Mesquite Pediatrics Blog

After having fluoride varnish applied, you may be able to see a thin coating of the varnish on the surface of the teeth. For it to be most effective, it needs to stay on the teeth for approximately 4 to 6 hours. Please follow the directions below:

• Do not brush or floss the teeth for at least 6 hours after treatment
• Have your child eat only soft food for at least 2 hours after treatment
• Do not give your child hot drinks for at least 6 hours after treatment
• Wait until the next day to brush the teeth
• A thorough brushing the next day will easily remove any remaining varnish.

Download these care instructions.

Information About Flu Vaccines

Flu vaccination is recommended for all people 6 months of age and older. The flu vaccine is offered in injectable and nasal spray forms.

Those who are at highest risk from the flu (and therefore for whom we most strongly recommend the vaccine) are:

• children aged 6 months to 5 years
• children and adolescents who are receiving long-term aspirin therapy and, therefore, might be at risk for experiencing Reye syndrome with influenza virus infection
• women who will be pregnant during the influenza season
• adults and children who have chronic disorders of the pulmonary or cardiovascular systems, including asthma (hypertension is not considered a high-risk condition)
• adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes mellitus), renal dysfunction, hemoglobinopathies, or immunodeficiency (including immunodeficiency caused by medications or by human immunodeficiency virus [HIV])
• adults and children who have any condition that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders).
• residents of nursing homes and other chronic-care facilities that house persons of any age who have chronic medical conditions
• persons aged > 65 years

Also, a flu vaccine is strongly recommended for any household contact of any of the people listed above and for anyone who works in health care.

Children under 9 years of age who have not received at least 2 doses of flu vaccine in the past are recommended to get 2 doses this year, at least 4 weeks apart.

Nasal Flu Vaccine (Flumist)

There are certain people who absolutely should not get the nasal vaccine and others for whom it may not be a good idea (these people should consult with their physician).

This year we have a limited supply of the nasal flu vaccine (Flumist). But there are certain people who absolutely should not get the nasal vaccine and others for whom it may not be a good idea (these people should consult with their physician).

Those who definitely should not get the nasal flu vaccine are people in the following categories:

• Children under 2 years of age
• Children under 18 years of age currently receiving aspirin- or salicylate-containing therapy
• Children under 5 years of age who have had wheezing or asthma in the past 12 months
• People who have had a serious allergic reaction to a flu vaccine or flu vaccine ingredient (including gentamicin, gelatin, or arginine)
• People who have a weakened immune system (immunosuppressed, immunocompromised, or on long term oral steroids)
• People who live with or care for a person who is immunocompromised
• People without a functioning spleen
• Pregnant women
• People with a cerebrospinal fluid (CSF) leak into the nose, mouth, ear, or other part of the skull
• People with a cochlear implant
• People who have taken flu antiviral drugs within the last 17 days

Those for whom it may not be a good idea and consultation with a physician is recommended include:

• People over 4 years of age who have asthma
• People with lung, heart, kidney, or liver disease, neurological or neuromuscular disease, or a metabolic disorder (including diabetes)
• People who currently have a fever or are otherwise sick
• People who have been diagnosed with Guillain-Barre Syndrome within 6 weeks of a previous flu vaccine

Care after a circumcision is really very simple. For the first few days we need to keep the healing circumcision site from being irritated by the diaper. We do this by applying petroleum jelly (Vaseline) to the penis with every diaper change and closing the diaper nice and tight to avoid friction. It’s easiest if you buy the petroleum jelly that comes in a tube and use it to apply a swirl over the entire penis (like a Dairy Queen ice cream cone). Do this for the first 7 days.

We also need to keep the site from being irritated with cleaning. So, for the first week, you should only use a wet washcloth to clean him in his diaper area. Baby poop cleans very well with just water, so soaps and wipes really aren’t necessary and they might cause irritation of the healing area.

Most babies do not have much pain, but if he seems very fussy today you can give him acetaminophen (Tylenol) infant drops. You can give it to him every 4 hours, up to 5 times a day. His dose is 1.25 ml (the first line on the dosing syringe) as long as he is at least 6 pounds. Ask us how much to give him if he is less than 6 pounds.

Complications or Reasons to Call Us

• Bleeding: If you see a little blood in a few of his diapers over the next couple of days, don’t worry. But if you see blood actually coming from the site of the circumcision, hold pressure on it with some gauze or a piece of tissue for 10 minutes. If it doesn’t stop with pressure, please call us.

• Infection: It is normal to see a yellow crust or film over the area of the circumcision for the first week or two. This is just a part of the healing process. If you see yellow liquid (like pus) leaking from the area, redness and swelling traveling up the penis toward his body, or if your baby develops a fever (temperature of 100 or higher), you should call us right away.

Download these care instructions.

