Misunderstanding the Affordable Care Act and Understanding Why It Should Be Saved

If the Affordable Care Act (Obamacare) gets repealed, it likely won’t be because folks understand what it does.

The American Academy of Pediatrics is opposed to plans to repeal the ACA and wants to KeepKidsCovered.
The American Academy of Pediatrics is opposed to plans to repeal the Affordable Care Act and is working hard to #KeepKidsCovered.

It will be because many people don’t realize that they are benefiting from Obamacare or even what it really does.

Obamacare Under Attack

The Affordable Care Act has been under attack almost from the day it was enacted.

Since the original Repealing the Job-Killing Health Care Law Act, and through dozens of others, we have most recently had the:

  • Better Care Reconciliation Act
  • Obamacare Repeal and Reconciliation Act
  • Health Care Freedom Act (“Skinny” repeal)

They all failed.

The latest attempt to repeal Obamacare is the Graham-Cassidy-Heller-Johnson Bill.

Will this bill pass?

Our organizations represent a combined membership of 500,000 physician and medical student members, most of whom are providing front line care to patients throughout the United States.

As discussions around health care reform continue, we urge Congress and the new administration to preserve essential coverage, benefits and consumer protections as established by current law, including the Affordable Care Act (ACA); we also acknowledge the need for additional reforms and improvements to address continued barriers to care and ensure a health care system optimized for patients and their physicians.

Joint Recommendations of the AAFP, AAP, ACOG, ACP, and AOA on Priorities for Coverage, Benefits and Consumer Protections Changes

Like the other bills, the Graham-Cassidy-Heller-Johnson Bill will fail if any of these organizations that have come out in opposition have anything to say and do about it:

  • American Academy of Pediatrics (AAP)
  • American Medical Association (AMA)
  • American Nurses Association
  • American Congress of Obstetricians and Gynecologists (ACOG)
  • American Academy of Family Physicians (AAFP)
  • American Osteopathic Association (AOA)
  • American Public Health Association
  • American Psychiatric Association
  • AARP
  • National Council for Behavioral Health
  • American Hospital Association
  • ALS Association
  • American Cancer Society Cancer Action Network
  • American Diabetes Association
  • American Heart Association
  • American Lung Association
  • Arthritis Foundation
  • Cystic Fibrosis Foundation
  • Family Voices
  • JDRF
  • Lutheran Services in America
  • March of Dimes
  • National Health Council
  • National Multiple Sclerosis Society
  • National Organization for Rare Diseases
  • Volunteers of America
  • WomenHeart

How can you pass a health law that every major health organization opposes?

“This bill contains proposals we have seen in previous bills, and we already know they would be bad for people with CF – and some cases, go even further. Graham-Cassidy would allow states to get rid of certain pre-existing condition protections, open the door to annual and lifetime coverage caps and high risk pools, and make massive cuts to Medicaid.”

Cystic Fibosis Foundation

In addition to repealing parts of the Affordable Care Act (ACA), Graham-Cassidy:

  • makes massive cuts to Medicaid
  • turns Medicaid into a block grant and caps its funding
  • ends Medicaid expansion
  • eliminates ACA’s marketplace subsidies

Graham-Cassidy should not be allowed to pass.

Add your voice to the opposition if you agree. Contact your Representative and Senators to let them know that you oppose the Graham-Cassidy ACA repeal bill.

Understanding the ACA

Most people understand that the ACA allowed many uninsured people to finally get insurance. Either with the help of tax credits, simply because the plans were available, or through the expansion of Medicaid, about 20 million have insurance because of the ACA.

What many people don’t realize is that they likely benefited from the ACA, even if they aren’t one of these 20 million people.

Some of the ACA benefits for everyone with any kind of insurance included:

  • no refusal for coverage because you have a pre-existing condition – which could include things like asthma, ADHD, anxiety, and depression or a cancer that is in remission
  • coverage for young adults so they could stay on their parent’s insurance plan until they are 26 years old, even if they are in school, working, or married
  • the elimination of annual and lifetime limits or caps – which some kids with complex health problems could reach in a single year
  • no co-pays for preventative care visits, from well-child visits and vaccines to mammograms and colonoscopies and well adult visits for men and women
  • no co-pays for breastfeeding support, supplies, and counseling
  • coverage for maternity services
  • coverage for mental health and substance abuse services
  • insurance plans can’t drop you if you get sick

Most people like those benefits.

Personally, I no longer see parents who worry about my diagnosing their child with asthma or anxiety because of how it “will look” on their insurance. And we don’t have to worry that a diagnosis of anxiety or depression won’t be covered because they have insurance that doesn’t include mental health benefits.

And, even though the Vaccines for Children program was available, it is nice knowing that insurance covers their vaccines that can protect them from life-threatening vaccine-preventable diseases.

