Tylenol brand back on the shelves for kids, oops, not anymore

If you have a young child, you’ve probably noticed that Tylenol was off the shelves for quite a while do to some production problems. Other brands have stepped in to fill that void in the past few months including Triaminic and Pediacare.

You’ve also likely noticed that the form it comes in for the infants and toddlers has changed. The “infant” drops with the 0.4 and 0.8 ml droppers are going buy the wayside. There were a number of instances where parents thought they could dose the drops as though they were the “children’s” for their older kids. The problem is that the infant drops are three times as concentrated as the children’s liquid.

All manufacturers have voluntarily stopped making the infant form to prevent this. A 0-36 month version has come out in its place. This is the same concentration as the “children’s” form, but comes in a smaller bottle with a syringe and special cap to insert the syringe in to draw it up. The equivalent dose to the old 0.4 and 0.8 ml is 2.5 ml (1/2 tsp) and 5 ml (1 tsp).

Tylenol brand came out with a version of this. The problem was that there were some reports of a small plastic part on the syringe designed to limit flow was falling off into the bottle making the syringe unusable.

Because of this, Tylenol (which is made by US manufacturer McNeil) withdrew about 574,000 bottles last Friday. Stop using these if you have them.

Since 2009, J&J has recalled millions of bottles of Tylenol, Benadryl, Motrin and Zyrtec as a result of such problems as metal shavings found in medicines, incorrect levels of an active ingredient and bad odors. The recalls prompted J&J to shut down a factory and have cost it more than $1 billion in lost sales.


Long Absense

Dear Readers,

Sorry about my long absence from writing this blog. I had health issues that slowed me down During January as well as a hospitalization in my family. I plan to make a real effort to get you caught up on what has been going on in pediatrics of late. So, keep coming back and there should be new stuff to read on a regular basis now.

Dr. Corp

Don't Forgrt to Take Your Infant or Toddler to the Dentist

It came out recently that this year’s National Poll on Children’s Health reported that only twenty-three percent of one year olds and forty-four percent of two year olds have been to the dentist.

I just want to make sure that you are aware that the current recommendation is that all children start routine dental care at age one year. The pediatric dentists report that they are already seeing in-between the teeth cavities in a significant number of children by that age. If left untreated, they can lead to complications such as periodontal abscesses and severe decay that may require the tooth to be pulled or a “baby root canal” to treat.

Also, many dentists are now routinely applying fluoride “varnish” to the teeth of young children at their routine dental visits to greatly reduce the risk of decay.

Parents should start cleaning the teeth and / or gums of their infant by six months of age or when the first tooth erupts, whichever comes first. This helps to keep the teeth and gums healthy and reduces the risk of cavities. Perhaps even more importantly, it gets your child used to your cleaning the teeth at an early age. If you don’t start early and come at your one year old with a toothbrush, it is likely going to be a struggle. But, if you’ve been cleaning their mouth for months already, it will be just par for the course.

To clean the teeth of infants, you can use a clean damp washcloth to massage the teeth and gums. If you don’t want to wash so many washcloths, you can use a non-sterile 2x2 gauze pad moistened with water (you can get a pack of 200 for $5 or 6 at any pharmacy) that you can throw away when done. Or, you can get one of the rubber bumpy gum massagers that you put on your finger.

At one year of age, you can start using a small head soft bristled toothbrush with water to clean the teeth. If brushing is a struggle, Gerber and Oragel make non-fluoride containing baby toothpastes that are safe for the toddler to swallow. These add some flavor to the brush that may make the child mind being brushed less. Once your child can spit out toothpaste (typically around age 2 -2 1/2) you can start using a fluoride toothpaste.

Parents should brush after their child at least once a day until they are age five or six, as they simply don’t do an adequate job until then. You can begin to teach your child how to floss and floss them around age 5.

Most children in the Chico and surrounding areas should also be on a once a day oral fluoride supplement from age six months through 16 years. This is so the fluoride gets incorporated through the enamel of the permanent teeth as they develop so they come in strong and cavity resistant. Fluoride is only available by prescription, so check with your doctor or dentist.

These are simple steps that can keep your child smiling beautifully for years to come.

What's Going around Week of 10/24/2011

There is a lot of infectious illness going around Chico right now.

What I have been seeing in the office is quite a bit of
croup, Strep. throat, colds, and viral sore throat. I have also seen a few cases of herpangina, hand - foot - and mouth disease and roseola. These last three are typically summer illnesses. I guess our late spring and mild fall have shifted things a bit.

As always, if you are concerned about your child’s condition, seek medical attention.

If You Have a Depressed Child or Teen, Monitor or Block Their Internet Chat and Forum Access

Depression is as common in children and teenagers as it is in adults. Children and teens often have a need to talk over their problems with others their age that are going through the same thing. This can be a good thing and is the basis of peer counseling which can be very effective in this age group.

Unfortunately, there is no way to control who may visit chatrooms and forums that are intended for children or teens with mental illness such as depression to interact. Sadly, a disturbing trend has emerged. There are individuals who will go to these sites and basically prey on the depression of these teens. I don’t know if you read about it in the paper, but there was a teenage girl who was “befriended” by someone on one of these sites who basically convinced her not to tell her parents or seek help for her condition. This person encouraged her to commit suicide and even instructed her on how to obtain and use the poison with which she ended her life a couple of weeks ago.

One can only surmise that this was done out of some perverse desire to be the causative agent of another’s death. This has not been the first event of this kind. So, if you have a teenager or older child who is depressed make them aware of this danger. Encourage them to feel comfortable talking with you or their physician. Let them know that anything goes in those conversations and that you are there to help, not judge them. Make sure you have parental control software that can let you control, or at least monitor, their computer use.

