9 month old - Westwood Mansfield Pediatrics

9 MONTH OLD
The Mobile Phase
Proactive in your child’s care.
Empowering families for over 50 years.
Please take the time to read through this material. We provide this information because
we see value in educating our patients.
Westwood Office
Mansfield Office
541 High Street
Westwood, MA 02090
(781) 326-7700
454 Chauncy Street
Mansfield, MA 02048
(508) 339-9944
www.wmpeds.com
VIDEOS
Let us help you be proactive and educated
in your child’s care!
These following videos are just a few that we feel may help you and
your child at this specific age. Please view our website at
www.wmpeds.com for these and many more.
9 Months
Fever
Ear Infections – including information on Swimmer’s Ear
Rashes – information on a Basic Rash, Diaper Rash, Fifth Disease,
Hand - Foot and Mouth Disease and also Hives
Cough/Croup – information on when to worry and a demonstration
on Croup and Stridor
Vomiting and Diarrhea
Colds
Westwood Office
Mansfield Office
541 High Street
Westwood, MA 02090
(781) 326-7700
454 Chauncy Street
Mansfield, MA 02048
(508) 339-9944
www.wmpeds.com
9 Month Visit: Immunizations
Your child is due to receive the following screening tests at this visit:
Hgb (Hemoglobin Screen)
Lead (Lead Screen)
Your child is due to receive the following immunizations at this visit:
NONE
In addition, we strongly recommend that all patients 6 months of age
and older receive an annual Influenza (flu) vaccine.
Please review the enclosed Vaccine Information Sheets (VISs) prior to
your visit for more information.
For our complete immunization schedule:
wmpeds.com/immunizationschedule
Westwood Office
Mansfield Office
541 High Street
Westwood, MA 02090
(781) 326-7700
454 Chauncy Street
Mansfield, MA 02048
(508) 339-9944
www.wmpeds.com
Healthy Parents, Healthy Kids
“Example is not just one way to effect change, it is the only way.”
Dr. Albert Schweitzer
Children learn by watching their parents and caregivers. This is how they learn to talk and
how they learn manners, as well as how they learn to eat. The eating “culture” in a baby’s
house has a very strong influence on how that child grows and matures as an eater.
Having a baby who is learning how to eat is a great opportunity for each family member to
evaluate his or her own eating habits and to think about making healthy changes. While it
can be very difficult for us to change our habits, hopefully your baby can help motivate you to
become healthier!
Some of the most important changes many people can make include:
1) making a conscious effort to increase the amount of vegetables and fruits on your
grocery list
- “strive for five” servings of fruits and vegetables daily
- studies show that you have to introduce a new food up to 30 times before a
child will try it; be persistent and patient
- have fruits and vegetables at all meals, even breakfast; think outside of the box
2) reducing the processed foods (hot dogs, pizza, chicken nuggets, etc…) in your home
- processed foods are often a major calorie source for babies by the time they
turn 1 year of age
3) minimizing soft drinks and juice – less is more
- soft drinks and juice are very high in sugar and very low in nutrition
- sugared drinks are bad for your baby’s teeth and are leading causes of obesity
4) paying attention to portions – beware of “Supersizing”
- we have lost our sense of what is a normal sized portion; what was considered
a large portion twenty years ago is now considered a small portion
- use regular size or small plates (and not large plates) to control portion size
For some simple and easy to follow suggestions on how to approach healthy eating, we
strongly recommend the book “Food Rules” by Michael Pollan.
Westwood Office
Mansfield Office
541 High Street
Westwood, MA 02090
(781) 326-7700
454 Chauncy Street
Mansfield, MA 02048
(508) 339-9944
www.wmpeds.com
Developmental Poetry by Dr. Hartman
Croup: The Fears
Is it a dog?
Is it a seal?
No, it’s my feverish child!
It makes my sleepy mind run wild!
Is it pneumonia, asthma, or bronchitis?
I did hear her with a little laryngitis!
Is that wheezing I hear?
Her throat could close up, I fear!
-Dr. Hartman
Croup: The Facts
Croup is caused by a virus that inflames the windpipe. It is most common in children under
the age of five. The symptoms of croup include fever and barky cough. Croup is almost always
worse in the middle of the night.
Although the symptoms of croup can be frightening, it is almost always a mild illness. While
about 6% of children under age five will contract croup, only 0.4% of children will be
hospitalized. Croup is a self-resolving illness. The nighttime cough and fever can last for 1-3
days, and a mild daytime cough may last for up to 10 days.