Misunderstanding the ACA

Not realizing all of these benefits is only one way that folks misunderstand the ACA.

Are premiums under Obamacare soaring?

Actually no. Insurance premiums have gone up at slower rates for all of us than they did before Obamacare took effect!

“We have a national law that will continue to work overall, but which has some problem spots. That frames the real choice here. It is not, as Trump, McConnell, and Ryan would cynically lead the American people to believe, between repealing the ACA or coping with impending disaster. Rather, it is between repealing the law and repairing it.”

Scot Lehigh on Hard truths about Obamacare

Do some people have fewer options as some major insurers drop out of the ACA Marketplaces? Sure. But that’s still better than the zero options they likely had before the ACA when they were uninsured.

What about the idea that Obamacare is failing overall? It’s not.

What to Know About Misunderstanding the ACA

Obamacare is not failing and has helped millions of people get insurance coverage. All of the plans to repeal and replace it have been huge steps backwards that have been opposed by every major health organization.

More Information About Misunderstanding the ACA

 

What Is the American College of Pediatricians?

Every time you hear about or read something and quickly think to yourself, “did the American Academy of Pediatrics really say that?” – it’s almost certainly from the American College of Pediatricians.

Tucker Carlson turns to the American College of Pediatricians when he wants to take sides against transgender kids and their parents.
Tucker Carlson turns to the American College of Pediatricians when he wants to take sides against transgender kids and their parents.

The names sound alike, perhaps intentionally, but the two groups couldn’t be more different.

Who are they?

The American College of Pediatricians is basically the Bizarro World version of the American Academy of Pediatrics.

The American College of Pediatricians vs American Academy of Pediatrics

Like the Association of American Physicians and Surgeons, the American College of Pediatricians (ACPeds) pushes and promotes “misleading and incorrect” recommendations based on the ideology of their members, not using science and evidenced based medicine.

“…ACPeds was born from an ideological split within a profession. It was founded in 2002 as a protest against the much larger American Academy of Pediatrics’ support for LGBT adoption rights — and that opposition remains central to the group’s identity…

But thanks to its deceptive name — which makes it sound as if it is the mainstream professional organization for pediatricians — ACPeds often serves as a supposedly scientific source for groups pushing utter falsehoods about LGBT people.”

Southern Poverty Law Center on how the American College of Pediatricians Defames Gays and Lesbians in the Name of Protecting Children

That’s why most of the press releases and position statements from the ACPeds are against (while the AAP supports):

Michelle A. Cretella, MD, FCP (Fellow of the College of Pediatricians), the President of the American College of Pediatricians, has even praised the book Preventing Homosexuality, calling it “an invaluable resource for parents.” She is also on the Board of Directors of the National Association for Research and Therapy of Homosexuality (NARTH), a group that supports reparative or conversion therapy for homosexuals.

The American College of Pediatricians goes so far as suggesting adding a ‘P’ to LGBT acronym. No, the ‘P’  wouldn’t stand for pansexual in their world – it would stand for pedophile.

“In one sense, it could be argued that the LGBT movement is only tangentially associated with pedophilia. I see that argument, but the pushers of the movement, the activists, I think have pedophilia intrinsically woven into their agenda. It is they who need to be spoken to and against.”

American College of Pediatricians Blog on “P” for Pedophile

The American College of Pediatricians (ACPeds) is considered a fringe group and should never be confused with the mainstream American Academy of Pediatrics (AAP):

ACPeds AAP
200 to 500 members in just 47 states 66,000 members in 50 states, Puerto Rico, Washington D.C., and Canada
founded in 2002 founded in 1930
makes claims against vaccines supports vaccinating and protecting kids
supports corporal punishment by parents opposes spanking
designated as a hate group not a hate group
“The American College of Pediatricians promotes a society where all children, from the moment of their conception, are valued unselfishly. We encourage mothers, fathers and families to advance the needs of their children above their own. We expect societal forces to support the two-parent, father-mother family unit and provide for children role models of ethical character and responsible behavior.” “The American Acade​my of Pediatrics is dedicated to the principle of a meaningful and healthy life for every child. As an organization of physicians who care for infants, ​​children, adolescents, and young adults, the Aca​demy seeks to promote this goal by encouraging ​and assisting its members in their efforts to meet the overall health needs of children and youth; by providing support and counsel to others concerned with the well-being of children, their growth and development; and by serving as an advocate for children and their families within the community at large.”

Yes, the American College of Pediatricians is actually considered an active hate group by the Southern Poverty Law Center!

What to Know About the American College of Pediatricians

A fringe group of pediatricians, the American College of Pediatricians promotes misleading information based on the ideology of their very small group of members.

More About the American College of Pediatricians

 

 

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What’s Wrong with Homemade Baby Formula?

Once upon a time, before we had commercial baby formula, didn’t everyone make their own homemade baby formula if they couldn’t breastfeed or were separated from their baby?

