Celebrate Earth Day, April 22!

Earth Day is an annual event celebrated on April 22. Worldwide, various events are held to demonstrate support for environmental protection. First celebrated in 1970, Earth Day now includes events in more than 193 countries, which are now coordinated globally by the Earth Day Network.

Here are a few ways you and your family can celebrate in Connecticut:

For more, try a Google search on “Earth Day 2019 events in CT.”

A Guide to Reading With Your Child

Start talking, singing, and reading with your child from the beginning. He will learn that reading is a fun activity you share together.

  • Point to words as you read them, showing your child that the print carries the story.
  • Ask your child to name things she sees in the pictures. Talk about how the pictures relate to the story.
  • Reading doesn’t have to be a huge project. Even a 3 minute story every night before bedtime will help your child learn.

Discuss Healthy Active Living using The Very Hungry Caterpillar:

  • Teach your child that apples, pears, plums, strawberries, and oranges are all fruits. Ask him if he can name other fruits.
  • Talk to her about how fruits are good for the body.
  • Talk about how when the caterpillar overeats, he gets a stomachache— so it is important to stop eating when you feel full.
  • Talk about how some foods are “sometimes” foods—like cake and ice cream—and how it is not a good idea to eat them all the time.
  • After reading the page where the caterpillar eats the green leaf and feels better, talk to your child about how you too eat green leaves (lettuce, spinach, cabbage, etc.) and how it is good for your body.
  • Teach your child that is important to eat healthy foods, so he can grow up healthy and active like a butterfly.

Download a printable guide that contains healthy eating tips and a reader’s guide to using The Very Hungry Caterpillar to encourage conversations about healthy eating. Print it out and share it with family and friends.


The information contained on this web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Healthy Active Living for Families

Healthy nutrition starts as early as infancy with breastfeeding. Once your baby begins eating solid foods, introduce nutritious foods early on and often. Sometimes toddlers need to try a food 10 times before they actually accept and enjoy it. It is also important to encourage play time as soon as they start crawling and walking. As your children grow, continue to help them live a healthy active lifestyle.

To lead a healthy active life, families can strive to reach these goals:

  • 5 fruits and vegetables a day,
  • 2 hours or less of screen time (TV, computer, video games) per day,
  • 1 hour of physical activity a day, and
  • 0 limit sugar-sweetened drinks.

To help children live healthy active lives, parents can:

  • be role models themselves by making healthy eating and daily physical activity the norm for their family.
  • create a home where healthy choices are available and encouraged.
  • make it fun – find ways to engage your children such as: playing a game of tag, cooking healthy meals together, creating a rainbow shopping list to find colorful fruits and vegetables, go on a walking scavenger hunt through the neighborhood, or grow a family garden.

In addition to 5, 2, 1, 0, families can make small changes in their family routines to help everyone lead healthier active lives. Try:

  • Eating breakfast every day;
  • Eating low-fat dairy products like yogurt, milk, and cheese;
  • Regularly eating meals together as a family;
  • Limiting fast food, take out food, and eating out at restaurants;
  • Preparing foods at home as a family;
  • Eating a diet rich in calcium; and
  • Eating a high fiber diet.

Help your children form healthy habits now. Healthy active children are more likely to be healthy active adults!


Source: American Academy of Pediatrics (Copyright © 2010). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Food Additives: What Parents Should Know

Food additives have been used for thousands of years, ever since people realized salt could keep meat from spoiling. Today, there are more than 10,000 additives approved by the U.S. Food and Drug Administration (FDA) to preserve, package, or modify the taste, look, texture, or nutrients in foods. But increasing evidence suggests some chemicals used as food additives should be avoided―especially for children.

Food Additives Effects on Kids

The American Academy of Pediatrics (AAP) policy, “Food Additives and Child Health,” explains that a rising number of studies suggest some food additives may interfere with hormones, growth, and development Some may also raise a child’s risk of obesity. Children may be particularly susceptible to the effects of these additives, given that they have more exposure than adults due to their size and dietary intake.

