor examine your eyes to understand what’s causing these changes. It’s the only true way to find out if you need glasses, and to improve your power of observation.

Do you think you might need glasses? Please come see us.

If you are experiencing any of the symptoms listed above, including headaches or distorted vision, please make an appointment with Westchester Health to see one of our eye specialists for a comprehensive eye exam. The sooner we can accurately diagnose your vision problem, the faster we can help you see more clearly.

By William B. Dieck, MD, FAAO, Vice President, Westchester Health; Director, Ophthalmology Division

Categories: Blog

8 Ways You Can Help Your Child Stand Up To Bullying

Westchester Health Blog - Thu, 06/08/2017 - 11:56

One of the most emotional issues we see at Westchester Health affecting our patients and their parents is bullying. We understand how extremely damaging it is to all involved but luckily, there are things you can do to help your child avoid or prevent bullying. A recent blog by Mason Gomberg, a pediatrician in our Westchester Health Pediatrics group, explains the many ways you can help your child in this area (synopsized below). We recommend that all parents take a read.

Why do bullies bully?

Mason Gomberg, MD

Understanding how and why a bully uses aggressive behavior is key to knowing how to handle a bullying situation. A common reason that a kid is a bully is because he/she lacks attention from a parent at home and therefore lashes out at others. This can include neglected children, children of divorced parents and/or children with parents with drug and alcohol problems. Older siblings can also be the cause of the problem. If they’ve been bullied themselves, they are more apt to bully a younger sibling.

Bullies lack empathy and see weaker kids as their target. They:
  • crave power and attention
  • have uncontrolled anger
  • have low impulse control
  • don’t think about the consequences of their actions
  • have a need to control or dominate
  • are experiencing domestic violence, emotional and/or physical abuse, and anger at home
  • have poor self-esteem and manipulate others through gossip, threats of (or actual) violence and teasing/insults
  • plan their attacks, usually when their support group in nearby and an adult is not
  • have not learned kindness, compassion and respect
Bullying behavior typically includes:
  • Hitting, shoving or tripping
  • Taunting, teasing
  • Making fun of the way a kid acts, looks, dresses or talks
  • Writing mean things or sending hurtful pictures of someone online (cyberbullying)
Here are 8 important ways you can help your child stand up to bullying

1) Watch for signs that your child is possibly being bullied.

If your child has frequent somatic complaints with no real origin (such as headaches or stomach aches), or does not want to go to school, this is a strong indicator that something is wrong. Ask your child whom he or she has lunch with or plays with at recess, and the names of his/her friends. If you sense something is wrong, contact the proper administrator at school.

2) Monitor what your child watches on TV, online and on social media (especially violent video games).

These have become important areas for bullying.

3) Talk with your child about bullying.

Many children who are being bullied will open up in the right environment, such as riding in the car or a similar place where you have little eye-to-eye contact. Don’t promise that you won’t tell anyone, because you may need to become involved. The important thing is to assure your child that you will do your very best not to make the problem worse.

4) Practice role-playing at home.

Help your child learn how to react calmly and confidently to taunting. For example, your child can practice saying “Leave me alone” and then walking away. Help him/her understand that responding with physical aggression or insults will usually only make the problem worse.

5) Help build your child’s self-esteem by encouraging new activities or clubs.

This can be a very good way of making new friends (and avoiding the bully/bullies). Plus, having several friends and interests can boost a child’s confidence and make him/her less likely to be bullied.

6) Encourage your child to exhibit the qualities that make a good friend.

These types of character traits include sharing, empathy, compassion, humor and loyalty.

7) Suggest to your child that he/she join activities that are supervised by a responsible adult.

IMPORTANT: Bullying is much less likely to occur near adults.

8) Encourage your child to talk to a teacher, school counselor or you.

Many children are too embarrassed or afraid to tell an adult about bullying. They may think that involving a grownup will only make the problem worse, but actually, silence only makes it easier for the bully to keep bullying. Telling someone about what’s going on is the first step to stopping it.

If your think your child is being bullied, please come see us

If you know or even suspect that your child is being bullied, please bring him/her to see one of our highly-experienced pediatricians at Westchester Health. Together, we’ll determine the best way forward so that your child can be happy, self-confident and safe.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

14 Signs That You May Be Gluten Intolerant

Westchester Health Blog - Mon, 06/05/2017 - 11:26

Did you know that more than 55 diseases have been linked to gluten, the protein found in wheat, rye and barley? And that up to 15% of the US population is estimated to be gluten intolerant? It is also estimated that 99% of people who have gluten intolerance or celiac disease are never diagnosed. Could you be one of them?