Not necessarily.

Some parents hired a wet nurse and others simply fed their baby wheat containing porridge or milk from camels, cows, goats, or even pigs. Of course, wet nursing was the safest option by far.

History of Homemade Baby Formula

There were recipes for ‘baby formula’ though, which often “consisted of a liquid ingredient (milk, beer, wine, vegetable or meat stock, water), a cereal (rice, wheat or corn flour, bread) and additives (sugar, honey, herbs or spices, eggs, meat).” These recipes were missing foods with vitamin C and were later missing vitamin D, iron, and protein, as they were mixed with more water and less meat and eggs.

Before commercial baby formula was widely available, public health nurses had to sometimes teach new moms how to make their own formula.
Before commercial baby formula was widely available, public health nurses had to sometimes teach new moms how to make their own baby formula.

Fortunately, there were several major breakthroughs in the mid-nineteenth century that offered hope to babies who couldn’t breastfeed, including the invention of the rubber nipple and other feeding devices, improved methods of hygiene and later pasteurization, and the first commercial baby formula.

Many of the first baby formulas basically looked like homemade recipes, such as the Leibig formula – a powder made up of wheat flour, malt, and potassium bicarbonate that was added to diluted cow’s milk. Later, there were recipes to make baby formula from condensed and then evaporated milk (mixed with corn syrup).

And eventually, in the 1950s, we got the commercial baby formulas that we still use today.

What’s in Baby Formula

Like breastmilk, baby formula has three main components that provide the calories:

  • a sugar
  • fats
  • proteins

Different combinations of these proteins (cow’s milk vs soy), sugar (lactose vs corn syrup), and fats (vegetable oils), etc., help produce cow’s milk based, soy based, and elemental baby formulas.

And then, to make it more like breastmilk, lots of other stuff can be added to baby formula, including DHA, probiotics, and nucleotides, etc.

Enspire, the newest formula from Mead Johnson, also adds lactoferrin, Milk Fat Globule Membrane (MFGM), and prebiotics, to try and make it their “closest formula ever to breast milk.”

What’s Not in Baby Formula

Are you still confused about what’s in your baby’s formula?

While it might make you feel better to feed your baby goat milk, it won't make your baby feel any better, and could make them sick...
While it might make you feel better to feed your baby goat milk, it won’t make your baby feel any better, and could make them sick… (CC BY-ND 2.0)

It’s possible that you are just confused about what you think is in your baby’s formula?

Kristin Cavallari has written that she made her own homemade baby formula because “I would rather feed my baby these real, organic ingredients than a heavily processed store-bought formula that contains ‘glucose syrup solids,’ which is another name for corn syrup solids, maltodextrin, carrageenan, and palm oil.”

So what are glucose syrup solids and why are they in your baby’s formula?

While cow’s milk based baby formulas use lactose (glucose plus galactose) as their source of sugar, non-milk based formulas usually use use sucrose (cane sugar) and corn syrup solids (glucose).

Should you worry about cane sugar in some organic formulas?

What about the corn syrup in formula? Isn’t that bad for them?

No. These are just different types of sugar. Even maltodextrin is simply glucose polymers made from corn starch that is used as a thickening agent in baby formula and other foods.

And no, corn syrup solids don’t have anything to do with high fructose corn syrup.

Goat Milk Formula

In addition to warning about making homemade formula, pediatricians have long warned about feeding baby’s goat milk and goat milk based baby formula.

Goat milk is very high in sodium and protein, giving almost three times the amounts present in breast milk. And cross-reactivity that occurs between proteins means that babies who are sensitive or allergic to cow’s milk will likely have problems with goat milk too.

“It is recommended that formula-fed infants who are allergic to milk use an extensively hydrolyzed, casein-based formula. This type of formula contains protein that has been extensively broken down so it is different than milk protein and not as likely to cause an allergic reaction.”

FARE on Formula for Infants with a Milk Allergy

Of course, that doesn’t keep folks from pushing “false and potentially dangerous information” about what some think are benefits of goat milk for infants.

What’s Wrong with Homemade Baby Formula?

In her latest book, Kristin Cavallari, known for dangerous stance against vaccines, even offers a recipe for a goat’s milk baby formula that is made with:

  • filtered water
  • goat milk powder
  • pure organic maple syrup – provides calories from sugar
  • extra virgin olive oil – provides calories and monounsaturated fats
  • unflavored cod-liver oil – for extra vitamin D and vitamin A
  • unsulfured blackstrap molasses – for extra iron and calcium
  • coconut oil – for omega-6-fatty acids
  • probiotics

In this homemade formula, much of the sugar, protein, and fat and half of the calories comes from goat milk.

The majority of the sugar comes from the maple syrup though, which is just sucrose. Just like the sucrose from cane sugar that folks complain about in some organic formulas.

