New Study Suggests Exposing Infants to Peanut Products Could Prevent Allergy

Once a lunchtime staple for many American children, PB & J is disappearing from lunchboxes since the rise of peanut allergies in recent years, an allergy that, for many children, can be life-threatening.

Blog contributed by Kathleen
Zimmerman, MD, Pediatrician 

In the US, about 2 percent of children are allergic to peanuts, a figure that has quadrupled since 1997.  As a result the American Academy of Pediatrics used to recommend that peanuts be withheld from children until they were 3 years old. However back in 2008, the American Academy of Pediatrics changed its policy, when a committee within the AAP concluded that there was no evidence that delaying the introduction of allergenic food protects against the development of allergies.

Policy or not, many parents are still avoiding allergenic foods for their young children, but surprising evidence from a recent study is proving the AAP policy shift to be the correct approach.

The study, involving infants 4 to 11 months old who had shown a high risk of developing a peanut allergy, indicated that feeding these children peanut products early in life may prevent a peanut allergy.  In the study, half of the children’s parents were told to avoid peanuts, while the others fed their children peanut products regularly.  After 5 years, only 1.9 percent of children who were fed peanuts were allergic to them, compared to 13.7 in the group that avoided peanuts.

According to Dr. Gideon Lack, a professor of pediatric allergy at King’s College, London and leader of the study, not feeding infants peanut products “could have been in part responsible for the rise in peanut allergies we have seen.”

While there is no evidence whether allergies will develop if regular feeding of peanuts is stopped, the results from this study are promising.  As attitudes shift in light of recent evidence, peanuts may start popping up in lunchboxes once again.

Here are some tips to stay safe:

• Do not feed whole peanuts to infants.  Because of the choking risk, opt for peanut butter or other foods.
• Get an allergy test if your baby has one of these risk factors for allergy:
• A sibling with food allergy
• Had previous allergy to foods
• Has severe eczema
• Always try one new food at a time for at least 3 days at a time and watch for rashes, vomiting, diarrhea, or any sign of reaction to that food. 
• Before feeding peanut products to your child, see your doctor for an allergy test to determine whether your child already has a peanut allergy.
• Be aware of other children’s allergies.  Always inquire before bringing snacks or lunches that contain peanut products around other children.

Do I have allergies or a cold?

Blog contributed by Kathleen 
Zimmerman, MD, Pediatrician

Do you have a constant runny or stuffy nose?  Or have you ever thought, “I can’t get rid of this cold”?  It is possible that you may actually have allergic rhinitis.  Allergic rhinitis is also called “hay fever”, although that name is misleading because there is no fever involved.

Allergic rhinitis is very common.  It affects 1 out of every 5 people in the U.S.  Allergic rhinitis happens when your immune system overreacts to a substance in the environment, such as tree or grass pollen, animal dander, or indoor particles of dust.  This causes a release of histamines in the body.  Histamines produce the typical symptoms of allergic rhinitis, such as:  stuffy nose, runny nose, sneezing, and itching of the eyes, nose, ears, and/or mouth.  Don’t be confused – these symptoms are very similar to what is seen with a cold.  However, colds are caused by a virus and should only last 10-14 days.  Allergies can last many weeks to months and tend to occur around certain triggers in the environment or during certain times of the year.

If you are concerned you may have allergic rhinitis, discuss it with your medical provider.  He or she may recommend a trial of an over the counter medication, such as an antihistamine, which can help block the symptoms discussed above.   Or they may recommend a blood or skin test to determine what, if anything, you may be allergic to.  Often avoidance of the allergy trigger is the most important step in reducing allergic rhinitis symptoms.

Questions? Contact your primary care provider.  If you are looking for a new primary care provider, visit: primary.pinnaclehealth.org.

Stay Away, I have “Pink Eye”

Blog contributed by Kathleen
Zimmerman, MD, Pediatrician

Why do we cringe when we see someone with a red eye? Perhaps it’s because it looks painful and our eyes water just looking at it.  But another reason is we are afraid of it spreading to us!  Pink eye, or conjunctivitis (the medical term), is extremely contagious and epidemics occur easily in daycares, school and work settings and even sports teams.

Conjunctivitis is inflammation of the lining of the eye.  This lining has a lot of blood vessels – when the inflammation occurs, the blood vessels get bigger and this gives the eye a red or “pink” appearance.