Gluten intolerance is more than just a digestive problem

Bryan E. Dorf, DO, MBA

Gluten can actually cause significant changes in the gut microbiota—a significant problem, considering that a person’s overall health depends heavily on the health of their gut.

In addition, gluten intolerance can affect almost every cell, tissue and system in the body because the bacteria that populate the gut help control everything from nutrient absorption and hormone production to metabolic function and cognitive processes. This is why for so many of my patients, and for the population at large, gluten intolerance is a very serious health issue.

In the US, it’s estimated that grain flours (especially wheat products containing gluten), vegetable oils and added sugar now make up about 70% of the total calories most people consume each day. Considering the fact that quality proteins, healthy fats and vegetables/fruits only play a small part in the average American’s diet, it’s no surprise so many people struggle with gluten intolerance, related health issues and weight control.

What is gluten, exactly?

Gluten is a type of protein found in grains including wheat, barley and rye, and makes up about 80 percent of the amino acids (the building blocks of proteins) found in these grains.

Unfortunately for people with an intolerance, today gluten is used to make many highly-processed chemical additives that are found in packaged foods of all kinds. Coupled with the fact that manufacturing can lead to cross-contamination, this means that trace amounts of gluten often wind up in food products that are seemingly gluten-free, such as salad dressings, condiments, deli meats, even candy. This makes avoiding gluten even more challenging.

14 symptoms of gluten intolerance

If you have any of the following symptoms, it could be a sign that you have gluten intolerance. Symptoms are widespread and can include:

  1. Digestive issues including gas, abdominal pain, cramping, bloating, constipation or diarrhea.
  2. Skin issues including dermatitis, eczema, rosacea, skin rashes and keratosis pilaris (also known as ‘chicken skin’ on the back of your arms), resulting from fatty acid and vitamin A deficiency, as well as fat-malabsorption, caused by gluten damaging the gut.
  3. Ongoing low energy levels, “brain fog,” chronic fatigue syndrome or fibromyalgia. A major indicator is feeling tired after eating gluten.
  4. Autoimmune disease such as Hashimoto’s thyroiditis, rheumatoid arthritis, ulcerative colitis, lupus, psoriasis, scleroderma or multiple sclerosis.
  5. Neurologic symptoms such as dizziness or feeling off balance.
  6. Hormone imbalances such as PMS, PCOS, delayed menstruation onset and stunted growth.
  7. Migraines and/or frequent headaches.
  8. Joint pain, inflammation and swelling, particularly in fingers, knees or hips.}
  9. Mood-related issues such as anxiety, depression, mood swings and ADHD.
  10. Numbness and tingling in the arms and legs.
  11. Reproductive problems and infertility.
  12. Nutrient deficiencies including anemia (iron deficiency).
  13. Higher risk of learning disabilities including autism and ADHD.
  14. Possibly a higher risk for neurological and psychiatric diseases including Alzheimer’s, dementia and schizophrenia.
Tests that can determine if you are gluten intolerant 1. Elimination diet

With my patients, I have found that the single best way to determine if they have an issue with gluten is to do an elimination diet. This involves removing gluten from the diet completely for a period of at least 30 days (preferably longer, such as three months) and then adding it back in. If symptoms improve during the elimination period and then reappear once gluten is eaten again, that’s a clear sign that gluten was contributing to the symptoms. However, it’s very important to test only one variable at a time (gluten) and not several (such as dairy, gluten and sugar) because this can result in inaccurate results.

Remember: In order to get accurate results from this no-gluten method, you must eliminate 100% of the gluten from your diet.

  1. Gluten-free diet

If you have a serious reaction to gluten when you add it back into your diet after the elimination period, you might want to get tested for celiac disease to find out whether you need to avoid 100% of gluten indefinitely. If you do not have celiac disease, you should still try to avoid gluten as much as possible in order to prevent gut irritation, further digestive issues and ongoing symptoms.

A gluten-free diet avoids wheat, rye and barley, including most baked products, foods made from gluten flour (pizza, bread, pasta, cereal, cookies, cakes, etc.) and some types of alcohol, especially beer. Alternatives: organic animal products, raw dairy products, vegetables, fruits, nuts, seeds and probiotic foods.

  1. Additional tests

Researchers believe that patients who test negative for two main genes that are associated with celiac disease (HLA-DQ2 and HLA-DQ8) are less likely to have gluten intolerance. If celiac disease or gluten intolerance runs in your family, you may want to get tested for these genes, as well as for antibodies that reveal how active your immune system is.

