Parkside News March 2008

That Bites!

What comes to mind when you hear about a child that bites another child? It probably depends upon whether your child is the one who was bitten or if your child was the "biter". The parent of the child who has been bitten is usually upset and possibly worried about the risk of infection. Often the parent of the biter is worried about how their child will be treated and if he will be labeled as a "biter". Often, if biting happens in the day care setting, the other parents may want the biter to be disciplined or expelled. Parents need to remember that biting is a normal part of childhood and occasional biting offences are to be expected.

There are many potential reasons for biting:

Teething. Biting and chewing often relieves teething pain.
Oral Exploration and Stimulation. Biting often feels good.
Exciting Cause and Effect. Biting often gets an exciting reaction.
Mimicking Behavior. Older toddlers sometimes mimic biting from other biters.
Frustration. Toddlers sometimes bite when they are unable to communicate a need, responding to the aggression of another child, or when defending possessions.

While biting is a normal toddler behavior, with proper interventions, most kids stop biting after a few days or weeks. Most of these kids are too young for a lecture or even timeout and radical interventions may actually reinforce their biting. Instead, it is probably best to keep it simple. Some of the strategies we give parents include:

try to intervene and distract the child by saying 'no bite' firmly, when she is about to bite.
after the child bites, it can be a good idea to move the child away from the other child and ignore her for a few minutes, although this isn't really a formal timeout like you would use for an older child
remind her not to bite from time to time, including perhaps a short reminder that 'biting hurts'
provide some praise and positive attention when she isn't biting and is playing nicely
keep to a good routine all day, including meals, naps, and playtime
avoid asking a parent to pick up the child and sending her home after she bites, since that can reinforce biting

When a child receives a bite from another human, a semicircular or oval area of redness or bruising may be visible; the skin itself may or may not be intact. Human bites are typically located on the face, upper extremities, or trunk in younger children because they generally occur as the result of aggressive play with another child who inflicts the bite. Only about 10 percent of children with human bites develop infection, compared to 20 percent of adults. Actual breakage of the skin is much more likely to cause infection than just bruising.

For more information on biting prevention click here: Biting Resources

Congratulations! Parkside Pediatrics Recognized for Quality Laboratory Services

Parkside Pediatrics has met all criteria for Laboratory Accreditation by COLA, a national healthcare accreditation organization. Accreditation is given only to laboratories that apply rigid standards of quality in day-to-day operations, demonstrate continued accuracy in the performance of proficiency testing, and pass a rigorous on-site laboratory survey. Parkside Pediatrics has earned COLA accreditation as a result of a long-term commitment to provide quality service to its patients. COLA is a nonprofit, physician directed organization promoting quality and excellence in medicine and patient care through programs of voluntary education, achievement, and accreditation.

COLA is approved by the federal government and sponsored by the American Academy of Family Physicians, the American Medical Association, the American College of Physicians, American Society of Internal Medicine, and the American Osteopathic Association.

Detailing the DTap Vaccine

The DTaP vaccine is a combination vaccine that helps to protect against 3 different illness: Diptheria, Tetanus, and Pertussis. This vaccine is routinely given at 2, 4, 6, 18 months, and then again at 4-6 years.

What are the specifics of the diseases that the DTaP vaccine helps to prevent?

Diptheria is a severe throat infection that is caused by a bacteria called Corynebacterium diptheriae. The bacteria makes a toxin that inflames the lining of the throat making breathing very difficult. Although the disease is not very common (due in fact to the overwhelming success of the vaccine), diptheria is a very serious infection with about 10% of cases being fatal.

Tetanus is an infectious disease caused by a bacterium that lives in soil, and on dirty rusty metal objects. After the bacteria penetrates under the skin, it produces a toxin that affects the individual's nervous system leading to paralysis throughout the body. Tetanus is often referred to as lockjaw due to the fact that the jaw muscles are often the first muscles affected. Tetanus is not very common, but like diptheria it is very serious with a 15% mortality rate. Tetanus germs can be treated with antibody injections and antibiotics, but there is no medication that can reverse the paralysis. Often a person will need ICU medical care while the paralysis resolves.

Pertussis, otherwise known as "whooping cough" is a relatively common and serious infection, caused by the bacterium Bordatella pertussis. Pertussis starts out looking like a common cold for the first week or so, then evolves into an illness characterized by coughing fits that may last up to several minutes in duration. Often following the coughing fit, the individual takes a large breath in that sounds like a "whoop". We recently have seen an increase in the number of cases of pertussis due to the fact of waning immunity in adolescence. Often times teenage patients will pick up the infection and bring it home to their younger siblings. Younger children suffer much more from the disease, with children under 6 months having the most serious course.

Although diptheria and tetanus are not common conditions, pertussis is both a common and serious infection, which makes for a good argument as to why your infant needs to get this very important vaccine. Vaccinating teens and adults also makes sense to help protect the younger patients from potentially serious disease. Are there side effects to this vaccine? Because all vaccines have potential side effects, the physician and parents need to weigh the risks and benefits. The most common side effects are swelling at the injection site, fever, and irritability. The DTaP vaccine has a much better side effect profile than the older DTP vaccine. This is due mainly because of the fact that today's vaccine (DTaP) contains an acellular (without cell) portion of the pertussis vaccine whereas the older DTP vaccine contained a whole cell portion.

At Parkside Pediatrics we recommend the DTaP vaccine and all other routine vaccinations. We feel that vaccines are the best way to help to protect our children from serious diseases and potentially fatal illnesses. For more information on vaccines please visit: Vaccine Information