Mesquite Pediatrics Blog

If you received a text message from us, then you have a child in an age group that is eligible for an accelerated vaccine schedule.  We are having a Saturday morning vaccination clinic on March 1st to provide vaccines for children whose parents are concerned about the availability of vaccines in the future.  Please see more details below and call us to schedule your child for the clinic if you are interested.  We will also be offering flu and COVID vaccines at this clinic. If you cannot make it on the morning of March 1st, you can make an appointment for a time during regular business hours after that date.  While we do not know if any changes may occur we do know that this is a safe and effective strategy.  Our primary goal remains ensuring your child’s health and wellness.

Vaccine Availability Concerns

We have heard from many families who have questions or concerns about potential changes in health policies in our country. As your pediatricians, we want to remind you of our goal of providing the best possible care for your children and helping them grow and thrive in a healthy community. We wish we could predict what will happen with vaccine policy in the near future, but unfortunately we cannot. We do know that the newly-confirmed Secretary of Health and Human Services has been an outspoken critic of vaccines, especially the MMR, HPV, and polio vaccines (references below). At the very least, he founded Children’s Health Defense, an anti-vaccination group; argued against measles vaccination in Samoa during an outbreak that led to 83 deaths; is an interested party in, and stands to profit from, a lawsuit against the manufacturer of the HPV vaccine; and is affiliated with a lawyer who has petitioned for the revocation of the license for polio vaccine.

Some Vaccines can be Given Early

Given the uncertainty regarding the future of vaccinations and protection against vaccine preventable infections, we are offering an optional accelerated vaccination schedule for our patients.  This accelerated schedule is within recommendations of the Advisory Committee on Immunization Practices (ACIP) that guides our immunization practices.  These doses would not be “extra” but would be given early to ensure the child is protected against vaccine preventable infections while the vaccines are available.  They will be just as effective when given on this schedule and will be accepted by any institution with vaccination requirements.

Vaccines on the Accelerated schedule

• MMRV: 2nd dose available for children 15 months- 4 yrs. Must be at least 3 months after the first dose of MMR & Varicella vaccinations (usually given at 1 yr). If your child is 4 years or older and has not yet received this vaccination they would also be eligible.  (Informative Links: RFK and Samoan Measles Outbreak, Children’s Hospital of Philadelphia on: MMR, Varicella, Sabin Vaccine Institute Q&A)
• HPV: Series can be started at 9 years of age instead of the usual 11 years of age.  If your child has not received this vaccination and is 9 years or older they are eligible. The second dose will be given 6 months later.  (Informative Links:  RKF on HPV Vaccine Lawsuit, Children’s Hospital of Philadelpha on: HPV)
• DTaP/Hib/IPV (Pentacel) and pneumoncoccal vaccine: 4th doses available for infants 12 months-14 months. Must be at least 6 months after the 6 month vaccinations. (Informative Links:  Children’s Hospital of Philadelpha on: RFK Lawyer Petitions to Revoke Polio Vaccine License, DTaP, Hib, Polio)

More Links that May be of Interest

• RFK on vaccines in general and race: Washington Post on RFK
• Concern for Outbreaks:  RFK and Outbreaks
• Article Oulining how Vaccines Have Saved 146 Million Lives Since 1974:  The Lancet on Vaccines
• Article on Excellent Effectiveness of HPV Vaccine in Preventing Cervical Cancer:  Journal of the Natinal Cancer Institute on HPV Vaccine
• Vaccines and Autism:  STATNews, Children’s Hospital of Philadelphia, CDC

If it is between October 1 and March 31 and you have a baby under 8 months of age, please read below to see if you should call us to schedule an appointment for this injection to help prevent RSV infection in your child.

RSV is the most common reason for babies under 1 year of age to be admitted to the hospital.  Every year there are about 2.1 million outpatient visits and 58,000-80,000 hospitalizations due to RSV for children under 5 in the US.  Fortunately, a vaccine for pregnant women (Abrysvo) and an injection for babies (Beyfortus) were released last year to help prevent RSV infections in the youngest babies.  We highly recommend this injection for any baby <8 months of age whose mother did not receive her RSV vaccine at least 2 weeks before the baby was born.  It is given only during RSV season, from October 1 to March 31.  It is also recommended for those 8-24 months with certain risk factors.

What is Beyfortus (nirsevimab)?

Beyforus is an antibody that is a passive immunization. The antibodies circulate in the baby’s bloodstream and protect the baby from RSV for a period of at least 5 months (about the length of a typical RSV season).  While not technically a “vaccine” in a traditional sense (active immunization), it is being used in a manner similar to routine childhood vaccines and may sometimes be referred to as a vaccine.

How effective is Beyfortus (nirsevimab)?

Data from the 2023-2024 RSV season show that Beyfortus was effective against RSV-associated emergency department visits and hospitalization among infants in their first RSV season. Specifically, data from the VISION Multi-Site Network of Electronic Health Records showed Beyfortus was 77% effective at preventing RSV-associated emergency room visits and 98% effective at preventing RSV-associated hospitalization.

What are the side effects of Beyfortus (nirsevimab)?

Because Beyfortus is a passive immunization and the baby’s immune system does not need to react to it in order for the baby to be protected, side effects are usually very mild.  The only common side effects are reactions at the site of the injection such as pain, redness, or swelling.  Allergic reactions can always happen with injections but they are very rare.  Overall, Beyfortus is very safe, well tolerated, and extremely effective.