Other tests include a zolulin test (also called a lactulose test) and an IgG food allergy test. These types of “leaky gut” tests can indicate if gluten is causing gut permeability. Over time, if the gut lining continues to become permeable, the microvilli (tiny cellular membranes that line the intestines and absorb nutrients from food) can become damaged.

Do you think you may be gluten intolerant? Please come see us.

If you are experiencing any of the symptoms listed above of gluten intolerance, please make an appointment with Westchester Health to see one of our specialists for an accurate diagnosis and an action plan for appropriate treatment. The sooner we can determine the extent of your condition, and if it is possibly something more serious than an intolerance to gluten, the faster we can help you get healthier and feel better.

By Bryan E. Dorf, DO, MBA, an Internist with Westchester Health.

Categories: Blog

How To Manage Incontinence Without Surgery

Westchester Health Blog - Thu, 06/01/2017 - 11:39

Urinary incontinence (the loss of bladder control) is a common problem for many of my patients, but that doesn’t make it any less embarrassing for them. The severity of it can range from leaking urine when they cough or sneeze to having an urge to urinate that’s so sudden and strong that they often can’t get to a toilet in time. No matter where a person is along the spectrum of urinary incontinence, it’s not a pleasant condition. The good news is that for most people, simple lifestyle changes and/or medical treatment can ease the discomfort of incontinence, or even stop it altogether, without having to resort to surgery.

4 factors that increase your risk of developing urinary incontinence:
  1. Female gender. Women are more likely to have stress incontinence, due to pregnancy, childbirth, menopause and normal female anatomy. However, men with prostate gland problems are at increased risk of urge and overflow incontinence.

    Jerry Weinberg. MD

  2. Age. As you get older, the muscles in your bladder and urethra lose some of their strength. This reduces how much urine your bladder can hold and increase the chances of involuntary urine release.
  3. Being overweight. Extra weight increases pressure on your bladder and surrounding muscles, weakening them and allowing urine to leak out when you cough or sneeze.
  4. Other diseases. Neurological disease or diabetes may increase your risk of incontinence.
Are you experiencing any of these 5 types of urinary incontinence?
  1. Stress incontinence. Urine leaks when pressure is exerted on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
  2. Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as neurologic disorder or diabetes.
  3. Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
  4. Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
  5. Mixed incontinence. You experience more than one type of urinary incontinence.
There are many treatments for incontinence that don’t involve surgery

Treatment for urinary incontinence depends on which type it is, its severity and the underlying cause. A combination of treatments may be needed. Your doctor, myself included, is likely to suggest the least invasive treatments first and move on to other options only if these techniques fail.

Behavioral techniques
  1. Bladder training. This is when you delay urination after you get the urge to go. (I.e., “holding it.”) Start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every two to four hours.
  2. Double voiding. This involves learning to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
  3. Scheduled toilet trips. Urinate every 2-4 hours rather than waiting for the need to go.
  4. Fluid and diet management. To control your bladder, you may need to avoid, or at least cut back on, alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.
Pelvic floor muscle exercises

Your doctor may recommend these exercises for you to do frequently to strengthen the muscles that help control urination. Also known as Kegel exercises, these techniques are especially effective for stress incontinence but may also help urge incontinence.

  • First, imagine that you’re trying to stop your urine flow. Then:
  • Tighten (contract) the muscles you would use to stop urinating and hold for 5 seconds, and then relax for 5 seconds. (If this is too hard, start by holding for 2 seconds and relaxing for 3 seconds.)
  • Work up to holding the contractions for 10 seconds at a time.
  • Aim for at least three sets of 10 repetitions each day.

To help you identify and contract the right muscles, you might want to work with a physical therapist or try biofeedback techniques.

Electrical stimulation

This method involves the temporary insertion of electrodes into your rectum or vagina to stimulate and strengthen pelvic floor muscles. Gentle electrical stimulation can be effective for stress incontinence and urge incontinence, but you may need multiple treatments over several months.


