Because We’re Now Affiliated With Cohen Children’s Medical Center, Your Child Is In the Best Possible Hands.

Westchester Health Blog - Wed, 09/19/2018 - 10:25

Now that Westchester Health is part of Northwell Health and its physician organization, Northwell Health Physician Partners, we have greatly expanded our services to bring you and your family the best possible care. Best of all, this new relationship means that you now have access to the outstanding resources of Cohen Children’s Medical Center, the New York metropolitan area’s only hospital exclusively for children.

Here’s the story of Donovan who survived being struck by a car because of the skill and caring of some very special doctors and nurses. The comeback kid Hit by a car, this Suffolk teen needed our Regional Pediatric Trauma Center specialists for a traumatic brain injury (TBI) and other serious wounds.

Donovan Maldonado’s walk home from school on January 12, 2016, nearly turned deadly. Then 13, he crossed a street in his Brentwood neighborhood when a car traveling at 35 miles per hour hit him.

“I got a call from one of our neighbors that Donovan had been in an accident, but I didn’t think it was severe,” said Laura Garces, Donovan’s mother. “I asked how bad it was, and she avoided the question and passed the phone to the police officer. The police officer asked questions about Donovan’s health but still wouldn’t tell me how bad it was. That’s when I knew something was really wrong.”

Ms. Garces drove an hour from her job in Queens to arrive by her son’s side at Southside Hospital. With a traumatic brain injury and several broken bones, Donovan had already received five units of blood. A ruptured spleen was later identified as the cause of his severe internal bleeding.

Hope for head trauma

Due to the seriousness of Donovan’s condition, Northwell Health’s SkyHealth helicopter service transported him to Cohen Children’s Medical Center, where physicians admitted him to the Pediatric Intensive Care Unit (PICU) and placed him in a deliberate coma. Pediatric specialists in orthopedics, vascular surgery, trauma surgery and neurosurgery examined Donovan and determined that the most pressing concern was his traumatic brain injury, which caused his brain to swell.

“To reduce the pressure on his brain, we drilled a small hole in the skull and inserted an external ventricular drain or EVD,” said Shaun Rodgers, MD, pediatric congenital and transitional neurosurgeon at Cohen Children’s Medical Center. “The EVD let us drain spinal fluid, continuously monitor the pressure on his brain and deliver medications.”

The brain swelling continued, so on January 13, pediatric neurosurgeons removed a large portion of Donovan’s skull to give his brain the space it needed. They stored the detached piece within a pocket in the teen’s abdominal wall to keep it viable and reduce the risk of infection when it was time to return it to its original location. (Clinicians can also freeze such a bone fragment when the “pocket” approach won’t work for a patient.)

Two weeks later, Donovan’s swelling went down enough for surgeons to rebuild his skull.

A long road, traveled together

During her son’s hospitalization, Ms. Garces left her job to stay by his side at Cohen Children’s Medical Center. Although it was the most difficult time in her life, she remembers how much the medical team meant to her and her family.

“Dr. Rodgers saved my son’s life,” Ms. Garces said. “The whole team at Cohen Children’s Medical Center was amazing. On top of caring for my child, they showed compassion toward my husband, Matt, and me. One nurse in particular, Sally Errico, was the biggest angel. We didn’t know what we were doing, but she clarified anything we didn’t follow. The social workers were also wonderful and comforting, especially the night we arrived.”

Donovan was discharged in early February 2016 but required further care and rehabilitation. In June, he began speaking for the first time since the accident. Today, Donovan is continuing his recovery with therapy and rehabilitation from specialists at Cohen Children’s Medical Center.

“He’s a miracle boy,” Ms. Garces said. “He’s not completely healed, but we have faith that he will be eventually. Some things are different, but he’s walking, talking, jumping and running. He’s still very smart, funny and loving.”

To read Donovan’s full story, click here. When you need us, we are here for you, now more than ever

At Westchester Health, even though some things have changed recently, the most important thing about us has not: our commitment to delivering the highest-quality standard of compassionate, patient-centered care for you and your family. Whenever, wherever you need us, we’re here for you.

Categories: Blog

You Now Have Access to Cohen Children’s Medical Center, One of the Nation’s Best Children’s Hospitals.

Westchester Health Blog - Wed, 09/12/2018 - 11:14

Rest assured, Westchester Health physicians will continue caring for your child at the state-of-the-art locations where you currently see us. But in addition, you can now take advantage of the 88 outstanding sub-specialties and programs available at Cohen Children’s Medical Center because of our new relationship with Northwell Health and its physician organization, Northwell Health Physician Partners.

A wide range of sub-specialty pediatric services are now available to you at Cohen Children’s Medical Center

To make sure your child receives the highest quality medical care, Cohen Children’s Medical Center offers a comprehensive array of sub-specialties, including cardiothoracic surgery, Childhood Brain and Spinal Cord Tumor Center, Cystic Fibrosis Center, Epilepsy Center, Fetal Cardiology Program, Hearing and Speech Center, Kidney Transplant Program, Leukemia and Lymphoma Program, Oncology Rare Tumors and Sarcoma Program, POWER Kids Weight Management Program and Stem Cell Transplant Program.

Here’s a story about how a dedicated pediatric specialist enabled her patient to be what every child wants to be: a normal kid. Olivia’s journey toward wellness When your child doesn’t respond to standard treatment, a seasoned specialist makes all the difference.

Olivia Perera, 10, is much like any fifth grader. She loves to swim and skate, and sometimes her mother, Priyangani Rajapakse, has to tell her siblings — Sylvia, 16, and Riley, 14 — not to tease her. Unlike her peers, though, the young Bellerose resident has spent eight years fighting a kidney disorder called minimal change disease.

It began when she was just shy of her second birthday, and Olivia’s whole body looked swollen.

“I thought it was spring [allergies], so I took her to the Cohen Children’s Medical Center Urgi Center,” Ms. Rajapakse said. “They agreed and sent us home. Afterward, I noticed the swelling was worse and that Olivia wasn’t going to the bathroom.”

Ms. Rajapakse and Olivia returned to the Urgi Center, and clinicians tested Olivia’s urine. The results showed high levels of protein, so the staff brought mother and daughter to the Emergency Department. The doctors diagnosed Olivia with nephrotic syndrome caused by minimal change disease.

“Most children with minimal change disease — more than 90 percent — respond to the standard treatment of a two-month course of steroids,” said Christine Sethna, MD, director of pediatric nephrology at Cohen Children’s Medical Center. She added that Olivia initially responded well to steroids, but relapsed when Dr. Sethna began to wean her off them.

“Olivia became dependent on them, so we had to look at other treatment options to avoid complications from long-term steroid use,” Dr. Sethna said. She has prescribed several immuno-suppressants during the past eight years while Olivia maintained a steroid regimen to prevent relapse. Unfortunately, the immuno-suppressants caused side effects like high blood pressure, abdominal pain, and oral ulcers and bruising.

High blood pressure increases the risk of a cardiovascular event in children with nephrotic syndrome, although the level of risk compared to the average child is unclear. Dr. Sethna is searching for answers.

Working to reduce future risks

“My research, which Olivia participates in, is a national, 14-site study of children with nephrotic syndrome,” Dr. Sethna said. “Cardiovascular disease is the number one cause of death in adults with a history of childhood kidney disease. Children usually develop it between the ages of 2 and 8. With our research, we hope to identify these patients early and intervene to reduce their risk.”

A customized medication regimen allowed Olivia to stop taking steroids last June, and she’s been in remission from minimal change disease and nephrotic syndrome since October 2016. Her doctors are hopeful she’ll outgrow the syndrome during puberty, like most children with the disease.

Now, Olivia’s enjoying life like any other tween girl, and she’s even hoping to start dance classes.

“I’m so thankful for the nurses and doctors who have helped us, and go out of their way to cheer up Olivia when we have follow-up visits,” Ms. Rajapakse said. “I’m confident her care is in good hands.”

