By West End Pediatrics
July 02, 2020
Tags: Brushing  

So, your child’s teeth just started to come in. We know that this can be an exciting milestone for parents. Of course, this also means considering your child’s oral health. Just as you brushingbrush and floss your teeth every day, you will now need to begin brushing your child’s teeth. While the techniques and practices will be a bit different and probably less time-consuming (seeing as your child probably only has one or two teeth at the moment), here are some tips for how to brush your child’s teeth properly,

  • Even before your child’s teeth start to erupt it’s important to keep their gums healthy and clean by wiping them with a soft, damp cloth after each feeding and right before bedtime. Your child will get their first tooth between 6-14 months.
  • Yes, even children’s teeth can develop decay. As soon as the tooth is formed it can develop decay, so it’s important that you start brushing it as soon as you see it.
  • Purchase a child-sized toothbrush from your local drugstore and wet the soft-bristled toothbrush with water to brush your child’s tooth or teeth (at this point you don’t need toothpaste).
  • Your child won’t start needing toothpaste until they are 2 years old. From 2-3 years old your child only needs toothpaste the size of a grain of rice in order to clean their teeth. After 3 years old, you can upgrade to a pea-sized amount of toothpaste.
  • Just as you do for your own teeth, you should also brush your child’s teeth twice a day (once in the morning and again at night right before going to bed).
  • Use soft, circular motions when brushing the teeth and the gums. Again, just as you do your own teeth, you should brush for a minimum of two minutes. Don’t forget to brush their tongue and roof of their mouth, too.
  • We know that your child may not fully understand the brushing process, so it’s a good idea to tell them what you are doing and the importance of brushing their teeth. Even though they can’t brush their own teeth yet it’s still great to show them how to brush so that when it’s time to start brushing their own teeth they understand how to do it.
  • Most children can start brushing their teeth around 7-8 years old, but still need to be supervised by an adult until around 10-11 years old.

Have questions about caring for your baby’s developing smile? Keeping your child’s smile healthy is so important for their development and practicing good oral hygiene at home will ensure that your child’s smile stays healthy.

March 12, 2020
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We know that Corona Virus has resulted in many questions for our families.

We would encourage you to use the resources below for the most up to date and accurate information
NY Department of Health:

Centers for Disease Control and Prevention:

In addition, please don't hesitate to contact us with any concerns or questions.

October 13, 2014
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Last month The Hollywood Reporter published an illuminating investigation on immunization trends in Los Angeles County, which revealed that vaccination rates on the city’s wealthy west side, in neighborhoods like Beverly Hills and Santa Monica, had plummeted, as incidents of whooping cough surged. The piece had the virtue of offering New Yorkers yet another opportunity to feel smugly superior to their counterparts in L.A., because of course here on the East Coast we like our science to come from scientists, not from former Playboy models and people who feel entitled to pontificate about public health because they drink kefir.

In an interview with NPR last month about her new book, “On Immunity: An Inoculation,” the author Eula Biss presented the idea that vaccinating your children on schedule was now seen as “an extreme position.”

New York State and city have strict immunization requirements, which have been further strengthened over the past two years. It is not possible here, as it is in California, to obtain a philosophically based exemption from those rules for your child. In January, the city health department decreed that all enrolled children from 6 months old through age 5, whether attending public or private schools, had to receive a flu shot before Dec. 31. Parents, though, can recuse their children from vaccination protocols with religious exemptions, which are relatively uncomplicated to obtain.

And certainly some exploitation of that loophole is exercised. Amanda Uhry, who runs a consultancy called Manhattan Private School Advisors, which, as its name suggests, helps parents through the private-school application process, said she recently turned down a half-dozen clients when she discovered that they were opposed to vaccination. For a long while she had never inquired about the issue, but a few years ago, a child she was working with missed his kindergarten interview because of whooping cough, which left her stunned.

“I thought, Whooping cough? Who gets whooping cough anymore?” she said. The episode compelled her to start asking about vaccination early on. “No application to any school asks, ‘Are you an anti-vaxxer?’ but these schools want to keep the anti-vaxxers out.” So, she said, “I ask people and if they get into the whole anti-vaxxer deal, I say, ‘Fine, we can’t work with you.’ ” You’re not, as she put it, “going to Horace Mann like this.”

There is enough appeal in anti-vaccination thinking among members of the affluent class that certain pediatricians in the city, as they have elsewhere around the country, have made it a policy in recent years to refuse to see children whose parents won’t have them immunized. A few years ago Pediatric Associates of NYC, which has branches in Murray Hill in Manhattan and Prospect Heights in Brooklyn, chose this course, David Horwitz, a partner in the practice told me, in large part because it simply became untenable to have unvaccinated children sitting in waiting rooms.