Medications commonly used to treat incontinence include:

  1. Anticholinergics. These calm an overactive bladder and may be helpful for urge incontinence.
  2. Mirabegron (Myrbetriq). Used to treat urge incontinence, this medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, which helps empty your bladder more completely.
  3. Alpha blockers. In men with urge or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder.
  4. Topical estrogen. Applying low-dose, topical estrogen in the form of a vaginal cream, ring or patch may help tone and rejuvenate tissues in the urethra and vaginal areas and reduce some of the symptoms of incontinence.
Medical devices

Devices designed to treat women with incontinence include:

  1. A urethral insert. A small, tampon-like disposable device is inserted into the urethra before a specific activity, such as tennis, that can trigger incontinence. The insert acts as a plug to prevent leakage and is removed before urination.
  2. A pessary. A stiff ring is inserted into the vagina and worn all day. This device helps hold up the bladder, which lies near the vagina, to prevent urine leakage, and may be recommended for incontinence due to a prolapsed bladder or uterus.
Absorbent pads and catheters

If these medical treatments do not completely eliminate incontinence, there are also these products you can try to help ease the discomfort and inconvenience of leaking urine:

  1. Pads and protective garments. These usually are no more bulky than normal underwear and can be easily worn under everyday clothing. Men who have problems with dribbles of urine can use a drip collector — a small pocket of absorbent padding worn over the penis and held in place by close-fitting underwear.
  2. Catheter. If you’re incontinent because your bladder doesn’t empty properly, your doctor may recommend that you insert a soft tube (catheter) into your urethra several times a day to drain your bladder. You can learn how to do this yourself, as well as how to clean the catheters for safe reuse.
Concerned about urinary incontinence? Please come see us.

If you are experiencing the embarrassment and inconvenience of urinary incontinence, please make an appointment with Westchester Health to see one of our urology specialists for an accurate diagnosis and immediate treatment. The sooner we can begin treatment, the faster you can control your bladder and enjoy life to the fullest.

By Jerry Weinberg, MD, a Urologist with Westchester Health.

Categories: Blog

10 Signs That You Might Have Anemia

Westchester Health Blog - Mon, 05/29/2017 - 11:30

More than 3 million people in the U.S. are living with anemia, a common blood disorder that develops when a person’s red blood cell count is low or when red blood cells do not have enough hemoglobin. This is something we see here at Westchester Health but if diagnosed properly and treated promptly, anemia in most cases can be successfully reversed.

What causes anemia?

Margaret Andersen, MD

Since organs and tissues all need oxygen to function correctly, being anemic can cause widespread health problems. According to the U.S. Department of Health and Human Services, women and people with chronic diseases are at the greatest risk for anemia, but it can affect anyone.

The most common cause, especially in women, is iron deficiency. Iron is an important component of hemoglobin and if you don’t have enough iron, your body cannot make enough healthy oxygen-carrying red blood cells. You can also become iron deficient from not eating enough iron—this is very common in pregnant women because they have to eat enough iron for two. In addition, some people may eat enough iron but have problems absorbing it, due to gastrointestinal disorders such as Crohn’s disease.

Other causes of anemia include:
  • severe injury
  • surgery
  • ulcers
  • poor diet
  • inadequate intake of vitamins and minerals
  • very heavy menstrual periods
  • childbirth
  • extreme blood loss
  • sickle cell disease
  • gastritis
  • hemorrhoids
  • colorectal cancer
  • inherited conditions such as the blood disorder thalassemia
  • environmental exposure to lead
10 symptoms of anemia to watch out for

You may have no symptoms at first, or very mild ones. However, as anemia gets worse some telltale signs become apparent. Here are the most common ones.

  1. You’re exhausted and weak

The most common symptom of iron-deficiency anemia is fatigue. Without enough oxygen being delivered to your cells you aren’t able to break down nutrients and make energy. Without energy, you continually feel tired and weak throughout the day and it can be difficult to complete your daily tasks.

  1. You have strange cravings for things that aren’t food

People who are anemic may develop a syndrome called pica, which causes strange cravings for non-food items such as dirt, ice or clay. There are some theories as to why iron deficiency leads to pica, but the true cause is unclear. Research shows that the cravings seem to go away when patients receive iron supplements.

  1. You get headaches or feel dizzy

Headaches, dizziness and lightheadedness can all be symptoms of anemia caused by a lack of oxygen to the brain. For some people, this may even lead to fainting.

  1. Your heartbeat is irregular

Heart palpitations, an irregular heartbeat or an increased heart rate can be signs that your body is attempting to compensate for its lack of energy. By circulating blood faster your body is trying to spread around the small amounts of available hemoglobin in order to deliver more oxygen.

  1. You’re short of breath

When your organs do not get enough oxygen your lungs may start to overcompensate and work harder to bring in more oxygen. For example, if walking up stairs leaves you winded or you can barely catch your breath during a workout (and these are new occurrences) your iron levels may be far too low.