To read Olivia’s full story, click here. When you need us, we are here for you, now more than ever

At Westchester Health, even though some things have changed recently, the most important thing about us has not: our commitment to delivering the highest-quality standard of compassionate, patient-centered care for you and your family. Whenever, wherever you need us, we’re here for you.

Categories: Blog

Our New Partnership With Cohen Children’s Medical Center Means That You Have Access To The Best Care For Your Child

Westchester Health Blog - Wed, 09/05/2018 - 11:05

Now that Westchester Health Pediatrics is part of Northwell Health and its physician organization, Northwell Health Physician Partners, a wide range of sub-specialty pediatric services are now available to you at Cohen Children’s Medical Center, one of the nation’s best children’s hospitals, according to U.S. News & World Report.

To make sure your child receives the highest quality medical care, Cohen Children’s Medical Center offers a comprehensive array of sub-specialties, including cardiothoracic surgery, Childhood Brain and Spinal Cord Tumor Center, Cystic Fibrosis Center, Epilepsy Center, Fetal Cardiology Program, Hearing and Speech Center, Kidney Transplant Program, Leukemia and Lymphoma Program, Oncology Rare Tumors and Sarcoma Program, POWER Kids Weight Management Program and Stem Cell Transplant Program. All of these sub-specialties and many more are now available to you as part of our new affiliation with Northwell Health.

Here’s a wonderful story about a concerned mom, a premature daughter and the dedicated staff of Cohen Children’s Medical Center’s lactation team. A new way to enhance preemies’ natural nutrition When Mackenzie was born prematurely, her mother was determined to give her the breast milk she needed to grow and thrive.

A mother of two boys, Axsa Medrano had some experience with breastfeeding. But the 31-year-old accountant from Queens needed guidance to produce breast milk when her daughter was born last December.

“I didn’t breastfeed much with either of my boys,” Ms. Medrano said. “My milk dried up after just a few weeks for both of them, and I didn’t have the help or education I needed to breastfeed them successfully.”

While Mackenzie stayed in the Neonatal Intensive Care Unit (NICU) at Cohen Children’s Medical Center, Ms. Medrano hoped her daughter would benefit from breastfeeding.

“On the first day, the lactation consultants brought a breast pump to my room and started educating me about how good a mother’s milk is for her baby,” Ms. Medrano said. “I felt like a first-time mom all over again.”

Ms. Medrano learned to pump about every three hours to encourage the production and expression of milk. She also focused on holding her baby and maintaining skin-to-skin contact to promote bonding and milk production.

Making the most of mother’s milk

The lactation team fortified Ms. Medrano’s expressed milk with key nutrients that would strengthen Mackenzie’s immune system and encourage her growth and development. Fortifying breast milk according to each baby’s needs is at the heart of Cohen Children’s Medical Center’s Human Milk Center.

“The Human Milk Center has trained milk technicians who label and store a mother’s milk in a temperature-controlled environment,” said Richard Schanler, MD, director of neonatal services with Northwell Health and Cohen Children’s Medical Center. “When a feeding order comes in for a baby in the NICU, the technicians bring a certain amount of the milk to the right temperature and mix it with the appropriate amount of fortifier. They then put it in a labeled feeding device, such as a syringe, and deliver it to the baby’s bedside.”

Getting adequate nutrients from a mother’s milk is crucial, especially for babies born ahead of schedule. Premature babies fed with their mother’s milk can better fight off intestinal disorders and infections, such as necrotizing enterocolitis, a common disease in preemies. If a mother cannot pump enough milk for her baby, Human Milk Center technicians may formulate servings with pasteurized donor milk.

“A mother’s milk improves the baby’s ability to withstand respiratory problems, like chronic lung disease, and reduces the incidence of retinopathy of prematurity, the growth of abnormal blood vessels in the retina that can cause blindness, and improves their development,” said Dr. Schanler.

The Human Milk Center’s streamlined delivery process helps the Cohen Children’s Medical Center team ensure that infants in the NICU consume their mother’s milk as often as possible.

“In the past, nurses had to spend significant time acquiring and preparing a mother’s milk for her preemie,” said Cynthia Pesce, RN, lactation coordinator at Cohen Children’s Medical Center. Ms. Pesce is a board-certified lactation consultant recognized by the International Board of Lactation Consultant Examiners and specializes in the clinical management of breastfeeding. “Our system allows nurses to concentrate more on patient care, so it’s a win-win for everyone.”

Today, Mackenzie is home and getting to know her big brothers. Ms. Medrano still marvels at the support she received from Cohen Children’s Medical Center lactation consultants.

“The lactation specialists are very knowledgeable, encouraging and uplifting,” Ms. Medrano said. “Thanks to their support, Mackenzie is getting stronger every day.”

To read Mackenzie’s full story, click here. When you need us, we are here for you, now more than ever

At Westchester Health, even though some things have changed recently, the most important thing about us has not: our commitment to delivering the highest-quality standard of compassionate, patient-centered care for you and your family. Whenever, wherever you need us, we’re here for you.

Categories: Blog

If Your Child Needs A Pediatric Specialist, You Now Have Access to Cohen Children’s Medical Center.

Westchester Health Blog - Wed, 08/29/2018 - 10:50

Great news! Now that Westchester Health is part of Northwell Health and its physician organization, Northwell Health Physician Partners, you now have access to the pediatric services of Cohen Children’s Medical Center, the New York metropolitan area’s only hospital designed exclusively for children and one of the nation’s best children’s hospitals. Rest assured, Westchester Health physicians will continue caring for you and your family at the state-of-the-art locations where you currently see us. But in addition, you can now take advantage of the outstanding sub-specialties and programs available at Cohen Children’s Medical Center.

Here’s a terrific story about a Cohen Children’s Medical Center patient, particularly if you have a child with a rare and hard-to-treat condition—in this case, Langerhans cell histiocytosis (LCH). Doctors who stop at nothing to find answers, and hopefully, cures

Taylor Ryan, a 15-year-old East Islip High School freshman, has already experienced a lifetime of medical care and hospital visits to treat her LCH. This rare disease usually responds well to treatment, but Taylor’s case is different. In 2010, she and her family learned that it was affecting her central nervous system, causing severe headaches, hand tremors and visual disturbances. It also produces unpredictable seizures that trigger numbness and blindness on her right side, plus weakness and dizziness.

Taylor’s pediatric hematologist/oncologist, Carolyn Fein Levy, MD, leads the Pediatric Oncology Rare Tumor and Sarcoma Program at Cohen Children’s Medical Center. “This disease is rare, but LCH of the central nervous system, like Taylor’s, is rarer still,” she said. “Treating it is very challenging.”

To try and find an effective long-term treatment, Taylor’s care team at Cohen Children’s Medical Center has collaborated with an international LCH specialist at Texas Children’s Hospital. “I could never thank the physicians at Cohen Children’s Medical Center enough for seeking out the highest level of expertise for my daughter,” Taylor’s mom said. “They don’t stop until they come up with the best plan for her.”

While the pediatric hematology/oncology specialists tirelessly work to control Taylor’s symptoms and put her LCH of into remission, she has a tremendously positive attitude that serves her well. The light at the end of the tunnel might still be far away right now, but optimism and trust in her Cohen Children’s Medical Center care team illuminate the way.

To read Taylor’s full story, click here. When you need us, we are here for you, now more than ever

At Westchester Health, even though some things have changed recently, the most important thing about us has not: our commitment to delivering the highest-quality standard of compassionate, patient-centered care for you and your family. Whenever, wherever you need us, we’re here for you.