Below is a list of the most commonly used food additives and the current health concerns. This list includes indirect additives, which are used in processing or packaging, as well as direct additives that are put directly into foods.

How to Reduce Your Family’s Exposure to Food Additives

  • Buy fresh or frozen. It’s best to buy and serve fresh or frozen fruits and vegetables when possible.
  • Eat fewer processed meats. Try to avoid processed meats, such as hot dogs, ham and meats in pre-packaged meals, especially during pregnancy.
  • Wash plastic food containers and utensils by hand, rather than in the dishwasher. Heat can cause plastics to leak BPA and phthalates into food. Avoid microwaving food or beverages―including infant formula and breastmilk―in plastic, if possible.
  • Use glass and stainless steel. Especially when cooking or serving hot foods, use alternatives to plastic, such as glass or stainless steel, when possible.
  • Learn plastic recycling codes. Look at the recycling code on the bottom of products to find the plastic type. Try to avoid plastics with recycling codes 3 (phthalates), 6 (styrene), and 7 (bisphenols) unless plastics are labeled as “biobased” or “greenware,” which means they are made from corn and do not contain bisphenols.
  • Wash your hands. Because chemicals from plastics are so common in items we touch throughout the day, be sure to wash your hands thoroughly before and after handling food.
  • Speak out. Join the AAP and other organizations calling for more research into food additives’ safety, including improvements to the U.S. food additive regulatory program and retesting some previously approved additives. A recent review of nearly 4,000 food additives showed that 64% of them had had no research showing they were safe for people to eat or drink. While some change to the current law could be achieved by the FDA, some may require congressional action.

Common Questions from Parents About Food Additives

How do I find out which additives are in foods? Additives that are put directly in foods are listed on ingredient labels, but often with their chemical names. For example, salt may be listed as sodium chloride, sugar as sucrose, vitamin C as ascorbic acid, and vitamin E as alpha-tocopherol. Artificial colors are usually listed by their numbers, such as Blue #2 or Yellow #5. However, there are also indirect additives from processing or packaging materials that are not listed on the ingredient labels. These can include chemicals from plastic, glues, dyes, paper, cardboard, and different types of coatings.

Are additives a problem in any baby products? The FDA recently banned BPA from baby bottles and sippy cups, but the chemical is still used in some food and beverage containers. Many companies have voluntarily removed BPA from their products, but in many cases replaced it with chemicals such as bisphenol S (BPS) that may have similar health effects. In 2017, the Consumer Product Safety Commission banned the use of some phthalates in child-care products such as teething rings.

Do artificial food colors cause childhood hyperactivity? More research is needed to better understand how artificial food colors (AFCs) may or may not impact a child’s behavior. This is because much of the original research on these additives were animal studies that did not include behavioral affects. For some children with attention-deficit/hyperactivity disorder (ADHD) and other problem behaviors, the AAP says that until we know more, it may be helpful to eliminate AFCs from their diet if they seem to worsen symptoms.

The Future of Food Additives

Many new techniques are being researched that will improve how additives are produced. One approach is the use of biotechnology, which can use simple organisms to produce food additives. These additives are the same as food components found in nature.

Remember..aAlthough there are ways to limit the amount of potentially harmful food additives in your family’s diet, stronger federal food safety requirements will help keep all children healthy


Last Updated 7/23/2018. Source: American Academy of Pediatrics (Copyright © 2018). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


March is National Nutrition Month

Choosing nutritious foods and getting enough physical activity can make a real difference in your health. For National Nutrition Month® 2019, in March, the Academy of Nutrition and Dietetics encourages people to make informed food choices and develop sound eating and activity habits.

Each March, the Academy focuses attention on healthful eating through National Nutrition Month®. “Through the campaign, we share good eating tips such as how to keep nutritious meals simple, the importance of making food safety a part of your everyday routine, the value of preparing meals with foods you have on hand to avoid wasting food, and how to select nutritious food options when dining away from home,” says registered dietitian nutritionist Robin Foroutan, a New York-based spokesperson for the Academy.