  1. You have chest pain

Your heart needs oxygen to function. Without enough hemoglobin and oxygen, the heart tissue will behave as though you have impaired blood flow. In very severe anemia this can lead to a myocardial infarction or what is more commonly known as a heart attack.

  1. Your legs tingle

Low iron stores are associated with restless leg syndrome. This is a strong, unpleasant urge to move your legs. This can also make it hard to fall asleep at night. Fortunately, iron supplements have been shown to help make this condition go away in people who are deficient.

  1. Your skin is pale

When your heart and brain, your two most vital organs, are not getting enough oxygen your body sends more blood there, depriving other parts of your body in the process. When less blood flows to your skin you’re likely to lose some of your color or skin tone. With severe anemia, the skin can look grey or ashen.

  1. Your nails are brittle

Nails like every other living cell in your body need oxygen to breathe and grow. Without it, the nail beds stop making healthy new cells leading to weak and brittle nails over time.

  1. Your hands and feet are always cold

Although it may sound harsh, your extremities are treated by your body as non-essential body parts, and consequently, blood flow to those areas may become limited when you are anemic. Limited circulation in your hands and feet can cause them to feel cold and often numb.

How to treat anemia caused by iron deficiency

I typically recommend to my patients iron supplements that contain the ferrous form of iron, which your body can absorb easily. If you are seriously anemic you may need to continue taking iron supplements for up to a year. In this case, you should heed the following precautions:

  • Excess iron intake can be harmful. Symptoms of iron overload include fatigue, vomiting, diarrhea, headache, irritability, heart disease and joint problems.
  • Iron supplements (and all supplements and medications) should be kept out of the reach of children. Iron poisoning is one of the most common causes of accidental poisoning in young children and can prove fatal in a matter of hours. Symptoms of iron poisoning in a child include dizziness, confusion, nausea, vomiting and diarrhea. Seek medical help immediately.
  • Watch for side effects. Taking iron supplements with food can help prevent common side effects which may include nausea, diarrhea, constipation, and stomach pain. Let your doctor know if you continue to have side effects. Different formulations are available.
  • Watch for drug interactions. Tell your doctor if you are being treated for another condition. For example, calcium supplements interfere with iron absorption, so it is best to take them at different times of the day.
  • The body absorbs iron best when taken in a mildly acidic medium. For this reason, your doctor may suggest taking iron with a half-glass of orange juice or with vitamin C. Your doctor may also recommend that you increase the amount of iron in your diet. Good dietary sources of iron include red meat, beans, egg yolk, whole-grain products, nuts and seafood. Many processed foods, as well as milk, are also reinforced with iron.

Your doctor will monitor your red blood cell counts during treatment. If your anemia doesn’t improve with iron supplements, he/she will look for some other underlying cause. In rare cases, your doctor may prescribe iron injections or give you iron intravenously. In extremely rare cases of life-threatening iron-deficiency anemia, treatment may involve a blood transfusion.

Worried that you may be anemic? Come see us.

If you think you may have anemia, or would like to learn more about how to prevent it, please make an appointment with Westchester Health to see one of our specialists. We will perform tests to determine if you are in fact anemic or are at risk of developing it. If you are anemic, we will work closely with you to determine the best treatment plan to reverse this potentially serious health condition. We also may prescribe medication, if appropriate.

By Margaret Andersen, MD, an internist with Women Caring For Women, an internal medicine practice focused solely on women.

Categories: Blog

Signs And Symptoms That Your Baby Is Sick

Westchester Health Blog - Thu, 05/25/2017 - 11:33

“Is my baby sick or just tired/hungry/wet?” “Is a fever good or bad?” “Is this a hospital emergency or should I simply phone the pediatrician?”

At Westchester Health, we’ve taken care of thousands of babies (and their parents) over the years and know how important it is to be able to recognize the signs that their baby may be sick. We pass along our time-tested advice here in a terrific blog by Lauren Adler, MD, a pediatrician in our Westchester Health Pediatrics group, in hopes that it can give parents everywhere some peace of mind, as well as timely information.

What constitutes a fever and is a fever bad?
  • Anything over 100.4 F is a fever.
  • Any fever in a baby under 3 months old should be checked by a doctor as soon as possible.