Within the American Academy of Pediatrics there has been a rancorous debate about whether doctors should see un-immunized patients, and the academy’s position has leaned toward an inclusive approach. But, Dr. Horwitz said, “we were spending a lot of time talking to parents who weren’t immunizing and who were terribly ill informed. A lot of people would continue to come back and come back and come back and we were spending so much time talking about vaccinations that we weren’t dealing with other things,” he said.

“We ultimately felt ethically uncomfortable seeing people who don’t vaccinate. We are advocates for children, not their parents.”

Among mothers and fathers coming in for an infant’s two-week visit, about 10 percent express opposition to vaccination, Barney Softness, a prominent Upper West Side pediatrician, told me, speaking of his practice. Dr. Softness works with patients to persuade them to immunize. Often he is successful, he told me, but often, “they give me lip service and then delay.”

Because so many New Yorkers are committed more to ambivalence than absolutism, and ultimately to their own neuroses above all else, the current moment of viral fear — the rise of Ebola and national reports of the spread of enterovirus 68 — is actually a fortuitous one for the project of shifting the opinions of deniers, even though there are no vaccines for those illnesses. A hepatitis-A scare on the Upper West Side last year led to a rush of patients coming in for various vaccines, Dr. Softness told me. “Nothing makes people want to get vaccinated more than reports of two cases of something in a ZIP code.”

Laura Popper, who has had a pediatric practice on the Upper East Side since the late 1970s, has never accepted families who refuse to vaccinate their children as patients. As a resident at Columbia nearly 40 years ago, she witnessed as two little girls who were sisters died of diphtheria after a relative visiting from the Dominican Republic turned out to be a carrier. The girls weren’t immunized. “I said to myself then, this will never again happen under my watch,” Dr. Popper said.

“My feeling is that it will take something like that on a very large scale to get upper-middle-class people to realize that this is serious stuff,” she said, even more so than terrorism or other global concerns. “You look around and most of the deaths in the world are from contagious diseases. Not ISIS.”


Original article by Ginia Bellafante of The New York Times

Link: Here


August 08, 2014
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What You Should Know for the 2014-2015 Influenza Season


What sort of flu season is expected this year?

It’s not possible to predict what this flu season will be like. Flu seasons are unpredictable in a number of ways. While flu spreads every year, the timing, severity, and length of the season varies from one year to another.

Will new flu viruses circulate this season?

Flu viruses are constantly changing so it's not unusual for new flu viruses to appear each year. For more information about how flu viruses change, visit How the Flu Virus Can Change.

When will flu activity begin and when will it peak?

The timing of flu is very unpredictable and can vary from season to season. Flu activity most commonly peaks in the U.S. in January or February. However, seasonal flu activity can begin as early as October and continue to occur as late as May.

What should I do to prepare for this flu season?

CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the seasonal flu vaccine is designed to protect against the top three or four flu viruses that research indicates will cause the most illness during the flu season. People should begin getting vaccinated soon after flu vaccine becomes available, ideally by October, to ensure that as many people as possible are protected before flu season begins.

In addition to getting vaccinated, you can take everyday preventive steps like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others.

What should I do to protect my loved ones from flu this season?

Encourage your loved ones to get vaccinated as soon as vaccine becomes available in their communities, preferably by October. Vaccination is especially important for people at high risk for serious flu complications, and their close contacts.

Children between 6 months and 8 years of age may need two doses of flu vaccine to be fully protected from flu.

Children younger than 6 months are at higher risk of serious flu complications, but are too young to get a flu vaccine. Because children younger than 6 months cannot get a vaccine, but are at high risk for serious flu-related complications, safeguarding them from flu is especially important. If you live with or care for an infant younger than 6 months of age, you should get a flu vaccine to help protect them from flu.

In addition to getting vaccinated, you and your loved ones can take everyday preventive steps like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading influenza to others.

When should I get vaccinated?

CDC recommends that people get vaccinated against flu soon after vaccine becomes available, preferably by October.

It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against the flu.

We encourage  vaccinating  patients soon after vaccine becomes available, preferably by October so as not to miss out on opportunities to vaccinate. Those children aged 6 months through 8 years who need two doses of vaccine should receive the first dose as soon as possible to allow time to get the second dose before the start of flu season. The two doses should be given at least 4 weeks apart.

When will flu vaccine become available?

Shipments may begin as early as late August and continue throughout September and October until all of the vaccine is distributed.

Where can I get a flu vaccine?

Flu vaccines are offered at both our Uptown and Downtown office locations.

What kind of vaccines will be available in the United States for 2014-2015?

We use intramuscular (IM) and nasal spray vaccines. The vaccines we use are formulated to protect against four flu viruses (quadrivalent flu vaccines).

Are there new recommendations for the 2014-2015 influenza season?

One possible change to the current recommendations is regarding the preferential use of LAIV in healthy children 2-8 years.

What flu viruses does this season’s vaccine protect against?

