Pediatrician - Wall
3350 Highway 138 Building 2 Suite 126
Wall, NJ 07719

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Posts for: December, 2016

December 14, 2016
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The Most Wonderful Time of the Year – Let’s Make It Injury Free

Diane P. Calello, MD, Executive and Medical Director

Bruce Ruck, Pharm.D., Director, Drug Information and Professional Education

New Jersey Poison Information and Education System (NJPIES)

(Newark, NJ) – December 13, 2016 - For many of us, Christmas and Hanukkah are long-awaited holidays. Whether you are looking forward to the decorations, presents, or time spent with loved ones, it’s important to remember that safety should come first. For most of us, the hectic nature of preparing for the holidays (cooking, entertaining, home decorating, etc.) distracts us from paying attention to what’s happening around us and in our homes. This is the perfect time for mishaps and injuries to occur. Even though the “to do” list seems to grow as the days count down, let’s not forget about the importance of prevention – being aware of common hazards that occur during the holiday season.


“The holidays are an exciting time of year so let’s make it an injury free one,” said Bruce Ruck, Director of Drug Information at the NJ Poison Center. “I encourage you to take a few moments to learn more about the possible dangers and to think about how you can lower the risk of unintentional injuries in your household,” said Ruck. 

1.       Household

Poison centers often see an increase in unintentional injuries around this time of year. Fortunately unintentional injuries can be prevented and the holidays can remain joyous and safe for everyone.

·         Alcohol (beer, wine, liquor, cocktails) – If accidentally swallowed by children and/or pets, leftover cocktails can be fatal!  Alcohol affects children and pets differently than it does adults, so even ingesting a small amount can be very toxic. Always empty beverage glasses and place them up high and out of reach of curious children and pets.

·         Cigars and Cigarettes – Empty all ashtrays after your holiday gathering. Children and pets have been known to eat cigars and cigarette “butts.” There is enough nicotine in these tobacco products to be considered poisonous to children and pets.  

·         E-cigarettes devices and liquid nicotine - Liquid nicotine exposures continue to concern poison center specialists. The liquid contains concentrated nicotine which is harmful if swallowed. Even small amounts can be fatal to small children and pets. Keep these products and their refill liquids locked up, out of sight and reach.   

·         Medicine - Be sure to offer a safe, locked, out of sight place for relatives and holiday visitors to store any medicines (over-the-counter, prescription, vitamins, herbal or dietary supplements) they may be carrying with them. Never leave medicines in purses, on nightstands or counters, or in the bathroom where children and pets can easily get them.

·         Pets – Make sure to keep chocolate, cocoa, candy and sugarless gum that contains Xylitol, yeast bread dough, leftover fatty meat scraps, fruit cakes with raisins and currants, alcohol and illicit drugs out of reach of your pets. Ingestion of any of these can cause serious harm and even death.  Be sure to keep all wires tucked away.    


2.       Gift Giving

Prevention is the best gift you can give your loved ones and guests this year.

·         Wrapping paper – Some types of wrapping paper may contain toxic metals like lead, may burn at such a high temperature that they may prove dangerous to the fireplace, or flake and send sparks out into the room causing a potential fire. Under no circumstance should you burn wrapping paper.

·         Toys – Antique toys and those made outside of the United States may contain lead or other toxic substances. Look for chipping or worn paint before letting children play with them. Be sure to look for toy recalls before buying new toys. For more information about toy recalls, contact the U.S. Consumer Product Safety Commission at 1-800-638-2772 Also keep in mind that many toys have small parts which young children and pets can easily swallow and choke on. 

·         Disc batteries – These are usually found in watches, toys, games, flashing costume jewelry, singing greeting cards, remote control devices, etc. They are easy to swallow and can cause serious harm to children and pets. Besides being a choking hazard, these batteries can cause serious burns if stuck in the throat or stomach and may even cause death.

·         Small magnets – If a child consumes two or more magnets, they can attract each other, resulting in serious harm to internal organs. You must get help immediately.


3.       Decorations

Decorations are just one way to show the holiday spirit. Deck your halls with prevention and safety.

·         Tree ornaments – Children or pets may mistake ornaments for food, especially if they look like candy or cookies.

·         Spray-on snow – Follow instructions when spraying artificial snow onto a tree or other decorations. If inhaled, this product can irritate the lungs.