It’s never too soon to read together! Reach Out and Read gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together.

When we look back on our childhood, many of us have fond memories of being read to, of snuggling up and enjoying a favorite story with the people who love us. And it’s not so much the story that we remember, but the feeling of love and security that it gave us.

It turns out that reading aloud, a time-honored tradition in so many families, is actually a wonderful way of helping children to reach their full potential.

More than thirty years ago, two Boston Medical Center pediatricians recognized their unique opportunity to have an impact on the development, as well as on the health, of the children they served. They adopted a simple model of prescribing books and reading aloud as a means of fostering the language-rich interactions between parents and their young children that stimulate early brain development.

Mesquite Pediatrics is a participating Reach Out & Read practice. Ask us about this simple and effective way to help your child develop language and literacy skills.

People often ask about the uses of probiotics in children. There are many conditions for which probiotics are often used, but the scientific evidence supporting their use is incomplete. Below are several conditions for which there does seem to be a benefit; also, we list the probiotic species that have been studied and shown to be of most benefit. This is not a comprehensive list, but the conditions with the most research showing the greatest benefits are included here. Generally, a dose of 10-20 billion colony forming units per day is necessary to have an effect for an adult. A good rule of thumb for children’s dosing is to use one quarter the recommended adult dosage for children up to 6 years of age, half the adult dosage for children 6 to 12 years of age, and a full adult dosage for teens.

It is important to recognize that probiotics are not as tightly regulated as medications. There really is no way to assure the purity of any particular preparation or the accuracy of what’s on the label. Your safest bet is to go with a well-known brand, if possible. Also, probiotics are often sold as combinations of species. How these combinations will work is not necessarily clear, so you may want to look for those preparations that are only a single species if you can.

Probiotics are not necessarily safe for all people and in all situations. People with the following conditions should probably not use them: chronic diseases (such as congenital heart disease or kidney disease), immune deficiencies (either from an immune disease or from medications such as chemotherapy), and those with indwelling catheters. If you have questions about whether it would be safe to use probiotics with your child, please check with us first.

Antibiotic-associated Diarrhea
Many of our patients realize that antibiotics can cause diarrhea by killing off the body’s normal intestinal bacteria. The use of probiotics can help replace these “healthy” bacteria and make it less likely that a person taking antibiotics will develop the diarrhea. Three probiotics have been shown to be helpful: Lactobacillus rhamnosus GG, Streptococcus thermophilus, and Bifidobacterium lactis (which is available in some infant formulas).

Acute infectious diarrhea
Also known as the stomach flu, stomach viruses, and viral gastroenteritis, acute infectious diarrhea if extremely common. Probiotics are not a cure for this, but can sometimes shorten the course by up to 2 days. Strains that may be of benefit are Streptococcus boulardii, Lactobacillus rhamnosus GG, Lactobacillus acidophilus, and Lactobacillus bulgaricus.

Infantile Colic
A study published in August 2010 showed a decrease in colic symptoms in infants given 10 billion CFU of Lactobacillus reuteri. It definitely is not a cure for all cases of colic, but it is a safe intervention that can be tried.

Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis)
There is little research done in children and teens with these conditions. In adults a stain of E. coli (strain Nissle 1917) has been shown to be of some benefit in lengthening the time between relapses. The usual dosage is 250mg three times a day for 4 weeks.

Irritable Bowel Syndrome
This condition is poorly defined and difficult to treat. A study was recently completed (in 2010) that seems to show that Lactobacillus rhamnosus GG has some benefits.

Allergic Diseases (Eczema, Allergic Rhinitis, and Asthma)
There have been a number of studies to look at whether probiotics can either prevent or treat any of these conditions. It does appear that probiotics can make it slightly less likely that these conditions will develop, but studies on whether probiotics can actually treat these conditions have had mixed results. Eczema is the condition on this list most likely to benefit from probiotics. Most studies have used Lactobacillus rhamnosus GG, though there is no consistent recommendation.

This is a technique of giving fluids to a young child who has been vomiting that often will allow you to get some fluids into their system and thereby alleviate the vomiting and avoid dehydration (and the emergency room). It does not work for every child, but it does work for most.

If your child has been vomiting repeatedly for a long time, appears dehydrated, is lethargic or poorly responsive, or just looks to you like he or she is very sick and worrisome, please seek medical attention (come see us or go to an emergency room) instead of trying this vomiting cure.

However, if your child is not very ill, try following the instructions below. Don’t be tempted to use Gatorade or other sports drinks instead of Pediatlyte (or a generic equivalent). Sports drinks contain too much sugar and not enough salt to hydrate appropriately so they don’t work as well and they also can cause diarrhea, which is a problem you probably don’t want right now.

• Give 1 teaspoon of Pedialyte (or a generic equivalent) every 10 minutes for 1 hour.
• Then give 2 teaspoons every 10 minutes for 1 hour.
• Then give 4 teaspoons every 10 minutes for 1 hour.

If your child tolerates this without vomiting:

• You can now give 2 to 3 ounces at a time in a cup or bottle for your child to work on at their own pace with some encouragement to take frequent sips.

If your child is able to take another 8-12 ounces of Pedialyte without vomiting:

• You can start with some bland foods and a little bit of milk, and increase what you give him or her over the next day or so.

If your child vomits:

• Wait 30 minutes without giving anything and start over.
• If you have to start over 3 times and your child is still vomiting, then call us.
• If your child does not urinate at least 4 times in 24 hours, then call us.