Pediatrician - New Port Richey
2044 Trinity Oaks Boulevard Suite 235
New Port Richey, FL 34655
(727) 375-5437

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By Sheridan Hernandez MD
April 06, 2020
Category: Coronavirus safety
Tags: COVID19   Pregnancy   Expecting parents  

For many people, pregnancy, and being the parent of a newborn, already causes a lot of anxiety. It is only natural to worry about the health of the pregnancy, how the delivery will go, and if your baby will be born healthy. And after the baby is born, it is natural to worry that your baby could become sick or get injured when they are at such a vulnerable age. Now with the new coronavirus causing such chaos in our lives, it is understandable that expecting parents and the parents of newborns would be feeling more anxious than ever. There is still a lot we don't know about this virus, but information is beginning to emerge and we wish to keep you all updated on what we do and do not know.

With regards to how this new coronavirus (also known as covid 19) can affect pregnant women, this is what we know. When a woman is pregnant her immune system changes, making her somewhat immunocompromised. This makes her more vulnerable to some some respiratory infections such as the flu for example. So far, the data that is available regarding covid 19 does not show that pregnant women, who become infected, are at more risk for severe disease than the general public. However, we do know, that the flu, SARS (severe acute respiratory syndrome) and MERS (middle eastern respiratory syndrome) do sometimes affect pregnant women more severely. SARS and MERS are also coronaviruses. We would therefore urge pregnant women to be especially careful during this pandemic.

It is likely that many expecting parents worry that if the mother does become infected with covid 19, can she then infect her baby. Thus far, there is no evidence to suggest that an infected woman is more likely to have a miscarriage or to pass the virus to the fetus. Current evidence shows that the coronavirus has not been found in either the amniotic fluid, or the placenta of infected women. This is rather reassuring.

So what if if mom  has covid 19 when the baby is born, or soon after? According to the CDC, recent studies have shown that the virus has not been found in breastmilk. It should therefore be safe for a positive mom, without symptoms, to feed her baby with the usual good hygiene of good hand washing. We would also suggest she wear a mask. If mom does have more symptoms such as a lot of coughing, then it might be better for her to pump the milk and have another uninfected person feed the baby with a bottle.

The good news is that childhood infection with covid 19 seems to be much less common than infections in adults. When children do become infected they typically have a very mild illness. The bad news is a small percentage of children can become severely ill. Children under the age of 5 are more vulnerable to more severe infection, and infants under 12 months of age are at highest risk of severe infection. Therefore any infected person caring for a newborn or young child should take the strongest precautions, with frequent hand washing and wearing a mask.

With regard to the delivery during these very difficult times, different hospitals have implemented different policies. All hospitals are likely limiting hospital visitation at this point. But many hospitals may only allow a single support person to be with the mother during delivery. Some hospitals do not want anyone but the mother herself present. However some hospitals are making it possible for doulas or other support people to skype or facetime in during the delivery. We would suggest that expecting parents check in at the hospital where they will be delivering, to find out the most recent policy. This way you are prepared and can plan ahead.

We know how hard this time is for our parents and patients. We will be here for you throughout this difficult period,  and we will do our utmost to keep our office as safe as we can. As we learn more information about covid 19, we will make it available on our website. Be safe.

By Chris Pope, ARNP
April 01, 2020
Category: Coronavirus safety
Tags: Safety   Covid 19   Coronavirus  

We pray that you are all doing well through this difficult time. Pinellas County has issued a Safer at Home order meaning everyone should stay home with exception of essential activities (medical care, getting food, going to jobs deemed essential). We ask that everyone heed these recommendations to help slow the spread of this virus.

We will remain open to care for your children’s health needs, but we have implemented some changes to help protect the health of our patient families and staff. We are currently only seeing healthy children during the morning hours for visits such as healthy check-ups, immunizations and follow up visits for noninfectious conditions. In the afternoons, currently 3 PM and later we will see our ill patients. Prior to your appointment, you will be asked screening questions to determine if a medical visit is in the child’s best interest. To reduce the risk of COVID19 exposure we ask that only one caregiver accompany the child to their visit, and when possible, do not bring in siblings or other children who are not being examined. We will not have our sick patients in the waiting room. At the time of your appointment you will be given direction as to when to come up to the office at which time you will be escorted through our back entrance directly into an exam room. In some instances we may even be able to utilize telemedicine, however this is very new for us and there are only a few conditions which will qualify. This is a very fluid situation and things will likely continue to change quickly. Please know that the health and safety of your child is our top priority, and we are trying our best to provide care for your child in the most effective and safe way that we can. Stay safe, please practice social distancing and keep washing those hands!

 
 
 
 
By Douglass Hasell, MD
March 26, 2020
Category: Dr Hasell
Tags: Covid 19   Coronavirus  

Things seem to be getting a little crazy with this Coronavirus pandemic.  People are not getting accurate or consistent information and are starting to get confused and scared.  A few things seem clear to me regarding our current situation.  The first is that there are way more Coronavirus cases in the U.S. than have been identified thru the limited testing that has been done so far.  The second is that, because of the lack of testing availability, even as I write this, the spread of Coronavirus in the U.S. has not been contained and is most likely going to be very widespread within the next few weeks.  The current public health strategy being discussed is no longer about containment but about being able to decrease the rate of increase of new cases so our health care system does not get overwhelmed and run out of ICU beds or ventilators for the sickest patients.

The reassuring part of this for our patients is that children do not seem to be under very high risk of getting seriously ill if they get this virus.  This may not be the case however for some of our patients with underlying medical conditions.  It is these patients that need to be monitored and those caring for them to be vigilant in handwashing and social distancing to protect them.