“Eating right doesn’t have to be complicated,” Foroutan says. “Think about what you want your plate to look like and ask if it’s incorporating all the major food groups. Select a mix of lean protein foods, vegetables, whole grains and fruits to enjoy a healthful meal.”

The Academy recommends balancing nutritious foods with physical activity most days of the week. According to the U.S. Department of Health and Human Services’ physical activity guidelines, adults should participate in at least 150 minutes of moderate-intensity aerobic physical activity per week, including at least two days of muscle-strengthening activities. Being physically active up to 300 minutes per week has even greater health benefits.

“Look into incorporating physical activity into your daily routine,” Foroutan says. “Walk to work or take a walk during your lunch hour. Do something physical during the weekend, such as playing basketball with your kids or going dancing with your friends. The goal is to get moving; every little bit helps.”

Initiated in 1973 as National Nutrition Week, National Nutrition Month® became a month-long observance in 1980 in response to growing interest in nutrition.

As part of National Nutrition Month®, the Academy’s website includes articles, recipes, videos and educational resources to spread the message of good nutrition and the importance of an overall healthy lifestyle for people of all ages, genders and backgrounds.

Consumers can also follow National Nutrition Month® on the Academy’s social media channels including Facebook and Twitter using #NationalNutritionMonth.

Energy Out: Daily Physical Activity Recommendations

​Physical activity in children and adolescents improves strength and endurance, builds healthy bones and lean muscles, develops ​ motor skills and coordination, reduces fat, and promotes emotional well-being (reduces feelings of depression and anxiety). Activities should be appropriate for their age and fun, as well as offer variety.

The daily recommendation for physical activity for children 6 years and older is at least 60 minutes per day. Active play is the best exercise for younger children.

The types of physical activity should be moderate to vigorous. Vigorous activity is activity that makes you breathe hard and sweat. During vigorous activity, it would be difficult to have a talk with someone. Some activities, such as bicycling, can be of moderate or vigorous intensity, depending upon level of effort.

The 60 minutes does not need to be done all at once. Physical activity can be broken down into shorter blocks of time. For example, 20 minutes walking to and from school, 10 minutes jumping rope, and 30 minutes at the playground all add up to 60 minutes of physical activity. If your child is not active, start from where you are and build from there.

Here are some types of sports and activities for children and teens (and parents, too!)

Aerobic Exercises

  • Use body’s large muscle groups
  • Strengthen the heart and lungs
  • Examples of moderate-intensity aerobic exercises include: brisk walking, Bicycle riding, dancing,hiking, rollerblading, skateboarding, martial arts such as karate or tae kwon do (can be vigorous too)
  • Examples of vigorous-intensity aerobic activities include: basketball, bicycle riding, games such as tag, ice or field hockey, jumping rope, martial arts, running, soccer, swimming, tennis

Muscle-Strengthening (or Resistance) Activities

  • Work major muscle groups of the body (legs, hips, back, abdomen, chest, shoulder, arms)
  • Examples of muscle-strengthening activities include: games such as tug-of-war, push-ups or modified push-ups (with knees on the floor), resistance exercises using body weight or resistance bands, rope or tree climbing, sit-ups (curl-ups or crunches), swinging on playground equipment/bars

Bone-Strengthening (Weight-Bearing) Activities

  • Tone and build muscles and bone mass
  • Can be aerobic exercises and muscle-strengthening activities
  • Examples of bone-strengthening activities include: basketball, hopping, skipping, jumping, gymnastics, jumping rope, running, tennis, volleyball, push-ups, resistance exercises using body weight or resistance bands

About Strength Training

Strength training(or resistance training) uses a resistance to increase an individual’s ability to exert force. It involves the use of weight machines, free weights, bands or tubing, or the individual’s own body weight. This is not the same as Olympic lifting, power lifting, or body building, which are not recommended for children. Check with your child’s doctor before starting any strength training exercises.