Hopefully, if parents are diligent, these tragedies can be prevented in the future.

If You Have Adopted A Foster Child, They May Already Be in Financial Debt - READ THIS!

I read about a disturbing trend the other day that I wanted make sure I passed on. It seems that children who are in foster care are increasingly becoming the target of identity theft. Biological parents who may need money for drugs or to pay the bills, unscrupulous previous foster parents and other relatives of these children have been victimizing them in fairly large numbers of late.

Since these people have access to the child’s personal info - birthdate, Social Security number, etc. It is fairly easy for them to swindle credit card companies to issue cards in the child’s name. Since most parents don’t think of checking their children’s credit rating, these children don’t usually find out until they turn 18 and apply for credit. What turns up in these cases is that the child may have hundreds or thousands of dollars in unpaid debt and a severely damaged credit rating even before they get their first personal credit. Credit companies are supposed to help sort these cases out, but it can take a lot of time and effort and incur fees as well.

The best thing to do is to do a yearly check on your child’s credit. Everyone in the US is entitled to check their credit rating with the three big rating companies - Equifax, TransUnion and Experian on a yearly basis by the Federal Trade Commission. The official site is

So, what are you waiting for - click the link and run the check!

Not Only Parents, but Grandparents of Newborns Should get a Whooping Cough Booster

We’ve been recommending for a couple of years now that parents of newborns receive a whooping cough booster (Tdap for tetanus, diphtheria and pertussis (whooping cough)) if it’s been at least two years since their last adult tetanus (Td) booster. For babies born at Enloe hospital, the parents are offered this vaccine before they take the baby home.

Earlier this week, the American Academy of Pediatrics formally recommended that grandparents over age 65 who will be caring for a young baby also get the Tdap booster.

Whooping cough has been on the rise big time the past few years. California was the state the hardest hit last year with 27,550 new cases and 10 deaths in young babies. The immunity from one’s childhood vaccines wears off by the teenage years. Although teens and adults rarely die from it, it can be miserable to have. With whooping cough, one gets into huge coughing fits. It is not uncommon for people with it to cough until they vomit or pass out. People have coughed hard enough to break ribs and puncture lungs and it goes on for weeks or months - it used to be called the 100 day cough for a reason.

The real concern is for young babies, because they are not completely immune until they have had their 2, 4, and 6 month shots, and whooping cough can be fatal in this age group as evidenced by the 10 deaths in California last year

So, make sure everyone in the family who will be caring for a young baby is vaccinated. If your young baby develops prolonged coughing fits until they turn red or purple or just seem unusually sick with a cold to you, please get them in to be seen by their doctor.

Prevent Pink Eye in the Classroom

September is “Children’s Eye Health Month”. In recognition of that, the American Academy is providing information for parents and educators on how to prevent the the spread of infectious conjunctivitis “pink eye” in the classroom.

Estimates are that over 164 million school days are missed by children nationwide because of infectious diseases about 3 million of which are from pink eye (source - American Journal of Infection Control).

Conjuctivitis means swelling of the conjunctiva, which is the thin membrane that covers the inside of the eyelids and the white part of the eye. It can be caused by cold viruses which usually cause irritation and redness but little discharge. It can be caused by allergies which gives one the “itchy / watery” eyes familiar to anyone with seasonal allergies. Or, it can be caused by a bacteria which leads to redness, irritation and typically a lot of mucous yellow or green discharge.

To help prevent it: encourage your child(ren) to wash or gel their hands often and avoid touching their eyes throughout the day. Discourage the reusing of towels, washcloths, handkerchiefs or tissues that have been used by others to wipe their face. Clean their pillowcases frequently.

If your child has conjunctivitis, a warm compress might help it feel better. If one eye is infected, make sure not to use the same cloth on the non-infected eye so it doesn’t spread. As always, if it worsens or if there is a lot of discharge, see your doctor t see if antibiotic drops, or some other treatment is warranted.

The American Academy of Pediatrics Emphasizes the Need to get the Flu Shot this Year

The American Academy of Pediatrics recently released a policy statement regarding the need for influenza vaccine for the 2011-2012 flu season.

Even though this year’s vaccine contains the same strains as last year’s, immunity can decrease by 50% in a year’s time. This means that even if someone had the flu shot last year, they may well still be susceptible to catching it this year.

It is recommended for everyone over 6 months of age. It is particularly important for all children under age 5 years as well as children of any age with high risk conditions such as asthma, heart disease or diabetes. It is also of great importance that family-members, household contacts and child care providers of these children also receive the vaccine.

The same policy statement also strongly urges all women who are pregnant, who may become pregnant or who are breastfeeding during the 2011-2012 flu season to be immunized as well.

The statement further clarifies that the flu vaccine is generally safe for children with mild egg allergy (the virus is grown in eggs although nearly all egg protein is removed during the production process).

Children 6 months of age to 8 years will need two doses of the vaccine one month apart if they did not get the flu vaccine last year, otherwise they and children over age 9 will need only one dose this year.

We have about 34,000 deaths a year from the flu in the US, with the elderly and the young most affected. Please do keep your child safe and get them immunized!

What's Going Around - Sep 5, 2011

Well, the kids are back in school, and that means they are sharing germs once again. What’s been in the office lately is a fair bit of Strep Throat as well as a viral sore throat with spots of pus on the tonsils of many of the kids. i have also been seeing some vomiting and diarrheal illness of the one to days of vomiting variety, and a nasty cold that has really been making people feel crummy for the first 2-3 days.

As always, if you are concerned about your child, get them in to a physician to be checked!