            People need to begin changing their behavior as of today.  Keep your social distance of 3 ft. away.  Greet people with a bow or fist bump and educate them why you are doing this.  Don’t touch your face.  Wash your hands every chance you get.  Avoid public gatherings, crowded spaces and unnecessary travel.  And most importantly, Do Not Panic.  Children need to feel a sense of calm by those who care for them during stressful times to help them feel reassured. 

            If you have questions about whether your child needs to be seen or not please call our office at 727-375-5437.  We are triaging patients accordingly by phone.  I would suggest thinking of this as a Flu epidemic in terms of responding to your child’s symptoms and need to be seen.  At his point it is still not easy to test patients, but this will hopefully change soon.  This is a time for calm and rational thinking.  Let’s all stay positive and help each other get thru this together.

by Douglass Hasell, MD

By Sheridan Hernandez MD
February 12, 2018
Tags: Atopic Dermatitis  

Hello, Dr. Hernandez here.

 

Many children have atopic dermatitis (AD) also known as eczema. I thought today I would I share some of our latest understanding and knowledge of AD.

 

AD affects 10-20% of all children and 1-3 % of adults. It can range from a mild condition which is generally quite easily managed with creams, ointments, oils and lubricants, to a very severe condition which causes severe breakdown of the skin barrier with associated unbearable itching. The severe form of eczema can be quite debilitating, causes a lot suffering and, unfortunately, can be very difficult to control.

 

AD has increased two to threefold in the last three decades in industrialized countries, but this increase has not been found in areas that are primarily rural and agricultural. Both genetic and environmental factors are felt to play a critical role in the expression of AD. For example, from a genetic point of view, a child of parents, both of whom had an atopic condition such as asthma, allergic rhinitis (hay fever etc.) or eczema, is 5 times more likely to have early onset, childhood eczema, than a child of parents neither of which had an atopic condition. From the environmental point of view, children whose mothers were exposed during pregnancy to farm animals in particular, but also dogs and cats, were less likely to develop early childhood AD, than the children of moms who had no such exposure. Also children who are fed yogurt with live active cultures in the first year of life have a decreased likelihood of developing AD (PASTURE study- Protection against allergy study in rural environments).

 

Childhood AD has been broken down into 3 types, early transient means the condition starts before age 2 but resolves by age 4, early persistent which means it starts before age 2 and lasts at least to age 6 (these children are much more likely to have AD that lasts to adulthood) and late onset AD that starts after age 2. Children with the early onset types are at increased risk of developing asthma by age 6 and are also at increased risk of developing or having food allergies. Children with early persistent AD are at the highest risk for both respiratory and food alleges.

 

Unfortunately, early persistent AD can be very difficult to manage. Topical corticosteroids are the most widely used treatment, but because of side effects of long term regular use they are not really recommended for maintenance therapy. Ceramide lipid creams such as EpiCeram can be very effective, as can calcineurin inhibitors such as tacromlimus and pimecromlimus. UV light therapy can also be effective.

 

Although there is no magic bullet answer out there to cure eczema, I think it is important for the parents of children with more severe AD or eczema to be aware of the increased risk their children have for developing asthma and allergies. They can then be proactive and observe their kids for signs of allergy and asthma and seek appropriate care. Furthermore, I wanted parents to be aware that there are some new treatments emerging that have been found to be helpful in treating this very troublesome condition.

 

As always, it is my honor and privilege to take care of your beautiful kids. Peace

 

Dr. Hernandez

By Thuy Pham, MD IBCLC
June 29, 2017
Category: infants
Tags: Starting Solids  

Thinking of starting your baby on solids? Try Baby Led Weaning.

 

Baby led weaning is a method of introducing baby food which relies of your baby’s natural cues and interests. It simply means bypassing pureed foods and letting your baby feed himself real food from the start. Instead of spoon feeding commercially prepared processed rice cereal or jar foods you can let your baby finger feed herself soft pieces of cooked vegetables or fruits. Your baby learns to chew first with his gums, then swallow.

 

This sensical approach  is a natural transition from breastfeeding on demand to introducing solid foods. Bottle-fed babies also adapt well to this method of feeding. Many eager parents tend to start solids too early. Instead you should wait for your infant to show for signs of readiness, such as interest in family meal time,  ability to sit without support, to pick up toys with fingers, loss of tongue thrust reflex(pushing solids out of the mouth with tongue). There is no need to ponder about which jar foods to buy, simply give your baby soft cooked wholesome vegetables that you prepare for your family at meal times, put it on his high chair tray and let him enjoy! Get your camera and be prepared to capture the moment when he explores, picks up, mashes and tastes his first foods.

 

Some examples of easy, wholesome BLW first finger foods are:

. banana chunks

. soft steamed carrot sticks

. slices of ripe avocados

. peeled slices of cucumbers (great for teething babies)

. boiled egg yolks

. peeled slices of peaches

 

Safety 

It is best to wait until your child is at least 6 months old and exhibits signs of readiness as stated above. Avoid foods that are choking hazards, such as whole grapes, apples with skin attached, nuts. In the first few weeks of BLW, you may see your baby gag. Remember gagging is a protective reflex to prevent foods from traveling too far to the back of the mouth where it can obstruct the airway.. Your child may have a mild cough and makes little noises. It is different than choking, when your child looks terrified, appears unable to breathe and makes no noise.

 

If you are wondering whether BLW is right for you, check with your paediatrician to that your child is developmentally ready to proceed.

 

Reference

Baby Led Weaning by Gill Rapley

 

Thuy Pham, MD, IBCLC

 

 





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2044 Trinity Oaks Boulevard, Suite 235
New Port Richey, FL 34655