Extra fat comes from the olive oil.

What about the other ingredients?

They provide extra vitamins and minerals, including vitamin D, vitamin A, and iron.

What’s missing?

This homemade formula seems to be missing folate. Goat milk is deficient in folate and can lead to megaloblastic anemia and it is one of the main reasons babies should avoid unfortified goat milk.

And it is missing enough vitamin D to avoid vitamin D deficiency.

Cavallari’s recipe seems to add just 100IU of vitamin D to the whole 32 ounce batch (from the cod liver oil). That’s just 10IU per 100ml, about 6 times less than baby formula. Keep in mind that it is recommended that infants get at least 400IU of vitamin D each day.

Remember that formula is fortified with vitamin D and breastfeeding babies are supposed to take a vitamin D supplement. Depending on your water filter, this homemade baby formula recipe might also be missing fluoride, which infants start to need beginning at around six months.

Can You Find a Safe Homemade Baby Formula Recipe?

You probably can, especially if you use a full fat milk powder that has been pasteurized and fortified with vitamin D and folic acid and the right combination of other ingredients to get enough calories, protein, fat, sugar, and all of the essential vitamins and minerals that your baby needs to gain weight and development normally.

“FDA regulates commercially available infant formulas, which are marketed in liquid and powder forms, but does not regulate recipes for homemade formulas. Great care must be given to the decision to make infant formulas at home, and safety should be of prime concern. The potential problems associated with errors in selecting and combining the ingredients for the formula are very serious and range from severe nutritional imbalances to unsafe products that can harm infants. Because of these potentially very serious health concerns, FDA does not recommend that consumers make infant formulas at home.”

FDA Questions & Answers for Consumers Concerning Infant Formula

You will almost certainly have to give your baby a multi-vitamin each day too.

Also, you will have to make sure you are mixing all of the ingredients of your recipe correctly and safely, so that you don’t contaminate any of the batches.

But it still won’t be any better for your baby than store bought formula.

So just like skipping your RhoGAM shot, skipping your baby’s vitamin K shot and delaying or skipping vaccines, you will have some very big risks and absolutely no health benefits.

What to Know About Homemade Baby Formula

Stick to breastmilk or an iron fortified baby formula until your baby is at least twelve months old. There are no benefits to feeding your baby a homemade baby formula and there are certainly some risks. Those risks go up even more if you use raw goat milk or leave out key nutrients.

More About Homemade Baby Formula

Viewing the Solar Eclipse – Hype or Hazard

A total solar eclipse is a big deal, although it seems like it might be a bigger deal for some people than it is for others.

What kind of eclipse will you be able to see on August 21st? Map courtesy of NASA.
What kind of eclipse will you be able to see on August 21st? Map courtesy of NASA.

It does start to seem like a bigger deal the more you learn about it…

Solar Eclipse HYPE

Still, there is a lot of hype surrounding the upcoming solar eclipse in the United States.

“Observing a total solar eclipse is a life-changing event. It challenges everything you conceive of as normal.”

Sean Lindsay on the Eclipse hype

Do you buy it?

  • will looking at the eclipse make you go blind?
  • will seeing the eclipse change your life?
  • will you regret missing the eclipse for the rest of your life?

While viewing the eclipse won’t make you go blind, at least not instantaneously, what about all of the hype about how important an event the eclipse is to view? That part has to be true, right?

“A partial eclipse is interesting but forgettable, while a total eclipse is a memorable, life-changing event which burns itself into memory – and never fades. And so we, who have seen this sight, ask you to join us on this momentous day, and do everything you possibly can to see it with us. But you must remember that “close” is not close enough; in order to see the eclipse in all its glory, you simply must…”

“Close” is NOT close enough!

It is for some people. And you might not know if you or your kids are that type of person unless you go and see the eclipse! In totality!

Solar Eclipse HAZARD

  • seeing the eclipse without protection will damage your eyes

We all know that you shouldn’t look directly at the sun or your eyes will get damaged.

And in most cases, you can’t.

It hurts to look at the sun. You’re pupils will constrict. You will blink a lot. And you will very quickly turn away.

At least in normal circumstances.

A solar eclipse is not a normal circumstance.

Since most of the sun is covered, you could likely stare at it (but definitely shouldn’t) and get a good long look at the eclipse. Unfortunately, the part that isn’t covered will be painlessly damaging your eyes, leading to burns on your retina and solar retinopathy.

But isn’t all of the sun covered in a total solar eclipse?

“During the very brief time the sun is in total solar eclipse it is safe to look at it, but do so with caution. Even during the total solar eclipse, the total eclipse may last only a short period of time, and if you are looking towards the sun as the moon moves away from blocking the sun, you might get a solar burn on your retina which can cause permanent damage to your eyes.”

Prevent Blindness America

Yes, but only for a very short time and only if you are in the path of totality.