Categories: Blog

Many People Think Tanning Beds Are Safe But They’re Wrong

Westchester Health Blog - Wed, 08/22/2018 - 10:36

Did you know that tanning beds emit ultraviolet (UV) radiation which is a significant risk factor for skin cancers, including malignant melanoma, the deadliest form of skin cancer? And that people who first use a tanning bed before age 35 increase their risk for melanoma by 75%? Don’t be fooled, get the facts in this blog by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

 Two myths about tanning beds
  1. Since tanning beds only emit UVA radiation and the sun emits both UVA and UVB rays, a lot of people think that tanning beds are safer than lying in the sun, but this is false. Numerous studies have shown that UVA rays can also cause skin cancer.
  2. In addition, many tanning beds emit rays that are 10-15 times higher than midday sun exposure and their rays go deeper into the skin, thus increasing the risk of skin damage and skin cancer.

    Lauren Adler, MD, FAAP

Despite the increased cancer risk, nearly 2.3 million teens have used indoor tanning machines
  1. At Westchester Health, we’re very concerned about the percentage of adolescent girls who use indoor tanning: 20-30%. This is particularly bad news because the earlier a person starts tanning and the more times they do it, the greater the risk of developing skin cancer later on.
  2. The Skin Cancer Foundation reports that just one indoor ultraviolet (UV) tanning session increases a person’s chances of developing melanoma by 20 percent, and each additional session during the same year boosts the risk almost another two percent, according to a major new study.
  3. The news for young people, the main users of tanning machines, is even worse, with those who started tanning before age 35 increasing their risk by almost 90 percent. These figures, based on an exhaustive analysis of 27 studies by the International Prevention Research Institute in Lyons, France, were higher than any previously reported, according to The Skin Cancer Foundation.
To stay safe in the sun, follow these Prevention Guidelines from the Skin Cancer Foundation:
  • Always use a sunscreen with an SPF 15 or higher
  • For extended outdoor activity, use a water-resistant broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher
  • Spend time in the shade, especially between 10am and 4pm
  • Do not let your skin burn
  • Avoid tanning and UV tanning beds
  • Cover your skin with clothing, including a broad-brimmed hat and UV-blocking sunglasses
  • Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or immediately after swimming or excessive sweating.
  • Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
  • Examine your skin head-to-toe every month.
  • See your physician or a dermatologist every year for a professional skin exam.
Be smart! There are safer alternatives to tanning salons

Nowadays there are a number of “sunless” tanning products that contain dihydroxyacetone, a chemical that combines with an outer skin protein to cause a reaction that simulates tanning. It is nontoxic, has few side effects and usually will not cause an allergic skin reaction. Be aware, though, that these products do not provide any sunscreen protection from the sun.

More resources about the dangers of tanning beds

To be as informed as possible about the pros and cons of tanning beds, we thought you might find these websites helpful:

If you’re worried about possible skin damage due to tanning salons, please come see us

If you’re concerned that your child may have damaged her (or his) skin by using tanning beds, make an appointment with Westchester Health to see one of our pediatricians. We’ll examine your child’s skin and if we feel a specialist’s evaluation is needed, make a referral to a dermatologist. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

If Your Baby Needed CPR, Would You Know What To Do?

Westchester Health Blog - Wed, 08/15/2018 - 10:20

If your baby stopped breathing, what would you do? Do you know how to administer CPR (cardiopulmonary resuscitation)? At Westchester Health, we hope you’ll never have to use CPR for your infant or child, but in case you do, it’s important to know the basics. As a guide, we recommend this very informative blog by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

CPR guidelines from the American Red Cross

Lauren Adler, MD, FAAP

The American Red Cross offers the following step-by-step CPR instructions that we think all parents should know. (Although you may have taken a class in child CPR, it’s still a good idea to keep these instructions handy so the information stays fresh in your memory.)

Print out several copies so you can keep them in your car, your desk, your kitchen, your child’s room and with your other first aid supplies. We also suggest that you read over the steps from time to time to keep your skills up-to-date.

Before giving CPR to a baby or child
  1. Check the scene and the child. Make sure the scene is safe, then tap the child on the shoulder and say loudly, “Are you OK?” to ensure that he or she needs help. For infants, brush the bottom of the foot to elicit a response.
  2. Call 911. If the child does not respond, call 911, then administer approximately 2 minutes of care.
  • If you’re alone with the child or infant, administer 2 minutes of care, then call 911.
  • If the child or infant does respond, call 911 to report any life-threatening conditions and obtain consent to give care. Check the child from head to toe and ask questions to find out what happened.
  1. Open the airway. With the child lying on his or her back, tilt the head back slightly and lift the chin.
  2. Check for breathing. Listen carefully, for no more than 10 seconds, for sounds of breathing. (Occasional gasps aren’t breathing.) Infants typically have periodic breathing, so changes in breathing pattern are normal.
  3. Deliver 2 rescue breaths if the child or infant isn’t breathing. With the head tilted back slightly and the chin lifted, pinch the child’s nose shut, make a complete seal by placing your mouth over the child’s mouth and breathe into the child’s mouth twice. For infants, use your mouth to make a complete seal over the infant’s mouth and nose, then blow in for one second to make the chest clearly rise. Then, deliver two rescue breaths.
  4. Begin CPR. If the child or baby is unresponsive to the rescue breaths, begin CPR.
Administering CPR to a baby or child
  1. Kneel beside the baby or child.
  2. Push hard, push fast.
  • For infants, use 2 fingers to deliver 30 quick compressions that are each about 1½ inches deep.
  • For children, place the heel of one hand on the center of the chest, then place the heel of the other hand on top of the first hand, and lace your fingers together. Deliver 30 quick compressions that are each about 2 inches deep.
  1. Give 2 rescue breaths (see above).
  2. Keep going. Continue these baby or child CPR steps until:
  • you see obvious signs of life, such as breathing
  • an AED (automated external defibrillator) is ready to use
  • another trained responder or EMS professional can take over
  • you’re too exhausted to continue
  • the scene becomes unsafe
What to do when your baby is choking

As well as their baby not breathing, choking is another fear for many parents. Babies easily can choke on food and toys, slip under the water in the tub or a pool, and get caught in drawstrings, elastics and curtain cords.

To know what to do if your baby is choking, we recommend the BabyCenter’s step-by-step illustrated guide, reviewed by health and safety services experts at the American Red Cross.

To learn more about CPR for babies and children

To see child and baby CPR steps performed, watch the American Red Cross child and infant CPR videos. For online, in person, and blended training courses on child, infant and adult CPR, visit the American Red Cross CPR Training Page. To find a class in your area, visit the Red Cross website or call 800-733-2767 (800-RED-CROSS).

For more information on CPR for your baby or child, please come see us

If you’d like to know more about how to perform CPR on your baby or child and when it’s needed, make an appointment with Westchester Health to see one of our pediatricians. We’ll go through all the steps with you, demonstrate how and when to administer CPR, and answer any questions you may have. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

6 Myths About Acne That Just Aren’t True

Westchester Health Blog - Wed, 08/08/2018 - 11:06

Contrary to popular belief, neither fatty foods nor chocolate causes acne. Primarily, hormones (male androgens or related compounds) cause acne, which is why so many young people get pimples during puberty, or for girls, right before their period starts. To debunk these and other acne myths, we recommend this blog by Mason Gomberg, MD, a pediatrician with our Westchester Health Pediatrics group.

6 acne myths that are just that: myths

KidsHealth article debunks the following 6 acne myths and we wanted to share them with you here. For the best ways to treat acne, we recommend that you and your child talk with a dermatologist or skin care specialist.

  1. Myth: Popping your pimples is the best way to get rid of them.

    Mason Gomberg, MD

Fact: No! Many teens think that popping zits will make them less noticeable and help them heal faster, but this is not true. Your fingers and fingernails are often dirty, and picking at or popping your pimples pushes germs and bacteria further under your skin. This can cause more redness, pain, inflammation and maybe even an infection. Also, popping zits can lead to scarring.

  1. Myth: Stress causes acne.

Fact: The normal stress of being a teenager does not cause acne. If you’re going through an especially stressful period in your life—such as switching schools or dealing with your parents’ divorce or the death of a beloved pet—your skin may produce more oil (sebum), but that doesn’t mean you’ll get more pimples.