Croup: The Plan
Croup can often be treated at home without medications. If the croupy cough is persistent,
croup can be treated with a one day course of Orapred (prednisolone), an oral steroid.
Orapred decreases the swelling in the windpipe and quiets the barky cough of croup.
If your child comes down with croup this season, please refer to our “Nighttime Croup Attack
Plan”. As always, please contact us with any questions!
By: Dr. Hartman
Follow Dr. Hartman on Twitter @DrHartmanWMPEDS
Westwood Office
Mansfield Office
541 High Street
Westwood, MA 02090
(781) 326-7700
454 Chauncy Street
Mansfield, MA 02048
(508) 339-9944
www.wmpeds.com
Nighttime Croup Attack Plan
Please follow this plan in the event that your child awakes in the night with a fever and a
barky cough.
1) If your child is under six months old, call the office. If your child is drooling unusually, is
difficult to wake up, or if his/her lips, hands or feet are blue, call 911 and then follow
steps 2 and 3 below.
2) Take your child into a warm steamy bathroom for 10 minutes.
3) If the cough does not clear, take your child into the cold night air or open a freezer door to
breathe the cold air for 10 minutes.
4) If the cough clears, consider running a humidifier in the room or opening the bedroom
window. If your child sleeps in a bed, you may want to prop him/her up on extra pillows.
5) If your child still has the barky cough or stridor (a wheezy sound made when they breathe in),
give your child a dose of Orapred according to the dosing table (see next page). Continue to
use the steamy bathroom or cold air therapy. The Orapred takes about two hours to work.
6) CALL THE OFFICE IMMEDIATELY IF THIS PLAN DOES NOT WORK.
7) Contact our office in the morning if you use the Orapred.
a. It is important for us to document this in the child’s medical chart.
b. Please contact us by phone or through the patient portal.
8) AS ALWAYS, PLEASE CALL US AT ANY TIME WITH YOUR CONCERNS.
Orapred (prednisolone) dosing table for croup
Child's Weight (Pounds)
15 lbs
20 lbs
25 lbs
30 lbs
35 lbs
40 lbs
45 lbs
50 lbs
55 lbs
60 lbs


Dose (teaspoons)
½ teaspoon twice a day for one day
½ teaspoon twice a day for one day
¾ teaspoon twice a day for one day
1 teaspoon twice a day for one day
1 teaspoon twice a day for one day
1 ¼ teaspoons twice a day for one day
1 ¼ teaspoons twice a day for one day
1 ½ teaspoons twice a day for one day
1 ½ teaspoons twice a day for one day
1 ¾ teaspoons twice a day for one day
This dose should be given twice a day for one day.
Contact our office in the morning if you use the Orapred.
a. It is important for us to document this in the child’s medical chart.
b. Please contact us by phone or through the patient portal.
MyPlate is part of a larger communications initiative based on 2010
Dietary Guidelines for Americans to help consumers make better
food choices.
ChooseMyPlate.gov
The website features practical information and
tips to help Americans build healthier diets.
It features selected messages to help consumer
focus on key behaviors. Selected messages
include:
 Enjoy your food, but eat less.
 Avoid oversized portions.
 Make half your plate fruits and
vegetables.
 Switch to fat-free or low-fat (1%) milk.
 Make at least half your grains whole
grains.
 Compare sodium in foods like soup,
bread, and frozen


meals—and choose foods with lower
numbers.
Drink water instead of sugary drinks.
ChooseMyPlate.gov1 includes much of the
consumer and professional information
formerly found on MyPyramid.gov.
Also on the web





Sample Menus for a Week
Food Group Based Recipes
Historical Development of Food
Guidance
Nutrition Communicators Network for
Partners – Application Forms
All print-ready content
FIRST
AID
Call 911 or an emergency number
for a severely ill or injured child.
Call 1-800-222-1222 (Poison Help)
if you have a poison emergency.
General
■■ Know how to get help.
■■ Make sure the area is safe for you and the child.
■■ When possible, personal protective equipment (such as gloves)
should be used.
■■ Position the child appropriately if her airway needs to be
opened or CPR (cardiopulmonary resuscitation) is needed.
(Please see other side.)