During totality, it is safe to take your eclipse glasses off and look at the eclipse, being aware that totality may last only a minute or two.

This diamond ring means that the eclipse is not at totality yet and you still need eye protection to look at the sun.
This diamond ring means that the eclipse is not at totality yet and you still need eye protection to look at the sun. Photo courtesy of NASA.

Again, you must be very sure that you are inside the path of totality for a chance at looking at the eclipse without protection – a 70-mile wide band from central Oregon through South Carolina.

If you are not in this relatively narrow band, you will still be able to see a partial solar eclipse, but at no time will it be safe to view the eclipse without protection.

Are you going to be able to see a total or partial eclipse on August 21st?
Are you going to be able to see a total or partial eclipse on August 21st?

Remember that even if you live in or have traveled to a spot inside the path of totality, the total eclipse itself will only last a few minutes.

The whole eclipse will last much longer though.

From the start of the eclipse, to maximum eclipse, to the end of the eclipse, you might be looking at a three hour event. That’s a lot of time to be at risk of looking at the sun outside of totality and getting eye damage if you aren’t wearing protection.

Safely Viewing the Solar Eclipse

What kind of protection do you need to safely view a solar eclipse.

Fortunately, you have a lot of options.

This solar eclipse viewing protection can include using:

  • solar filters, including ISO 12312-2 compliant eclipse glasses that have been sold online in packs of 5 or 10 (but including some that have been recalled), handheld solar viewers,  and full aperature solar filters for cameras and telescopes
  • a pin-hole viewer that you can easily make yourself with something as common as a cereal box
  • a 2D or 3D printable pinhole projector
  • a solar viewing projector using binoculars or a telescope (not looking through the telescope itself though, unless it had a proper solar filter!)
  • No. 13 or 14 welder’s glasses

But unless you are building a pin-hole viewer or are going to an official eclipse viewing event, be sure your protection is really going to protect your child’s eyes. Are the eclipse glasses you ordered fake, recalled, scratched, or damaged? Then don’t use them.

And make sure younger children are well supervised during the entire eclipse, so that they don’t look at the eclipse at any time that you are outside the time that you are in totality.

Some people will have a better chance of viewing a total solar eclipse in 2024.
Some people will have a better chance of viewing a total solar eclipse in 2024.

What if they miss it?

They won’t have to wait too long for the next total solar eclipse. Another one is headed our way in 2024.

What to Know About Safely Viewing the Solar Eclipse

I don’t know if it will change your child’s life, but there is no good reason to let them miss this total solar eclipse (or partial eclipse if you aren’t in the path of totality), as long as you take some very simple steps to make sure they view it safely.

More About Safely Viewing the Solar Eclipse

What to Do If a Mosquito Bites Your Child

Mosquito bites aren't good, but you don't have to get panicked about them.
Mosquito bites aren’t good, but you usually don’t have to get panicked about them.

Depending on where you live, a mosquito bite can be just a nuisance or it can lead to a life-threatening disease. From Chikungunya virus to Zika, most parents have learned to fear mosquito-borne diseases and because they hear about them so much, fear or even get panicked over mosquito bites.

While it is good to prepared and learn to avoid mosquito bites, you likely shouldn’t be panicked.

But even if your kids aren’t at risk for a mosquito-borne disease, it’s no fun getting bit by mosquitoes. Mosquito bites are itchy, and even when bites don’t get infected, they can leave behind crusted scabs that kids continue to pick at, over and over again.

Still no reason for panic or fear – just good reasons to learn to avoid mosquito bites.

Mosquitoes and Mosquito-Borne Diseases

Diseases that can be spread from the bite of a mosquito can include:

  • Chikungunya – can develop fever and severe and debilitating joint pain 3-7 days after a mosquito bite from Aedes aegypti and Aedes albopictus mosquitoes in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans, Caribbean countries, and most recently, in Florida, Puerto Rico, and the U.S. Virgin Islands.
  • Dengue – can cause severe flu like symptoms, including fever, severe headache, eye pain, joint and muscle pain, rash, and bleeding, after a mosquito bite in one of at least 100 endemic countries, including many popular tourist destinations in Latin America, Southeast Asia and the Pacific islands. While there are cases in the US, it is important to keep in mind that “nearly all dengue cases reported in the 48 continental states were acquired elsewhere by travelers or immigrants.”
  • Eastern Equine encephalitis – a very rare disease, which is fortunate, as it is one of the most deadly of the mosquito-borne diseases. Transmission is in and around swampy areas, with most cases in Florida, Georgia, Massachusetts, and New Jersey.
  • Filariasis – spread by repeated mosquito bites over months to years, this disease is still found in at least 73 countries in parts Asia, Africa, the Western Pacific, and parts of the Caribbean and South America, these parasitic worms can grow and live in our lymph system
  • Japanese encephalitis – you can get a Japanese encephalitis virus infection after being bit by an infected Culex species mosquito in one of 24 countries in South-East Asia and the Western Pacific, especially if you are not vaccinated.
  • La Crosse encephalitis – rare, but can occur in the upper Midwestern and mid-Atlantic and southeastern states and can cause severe disease, including encephalitis, in children.
  • Malaria – although malaria was eliminated in the US in the early 1950s, we still see about 1,700 cases each year in returning travelers. That’s because malaria is a still a big problem around the world, from certain some states in Mexico to most of sub-Saharan Africa and South Asia.
  • St. Louis encephalitis – can occur in eastern and central states, starts with mild symptoms, but can very rarely (between 1 to 12 cases a year) progress to encephalitis (inflammation of the brain).
  • West Nile – has now been found in every state except Alaska and Hawaii, but up to 80% of people don’t develop any symptoms and only 1% develop severe symptoms, with folks over age 60 years most at risk. Although West Nile season peaks in mid-August, cases are usually reported from late summer through early fall.
  • Western Equine encephalitis – rare, but deadly, like Eastern Equine encephalitis, and is found in states west of the Mississippi River
  • Yellow fever – a vaccine-preventable disease, the Yellow fever virus is still found in tropical and subtropical areas in South America and Africa.
  • Zika – is mostly a risk during pregnancy as it can cause serious birth defects, including microcephaly, so there are warnings to avoid high risk areas, which in addition to multiple countries and territories around the world, includes Brownsville, Texas and previously included Miami-Dade County, Florida

Won’t a long list of diseases get parent’s panicked? Only if they skip the part about where the mosquitoes that cause those diseases are active.

What to Do If a Mosquito Bites Your Child

Original Title: DPD_A.freeborni_861sRGB
 Do you know what to do if a mosquito bites your child? Photo by James Gathany

If a mosquito bites your child, don’t panic. There is no reason to run to your pediatrician or the ER and get tested for West Nile or Zika.

That’s not to say a mosquito bite couldn’t send you to the ER, but it would likely only be if your child was severely allergic, with the bite causing an anaphylatic reaction. Fortunately, most bites just leave little red bumps that go away in a few days if you don’t scratch them too much.

So the key treatment after a mosquito bite is classically about relieving the symptoms of itching. As with other itchy rashes, you can do this by:

  • applying an OTC anti-itch cream (hydrocortisone cream or calamine lotion) to the bite
  • taking an oral antihistamine, especially at night
  • applying a prescription steroid cream to help control itching

Also, keep your child’s finger nails short to minimize damage from scratching and wash the areas with soap and water to decrease the risk of secondary infections.

“Where you live, your travel history, and the travel history of your sex partner(s) can affect your chances of getting Zika.”

CDC on Know Your Zika Risk

In general, you should see your pediatrician if you have the symptoms of a mosquito-borne disease and have been in an area with risk of that disease.

Should you worry about dengue, West Nile, or Zika, etc?

  • Does your child live in an area where you can commonly find the mosquitoes that carry any of these diseases?
  • Did your child recently visit an area where you can commonly find the mosquitoes that carry any of these diseases?
  • Is your child a pregnant teen?
  • Is your teen sexually active?
  • Does your child have a chronic medical condition, such as cancer, diabetes, hypertension, or kidney disease?
  • Is your child a first- or second-generation immigrant from a malaria-endemic country who returned to their home country to visit friends and relatives?
  • Was your child at risk for a mosquito-borne disease and skipped taking preventative medications for malaria or skipped getting a Japanese encephalitis vaccine or a Yellow fever vaccine?

Again, see your pediatrician if your child had a mosquito bite and now has the symptoms of a mosquito-borne disease after being in an area with risk of that disease. This is especially important for anyone who is pregnant or with a chronic medical problem, as they might be at higher risk for severe disease. The elderly are more at risk too.

Preventing Mosquito Bites

Of course, whether you are traveling to the tropics or going for a walk in your neighborhood, your best bet is going to be trying to avoid mosquitoes and mosquito bites in the first place.

  • use insect repellent, which can protect your kids from tick bites too
  • wear long-sleeved shirts and long pants when possible
  • get rid of standing water around your home – places where mosquitoes can breed
  • make sure windows and doors have screens or are kept shut to keep mosquitoes out of your home
  • instead of insect repellent, consider using mosquito netting to cover your infant’s stroller or carrier when outside, and especially when in high risk parts of the world, using insecticide treated bed nets

And review travel advisories before planning a trip to see if you need to take any additional precautions to avoid a mosquito-borne disease.

What to Know About Mosquitoes and Mosquito Bites

Mosquito-borne diseases, like dengue, West Nile, and Zika, can certainly be serious, but you likely don’t need to panic your child has gotten one of them every time he or she gets a mosquito bite.