  1. Myth: Getting a tan clears up acne.

Fact: Baking in the sun does nothing to improve your acne. In fact, in many cases, getting excessive sun on your already-irritated face can actually make your acne worse. Our advice is to use a sunscreen that has an SPF of at least 30 and that says “noncomedogenic” or “nonacnegenic,” which means it won’t clog your pores and exacerbate your acne. And DO NOT visit tanning beds. This will not clear up your acne and may increase your risk of developing skin cancer. NOTE: Photodynamic therapy with UV-free blue light did not provide significant benefits in medical studies.

  1. Myth: You can get rid of acne by washing your face more.

Fact: Washing your face regularly is a good idea because it helps remove dead skin cells, excess oil and dirt from your skin’s surface. But over-washing or scrubbing your skin too vigorously can dry out and irritate your skin, which will only make your acne worse.

  1. Myth: If you want to avoid acne, don’t wear makeup.

Fact: Makeup does not give you acne. If you’re someone who likes to wear makeup, choose products labeled “oil-free,” “noncomedogenic” or “nonacnegenic,” which means the product won’t clog your pores or cause breakouts. Some cosmetics even contain acne-fighting ingredients such as benzoyl peroxide and salicylic acid.

  1. Myth: If you keep breaking out, using more medicine will cure your pimples.

Fact: False. Using too much acne medication can lead to dry, irritated skin. Whether you are applying over-the-counter remedies or using something prescribed by a doctor, be sure to follow the directions carefully. Using more than the recommended amount can cause troublesome and even dangerous side effects.

What’s the best way to care for your skin?

As a general rule, gently wash your face A FEW TIMES PER DAY with mild soap. For mild acne, you can try an OTC product containing 5% benzoyl peroxide once per day. Washes or cleansers, as opposed to acne creams, are better for those with widespread acne or more sensitive skin. The amount of medicine applied should be the size of a pea for your facial area. If OTC products do not work, your pediatrician or dermatologist can prescribe topical creams or antibiotics, oral antibiotics and/or other oral medicines to improve your skin condition.

To learn more

For more information on acne treatment and skin care, you might find this article, Taking Care of Your Skin, helpful.

If you’re concerned about your child’s pimples or acne, please come see us

If your son or daughter has persistent pimples or acne that’s not responding to treatment, make an appointment with Westchester Health to see one of our pediatricians. We’ll examine your child’s skin and together with you, choose the best treatment for their individual condition. If needed, we will refer you to a dermatologist for more aggressive treatment. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Will Ear Tubes Help Cure My Child’s Ear Infections?

Westchester Health Blog - Wed, 08/01/2018 - 10:51

For children who suffer from ear infections from an early age, ear tubes can be a very effective solution, and they’re something we at Westchester Health recommend for many of our young patients with ear issues. The average age for ear tube insertion is 1-3 years old. To learn more, Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, has written a very informative blog on the subject.

What can ear tubes do?
  1. Reduce the occurrence of future ear infections
  2. Restore hearing loss caused by a build-up of middle ear fluid
  3. Improve speech problems and balance problems
  4. Improve behavior and sleep problems caused by chronic ear infections
  5. Help children do their best in school
Your child might benefit from ear tubes if he/she:

Lauren Adler, MD, FAAP

  1. Has had three or more ear infections within six months, especially if they retain fluid in between the episodes
  2. Has ear infections that are not resolved with antibiotics
  3. Has ear infections that are affecting their gross motor skills and/or balance
  4. Is experiencing hearing loss caused by the persistent build-up of fluid in the middle ear
  5. Has a collapsing eardrum, a condition known as atelectasis which causes decreased hearing and can also erode the bones in the ear
  6. Is at higher risk for fluid build-up-related developmental delays, including those with autism, permanent hearing loss, Down syndrome, cleft palate or any other developmental delay
  7. Has malformation of the eardrum or eustachian tube that inhibits drainage of the middle ear
Ear tubes: the facts

Usually made of plastic, these small tubes (1/20th of an inch) are surgically inserted into the tympanic membrane (ear drum) while the child is under light anesthesia. This allows air to flow in and out of the middle ear, which typically reduces the number of ear infections by ventilating and eliminating the pressure inside the middle ear. A child should not be able to feel the tubes while they’re in the ear.

Ear tubes come in two basic types: short-term and long-term. Short-term tubes are smaller and typically stay in place for 6-18 months before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist may be necessary.

The good news is that children with ear tubes are able to play in water, swim and bathe without wearing earplugs. If the water is more than six feet deep, a child with ear tubes should wear ear protection.

To learn more

For more information about ear tubes and ear infections, you might find this article from the American Academy of Otolaryngology-Head and Neck Surgery Foundation helpful.

If you think your child may need ear tubes, please come see us

If your child is having persistent ear infections or other problems with his/her ears, please make an appointment with Westchester Health to see one of our pediatricians. We’ll examine your child and together with you, choose the best treatment to clear up the condition, which may or may not include ear tubes. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

How To Know If Your Baby Has Cradle Cap And What To Do About It

Westchester Health Blog - Wed, 07/25/2018 - 10:31

Cradle cap is the common term for seborrheic dermatitis, and it’s something we see quite often in our newborn patients here at Westchester Health. Basically infant dandruff, cradle cap is extremely common and it usually doesn’t cause pain or itching. To learn more, read this excellent blog by Heather Magnan, MD, a pediatrician with our Westchester Health Pediatrics group.

Does your baby have thick, oily, white or yellow crusty or scaly patches on his/her scalp? Relax, it’s nothing serious, it’s probably cradle cap.  Some babies get it in a small patch, while others get scales all over their head. And by the way, cradle cap doesn’t just appear on the head. Although the scalp is the predominant location, this condition can also show up on your baby’s forehead, eyebrows, ears, nose, diaper area, back of the neck, armpits and other parts of the body.

It’s not contagious and it is not caused by poor hygiene or improper care of your baby.

What causes cradle cap?

Unfortunately, we really don’t know what causes it, although there are several theories.

  • Some experts believe that the hormones a baby gets from his/her mother toward the end of pregnancy overstimulate the production of oil (sebum) in the oil glands and hair follicles.
  • Others think that cradle cap may be caused by a yeast (fungus) that grows in the sebum along with bacteria.
  • Also, certain factors—like weather extremes, oily skin, immune system problems, stress and other skin disorders—can make it more likely that a baby will get cradle cap.
Ways to treat it

In most cases, cradle cap just goes away on its own, usually in a few months and certainly by your baby’s first birthday. However, if your baby has a severe case or if cradle cap keeps coming back, you may want to try the following home treatments:

  1. Wash your baby’s scalp daily with a mild shampoo or twice weekly with a dandruff shampoo. This helps loosen and remove the scales and crusty patches. Make sure the shampoo doesn’t get in your baby’s eyes because it will irritate them.
  2. To loosen the scales, brush your baby’s hair with a soft-bristle brush, soft toothbrush or fine-tooth comb before rinsing off the shampoo.
  3. If the scales don’t loosen easily, try rubbing a small amount of baby oil, mineral oil or petroleum jelly (not olive oil) onto your baby’s scalp. Let the oil soak into the scales for a few minutes, then shampoo your baby’s hair. Be sure to wash the oil away each time you apply it—too much oil on the scalp may cause the scales to build up and could actually make cradle cap worse.
  4. Gently massage your baby’s scalp with your fingers or a washcloth to loosen the scales.
When to take your infant to the pediatrician

In most cases, cradle cap is not serious. However at Westchester Health, we recommend taking your child to your pediatrician if:

  • cradle cap appears in places where your baby doesn’t have hair
  • home remedies have not worked
  • the rash is getting worse, is causing hair loss or becomes itchy
  • it covers large parts of your baby’s body
  • the affected skin becomes firm and red, starts to drain fluid, or feels warm, which could be signs of an infection
  • your baby has a weakened immune system
  • your baby has cradle cap and is having trouble gaining weight
Another good resource

For more information about cradle cap, you might find this article from KidsHealth helpful.