What causes conjunctivitis and how can we prevent it?  Sometimes the cause is not contagious, such as allergies to pollens or pets.  Other times it is from irritation from chemicals or something in the eye like contact lenses.  But the most common causes are viruses and bacteria. These ARE contagious and easily spread through the hands rubbing the eye.  Because the eye is inflamed, it itches and also produces a lot of watery or sticky discharge.  We rub our eyes and the bacteria or virus is then on our hands.  Anything we touch (doorknobs, toys) is then touched by someone else – if this person touches their eye then they will likely get pink eye in a few days. 

The best prevention for pink eye is hand washing.  Also, do not rub your eye with your hand – use a disposable tissue.  If you have pink eye you should avoid close contact with other people until it’s  cleared up or until you’ve been on antibiotic drops for at least 24 hours (if indicated and prescribed by your medical provider).   Antibiotic drops only work if the cause is bacterial.   It is also helpful to wash pillowcases and towels in hot water, throw away contaminated eye makeup, clean eyeglasses, and do not wear contact lenses during treatment. 

Although pink eye is a mild illness most of the time, you should watch for complications.  If your eye does not improve after 24 hours of using medicated drops, you should contact your medical provider. If the eye continues to be red for more than a week, if you have recurrent episodes of pink eye, if your symptoms are worsening, or if you have eye pain, you may need to see an eye specialist immediately.  Although it is not common, permanent damage to the eye and vision loss can occur if a red eye is not treated promptly or appropriately.

Questions? Contact your primary care provider.  If you are looking for a new primary care provider, visit: primary.pinnaclehealth.org.

Why Your Doctor Is Asking You About Guns

Joseph Cincotta, MD

One of the routine questions I ask my patients during an office visit is whether they have guns in their home. Some of my patients find this intrusive and even offensive, and they are not alone. But my goal, and that of other doctors like myself, is not to judge or debate, but to make sure my patients stay safe and healthy.

Whether or not health professionals should be asking about guns in the home has sparked a national debate. Emotions may run high when there is any conversation that is perceived to challenge one’s right to own and keep a gun, and those emotions can block any further conversation about guns and gun safety.  Health care professionals are not challenging anyone’s Constitutional right to own a gun.  Many health professionals own guns themselves and use them for a variety of recreational activities.  Our focus when we discuss this issue is one of safety, not the right of ownership.  According to a report by NBC News, firearms injured 15,576 children in 2010. And because of frightening statistics like this, the American Academy of Pediatrics recommends that pediatricians and other health care professionals counsel patients about gun safety.

When I inquire about guns in the home, it is with the best intentions. I am not calling a parent’s judgment into question, nor am I attempting to interfere with anyone’s right to own guns. But, the fact is that unsecured guns pose a health risk to children. Just as I would counsel parents about car seat safety, I counsel parents about precautions they should take to keep firearms safe.

A few states have enacted laws prohibiting doctors from asking patients about guns in the home. The practice is not prohibited in Pennsylvania, but patients are also not required to disclose whether or not they have guns in the home to their doctor.

For parents or caregivers who have guns in their home, I recommend taking the following precautions:

• Make sure that guns are unloaded and stored in a locked location, preferably out of a child’s reach and sight.
• Store ammunition in a different locked location from the gun, preferably out of a child’s reach and sight.
• Keep keys and combinations hidden from children.
• Do not leave your gun unattended when it is not locked up.
• Use gun locks.
• Do not leave guns, loaded or unloaded, anywhere where a child can access them (nightstand, table, etc.)
• Talk to older children about gun safety. Let them know that they should tell an adult immediately if they find one.
• Talk to your child’s other caregivers about gun safety.

When it comes to gun accidents involving children, there are very few second chances. A high percentage of accidental shootings result in death. Remember, when your doctor asks about guns in the home, they have your family’s best interests in mind.

For more information about gun safety. 

Detergent Pods Pose Poisoning Risk

Dr. Joseph Cincotta

Although consumers love the convenience, laundry and dishwasher detergent pods can pose serious health risks if they fall into the hands of young children. According to a recent study by the American Academy of Pediatrics, more than 17,000 children younger than six years of age were exposed to detergent pods in 2012-2013.

Children often mistake the brightly colored pods for candy or toys. Because the sacs containing the detergent are water-soluble, they are especially dangerous if a child puts them in his or her mouth. The study showed that nearly 80 percent of detergent pod exposures involved ingestion, which can cause vomiting, respiratory distress, lethargy and, in one case, death. If a child’s skin or eyes are exposed to the detergent, serious irritation can occur.


