The American Academy of Pediatrics, California, is committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults living in California.

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Kris Calvin, CEO: Three for Thought

Pertussis and Immunizations: Facts, Myths, and Misconceptions

By James D. Cherry MD, MSc | As a physician I have seen pertussis cases and participated in pertussis immunization for 57 years (1). We studied reactogenicity of DTwP vaccines in 1978-1979 and subsequent to that time I, with various colleagues, studied the epidemiology of pertussis and pertussis immunization; adolescent and adult pertussis; and carried out numerous studies with a DTaP vaccine including a DTaP vaccine efficacy trial in Germany. More recently in conjunction with investigators at the California Department of Public Health and pediatric infectious diseases colleagues we have studied severe pertussis in young infants (2, 3) and have recommendations in place for young infants who are hospitalized with pertussis. I have analyzed why pertussis vaccines fail as well as the present resurgence of pertussis (4-7). During the last decade I have given numerous presentations to pediatricians about pertussis and pertussis immunization. During this period I have fielded many questions and in this presentation I will address many of these as well as recommendations which I think are important in 2014. Severe Pertussis in Young Infants in California During the period between 1998 and January 2011 there were 50 pertussis deaths in young infants in California. In the fall of 2009 a number of us presented advice relating to the diagnosis and management of pertussis in young infants to all AAP District IX members (8). Also in 2010-11 we had the opportunity to study severe pertussis in 31 infants ≤ 90 days of age and to evaluate exchange blood transfusion in the management of extreme leukocytosis with lymphocytosis (2, 3). The following predictors of death or pulmonary hypertension... read more

Teens and Table Talk

By Kate Land, MD, FAAP | Before my kids were born and when they were very small, I used to fear the teen years. Visions of my sweet cuddling tots turned into Goth, rude teens hiding in their rooms with ear buds in danced through my brain. Now with two, nearly three teens at home I no longer fear. Their reality is a thing of wonder to me. They are not rude. Quiet at times, but not rude. I have to pull out the ear buds all too often but, they do not sulk behind closed doors. And most reassuring, they are still quite cuddly – when they want to be. Given this reassuring state, I can be taken aback when they momentarily act like “real” teens. Family dinnertime is sacred in my house. Even through change, upheaval and redefinition of family itself, dinners together come first. Last night at dinner, I asked the kids why they thought dinners together were so important. My middle child said with a snarky tone, “Because they keep us connected at the heart.” Her hands acted this out with fingers first intertwined and then in the shape of a heart. Eyes rolled. But then, thankfully there came a smile. The evidence continues to pour in — eating meals with family is good for kids. In 2010 a study of nearly 9,000 4 year-old children published in the journal Pediatrics concluded (in part) that young children who regularly ate the evening meal as a family had a significantly lower prevalence of obesity. A 2011 meta-analysis in Pediatrics examines three concerns: obesity, unhealthy eating and disordered eating. It found that each of these negative behaviors was decreased in... read more

E-Cigarettes

By Wendy Sue Swanson, MD, MBE, FAAP | Grim news out. E-cigarette use in teens has doubled in a year. The CDC reports that 1 in 10 high school students admitted to ever using an e-cigarette in 2012. The rate of use doubled for middle school students as well. Although I’m not surprised, I remember just weeks ago tweeting about my dismay with Jenny McCarthy’s new job– advertising e-cigarettes. I took flak. Some advocates for e-cigs felt I was shortsighted and not valuing the potential benefits of these electronic nicotine-laden vapor tubes. All I could think of was her image, the lure she may create for teens, and the likelihood that teens would peek in on e-cigs with greater fervor. Just a month ago we learned that smokeless tobacco use is steady with teens (5%) and many teens are now turning to novel sources of nicotine (dissolvable tobacco, snuff, snus) in addition to tobacco cigarettes. I consider myself fairly up to date, and until the AAP report came out in August I’d never once heard of snus. You? Some people are wed to the concept that e-cigs may reduce the burden of illness and smoking-related morbidity from tobacco cigarettes. Even if you believe in harm-reduction for adults (switching from tobacco cigarettes to e-cigs to reduce use or quit) this is an entirely different issue for our middle and high-school students. A nice summary of the data for e-cigs from pediatrician, Dr Aaron E Carroll, with numerous associated comments helps frame the issue. I wish I could remain agnostic about these devices, but I can’t. This is pretty easy to say: I don’t recommend e-cigarettes for a... read more