    Lauren Adler. MD, FAAP

  • Any temperature over 101°F in a baby under 6 months old also should be checked by a doctor as soon as possible.
  • If your baby is over 6 months old with a fever, you can observe and see how he/she is the next day.
  • A fever is the body’s way of combating infection and if not too high, is actually a good thing. If your baby is not suffering too much, resist the urge to administer fever reducers and instead, let the fever break on its own.
  • Fever is not dangerous for your baby. If your baby is older than 6 months old and still taking in fluids, is not acting listless and is not crying a lot, you don’t need to rush to the doctor.
How to know if your baby is dehydrated (which is actually quite serious)

Since your baby can’t tell you what’s going on, parents need to be very observant because the effects of dehydration can escalate quickly in babies under 2 years old. The easiest dehydration symptom to spot is the number of wet diapers. If your baby is passing hardly any urine, or the urine in the diaper seems very dark and concentrated, he/she may be dehydrated.

Other things to look out for:

  • Moistness of the mouth (should not be dry)
  • If baby is floppy or listless
  • If the fontanelle (soft spot on the top of the head) seems especially sunken
  • If the baby has no tears when crying

If a baby is not drinking milk (either breast milk or formula) or is having diarrhea or vomiting, the chances of him/her becoming dehydrated are high and parents should head to the doctor as soon as possible. Babies that are severely dehydrated may need to have IV fluids.

Does your baby have a rash?

There are many viruses, allergies and non-serious conditions that can cause rashes in babies but if a rash is accompanied by a fever, parents should seek medical advice, especially if there is a purple or bruise-like rash on the baby.

Another common cause of viral rashes is roseola, a mild virus which causes babies to have a high fever and be irritable for a few days. When the fever stops, a red, blotchy rash breaks out. Rashes are also symptoms of measles and rubella which can have complications, so if in doubt, take your baby to your pediatrician.

If your baby is listless, whiney or unresponsive

This is usually a giveaway that baby is very sick, particularly when accompanied by a fever. If your baby is under 3 months old, you need to head straight to the doctor.

What persistent diarrhea can signal

Diarrhea can cause dehydration which can be serious in a small baby. Diarrhea can cause a temporary lactose intolerance which can lead to ongoing diarrhea for a few weeks after a stomach bug.  If this is the case, see your doctor who will probably advise stopping all dairy for a day or two.

Abnormal crying

Different from a hungry, wet, tired or painful cry, a high-pitched, moaning cry or whimpering can be a sign of meningitis, which is very serious. As a rule of thumb, if the crying does not sound normal to you, seek medical attention immediately.

Trust your instincts

Most of the time, parents can sense when something is wrong with their baby. If you have any concerns at all, you should always contact your pediatrician–this is what we’re here for.

Best way to take your baby’s temperature

At Westchester Health, we recommend taking your baby’s temperature rectally, the most accurate way. Here’s how:

  • The normal range for a temperature taken rectally is 97.9°F-100.4°F
  • Using a digital thermometer, lay your baby on his/her back and bring the knees up over the abdomen
  • Make sure the thermometer is clean, then dip it in water-soluble jelly
  • Insert the thermometer into your baby’s rectum, about 1 inch
  • Wait for the thermometer to take the reading (usually indicated by a beep)
  • Clean the thermometer after each use with soap and water or rubbing alcohol
When you should take your baby to the pediatrician

Contact your pediatrician right away if you notice any of the following signs:

  • rectal fever above 100.4 for babies younger than 2 months
  • rectal fever of 102 or higher for babies older than 2 months
  • fever lasting more than 48-72 hours
  • crying inconsolably
  • listless or limp
  • having convulsions (seizures)
  • swelling of the soft spot at the top of the head (fontanelle)
  • pain
  • purple splotches on the skin, or another type of rash
  • pale
  • problems breathing
  • refuses to breastfeed or drink from a bottle
  • has trouble swallowing
  • persistent vomiting or diarrhea
Want to learn more about how to tell if your baby is sick? Come see us.

If you’re wondering how to tell if your baby is truly sick, or if you have any other questions relating to your child’s health and well-being, please come in to see one of our Westchester Health pediatricians. Together, we’ll discover what’s going on with your child and decide on the best course of treatment, if needed.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

How Kids Benefit From Different Parenting Styles

Westchester Health Blog - Mon, 05/22/2017 - 11:11

Throughout our years of experience with many kinds of families, we at Westchester Health realize that moms and dads often have different parenting styles and that in almost all cases, kids do just fine. In fact, they usually thrive with two different parental methods. To explain it more fully, here is a great blog on the topic by Rodd Stein, MD in our Westchester Health Pediatrics group.