More About Mosquitoes and Mosquito Bites

The Myth of an Autism Epidemic

We hear stories about the rise in autism and the autism epidemic all of the time.

Autism prevalence rates have been steady at 1 in 68 since 2010.
Autism prevalence rates have been steady at 1 in 68 since 2010.

Every few years, the CDC had been releasing a new report which showed a higher prevalence of autism in the United States, including:

  • 1 in 150 children in 2000
  • 1 in 150 children in 2002
  • 1 in 125 children in 2004
  • 1 in 110 children in 2006
  • 1 in 88 children in 2008
  • 1 in 68 children in 2010
  • 1 in 68 children in 2012

Looking at those numbers, it is easy to see most people think that the rate of autism is rising.

And if the rate of autism is rising, then there must be a cause.

Thinking about it like that, it becomes easy to see why vaccines became the scapegoat for causing autism, especially after Andrew Wakefield told everyone that it “is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR…”

The Myth of an Autism Epidemic

Many experts don’t think that there is an autism epidemic though.

“…the numbers of people born with autism aren’t necessarily increasing dramatically. It’s just that we’re getting better and better at counting them.”

Emily Willingham

There are several different explanations for the apparent rise in the number of children being diagnosed with autism, including:

  • better recognition among health care providers
  • better recognition among parents
  • diagnostic substitution – children were once diagnosed with other conditions, such as mental retardation and learning disabilities
  • broadening of the criteria used to diagnose autism, including changes in DSM criteria, which went from labeling children with autism as having childhood schizophrenia (1952) and including just three essential features of infantile autism (1980) to adding PDD-NOS (1987) and more subtypes and symptoms to the autism diagnosis category in DSM-IV (1994).
  • social influences, including that more parents may have wanted to seek help when more resources become available and because they may have become more accepting of the possibility that their child had autism, leading them to seek a diagnosis and services. For example, before 1975 and the Education for All Handicapped Children Act, children with disabilities were excluded from school. And then in 1990, the Individuals with Disabilities Education Act (IDEA) included autism as a separate disability, making it a little easier to get services.

All together, these explanations help explain what has been confirmed by numerous studies, that the true prevalence of autism hasn’t changed over time.

What To Know About The Autism Epidemic Myth

There is no autism epidemic.

  • There are adults and older people with autism. Did you know that the the first meeting of the National Society of Autistic Children was held in 1965?
  • The idea that the ‘autism epidemic’ is a myth is not new – experts have been talking about it for over 10 years, which makes you wonder why some people still push the idea. An idea that hurts autistic families.
  • A 2015 study concluded that “Changes in reporting practices can account for most (60%) of the increase in the observed prevalence of ASDs in children born from 1980 through 1991 in Denmark. Hence, the study supports the argument that the apparent increase in ASDs in recent years is in large part attributable to changes in reporting practices.”
  • Autism is thought to be genetically based.

Some folks, especially those in the anti-vaccine movement, don’t want to believe that there is no autism epidemic though.

“If there is no autism epidemic, if there is a “stable incidence” of autism over recent decades, then this alone is powerful evidence against the vaccine hypothesis – and in fact removes the primary piece of evidence for a vaccine-autism connection.”

Steven Novella on The Increase in Autism Diagnoses: Two Hypotheses

After all, if there is no autism epidemic, then they can’t blame vaccines for be causing an autism epidemic…

More About the Autism Epidemic Myth

 

What to Do If a Tick Bites Your Child

Lyme disease.

That’s usually what comes to mind when people find a tick on their child or if they simply think about tick-borne diseases.

It is important to know that there are many other diseases that can be caused by many different types of ticks though, from anaplasmosis to tularemia. And since these ticks and the diseases they transmit are fairly regional, it is easy to be unfamiliar with them if you don’t live in their specific habitats.

That can especially be a problem if, for example, you are from Hawaii, where tick-borne diseases aren’t a big issue, and you travel for a camping trip to Oklahoma and your child is bitten by a tick. Will you or your doctor know what to do if your child develops symptoms of Rocky Mountain spotted fever?

How To Remove a Tick

Fortunately, if you find a tick on your child, you can decrease their chance of getting sick if you remove it quickly. That makes doing daily full body tick checks important.

 

Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure.
Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure. A special tick-removal spoon can make it even easier!

How quickly?

At least 36 hours.

“Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.”

CDC on Preventing Tick Bites

After removing the tick, wash the bite area and your hands with soap and water and observe your child over the next few weeks for symptoms of a tick-borne disease.

Symptoms of a Tick Bite

Although some of the symptoms of tick-borne diseases are specific to the tick that bit your child, some other symptoms are common to all of them, including:

  • fever
  • headache
  • fatigue
  • muscle aches and joint pains
  • skin rashes
  • chills

Like spider bites, tick bites are usually painless. That often leads to a delay in actually figuring out that a tick has bitten your child, which makes it important to do frequent tick checks if they are doing anything that could expose them to ticks.