Children of Immigrants

Ricky Y. Choi, MD, MPH, FAAP | For many the immigration debate in Washington is more than just a debate. It’s potentially life altering. And while most of the focus has been on beefing up borders and deciding who deserves citizenship, there is one group that does not get enough discussion, children. As a pediatrician for many immigrant families and as a child of immigrants, I know that getting the right reforms is stronger medicine for my patients than anything I could prescribe. One in four children in the United States lives in an immigrant family, so this is not a small group. They are the fastest growing segment of the U.S. population. One day they will grow up to become our nation’s future. So how are we treating them? Frankly, not very well. Children from immigrant families are twice as likely to be uninsured and more likely to live in poverty. In some states, even legal immigrant children must endure waiting periods before they are eligible to access public programs including Medicaid. This means delays in getting needed health care as well as immunizations and care for chronic illnesses. Parent deportation is exacting a heavy toll. It is estimated over 200,000 parents of citizen children have been deported in the past two years. This has been shown to cause anxiety, depression and poor school performance in affected children not to mention adding to a child’s risk to food and housing instability. At a young age this type of stress is physiologically toxic with the potential for lifelong consequences. But it doesn’t have to be this way. The Senate... read more

It’s All About the Snacks

By Cara Barone, MD, FAAP | Every day at work as a pediatrician I talk about healthy lifestyle habits.  I never have as much time as I would like for this discussion, but I always make a point to discuss the importance of exercise and nourishing our bodies with wholesome foods.  My goal is to try and motivate children and families to make healthier choices wherever and whenever I can. Children look to their parents as sources of information and inspiration. Modeling a healthy lifestyle as a parent is critical to a solid foundation in their children’s development of their own health habits.  As parents I think we intuitively know this, but it is always important to remind one another of this awesome role in our children’s lives. In the merging of my mom and pediatrician roles, one of my biggest personal struggles so far is the culture of “the sport snack.”  So many of us have children in American Youth Soccer Organization (AYSO), basketball leagues, swim teams, and other team sports which clearly foster much physical and emotional development for our children. We want our children to have a love for exercise and to continue this interest and dedication throughout their lifetimes.  But as my husband says: “It’s all about the snack and uniform” for the majority of young kids. I’m certain there is much truth in his statement. So last year for my first snack duty for my son’s basketball league game I packed water, cheese sticks, and bananas to bring for his teammates. Needless to say, my snack was not met with warm reception from the... read more

Social Media Makes Me A Better Pediatrician

Heidi Román, MD, FAAP | About two years ago I started writing more regularly–reflections on being a new mom, thoughts on my changing perspective as a pediatrician. I kept a notebook that quickly filled with musings that occurred to me during clinic, questions parents asked, things that came up with my son. I realized that a lot of other parents had the same kinds of questions I did. They too were Googling questions and looking for credible sources of information. So, I started actively creating and curating child health information via social media. I’m still a neophyte compared to many online pediatricians that I respect and follow. Nonetheless, I’m a relative veteran compared to most of my colleagues. I’m often asked about how and why I do this. When I answer that I think being online is making me a better pediatrician, I get some curious and quizzical looks. I admit that I didn’t expect it when I started all of this, but being involved in social media is shifting the way I think about medicine and ultimately making me a better doctor. Here’s how. • I write more. I write, on average, a post a week. Writing has made me a better doctor and mom, in many ways. When a parent asks a question on a topic I’ve recently researched and written about I can direct them to useful resources without a moment’s hesitation. And, writing makes me read more too. I now have a set of go-to sources for quality child health information that I am well acquainted with and that I can use quickly in clinic. • I... read more

American Academy of Pediatrics, California, Chapters

Chapter 1

Chapter 1 members represent communities from the Northern California border to the central San Joaquin Valley.

Chapter 2

Chapter 2 serves Kern, LA, Riverside, San Bernardino, San Luis Obispo, Santa Barbara & Ventura Counties.

Chapter 3

Chapter 3 is dedicated to achieving optimal health for all children in San Diego and Imperial Counties.

Chapter 4

Chapter 4 provides evidence-based recommendations for child health in Orange County.