Source: Energy In Energy Out: Finding the Right Balance for Your Children (Copyright © 2014 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Healthy New Year’s Resolutions for Children & Teens

The start of the new year is a great time to help your children focus on forming good habits. The American Academy of Pediatrics (AAP) provides the following list of ideas for you to talk to your children about trying, depending on their age. ​

Preschoolers

  • I will try hard to clean up​ my toys by putting them where they belong.
  • I will let my parents help me brush my teeth twice a day.
  • I will wash my hands after going to the bathroom and before eating.
  • I will learn how to help clear the table when I am done eating.
  • I will be friendly to all animals. I will learn how to ask the owners if I can pet their animal first.
  • I will do my best to be nice to other kids who need a friend or look sad or lonely.
  • I will talk with my parent or a trusted adult when I need help or am scared.

Kids, 5 to 12 years old

  • I will drink reduced-fat milk​ and water most days. Soda and fruit drinks are only for special times.
  • I will take care of my skin by putting on sunscreen before I go outdoors on bright, sunny days. I will try to remember to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports.
  • I will try to find a sport (like basketball or soccer) or an activity (like playing tag, jumping rope, dancing or riding my bike) that I like and do it at least three times a week!
  • I will always wear a helmet when riding a bike, scooter or skateboard.
  • I will wear my seat belt every time I get in a car. I’ll sit in the back seat and use a booster seat until I am tall enough to use a lap/shoulder seat belt.
  • I’ll try to be friendly to kids who may have a hard time making friends by asking them to join activities such as sports or games.
  • I will tell an adult about bullying that I see or hear about to do what I can to help keep school safe for everyone.
  • I will keep my personal info safe and not share my name, home address, school name or telephone number on the Internet. Also, I’ll never send a picture of myself to someone I chat with on the computer without asking my parent if it is okay.
  • I will try to talk with my parent or a trusted adult when I have a problem or feel stressed.
  • I promise that I’ll do my best to follow our household rules for videogames and internet use.

Kids, 13 years old and older

  • I will try to eat two servings of fruit and two servings of vegetables every day. I will drink sodas only at special times.
  • I will do my best to take care of my body through fun physical activity and eating the right types and amounts of foods.
  • When I have some down time for media, I will try to choose educational, high-quality nonn-violent TV shows and video games that I enjoy. I will spend only one to two hours each day – at the most – on these activities. I promise to respect out household rules for videogames and internet use.
  • I will do what I can to help out in my community. I will give some of my time to help others, working with community groups or others that help people in need. These activities will make me feel better about myself and my community.
  • When I feel angry or stressed out, I will take a break and find helpful ways to deal with the stress, such as exercising, reading, writing in a journal or talking about my problem with a parent or friend.
  • When faced with a difficult decision, I will talk about my choices with an adult whom I can trust.
  • When I notice my friends are struggling, being bullied or making risky choices, I will look for a trusted adultso that we can attempt to find a way to help.
  • I will be careful about whom I choose to date. I will treat the other person with respect and not force them to do something they do not want to do. I will not use violence. I will expect to be treated the same way in return.
  • I will resist peer pressure to try tobacco-cigarettes, drugs, or alcohol. I will also avoid the use of e-cigarettes.
  • I agree not to use a cell phone or text message while driving and to always use a seat belt.

Source: American Academy of Pediatrics (Copyright © 2018). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Holiday Mental Health Tips

​The holidays can be a happy time of year for many people, as they gather with family and friends, exchange gifts and celebrate traditions. But the changes in family routines and extra demands on time can also cause some stress, especially for children. The American Academy of Pediatrics offers some tips to help your family enjoy the best of the holiday season:

  • During the busy holiday time, try to keep household routines the same. Stick to your child’s usual sleep and mealtime schedules when you can, which may reduce stress and help your family enjoy the holidays.
  • Take care of yourself, both mentally and physically. Children and adolescents are affected by the emotional well-being of their parents and caregivers. Coping with stress successfully can help children learn how to handle stress better, too.
  • Make a plan to focus on one thing at a time. Try a few ideas to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: Stop and pay attention to what is happening at the moment, focus your attention on one thing about it, and notice how you are feeling at the time. Withhold immediate judgment, and instead be curious about the experience.
  • Give to others by making it an annual holiday tradition to share your time and talents with people who have less than you do. For example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter, or sing at a local nursing home. Help your child write a letter to members of the armed forces stationed abroad who can’t be home with their own family during the holidays.
  • Remember that many children and adults experience a sense of loss, sadness or isolation during the holidays. It is important to be sensitive to these feelings and ask for help for you, your children, family members or friends if needed.
  • Don’t feel pressured to over-spend on gifts. Consider making one or two gifts. Help your child make a gift for a parent, grandparent, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons.
  • Most important of all, enjoy the holidays for what they are — time to enjoy with your family. So, be a family, do things together like sledding or playing board games, and spend time visiting with relatives, neighbors and friends.

Source: American Academy of Pediatrics (Copyright © 2017). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Encouraging Teens to Take Responsibility for Their Own Health

As children mature, they may become increasingly reluctant to share health concerns with Mom and Dad; partly out of modesty and partly to assert their independence. That is why teenagers need a pediatrician in whom they can confide.

Now is also the time for teens to learn to become savvy medical consumers. They should be encouraged to schedule their own doctors’ visits and to ask questions anytime they don’t understand something the pediatrician has said. Where health matters are concerned, there is no such thing as a “dumb” question. Every patient, regardless of age, is entitled to clear explanations of her condition and the recommended treatment plan.

Above all, adolescents need to be coached on the importance of taking medications as directed. If there is one source of frustration for pediatricians, it’s their young patients’ lack of compliance (although as Dr. Kulig, M.D., M.P.H. points out, “compliance among adults isn’t much better”). In one study of children suffering from throat infections, more than 80 percent failed to finish their antibiotics, which had been prescribed for ten days. Presumably, most of them started to feel better after several days and figured they could stop taking the medicine. But we know that the entire course of antibiotics must be completed in order to fully eradicate the infection. Otherwise, the bacteria regain a foothold, stronger than ever, and the symptoms return.

Teens may also resist following doctors’ orders as a display of rebellion. Dr. Kulig advises that parents monitor their youngster’s compliance, but without assuming the mantle of responsibility. The most successful strategy, he’s found, “is to solicit kids’ input about how to best stick to medication schedules, rather than demanding, ‘You must take this medicine.’ ” He offers several tips:

To eliminate confusion, post a calendar on the refrigerator and place a check mark in the appropriate box each time the medication is taken. Or purchase an inexpensive plastic pill holder, in which oral drugs are stored according to the day of the week and daily Sunday through Saturday, and dose (morning, afternoon, evening).

Have the teenager take the medicine at the same time as one of his daily rituals, like brushing his teeth. “It becomes a cue for compliance,” explains Dr. Kulig. “When they brush their teeth in the morning and at night, they remember they need to take their medicine.”

Practice positive reinforcement. Praise your adolescent each time he adheres to the medication schedule.

Remind young men and women why a medication has been prescribed. “Adolescents should understand the purpose of the therapy as well as the potential consequences of noncompliance,” says Dr. Kulig. “They should also be aware of how long they may have to be on the medication before they can expect to see optimum results.

“For instance, some acne medications can take upward of twelve weeks to start working. If a teen gets discouraged and discontinues the drug, obviously the acne won’t get better. Likewise, if he grows impatient and overuses it, he may irritate and dry out the skin.”

Another reason for supervising young people’s consumption of medicines is that some drugs have the potential for abuse, whether they’re prescribed or over-the-counter. “Tylenol is a good example,” says Dr. Kulig. “Too high a dose can basically destroy the liver.” Most overdoses of nonprescription agents are taken intentionally, as part of suicide attempts, but excessive amounts can be ingested accidentally. “Teenagers,” he stresses, “are not aware of how toxic these products can be.”

As a precaution, it’s wise to never leave a family member’s medication out where it can fall into the hands of an inquisitive child or a teenage pal looking for a “legal” high. According to Dr. Timothy Wilens, a pediatric psychiatrist at Massachusetts General Hospital, also in Boston: “Most prescription drugs are abused not by the kids for whom they’re prescribed, but by other children. All containers should be stored away, with each dose administered individually.”