Many people are also surprised at how many different diseases can be transmitted by ticks, including:

  • Anaplasmosis – transmitted by the black-legged tick (northeast and upper midwestern United States) and the western black-legged tick (Northern California). May not cause a rash.
  • Babesiosis – transmitted by the black-legged tick (northeast and upper midwestern United States). Can cause severe hemolytic anemia.
  • Colorado Tick Fever – a viral infection that is transmitted by the Rocky Mountain wood tick (western United States, especially Colorado, Utah, Montana, and Wyoming). Can cause meningoencephalitis.
  • Ehrilichiosis – transmitted by the lone star tick in southcentral and eastern US.
  • Lyme disease – transmitted by the blacklegged in the northeastern U.S. and upper midwestern U.S. and the western blacklegged tick along the Pacific coast. Erythema migrans rash or Bull’s eye rash.
  • Powassan disease – a viral infection that is transmitted by the black-legged tick (northeastern United States and the Great Lakes region). Can cause biphasic illness, with children appearing to get better and then the symptoms reappearing again.
  • Rocky Mountain spotted fever – transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. Causing a classic petechial rash on the wrists, forearms, and ankles, which can then spread to the trunk.
  • Rickettsia parkeri Rickettsiosis – transmitted by the Gulf Coast tick in the eastern and southern United States.
  • STARI (Southern Tick-Associated Rash Illness) – “transmitted” by the lone star tick (central Texas and Oklahoma eastward to the the whole Atlantic coast). Children have an expanding “bull’s eye” lesion at the tick bite, like Lyme disease, but the cause is unknown.
  • Tickborne relapsing fever (TBRF) – spread by multiple soft ticks in the western United States which live in rodent infested cabins and can cause relapsing fever – 3 day episodes of fever, in between 7 days stretches in which a child might be fever free, over 3 to 4 weeks.
  • Tularemia – transmitted by dog ticks, wood ticks, and lone star ticks or by handling a sick animal, including wild rabbits, muskrats, prairie dogs, and domestic cats. Can cause an ulcer at the site of infection.
  • 364D Rickettsiosis – transmitted by the Pacific Coast tick in Northern California dn along the Pacific Coast.

And although it can be helpful to know about all of the different tick-borne diseases and their symptoms, you should basically just know to seek medical attention if your child gets sick in the few weeks following a tick bite.

What to Know About Ticks and Tick Bites

Of course, it would be even better to reduce your child’s risk of getting a tick-borne disease by avoiding ticks in first place, including limiting his exposure to grassy and wooden areas, wearing protective clothing, using insect repellent, treating your dogs for ticks, taking a shower within two hours of possibly being exposed to ticks, and doing frequent tick checks.

In addition to avoiding ticks, it is important to know that:

  • The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.
    The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.

    Tick activity is seasonal, with adult ticks most active in spring and fall, and the smaller nymphal ticks more active in late spring and summer.

  • Tick bites that lead to tick-borne diseases are often not noticed because they are usually painless and are often caused by nymphs, the immature, smaller forms of a tick. So while you might be thinking about a large, adult tick when you are asked about a recent tick bite, a nymph is tiny (about 2mm long) and might even be missed.
  • Testing (on your child), including antibody tests, can be done to confirm a diagnosis of most tick-borne diseases, but keep in mind that testing can be negative early on. You also shouldn’t wait for results before starting treatment in a child with a suspected tick-borne disease. Testing is usually done with either indirect immunofluorescence antibody (IFA) assay or enzyme immunoassay (EIA) tests.
  • It is usually not recommended that you have a tick that has bitten your child be tested for tick-borne diseases. Even if the tick was positive for something, it wouldn’t mean that it transmitted the disease to your child.
  • Experts don’t usually recommend that people be treated for tick-borne diseases after a tick bite unless they show symptoms. The only exception might be if the tick was on for more than 36 hours and you were in an area with a high risk for Lyme disease.
  • Although doxycycline, one of the antibiotics often used to treat tick-borne diseases, is often restricted to children who are at least 8 years old because of the risk of side effects, it should still be used if your younger child has Rocky Mountain spotted fever, ehrlichiosis, or anaplasmosis.

You should also know that most old wives tales about ticks and tick bites really aren’t true. You should not try to burn a tick that is biting your child with a match, paint it with nail polish, or smother it with vaseline, etc. Just remove it with tweezers and throw it away in a sealed bag or by flushing it down the toilet.

What to Do If a Tick Bites Your Child

Don’t panic if a tick bites your child. You have up to 36 hours to remove it, before it is can likely transmit any diseases to your child, like Lyme disease or Rocky mountain spotted fever.

More About Ticks and Tick Bites