Flu vaccines are designed to protect against flu viruses that experts predict will be the most common during the upcoming season. Three kinds of flu viruses commonly circulate among people today: Influenza A (H1N1) viruses, influenza A (H3N2) viruses, and influenza B viruses. Each year, one or two flu viruses of each kind are used to produce the seasonal influenza vaccine.

All of the 2014-2015 influenza vaccine is made to protect against the following three viruses:

  • an A/California/7/2009 (H1N1)pdm09-like virus
  • an A/Texas/50/2012 (H3N2)-like virus
  • a B/Massachusetts/2/2012-like virus.

Some of the 2014-2015 flu vaccine also protects against an additional B virus (B/Brisbane/60/2008-like virus).

Vaccines that give protection against three viruses are called trivalent vaccines. Vaccines that give protection against four viruses are called quadrivalent vaccines.

How effective is the flu vaccine?

Inactivated influenza vaccine effectiveness (VE) can vary from year to year and among different age and risk groups.

How long does a flu vaccine protect me from getting the flu?

Multiple studies conducted over different seasons and across vaccine types and influenza virus subtypes have shown that the body’s immunity to influenza viruses (acquired either through natural infection or vaccination) declines over time. The decline in antibodies is influenced by several factors, including the antigen used in the vaccine, the age of the person being vaccinated, and the person's general health (for example, certain chronic health conditions may have an impact on immunity). When most healthy people with regular immune systems are vaccinated, their bodies produce antibodies and they are protected throughout the flu season, even as antibody levels decline over time. Older people and those with weakened immune systems may not generate the same amount of antibodies after vaccination; further, their antibody levels may drop more quickly when compared to healthy people.

For everyone, getting vaccinated each year provides the best protection against influenza throughout flu season. It’s important to get a flu vaccine every year, even if you got vaccinated the season before and the viruses in the vaccine have not changed for the current season.

Will this season's vaccine be a good match for circulating viruses?

It's not possible to predict with certainty if the vaccine will be a good match for circulating viruses. The vaccine is made to protect against the flu viruses that research indicates will likely be most common during the season. However, experts must pick which viruses to include in the vaccine many months in advance in order for vaccine to be produced and delivered on time. And flu viruses change constantly (called drift) – they can change from one season to the next or they can even change within the course of one flu season. Because of these factors, there is always the possibility of a less than optimal match between circulating viruses and the viruses in the vaccine.

Over the course of the flu season, CDC studies samples of circulating flu viruses to evaluate how close a match there is between viruses used to make the vaccine and circulating viruses.

One of the ways that helps CDC evaluate the match between vaccine viruses and circulating viruses is with a lab process called ‘antigenic characterization’. The match between the vaccine viruses and the circulating viruses is one factor that impacts how well the vaccine works.

Can the vaccine provide protection even if the vaccine is not a "good" match?

Yes, antibodies made in response to vaccination with one flu virus can sometimes provide protection against different but related viruses. A less than ideal match may result in reduced vaccine effectiveness against the virus that is different from what is in the vaccine, but it can still provide some protection against influenza illness.

In addition, it's important to remember that the flu vaccine contains three or four flu viruses (depending on the type of vaccine you receive) so that even when there is a less than ideal match or lower effectiveness against one virus, the vaccine may protect against the other viruses.

For these reasons, even during seasons when there is a less than ideal match, CDC continues to recommend flu vaccination for everyone six months and older. Vaccination is particularly important for people at high risk for serious flu complications, and their close contacts.

Can I get vaccinated and still get the flu?

Yes. It’s possible to get sick with the flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:

  • You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (About 2 weeks after vaccination, antibodies that provide protection develop in the body.)
  • You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. The flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
  • Unfortunately, some people can become infected with a flu virus the flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, the flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

Is there treatment for the flu?

Yes. If you get sick, there are drugs that can treat flu illness. They are called antiviral drugs and they can make your illness milder and make you feel better faster. They also can prevent serious flu-related complications, like pneumonia.


July 25, 2014
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Make sure you see your physician at the most convenient time for your schedule by making your “Back to School” physical appointment now.

Simply give us a call, reserve your appointment date and time, and then enjoy the summer knowing you won’t be scrambling before fall to get all your “Back to School” tasks done.

West End Pediatrics is ready to help you with:

Pre-School and Kindergarten physicals and required vaccinations: You’ll be ready to supply the school with the necessary forms when they’re requested!

Middle School and High School sports physicalsYour children will be ready for fall sports practice when it starts in late summer! 

Annual wellness appointmentsMedication reviews, upcoming school trips abroad, and influenza vaccinations can all be discussed with your physician at the time of your appointment.

College physicals: Many universities have students moving into dorms by mid-August. Be prepared now to send them off in excellent health!

Asthma, Allergy & Special School Action PlansMeet with your physician to discuss your action plan for fall and have medications, the plan, and forms ready for the school nurse before school starts.

Call (212) 769-3070 for Uptown Appointments or (212) 353-0072 for Downtown Appointments.

Thanks for choosing West End Pediatrics.

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