Questions to Ask the Pediatrician Before a Teenager Starts Any New Medication

  • What are the medication’s generic name and trade name?
  • What is the purpose of using this medication?
  • How often should the medication be taken, and at what time(s) of day?
  • What is the dosage?
  • Is it necessary to swallow this medication with food or milk?
  • If your youngster has difficulty ingesting pills, ask if the medication can be crushed, or if it comes in the form of a liquid, skin patch, rectal suppository, inhaler or nose spray.
  • Are there any foods or beverages to avoid while on this medication?
  • Will the drug interfere with other medications my child is taking, or vice-versa?
  • List for the pediatrician all medications your teenager takes, including over-the-counter agents, nutritional supplements and “natural” herbal remedies.
  • What should we do if we miss a dose?
  • For how long must the medicine be taken? Does my child have to finish the entire prescription?
  • Does the prescription include refills? If so, how many? What should we do if we need a new prescription ordered?
  • What are the potential side effects of this drug, and which ones should we report to you?
  • If side effects occur, how will they be managed?
  • When will we be able to tell if the medicine is working?
  • How much does the prescription cost?
  • Is there any written information available about the medication?

Source: Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Is Your Child Overweight?

Pediatricians evaluate children’s growth and build by means of standardized growth charts and body mass index (BMI). Growth charts show whether a child falls within the normal range of height and weight for her age. Children whose weight or height is above the 85th or below the fifth percentile should be examined by a doctor to determine whether further evaluation is needed. Pediatricians also will watch for fluctuations in children’s weight, which may mean something has changed and put them on the path toward gaining excess weight.

Body mass index is a calculation of your child’s weight relative to height. A BMI above the 85th percentile means overweight, while children above the 95th percentile are considered obese, which increases their risk of chronic diseases such as heart disease and diabetes. The BMI percentile that defines severe obesity is 120% of the 95th percentile. If your child’s BMI is between the 85th and 95th percentiles, her excess weight may be fat or muscle. Growth charts and BMI tell only part of the story because neither method measures body fat. Children and adolescents who are particularly athletic with unusually muscular or lean builds may have a high BMI without having excess fat or being obese. In some obesity clinics, as many as 10% to 15% of children fall into this category. Also keep in mind that there are small differences between African American and white children; at the same BMI measurement, African American children and teenagers tend to have more muscle and bone mass and less body fat. However, almost all children and adolescents with a BMI above the 95th percentile have too much body fat, regardless of their ethnicity or muscularity.

Some parents wonder how it is possible for 17% of 2- to 19-year-olds to be obese when only 5% of the population should have a BMI above the 95th percentile. The BMI charts were based on children and teens studied before 1988, when not as many youth were obese. At that time, only 5% of children and teens were obese.

If your child is overweight because her frame size is increased, reassure her that her extra weight is not fat and encourage her to be physically active to maintain her muscle tone. Also, be actively involved in any discussions with your pediatrician and your child about your child’s weight. To prevent worries about body size, parent and child need to accept the child’s body type. Other members of the family may have a similar build. If you focus inappropriately on weight alone and pester your child to lose weight, she may develop a distorted body image and risk an eating disorder. It’s estimated that 70% to 80% of girls perceive themselves, whether rightly or wrongly, as too fat. Experts warn that a misperception of body image may be partly fueling the current obesity epidemic, with inappropriate dieting followed by rebound weight gain.

Choose to Be Happy – Many adolescents, particularly girls, become deeply unhappy when they realize that they are never going to be shaped like supermodels or earn multimillion-dollar contracts as movie stars.

Help your daughter feel comfortable with who she is. Reassure her that real beauty is more than skin deep. Help her develop her skills and talents and emphasize her positive attributes. Offer her female role models who have made the most of their talents, achieving intellectual and humanitarian goals or raising healthy, balanced children, instead of trading on their looks for superficial success.


Source: Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.