Anyone who lives in southern Arizona is aware that sun exposure can be bad for your skin. Even a “healthy” tan is actually a sign of damaged skin. But sunscreens can be confusing. At Mesquite Pediatrics, we feel it is important that people are as informed as possible about sunscreens and their use. Here are some facts and recommendations for our patients.

• Ingredients are more important than SPF: Sunburns are caused by UVB radiation, but 95% of cancer-causing radiation from the sun is UVA. The SPF only indicates how well a sunscreen blocks UVB and has nothing to do with its ability to block UVA. The following ingredients block UVA: avobenzone, oxybenzone, titanium dioxide, zinc oxide, and ecamsule. Many sunscreens do not contain any of these ingredients. Avobenzone and oxybenzone are not as effective as the others and don’t last as long. There is usually no difference between a sunscreen with an SPF of 15 and one with an SPF of 50.
• Sunscreen needs to be applied FREQUENTLY: Many sunscreen ingredients degrade in the sun. When not in the water or sweating significantly it should be re-applied every 2 hours. “Water/sweat resistant” sunscreen lasts 40 minutes in the water or when sweating. “Very water/sweat resistant” or “Water-Proof” sunscreen lasts 80 minutes.
• Most people don’t put on enough or they put it on too late: The amount you use can really affect the protection you get. Apply more than you think you need and do it 30 minutes before going out in the sun.
• It is OK to use sunscreen on very young babies: You do not have to wait until a baby is 6 months old to use sunscreen. For all children it is best to protect their skin with clothing and a hat, but sunscreen can be used after 1 month of age if sun exposure can’t be avoided. Use one that is made for babies or labeled as “hypo-allergenic”.
• Don’t use sunscreens that are combined with insect repellents: Sunscreens need to be re-applied at least every 2 hours (more often if sweating or swimming) but insect repellents shouldn’t be re-applied.

Below is our usual check-up and immunization schedule. Your child’s schedule may vary, so make sure you ask us when your child’s next visit should be.

Additional Information

• We do not recommend giving your child Tylenol (acetaminophen) before the vaccines as there is some evidence that this may decrease the effectiveness of the vaccines.
• If you are interested in more information on a particular vaccine-preventable disease, visit our AAP Patient Education Library where you can download Vaccine Information Sheets to learn about the disease, side effects of the vaccine, and other pertinent information.
• Download our Well-Child Exam Handouts for more detailed information and guidance, based on your child’s age.

First Week Check (usually 1-3 days after leaving the hospital)

• Usually no vaccines

Two Week Check

• Usually no vaccines ( Hepatitis B if not given at birth)
• Second newborn genetic disease screen collected

One Month Check

• Usually no vaccines

Two Month Check

• Pentacel ( Diphtheria , Tetanus , acellular Pertussis , Hib , and Polio )
• Hepatitis B
• Pneumococcal Conjugate Vaccine
• Rotavirus

Four Month Check

• Pentacel ( Diphtheria , Tetanus , acellular Pertussis , Hib , and Polio )
• Pneumococcal Conjugate Vaccine
• Rotavirus

Six Month Check

• Pentacel ( Diphtheria , Tetanus , acellular Pertussis , Hib , and Polio )
• Hepatitis B
• Pneumococcal Conjugate Vaccine
• Rotavirus

Nine Month Check

• Hearing Screen

One Year Check

• MMR ( Measles , Mumps , and Rubella )
• Varicella (Chicken Pox)
• Hepatitis A
• Anemia and Lead Screens
• Vision Screen

Fifteen Month Check

• Pentacel ( Diphtheria , Tetanus , acellular Pertussis , Hib , and Polio )
• Pneumococcal Conjugate Vaccine

Eighteen Month Check

• Hepatitis A

Two Year Check

• No Vaccines
• Vision Screen
• Lead Screen

Thirty Month Check

• No Vaccines

Three Year Check

• Hearing Screen
• Vision Screen

Four Year Check

• DTaP-IPV ( Diphtheria , Tetanus , acellular Pertussis and polio)
• MMRV ( Measles , Mumps , Rubella , Varicella )

Five Year Check

• Hearing Screen
• Vision Screen

Six to Eight Years

• Checkup every year

 Nine Year Check

• Vision Screen

 Ten Year Check

• Hearing Screen
• Cholesterol Screen

Eleven Year Check

• Tdap ( Tetanus , Diphtheria , acellular Pertussis )
• Meningococcal (meningitis)
• Human Papillomavirus

Twelve to Twenty-Six Years

• Checkup every year
• Usually no vaccines
• Anemia screen at 12 year check
• Meningococcal (meningitis) – second dose given at 16 years
• Hearing screen to 16 year check
• Anemia screen at 16 year check
• Cholesterol screen at 18 year check
• Tdap (Tetanus, diphtheria, and acellular pertussis) at 21 year check