·         Tinsel – If you have pets, we suggest not using tinsel to decorate. Tinsel can easily be swallowed and get stuck in the intestines.

·         Plants – Holiday plants are a fun way to add cheer to your home, but some can have toxic effects. Be mindful of Holly, Jerusalem Cherry, Mistletoe, Boxwood and a variety of species of the Yew. Contrary to popular belief, poinsettias are not considered toxic when consumed in small amounts.

·         Candles – While they can be warm and even romantic, candles can be dangerous. Place candles in secure areas where they cannot fall or be knocked over by children and pets. Use non-flammable holders and remember that small amounts of melted wax can cause burns as well as become a choking hazard to small children and pets. Be aware that liquid candles are not candles at all, but lamp oil (see below).


The best way to be prepared for poisoning emergencies this holiday season is to program the Poison Help line, 1-800-222-1222, into your mobile phones, and post it in a visible place in your home. Time is of the essence in many situations since poisons and medicines may act very quickly. Calling the NJ Poison Center is always the fastest way to get the medical help or information you need to prevent further injury.


Source: The New Jersey Poison Information & Education System — Serving New Jersey Since 1983

December 05, 2016
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Many children and parents associate a trip to the pediatrician with shots. There are actually a couple of vaccines that we don't give as an injection, specifically the oral rotavirus vaccine. It would be great if we could give them all by mouth, but vaccines contain proteins and complex sugars that are digested quickly in the stomach, so the only way to get most of them into contact with the immune system is to inject them into the skin or muscle.

Combination Vaccines

The good news is that pediatricians have gotten better at minimizing or even eliminating the pain of vaccination. For one thing, we can often administer multiple vaccines in a single injection.

Thanks to combination vaccines, the greatest number of injections many children receive at any given wellness examination is 3. We usually give these vaccines in the thighs during the first few years of life and in the shoulder muscles after that. When staff are available, they can use both legs at the same time to minimize the duration of discomfort. Because what pain there is tends to be experienced as a single event, it is discouraged for parents to spread vaccines out over multiple visits. There is no medical reason to do so, and it tends to prolong the discomfort for everyone

Pain-Control Techniques

A number of pain control techniques are currently available and can make shots much less stressful. For toddlers and school-aged children, the combination of distraction techniques, like blowing bubbles or playing games and numbing creams or sprays can be very effective for all shots and needle procedures.

Numbing agents include:

  • A cooling spray which can be applied just before shots are given so there is no poking sensation.

  • Topical anesthetic creams that can also be applied ahead of time to make the skin numb when the shot is given.

  • A plastic plate covered with small points and a buzzing sensation that blocks pain signals.

For babies who are nursing, breastfeeding during a vaccination can provide significant pain relief.  Sucking on a pacifier can also be comforting.

Even without using any of these techniques, most babies calm down very quickly after their shots with being held. The calm in your voice and the firm reassurance of your embrace tell your baby that everything is fine. Remember, the shots may hurt for a moment, but the protection they're giving your baby is good for a lifetime.

Adverse Reactions

By far the most common adverse reactions following vaccination are fever and fussiness, and sometimes there may be a little redness or swelling at the injection site. Many parents ask if they should give acetaminophen (eg, Tylenol, PediaCare Fever Reducer) or ibuprofen (eg, Motrin, Advil) prior to the vaccine visit. In the past we have encouraged using these medications to reduce any discomfort or potential fever from vaccines. Some newer studies have questioned whether giving acetaminophen might make the vaccines slightly less effective, so some pediatricians are no longer recommending it.

Any medication or vaccine has the potential to cause an allergic reaction, sometimes a severe one. Rates of severe allergic reactions with vaccines run in the 1 per million range, making them quite rare.

When to Call the Doctor

No symptoms after receiving vaccines should be dramatic. If your child has a temperature above 102°F or a fever that lasts more than a few days, or if she is unusually fussy, you should still consult her doctor and not just assume her symptoms are from vaccines.

If you notice your child getting hives, wheezing, or seeming unusually ill shortly after she gets vaccines, alert office staff if you're still there or call emergency medical services (911) if you're not.

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3350 Highway 138 Building 2 Suite 126,
Wall, NJ 07719