Dads’ and moms’ parenting styles: different but equal

Here are 8 ways that fathers’ and mothers’ approaches to childrearing differ but can still result in a happy, healthy, confident child.

  1. Dads can turn chores into playtime

Rodd Stein, MD, FAAP

What moms often see as repetitive routines (diaper changing, meal time, brushing teeth), dads often turn into a fun interlude. A diaper becomes a hat, a spoonful of strained carrots can be a choo-choo train, clean-up time can turn into a race. The tasks still get done but Dad has made them fun.

  1. Not so quick to fix the problem

When a toddler falls down, moms often swoop in to pick him/her up and soothe. Dads do the opposite: they let the child get back on his/her own two feet, figure out what went wrong and continue on their way. By letting their children work through problems themselves, dads are teaching them resilience and “stick-to-it-tiveness,” which are very important qualities in life.

  1. Use grown-up words

Men tend to speak to their kids as equals, using bigger words and less baby talk. They are more inclined to teach them independence and less inclined to coddle. They are also quicker to offer constructive criticism. By giving “straight talk,” they’re subtly teaching their kids the way the world works and how to navigate it.

  1. Let kids take a risk

Dads are usually less overprotective than moms, allowing their kids to take risks, recognizing these as important steps in making their own way in the world.

  1. Trust their gut

While moms have a tendency to seek guidance and advice on what to do and how to do it, dads tend to follow their instincts. From potty-training to bedtimes, dads go with what makes sense to them and what seems right for their child.

  1. Get goofy

A lot of dads love to kid around. By being spontaneously silly and yet still keeping the house from falling apart, they’re teaching their children important lessons in balancing business with pleasure, chores with fun.

  1. Pick their battles

With a headstrong toddler or preschooler (or teenager), it often feels like everything’s a fight. Dads tend to compromise, redirect the child’s attention or revisit what’s causing the tantrum at a later time. They often just seem to have an innate sense of what’s worth fighting over and what can be let go.

  1. Don’t sweat the small stuff

Dads are notorious for not worrying about certain details like stripes with polka dots, purple hair and untied shoelaces…and in the great scheme of things, we think that’s perfectly okay. We see a lot of angry, depressed kids who resent being micromanaged when they would rather be allowed to express themselves in creative ways.

For more tips and advice on healthy ways to parent your child, come see us.

If you have questions about parenting styles or any other aspect of your child’s health, please come in to see one of our Westchester Health pediatricians. Our #1 is to help you raise a happy, healthy child, and whether you’ve been with us for years or you’re a brand new parent, when you need us, we’re here for you.

To read Dr. Stein’s blog in full, click here.

Categories: Blog

How to Help Your Toddler Start Talking

Westchester Health Blog - Thu, 05/18/2017 - 11:17

Whether you realize it or not, parents have a huge impact on their children’s language and speech skills. The more you encourage your toddler to talk, the better he/she will do in preschool and in life. Conversely, if your child does not develop a solid verbal foundation as a toddler, he/she may struggle to keep up with peers, possibly for years to come. That’s why talking to your toddler, all the time, is very important, writes Robert Pitaro, MD, a pediatrician with our Westchester Health Pediatrics group, in a recent blog.

6 tips for helping your toddler learn to talk

Drawing on our years of experience at Westchester Health, we’ve put together a list of ways you can encourage your little one to develop his/her language skills.

1) Read to your child

Robert Pitaro, MD

Reading is one of the best ways to help your toddler begin to talk. Not only does reading provide very meaningful one-on-one time with your little one, it teaches important language skills such as the pronunciation of words, voice inflection and the rhythm of speech.

2) Repeat yourself

It’s important to use a new word in more than one sentence to help it stick in your child’s memory. (“Wow, you’re getting so big!” “Doesn’t Daddy have big feet!”) Toddlers need to hear words over and over again before they become permanent parts of their vocabulary.

3) Be descriptive

Take time to describe objects, emotions, colors, smells…everything, rather than just naming them. Talking about how something looks, feels or tastes is a great way to introduce new words, such as, “This apple is round and red. Our kitten’s fur is so smooth and soft.”

4) Give your toddler simple instructions

Asking your child to do things like “Pick up the ball and throw it to me” or “Bend down and touch your toes” promotes speech and language comprehension, while also strengthening his/her ability to follow directions.

5) Don’t take over the conversation

In your enthusiasm to teach your toddler words, make sure he/she has plenty of opportunities to say them. Many of our parents tell us that a toy telephone works well. You can pretend to talk to Grandma, then pass the phone to your child and encourage him/her to chat too.