If you’re concerned about your child’s cradle cap, please come see us

If your baby has cradle cap that is not responding to treatment and you want it checked out, please make an appointment with Westchester Health to see one of our pediatricians. We’ll examine your baby and together with you, choose the best treatment to clear up the condition as soon as possible. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Don’t Believe That E-Cigarettes And Vaping Are Safe. They’re Not.

Westchester Health Blog - Wed, 07/18/2018 - 10:28

The good news is that the rates for adolescents smoking tobacco have dipped slightly. The bad news is that e-cigarette use in middle and high school students has tripled. Many people, especially teens, think that e-cigarettes are a safe alternative to smoking. Unfortunately, this is simply not true. E-cigarettes are just another way of absorbing nicotine—which is a highly addictive drug—into your body. To learn more, read this blog by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

Electronic cigarettes (e-cigarettes) are battery-powered smoking devices often designed to look and feel like regular cigarettes

E-cigarettes use cartridges filled with a liquid that contains nicotine, flavorings, and other chemicals. A heating device then converts this liquid into a vapor, which the person inhales. This is why using e-cigarettes is known as “vaping.”

Lauren Adler, MD, FAAP

Because e-cigarettes do not burn tobacco, you don’t inhale the same amounts of tar and carbon monoxide as you would with a regular cigarette. But anyone using an e-cigarette is still putting an unhealthy dose of nicotine and other chemicals into their lungs.

The very real health dangers of e-cigarettes

Even though e-cigarettes do not fill the lungs with harmful smoke, they are not a healthy alternative to regular cigarettes.

  1. When you vape, (use an e-cigarette), you’re still putting nicotine—which is absorbed into the bloodstream through your lungs—into your body. In addition to being a highly addictive drug, nicotine is also toxic in high doses. (It used to be used as an insecticide to kill bugs.) There have even been fatal cases when the nicotine liquid in e-cigarettes has been ingested or absorbed through the skin.
  2. Nicotine affects your brain, nervous system and heart. It raises blood pressure and heart rate. The larger the dose of nicotine, the more a person’s blood pressure and heart rate go up. This can cause an abnormal heart rate (arrhythmia). In rare cases, especially when large doses of nicotine are involved, arrhythmias can cause heart failure and death.
  3. After its initial effects wear off, the body starts to crave nicotine. You might feel depressed, tired and irritable (known as nicotine withdrawal), and crave more nicotine to perk up again. Over time, nicotine use can lead to serious medical problems, including heart disease, blood clots and stomach ulcers.
Vaping is not a way to stop smoking, no matter what the ads say

Electronic cigarettes are marketed to smokers as a way to help them quit, but there’s no evidence that they actually help people stop smoking. Instead, they have actually been found to be a health risk for people who use them, as well as for bystanders who breathe in the secondhand vapor (which comes out of the device as well as exhaled from the user’s mouth) and third-hand vapor (which sticks to surfaces such as upholstery, clothing, bedding and floors).

Effective ways to stop smoking, either regular cigarettes or e-cigarettes

Because nicotine is so addictive, the best way to quit smoking or stop using e-cigarettes is not to start. But if you smoke and want to quit, e-cigarettes probably aren’t your best option. Using an e-cigarette mimics the experience of smoking tobacco cigarettes more closely than other quitting options (like nicotine gum or patches). You don’t want to give up smoking only to find you’re now hooked on e-cigarettes.

From our years of experience here at Westchester Health helping our patients quit smoking (either tobacco cigarettes or e-cigarettes), here are the 7 steps that have proven to produce the best results:

  1. Make a specific plan. Set a date to begin the quitting process. If you smoke cigarettes, try quitting altogether before relying on e-cigarettes to help. If that doesn’t work, create a specific goal, such as using one less e-cigarette a day for a week. Keep cutting back until you no longer smoke or vape.
  2. Stay busy. Take your mind off cigarettes by exercising or doing something that involves your hands, like drawing, playing music or basketball. Be aware of specific times and situations that make you want cigarettes (like at a party or after a meal), and come up with a plan to handle those times.
  3. Delay giving in to a craving. When you crave a cigarette or e-cigarette, put off giving in to the urge. Sometimes it’s easier to wait than to tell yourself “no.” Do something else to take your mind off the craving.
  4. Keep focused on why you want to quit. Write down all the reasons you want to stop using cigarettes or e-cigarettes, like the money you’ll save or the extra energy you’ll have or how much better you’ll feel. Keep the list where you can see it. Read it every day, even though you already know the reasons. Doing this helps your brain automatically remind you of a reason when you feel a strong craving.
  5. Get support. Turn to your family or a trusted friend or doctor for moral support when you really want a cigarette. It also helps strengthen your resolve to tell other people that you are quitting. If you don’t want friends and family to know you smoke or use e-cigarettes, join an online or in-person support group. See if friends will join you in quitting. If not, ask them not to smoke or use e-cigarettes in front of you.
  6. Be good to yourself. Believe in yourself and give yourself lots of praise each time you avoid reaching for a cigarette. Remember, you’re doing this for you: your life, your health and your future.
  7. Nicotine is an addictive drug. It’s not easy to stop using it once you’ve started. That’s why we stress that the best strategy is to never start smoking or vaping in the first place. If it’s too late for that, remind yourself that it is possible to quit. You can do it. You really can.
Check out these resources to help you or your teen stop smoking or vaping: Concerned that your teen is smoking, vaping or might start soon? Come see us.

If you’re worried that your child is smoking, either tobacco cigarettes or e-cigarettes, or might start smoking, please come in and see one of our Westchester Health pediatricians. Together, we’ll talk it out with you and your child, and together figure out the best way forward. If needed, we’ll also help your child find the right support network to stop smoking. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Taking Your Kids To The Doctor Is Just As Important When They’re Well As When They’re Sick

Westchester Health Blog - Wed, 07/11/2018 - 11:07

Here at Westchester Health, we want to make sure parents know that it’s just as important to take their children to the doctor when they are well as when they are sick. These well-child visits are not only a chance to review a child’s physical, cognitive, emotional and social development, but they’re a good time to review health issues and answer any questions our parents or young patients may have. To learn more about why we recommend annual physicals, read this blog (excerpted here) by Mason Gomberg, MD, a pediatrician with our Westchester Health Pediatrics group, can help.

At the well-child visit, healthy behaviors such as diet, sleep, social skills and physical activity will be discussed

Mason Gomberg, MD

At Westchester Health, our pediatricians use the well-child visit to discuss such issues as prevention of injury and illness, reviewing car seat and seat belt usage, safe firearm storage, fire prevention and safety, screen time, and current and up-to-date immunizations. For teens, part of the exam should be done in private between the teenager and physician, allowing the doctor to ask sensitive questions and get important answers concerning such issues as substance abuse, mental health concerns, sexual activity and puberty.

A complete physical examination, blood pressure test, and vision and hearing screens

These additional tests may also be included in your child’s annual exam: testing for anemia, lead exposure, tuberculosis, cholesterol and depression.

If you are seeing a new doctor

Make sure to bring your child’s most recent and complete immunization records and health reports, any school reports that you are concerned about, your list of questions and any school or sports forms that need to be filled out.

To schedule your well-child visit, or to learn more about why your child needs one, give us a call

If it’s time for your child’s annual well-child visit, or if you have questions about any aspect of your child’s health, please make an appointment with Westchester Health to see one of our pediatricians. We’ll examine your child, perform age-appropriate tests and screenings, administer needed vaccinations, offer advice and guidance, and answer any questions you or your child might have. Always, our #1 goal is for your child to grow up healthy and happy. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

How Can I Protect My Baby From Dying From SIDS?

