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

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Posts for: June, 2016

By Douglass Hasell, MD
June 26, 2016
Category: Dr Hasell
Tags: Health   Nature  

Did you know that some Pediatricians are writing prescriptions for their patients to be taken to a park or other green space for an hour a day? This has shown to be beneficial for many childhood emotional and behavioral issues as well as attention and sleep problems. 

More studies are coming out every day decrying the change in children’s lifestyles that has resulted in them spending more and more time inside, usually interacting with electronic devices, and less and less time outside interacting with nature. Evidence is starting to accumulate on the adverse effect this has on children: increasing rates of childhood obesity, ADHD, Anxiety and Depression to name just a few. All of these plus many more indicators of health and well-being are found to be directly linked to lack of time outside in nature. In fact even studies in adults find that the closer someone lives to green space the healthier they are on average. 

Many parents do not appreciate this fact even though they are very attentive to every other need of their child. “Children who play outside are more physically active, more creative in their play, less aggressive and show better concentration.” (Ginsburg et al, 2007). Nature has been found to have a soothing effect on the brain. Outside in a green space there is a natural order of things. I believe when people can attune themselves to this it is beneficial in helping them to relax and to reduce stress which has been found to be a factor in so many diseases. When children play in the sand at the beach or in the dirt at the park or climb trees they are connecting with their natural environment and recognizing how they fit in the natural world.

I believe we should be very weary when the time our children spend in the virtual world on electronics is greater than that spent in the natural world. So take a prescription for your child from me and try to spend as much time as possible interacting or relaxing in nature with them. It will benefit you as much as them.

Gabrielle Renee Photography

June 16, 2016
Tags: car seats  

You may have seen Facebook friends posting about it and your pediatrician may have recommended it, but what’s the deal with extended rear-facing? Won’t their legs get too long? Won’t it look funny? What is the benefit?

It is 5000% safer to rear-face than forward-face! As you can see in this video of 12-month-old crash test dummies engaged in a frontal collision (the most common kind of accident), the rear-facing dummy bears down with the collision while the forward-facing dummy’s body is fiercely forced headfirst with the crash.  This poses a serious problem as the cervical spine is not fully developed in small children. Forward motion at that velocity often results in serious injury, including paralysis or much worse1. It is as simple as that – it’s recommended because it is proven to be safer!

Convertible car seats are the seats used for extended rear-facing. They can both rear-face or forward-face and are the standard “next step” from an infant-only car seat. Most convertibles rear-face up to 40lbs and forward-face up to 65lbs, but it's important to check the manuals. All brands and models of seats are very different!

It is OK for their legs to touch the vehicle seat! Afterall, it's OK for our adult legs to touch the floors of our cars. While we would never want our babies to endure any sort of injury, it is much more important to protect the head and neck from crash impacts and rear-facing does just that. Not to mention, studies have shown that children sustain more leg injuries when forward-facing2.

Still, I understand that leg room is a concern for many parents and there are options. As seen below, my daughter often crosses her legs in the car. It is a great way to stay relaxed and secure, but not necessary for protection.

Lila in her Graco Nextfit weighing 38lb and 38.5 inches. We still fit for now!

Her feet touch the back of the vehicle seat and that's OK.

Still comfortable enough to take naps with a few favorite friends.

There are also car seats on the market that have these concerns in mind. Recently Graco released their Extend2fit model, a budget-friendly convertible car seat that rear-faces until 50lbs and offers more legroom with an extender. This is great for larger toddlers and any parents who may feel concerns about comfort.

Graco Extend2fit

It might look funny, but motor vehicle accidents are still the leading cause of death in children under 13 and extended rear-facing is proven to keep littles ones safer. It might not be the norm now, but as research continues to show the safety benefits, it will certainly be soon. 

“This just doesn’t work for us.” All kids are different and there are situations where parents feel forward-facing before 2-years-old is the safest travel option – motion sickness or excessive crying are the top reasons I hear of parents turning their tots around early. That’s OK! I wholly agree that you know what is best for your child and only hope to ensure the safest transportation conditions within your comfort zone. It is only my mission to get children rear-facing as long as possible.

If you have any questions about rear-facing or car seats, absolutely comment or call our office. I'm always here to answer your questions! 

Kindest regards,
Kasondra Arone-Miller, CPST



1. Narayan Yoganandan, PhD, Frank A. Pintar, PhD, and Sean M. Lew, MD.  Ann Adv Automot Med. 2011; 55: 159–168. 
2. Arbogast KB, et al. Injuries to children in forward facing child restraints. Annu Proc Assoc Adv Automot Med. 2002; 46: 213-30.

By Dr. Thuy Pham
June 07, 2016
Category: Breastfeeding
One of the greatest challenges new mothers face is returning to work and continuing to breastfeed. Over the years I have watched the gradual improvement in resources and support for working mothers, from the availability of a portable double electric pump, to a hands free bra, to informative nursing blogs and web sites. We owe it to strong, determined and dedicated women who have carved the way and made it easier for the next generation. Pumping in the work place is not just a privilege, it has become a right.
We all know the unique nutritional benefits of breastmilk. However, for me the most compelling reason why I continued to nurse each of my 3 children, including my twin sons until they were 2, was the joy of coming home and feeling immediately relaxed and connected with them when I sat down to nurse. I still remember clearly how each child would reach out for me, the eager look in their eyes, the warmth and softness of their skin.  Breastfeeding was an offering of love, a gift of nutrition and comfort that I alone could provide. This special feeling of closeness was the fuel that motivated me to let my baby nurse on demand with unlimited frequencies at home and pump every 3-4 hours at work. Frequent emptying of the breast helped me maintain my milk supply so that I did not need to give our baby any formula supplements during the first year.
What are the key ingredients successful breastfeeding and working?
  1. Establish an abundant milk supply early on and prior to returning to work.
  2. Acquire a quality double electric pump. Most insurance companies will cover the costs with a prescription from your doctor and your due date.
  3. Be an expert at hand expressing and pumping. Start pumping 2 weeks before returning to work. Your right to pump at work until your baby turns 1 is protected by the Affordable Care Act.
  4. Be prepared to nurse more frequently when you are home in the evening, during the night and on the weekends. ( Keep it simple: the more you nurse, the less you have to pump)
  5. Make plans early on with your child care provider. Have an ample supply of stored breast milk ready. If you can give  what you pump the day before then you are able to meet your baby demand.
  6. A hands free bra makes pumping easier.
  7. Involve your partner, family and friends. Join breastfeeding support group in the community or on line. Nursing is more than providing food. It is a way of life.
  8. Nurture yourself. You will have to cut back on other activities and take naps to make up for your lack of sleep.
Nursing was not easy for me in the beginning. There were tears of pain, fatigue and overwhelming stress. Somehow it all worked out in the end. I am grateful for the support of my family and the breastfeeding community. I owe it to you, all the dedicated mothers who did their very best to nurture their child. You inspire me to help other nursing mothers. Whether you are able to nurse for one day, one year or longer, I applaud your effort.
Dr. Thuy Pham , IBCLC


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New Port Richey, FL 34655