6) Plan playdates with other toddlers to encourage talking

When toddlers hear other kids their age talking, they typically want to join in. In this way, playdates help your child practice his/her conversation skills with peers and also help him/her make friends. A win-win!

How to recognize if your toddler has a speech problem

It can be difficult to tell whether your child is just delayed in his or her ability to communicate or has a problem that requires professional attention.

To get some clues, listen for these red flags:
  1. By age 2, your child does not make requests like, “Can I have a cookie?” or is unable to string two words together.
  2. You can’t understand most of what your child is saying by the time he/she is 3.
  3. Your child communicates by grunting rather than babbling or talking.

Remember: All children develop at different rates, but if you’re concerned that your child’s vocabulary and language skills are not progressing, contact us at Westchester Health.

If you’re worried that your child is not saying enough words or talking early enough, come see us.

If you’re concerned about your child’s language development, or if you have other questions relating to your child’s health and well-being, please come in to see one of our Westchester Health pediatricians. Together, we’ll determine if there’s a problem and what steps need to be taken.

To read Dr. Pitaro’s blog in full, click here.

Categories: Blog

10 Tips for Dealing With Your Child’s Acne

Westchester Health Blog - Mon, 05/15/2017 - 11:04

At Westchester Health, we pay a good deal of attention to how acne is affecting our patients on the inside. A recent study has shown that even having mild acne can bring on feelings of low self-esteem, depression and suicidal thoughts in adolescents and teenagers. Coming at the same time as puberty only adds to the feelings of uncertainty about body image, self-esteem and other emotional issues that young people experience. To alert parents to the potentially damaging psychological effects of acne, Glenn E. Kaplan, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, has written an excellent blog.

As well as visible skin problems, acne can have the following psychological effects:
  • social withdrawal
  • decreased self-esteem
  • reduced self-confidence
  • poor body image
  • embarrassment

    Glenn Kaplan, MD, FAAP

  • feelings of depression
  • anger

If you notice that your child is experiencing any of these symptoms, please bring him/her in to talk to us. We have years of experience treating young people with acne and we’re here to help yours. If we feel it might help, we may refer your child to a counselor or therapist.

10 effective tips for dealing with acne

To help adolescents and teens get rid of acne, and to dispel some myths, we offer these 10 important tips:

  1. The old wives’ tale of certain foods causing acne is NOT TRUE. Chocolate and fatty, greasy foods do not cause acne.
  2. Pimples SHOULD NOT be squeezed.
  3. Some cosmetics can cause acne by blocking the skin’s pores. Your child should use products that are labeled “non-comedogenic.”
  4. Brief sun exposure can be helpful for acne but extended sunbathing can cause skin irritation that will worsen the condition.
  5. If your child’s acne is mild, start with OTC products, beginning with an acne cleanser/wash at least twice a day, then use a medicine containing 5% benzoyl peroxide at bedtime. If this does not work, change to a 10% concentration of the OTC medicine. As with all acne creams, the three most common side effects are dryness, burning and redness.
  6. If OTC medicines do not do the trick, speak to your pediatrician — he/she has stronger creams such as retinoids which have an anti-inflammatory effect, plus they remove excess skin cells to prevent them from causing pimples. Another type of cream you can get from your pediatrician combines benzoyl peroxide with a topical antibiotic. These two creams can be used as alternating therapy.
  7. If creams do not work, the next step is an oral antibiotic (erythromycin or tetracycline). This should be used along with the acne skin creams and is usually reserved for the more inflammatory acne conditions (large, deep pimples, cysts or nodules).
  8. In girls, estrogens (female hormones) in the form of oral contraceptives can be used if other treatments have failed and if there seems to be a relationship between the acne and ovulation or her menstrual period.
  9. An additional option is Accutane (oral isotretinoin). This medicine is prescribed by a dermatologist. There are some associated side effects that need to be monitored and so this medication is reserved for severe cases.
  10. The cause of your child’s acne may be allergy-related. If nothing seems to be helping, try removing dairy (lactose intolerance) and wheat-based foods (gluten allergy) from your child’s diet and see if this makes a difference in his/her skin.
Acne and puberty can be tough but we can help

At Westchester Health, we’re here for you and your child, whenever and wherever you need us, with advice, guidance and even just a listening ear. Acne and puberty together make it a very emotional time for all involved and we want to help your child get through it in a healthy way, mentally and well as physically.

To read Dr. Kaplan’s blog in full, click here.

Categories: Blog


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