Westchester Health Blog - Wed, 07/04/2018 - 10:43

Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. SIDS is sometimes called “crib death” because the infants often die in their cribs. What makes SIDS so frightening is that it strikes babies who seem to have nothing wrong with them. To do everything we can to prevent this, Westchester Health offer this very informative blog (excerpted here) by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

Is your baby at risk of SIDS? Here’s how to know. Physical factors that can increase an infant’s risk of SIDS:
  1. Brain abnormalities. Some infants are born with problems that make them more likely to die of SIDS. It is believed that the portion of the brain that controls breathing and arousal from sleep does not work properly.
  2. Low birth weight. Premature birth or being part of a multiple birth increases the likelihood that a baby’s brain doesn’t mature completely, resulting in less control over such automatic processes as breathing and heart rate.
  3. Respiratory infection. Many infants who died of SIDS had recently had a cold, which may contribute to breathing problems.
  4. Boys are more likely to die of SIDS.
  5. Infants are most vulnerable during the 2nd and 3rd months of life.
  6. For reasons we don’t understand, African-American, American Indian and Alaska Native infants are more likely to develop SIDS.
  7. Family history. Babies who’ve had siblings or cousins die of SIDS are at higher risk themselves.
  8. Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.
Environmental factors that can increase an infant’s risk of SIDS:
  1. Sleeping on stomach or side. Babies who are placed on their stomachs or sides to sleep may have more difficulty breathing than those placed on their backs.
  2. Sleeping on a soft surface. Lying face down on a fluffy comforter or a waterbed can block an infant’s airway. Draping a blanket over a baby’s head also is risky.
  3. Sleeping with parents. While the risk of SIDS is lowered if an infant sleeps in the same room as his or her parents, the risk increases if the baby sleeps in the same bed, partly because there are more soft surfaces to impair breathing.
Maternal risk factors that can increase an infant’s risk of SIDS:

The mother:

  1. Is younger than 20
  2. Smokes cigarettes
  3. Uses drugs or alcohol
  4. Has inadequate prenatal care
10 things that can reduce the likelihood of your baby dying from SIDS
  1. Place your baby to sleep on his/her back, every time. Babies up to 1 year of age should always be placed on their backs to sleep during naps and at night. However, if your baby has rolled from his back to his side or stomach on his own, he can be left in that position if he is already able to roll from tummy to back and back to tummy. If your baby falls asleep in a car safety seat, stroller, swing, infant carrier or infant sling he/she should be moved to a firm sleep surface as soon as possible.
  2. Place your baby to sleep on a firm sleep surface. Your crib, bassinet, portable crib or play yard should meet current safety standards. Check to make sure the product has not been recalled. Do not use a crib that is broken or missing parts, or that has drop-side rails. Cover the mattress that comes with the product with a fitted sheet. Do not put blankets or pillows between the mattress and the fitted sheet. Most important: Never put your baby to sleep on a chair, sofa, water bed, cushion or sheepskin. For more information about crib safety standards, visit the Consumer Product Safety Commission website at
  3. Keep soft objects, loose bedding or any objects that could increase the risk of entrapment, suffocation or strangulation out of the crib. Pillows, quilts, comforters, sheepskins, bumper pads and stuffed toys can cause your baby to suffocate so keep them out of the crib.
  4. Place your baby to sleep in the same room where you sleep but not the same bed. Babies who sleep in the same bed as their parents are at greater risk of SIDS, suffocation or strangulation. Parents can roll onto babies during sleep or babies can get tangled in the sheets or blankets.
  5. Breastfeed as much and for as long as you can. Studies show that breastfeeding your baby can help reduce the risk of SIDS.
  6. Keep up with all well-baby visits. Your baby needs important immunizations and other crucial health checks at regularly scheduled well-baby visits.
  7. Don’t smoke around your baby and keep him/her away from smokers and places where people smoke. If you smoke, quit. Plus, don’t allow anyone to smoke near your baby, even if he/she is outside.
  8. Don’t let your baby get too hot. Keep the room where your baby sleeps at a comfortable temperature. In general, dress your baby in no more than one extra layer than you would wear. If you are worried that your baby is cold, dress him/her in clothing designed to keep babies warm but that doesn’t cover their heads.
  9. Offer a pacifier at naptime and bedtime. Studies show that this helps reduce the risk of SIDS.
  10. Do not use products that claim to reduce the risk of SIDS. Products such as wedges, positioners, special mattresses and specialized sleep surfaces have not been shown to reduce the risk of SIDS. In addition, some infants have suffocated while using these products.
If you are worried about SIDS, please come see us.

At Westchester Health, one of our top priorities is to do everything we can to prevent SIDS. If you’re concerned about the possibility of your baby succumbing to SIDS, please come in and meet with us. From our years of experience with all kinds of babies, we have advice, guidance and support to give you information and more importantly, peace of mind. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Should I Take My Child To The Pediatrician Or The ER? Here’s How To Know.

Westchester Health Blog - Wed, 06/27/2018 - 10:19

At Westchester Health, we know it’s really hard not to panic when your child has a broken bone, high fever, open wound or is vomiting uncontrollably. In many instances, it would make sense to rush him/her to your local ER. However, there are times when the best course of action is to see your local pediatrician who knows your child and his/her health history. How do you know what to do when? This insightful blog (excerpted here) by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, can help.

When to take your child to the ER Head straight to the ER if your child:
  • is less than 2 months old and has a fever. Fever is defined as a (rectal) temperature of 100.4 degrees Fahrenheit or higher
  • has a broken bone, particularly if there is visible swelling or unevenness/bumps in the injured area (a sign that the broken bone is misaligned)

    Lauren Adler, MD, FAAP

  • hits his/her head and appears to pass out or lose consciousness for a few seconds
  • has had a seizure
  • is showing signs of dehydration, such as very dry/cracked lips and mouth, absence of urination for more than 12 hours, lethargy and confusion
  • has heavy, fast breathing, is gasping for air or manages to utter only 2-3 words before taking a breath
  • has gaping cuts on the face, especially younger children who need sedation while the injury is being repaired
Negative consequences of going to the ER
  1. The ER can expose your already sick child to potentially dangerous germs and other infections carried by everyone there in the ER (not just the patients but also the families waiting for the patients to be seen).
  2. ER care is almost always going to be more expensive than going to your own pediatrician.
  3. Emergency departments are, by definition, designed to care for the sickest or most seriously injured patients first, meaning that those with less severe illnesses or injuries will have longer waits.
  4. In an ER, your child is a stranger, but here at Westchester Health, we know your child personally, as well as his/her health history, family history, record of immunizations, risk factors, mental health issues, STDs and any other related health conditions. We strongly feel that this enables us to give more accurate, more informed and more compassionate care.
When to take your child to your pediatrician Go to the doctor if your child:
  • has fever accompanied by cold symptoms and you suspect it may be the flu
  • maybe has an ear infection—symptoms include drainage from the ear, earache and pulling on the ears
  • has a sore throat with or without white patches on the tonsils, a possible sign of strep infection
  • has pink eye (conjunctivitis)—symptoms include red, inflamed eyes with or without discharge
  • has had a few episodes of vomiting or diarrhea (without blood in the stool) but has no belly pain or signs of dehydration
If you think your child is experiencing a true emergency, call 911 immediately. For more information on when to take your child to the ER vs. pediatrician, please come see us

Questions? Still unsure of what to do when? We urge you to come in and see one of our pediatricians at Westchester Health. If your child is sick or injured, we will try our very best to see him/her as soon as possible and treat the problem so your child can feel better soon. If we feel your child should indeed go to the ER, or needs to see a specialist, we’ll speed that process along right away. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Does Your Child Has Type 1 Diabetes? 8 Ways To Know.

Westchester Health Blog - Wed, 06/20/2018 - 10:51

If you’re the parent of a child with type 1 diabetes, you know how challenging this disease can be, from giving injections to counting carbohydrates to monitoring blood sugar. At Westchester Health, we have many patients with this condition and are very experienced at helping our parents and young patients (when old enough) adequately manage it. To learn more, read this blog (excerpted version) by Rodd Stein, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

How can you know if your child has type 1 diabetes? The best way is to be informed and know the facts. To help, here are 8 guidelines.