“It is critical that parents are aware of the potentially harmful effects of household products and take preventative measures to protect their children,” said Dr. Joseph Cincotta, family physician and medical director for PinnacleHealth Medical Group. “One mistake could have serious consequences.”
If you use detergent pods in your home, your best bet is to keep them safely out of sight and out of reach in a locked cabinet. Here are some other tips to help you protect your children and prevent poisoning at home:

• Store household products and medicines in their original containers. Store household products in a different place than food and medicine.
• Keep the nationwide poison control center phone number (1-800-222-1222) near every phone in your home and save it in your cell phone. Poison Control can provide assistance 24 hours a day, seven days a week. If your child is unresponsive or is having a severe reaction, dial 911.
• Do not store household products under the sink or in unlocked cabinets. Never underestimate your child’s ability to defeat a safety lock or climb. 
• Put household products away immediately after use. Do not leave household products unattended during use.
• Do not rely on packaging. Containers are typically child-resistant, not child-proof.
• Don’t keep it if you don’t need it. Safely dispose of any medicines or household products that you no longer use.
• Talk to older children. Explain the importance of staying away from unfamiliar plants and household products. Tell children they should never take any medicine unless an adult says it’s okay.

“In the course of busy family life, it can be easy to forget to keep household safety a top priority,” said Dr. Cincotta. “Fortunately, there are a number of online resources that can provide a good refresher for busy parents.”

For additional tips on preventing poisoning and other common childhood accidents, visit the Centers for Disease Control and Prevention’s Safe Child website at: www.cdc.gov/safechild.

School bus safety

Blog contributed by Kathleen
Zimmerman, MD, Pediatrician

School is well on its way and your child is probably getting comfortable in their routine.  This is a good thing, but we don’t want them to forget to be safe.  You should review school bus safety rules with your child:

1. Wait for the bus to come to a complete stop before stepping off the curb
2. Stay in seat  and don’t move around on the bus
3. Listen to the bus driver – they are in charge
4. When getting off the bus, don’t cross until the bus is at a complete stop, with the red lights flashing. Children should cross at least 10 feet in front of the bus.
5. Always watch for oncoming cars before crossing.  Not everyone stops for those flashing lights like they are supposed to!

Your child may ask why they don’t need to wear their seatbelt on the bus.  Pennsylvania does not require this.  Why not?  National Highway Traffic Safety Administration has done research that showed that the “compartmentalization” of school bus seats protects children very well.  Their research also shows the lab belts provide little if any benefit and could even cause injury because of misuse.  Shoulder belts would likely give better safety statistics, but children are not reliable to put these on appropriately and could increase their risk.   So, as of now, your child will not need to wear their seatbelt on the bus.  But you should explain to them the importance of seatbelts in all other vehicles.

Feeling Overwhelmed with Health Related News?

Blog contributed by Melissa M. Brown, Psy.D, PinnacleHealth Psychological Associates

As with any serious event that carries uncertainty it can create stress and lead to worry.  Recently, we have been hearing a lot about the Ebola virus and may have developed a heightened awareness because it has affected several U.S. citizens.  While the United States is not currently experiencing an outbreak, it is important to keep yourself informed; however, at a healthy level.  One of the negative consequences of doing so can lead to feeling overwhelmed by information, excessive worry, or displaying symptoms of stress.  Therefore, it is important to be aware of when too much information is not helping but hurting you.  Some symptoms which may indicate that you are reaching a critical point include: not sleeping, sleeping too much, over or under eating, disengaging from previously enjoyed activities, constant worry or fear that you will contract the illness, excessive thoughts about the virus, unnecessary precautions with you or other family members, dizziness, difficulty focusing or concentrating, or anything else that is a deviation from your normal life functions.

There are numerous things to do to protect your mental health while taking the appropriate measures to inform yourself.  First, limit the amount of media information you are viewing about the virus.  If necessary turn off the television or change the channel. Second, educate yourself about the virus through reputable sources of information such as the: CDC, The WHO and your local hospital. These resources use scientific information which has been demonstrated to be the most accurate at the time and will alleviate any concern about things you have heard that may or may not be true.  Third, take the necessary steps to ensure good mental and physical health.  There are a few things you can do that will reduce your stress and anxiety: exercise regularly, eat a well balanced healthy diet, disengage from the media information, and reach out to family members and trusted support systems.  If you find that your symptoms are becoming increasingly bothersome or interfering with your life on any level, it may be time to seek out professional intervention.  A psychologist or other mental health professional can work with you to alleviate your fears and reduce your symptoms of stress.

Finally, it is important to remember that various professionals are available to provide support and, if necessary, intervention.  They have the training and expertise on what to do if you are experiencing any forms of distress.  Allow these individuals and professional organizations to provide you with accurate information.