8 warning signs that your child might have type 1 diabetes

NOTE: If your child has 1 or any combination of the 8 signs and symptoms listed below, he/she should see your pediatrician as soon as possible.

  1. Increased thirst and frequent urination. Excess sugar buildup in your child’s bloodstream pulls fluid from tissues. As a result, your child might be thirsty and drink and urinate more than usual. In fact, a young, toilet-trained child might suddenly experience bed-wetting.

    Rodd Stein, MD, FAAP

  2. Extreme hunger. Without enough insulin to transfer sugar to your child’s cells, his/her muscles and organs lack energy, which triggers intense hunger.
  3. Weight loss. Unexplained weight loss is often the first sign of type 1 diabetes in children. Despite eating more than usual to relieve hunger, your child may lose weight, sometimes rapidly. Without the energy that sugar supplies, muscle tissues and fat stores simply shrink.
  4. Your child is unusually tired and lethargic.
  5. Irritability or behavior changes. In addition to mood swings, your child might suddenly have a decline in performance at school.
  6. Fruity-smelling breath. Burning fat instead of sugar produces certain substances (ketones) that can cause a fruity breath odor.
  7. Blurred vision. If your child’s blood sugar is too high, fluid may be pulled from the lenses of his/her eyes, causing your child to be unable to focus clearly.
  8. Yeast infection. Girls with type 1 diabetes may develop genital yeast infections. Also, babies can develop diaper rashes caused by yeast.
Is your child at risk for type 1 diabetes? Know these risk factors:
  1. Family history. A child with a parent or sibling with type 1 diabetes has an increased risk of developing the condition.
  2. Genetic susceptibility. The presence of certain genes indicates an increased risk of developing type 1 diabetes.
  3. Race. In the U.S., type 1 diabetes is more common among non-Hispanic white children than among other races.
  4. Certain viruses. Exposure to various viruses may trigger the autoimmune destruction of the islet cells.
  5. Infant diet. No specific dietary factor or nutrient has been shown to play a role in the development of type 1 diabetes starting in infancy. However, early intake of cow’s milk has been linked to an increased risk of type 1 diabetes, while breastfeeding might lower the risk. The timing of the introduction of cereal into a baby’s diet also may affect a child’s risk of type 1 diabetes.
5 things you can do to manage your child’s type 1 diabetes
  1. Monitor blood sugar. Depending on what type of insulin therapy your child needs, you will probably be instructed to check and record your child’s blood sugar at least 4 times a day (maybe more often), requiring frequent finger sticks. This is the only way to make sure your child’s blood sugar level remains within his/her target range, determined by your pediatrician.
  2. Administer insulin and other medications. Anyone with type 1 diabetes needs insulin treatment. Because stomach enzymes interfere with insulin taken by mouth, insulin needs to be injected with a fine needle syringe or an insulin pen. An insulin pump is another option, worn outside of the body, where, a tube connects the reservoir of insulin to a catheter inserted under the skin of the abdomen. A wireless pump that uses small pods filled with insulin is yet another option, automatically dispensing specific amounts of insulin automatically.
  3. Healthy eating. At WHP, we feel it’s important to work with a registered dietician who is familiar with diabetes to ensure that your child is getting the right nutritional intake with an emphasis on the different glycemic effects of various carbohydrates. Carbohydrates should be limited to ones high in fiber, and intake should be consistent.
  4. Physical activity. All children need regular cardiovascular exercise, and those with type 1 diabetes are no exception. Encourage your child to get regular physical activity, whether it’s soccer, swimming, dance, basketball, football, jogging, bike riding or any other aerobic activity. However, be aware that physical activity usually lowers blood sugar, possibly affecting your child’s blood sugar levels for up to 12 hours after exercise. You might need to adjust your child’s meal plan or insulin doses to compensate for the increased activity.
Remember: kids with diabetes can do everything other kids can do

It takes some extra effort to keep blood sugar levels within a healthy range but this gets easier with practice.

Do you think your child might have type 1 diabetes?

If you’re concerned that your child might be developing type 1 diabetes, or already has diabetes, please make an appointment with Westchester Health to see one of our pediatricians. We have years of experience and lots of advice and guidance to help make living with this disease easier on everyone. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Is Your Child Overweight? Here’s What You Can Do.

Westchester Health Blog - Wed, 06/13/2018 - 11:24

Did you know that in the past 30 years, the number of overweight children in the U.S. has tripled? Alarmingly, it is now estimated that 1 in 5 children is overweight (18.5%). With these numbers, it’s no surprise that childhood obesity is something we encounter a lot here at Westchester Health. However, we firmly believe (and we’ve seen results proving this theory) that with a concerted effort from many people in a child’s life, overweight kids can achieve a healthier lifestyle and reduce their weight. To shed important light on the subject, Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, has written a great blog which we excerpt here.

Why are there so many overweight and obese children in the U.S.? Many reasons.

Unfortunately, the majority of American children are not eating enough nutritious foods or getting sufficient physical activity. Many children have limited access to safe places to play, while others live in “food deserts” where there are few neighborhood places nearby for their parents to buy affordable, healthy food. Studies show that the odds of a child being obese or overweight increase by 20-60% when they live in poor housing, unsafe surroundings and/or limited access to sidewalks, parks and recreation centers. Contributing factors:

  1. 91% of American children have poor diets
  2. Less than half get the recommended 60 minutes of daily physical activity

    Lauren Adler, MD, FAAP

  3. Almost two-thirds of American youth consume a sugary beverage daily
  4. 25% of American high school students spend 3 or more hours a day staring at a screen
  5. Schools have reduced recess time in favor of academic instruction, particularly among older children
Several factors contribute to childhood obesity
  1. Unhealthy food choices: Diets high in calories (including fats and simple sugars) and lower in fruits and vegetables
  2. Lack of physical activity: Too much time spent in sedentary activities such as watching TV, video games and/or on phones
  3. Obese parents: Children of obese parents are more likely to be overweight themselves.
  4. Eating patterns: Skipping meals or not having a regular eating schedule can result in eating too much at one time.
  5. Parenting style: Overprotective parents regarding their children’s eating can cause those children to have poor self-regulation regarding food.
  6. Diabetes during pregnancy: Overweight and type 2 diabetes occur with greater frequency in the offspring of diabetic mothers (who are also more likely to be obese themselves).
  7. Low birth weight: A risk factor for being overweight in several studies.
  8. Excessive weight gain during pregnancy: Excessive maternal weight gain during pregnancy is associated with increased birth weight and being overweight later in life.
  9. Formula feeding: Breastfeeding is generally recommended vs. formula feeding, and studies suggest that it may also prevent excess weight gain as children grow.
  10. Parental eating and physical activity habits: Parents with poor nutritional habits and sedentary lifestyles model these unhealthy behaviors for their children, who often copy them in their own choices.
  11. Demographic factors: Certain demographic factors are associated with an increased risk of being overweight in childhood. For example, statistics show that African-American, Hispanic, Asian and Pacific Islander children are more likely to be overweight.
In spite of the statistics, childhood obesity can be reversed with healthy eating and exercise

Fortunately, healthy habits, including healthy eating and physical activity, can be taught—and when put into practice, can change a child’s life, both physically and mentally.

  • Schools play a critical role in influencing a child’s weight by establishing a safe and supportive environment that supports healthy behaviors. They also provide opportunities for students to learn about and practice healthy eating and physical activity (the dreaded gym class!).
  • Your child’s pediatrician also plays a vital role in helping your child reach and maintain a healthy weight. He/she can explain the health risks and benefits of a healthy and physically active lifestyle, create a customized diet and exercise plan, and encourage your child when he/she is struggling. Also, with regular checkups, your child’s doctor is more likely to notice changes in your child’s weight, both positive and negative, and can respond quickly to issues.
  • Parents probably have the most influence on a child’s eating and exercise habits. They can make sure there are healthy foods available at home, consult a nutritionist for meal guidelines, take their child to the gym with them, and be a cheerleader or a drill sergeant, whichever is needed.
What you can do to fight childhood obesity

From our years of experience here at Westchester Health, here are our tips that have proven to be most effective:

  1. Serve and eat a variety of foods from each food group.
  2. Serve small portions. Compared to adult portions, child portions should be very small. More food can always be added if needed.
  3. Bake, broil, roast or grill meats instead of frying them.
  4. Limit use of high calorie, high fat and high sugar sauces and spreads.
  5. Use low-fat or nonfat dairy products for milk, yogurt and ice cream.
  6. Encourage participation in sports and other physical activity at school, church or community leagues.
  7. Be active as a family: go on walks, bike rides or hikes together.
  8. Limit screen time.
  9. Avoid eating while watching TV. TV viewers typically eat too much, too fast, and are influenced by the foods and drinks that are advertised.
  10. Replace sugary drinks, especially sodas, with water and/or low fat milk.
  11. Limit fruit juice intake to two servings or less per day (one serving = ¾ cup). Many parents allow their children unlimited intake of fruit juice because of the vitamins and minerals it contains. However, children who drink too much fruit juice may be consuming excess calories.
  12. Encourage physical play in young children and provide environments that allow children to play indoors and outdoors.
  13. Model healthy dietary practices, nutritional snacks and lifestyle activities.
  14. Avoid using food as a reward for good behavior or good grades.
Concerned that your child is overweight or obese? Please come see us

If you are worried about your child’s weight and the effect this is having on his/her health, please make an appointment with Westchester Health to come in and talk to one of our pediatricians. We will meet with you and your child, assess their weight and overall health, and together with you, decide on the best course of action to steer him/her toward a healthier lifestyle and weight. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

10 Best Ways To Bring Down Your Blood Pressure

Westchester Health Blog - Wed, 06/06/2018 - 11:00

At Westchester Health, a great many of our patients have high blood pressure (also known as hypertension) but not all of them fully understand what this condition means. Blood pressure refers to the force of your blood pushing against your artery walls as it flows throughout your body. Too much force, i.e., high blood pressure, can damage your arteries and lead to life-threatening conditions such as heart disease and stroke.

Many people can have high blood pressure for years without any symptoms

James W. Catanese, MD, FACC

The only way to know if your blood pressure is too high is through regular checkups, which is why annual physicals are so important, no matter your age. In the U.S. alone, more than 30% of American adults have high blood pressure.

High blood pressure, not heart attack or stroke, is the most common cardiovascular disease

If left untreated, it can lead to serious consequences and possibly death.

How blood pressure is measured

Your blood pressure is represented by two numbers, the systolic (the top number) and diastolic (the bottom number). These numbers are determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

When your heart beats, it squeezes and pushes blood through your arteries to the rest of your body. This force creates pressure on those blood vessels, which is the systolic blood pressure.

  • A normal systolic pressure is below 120.
  • A reading of 120-129 is elevated.
  • 130-139 is stage 1 high blood pressure (also called hypertension).
  • 140 or more is stage 2 hypertension.
  • 180 or more could be a hypertensive crisis and you should call your doctor right away.

The diastolic reading, or bottom number, is the pressure in the arteries when the heart rests between beats. This is when the heart fills with blood and gets oxygen.

  • A normal diastolic blood pressure is lower than 80, but even if your diastolic number is below 80, you can still have high blood pressure if the systolic reading is 120-129.
  • 80-89 is stage 1 hypertension.
  • 90 or more is stage 2 hypertension.
  • 120 or more is a hypertensive crisis and you should call 911 right away.
How to know if you have high blood pressure: what to look for

If you have any of the following symptoms, see a doctor immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke.

  • Severe headache
  • Dizziness
  • Severe Fatigue
  • Confusion
  • New Vision problems
  • Chest discomfort
  • Difficulty breathing
  • Irregular heartbeat
  • Nosebleeds
  • Blood in your urine
  • Pounding in your chest, neck or ears
10 things you can do to lower your blood pressure

If you can successfully control your blood pressure with a healthy lifestyle, you may avoid, delay or reduce the need for medication and hopefully prolong your life. Here are 10 important lifestyle changes you can make to lower your blood pressure and keep it down.

  1. Lose extra pounds and watch your waistline

Weight loss is one of the best ways to control blood pressure. Losing just 10 pounds can help bring it down. But as well as shedding pounds, you also need to keep an eye on your waistline. Carrying too much weight around your waist can put you at greater risk of high blood pressure.

  • Men are at risk if their waist measurement is greater than 40 inches
  • Women are at risk if their waist measurement is greater than 35 inches
  1. Exercise regularly

Regular physical activity—at least 30 minutes several days a week—can lower your blood pressure significantly. It’s important to be consistent because if you stop exercising, your blood pressure can rise again.

  1. Eat a healthy diet

Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and low in saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg.

  1. Reduce sodium in your diet

Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. To decrease sodium in your diet, follow these tips:

  • Read food labels. When possible, choose low-sodium alternatives of the foods and beverages you normally buy.
  • Avoid processed foods. Only a small amount of sodium occurs naturally in foods. Most sodium is added during processing.
  • Don’t add salt. Just 1 level teaspoon of salt has 2,300 mg of sodium. Instead, use herbs or spices to add flavor to your food.
  1. Limit alcohol

If you drink alcohol, do so in moderation. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.

  1. Quit smoking

Each cigarette you smoke increases your blood pressure for several minutes after you finish. The good news: quitting smoking helps your blood pressure return to normal. People who quit smoking, regardless of age, have substantial increases in life expectancy.

  1. Cut back on caffeine

Caffeine can raise blood pressure by as much as 10 mm Hg.

  1. Reduce your stress

Chronic stress is a major contributor to high blood pressure, particularly if you react to stress by eating unhealthy food, drinking or smoking. Instead, look for healthy ways to relieve stress, such as exercise, yoga, group activities or meditation.

  1. Monitor your blood pressure at home and see your doctor regularly

Home monitoring can help you keep up to date with your blood pressure, find out if your lifestyle changes are working, and alert you and your doctor to potential health complications. Blood pressure monitors are widely available without a prescription.

  1. Get support

Having supportive family and friends can really help in your efforts to lower or control your blood pressure. If you find you need support beyond your family and friends, consider joining a support group which can put you in touch with others who can give you valuable encouragement and advice to cope with your condition.

Risk factors for high blood pressure
  • The risk of high blood pressure increases as you age. Men are more likely to develop high blood pressure around age 45, while women are more likely to develop it after age 65.
  • High blood pressure is more common among African Americans, often developing at an earlier age than in Caucasians. Serious complications, such as stroke, heart attack and kidney failure, also are more common in African Americans.
  • Family history. High blood pressure tends to run in families.
  • Being overweight or obese. The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
  • Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the likelihood of being overweight.
  • Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Note: Secondhand smoke also can increase your blood pressure.
  • Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
  • Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don’t get enough potassium, you can accumulate too much sodium in your blood.
  • Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than 2 drinks a day for men and more than 1 drink a day for women may affect your blood pressure.
  • High levels of stress can lead to a temporary increase in blood pressure. But if you try to counteract stress by eating more, smoking or drinking, you may only increase your risk of high blood pressure.
  • Chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease, diabetes and sleep apnea.
  • Sometimes pregnancy contributes to high blood pressure.
If you’re concerned about your blood pressure and want to get it checked, please come see us

If you think you may have high blood pressure, have been experiencing symptoms, or want to know what your exact numbers are, please contact us at Westchester Health. We’ll measure your blood pressure, evaluate if it is normal or too high, and together with you, decide on the best treatment plan to keep you as healthy as possible. Whenever, wherever you need us, we’re here for you.

By James W. Catanese, MD, FACC, a cardiologist with Westchester Health, member of Northwell Health Physician Partners

Categories: Blog
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