■■ DO NOT MOVE A CHILD WHO MAY HAVE A NECK OR BACK
INJURY (from a fall, motor vehicle crash, or other injury, or
if the child says his neck or back hurts) unless he is in ­danger.
■■ Look for anything (such as emergency medical identification
jewelry or paperwork) that may give you information about
health problems.
Stings, Bites, and Allergies
Stinging Insects Remove the stinger as soon as possible with
a scraping motion using a firm item (such as the edge of a credit
card). Put a cold compress on the bite to relieve the pain. If trouble
breathing; fainting; swelling of lips, face, or throat; or hives over
the entire body occurs, call 911 or an emergency ­number right
away. For hives in a small area, nausea, or vomiting,
call the pediatrician. For spider bites, call the pediatrician or Poison Help (1-800-222-1222). Have the
pediatrician check any bites that become red, warm,
swollen, or painful.
Animal or Human Bites Wash wound well with soap and
water. Call the pediatrician. The child may need a ­tetanus or rabies
shot or antibiotics.
Ticks Use tweezers or your fingers to grasp as close as possible
to the head of the tick and briskly pull the tick away from where
it is attached. Call the pediatrician if the child develops symptoms
such as a rash or fever.
Snake Bites Take the child to an emergency department if you
are unsure of the type of snake or if you are concerned that the
snake may be poisonous. Keep the child at rest. Do not apply ice.
Loosely splint the injured area and keep it at rest, positioned at
or slightly below the level of the heart. Identify the snake, if you
can do so safely. If you are not able to identify the snake but are
able to kill it safely, take it with you to the emergency department
for identification.
Allergy Swelling, problems breathing, and paleness may be
signs of severe allergy. Call 911 or an emergency number right
away. Some people may have emergency medicine for these
times. If possible, ask about emergency medicine they may
have and help them administer it if necessary.
Fever
Fever in children is usually caused by infection. It also can
be caused by chemicals, poisons, medicines, an environment that is too hot, or an extreme level of overactivity.
Take the child’s temperature to see if he has a fever. Most
pediatricians consider any thermometer reading above
100.4°F (38°C) as a fever. However, the way the child
looks and acts is more important than how high the child’s
­temperature is.
Call the pediatrician right away if the child has a fever and
■■ Appears very ill, is unusually drowsy, or is very fussy
■■ Has other symptoms such as a stiff neck, a severe
■■
■■
■■
■■
­ eadache, severe sore throat, severe ear pain, an
h
­unexplained rash, repeated vomiting or diarrhea,
or difficulty breathing
Has a condition causing immune suppression (such as sickle
cell disease, cancer, or chronic steroid use)
Has had a first seizure but is no longer seizing
Is younger than 2 months and has a temperature of 100.4°F
(38°C) or higher
Has been in a very hot place, such as an overheated car
To make the child more comfortable, dress him in light clothing,
give him cool liquids to drink, and keep him calm. The pediatrician may recommend fever medicines. Do NOT use aspirin to
treat a child’s fever. Aspirin has been linked with Reye syndrome,
a serious disease that affects the liver and brain.
Turn Over for Choking and CPR Instructions.
Skin Wounds
Make sure the child is up to date for tetanus vaccination. Any
open wound may need a tetanus booster even when the child
is currently immunized. If the child has an open wound, ask the
pediatrician if the child needs a tetanus booster.
Bruises Apply cool compresses. Call the pediatrician if the child
has a crush injury, large bruises, continued pain, or swelling. The
pediatrician may recommend acetaminophen for pain.
Convulsions, Seizures
If the child is breathing, lay her on her side to prevent ­choking.
Call 911 or an emergency number for a prolonged seizure
(more than 5 minutes).
Make sure the child is safe from objects that could injure her.
Be sure to protect her head. Do not put anything in the child’s
mouth. Loosen any tight clothing. Start rescue breathing if the
child is blue or not breathing. (Please see other side.)
Cuts Rinse small cuts with water until clean. Use direct pressure
with a clean cloth to stop bleeding and hold in place for 1
to 2 minutes. If the cut is not deep, apply an antibiotic
ointment, then cover the cut with a clean ­bandage.
Call the pediatrician or seek emergency care
for large or deep cuts, or if the wound is
wide open. For major bleeding, call for
help (911 or an emergency number). Continue direct pressure with
a clean cloth until help arrives.
Scrapes Rinse with clean, running tap water for at least 5 minutes to remove dirt and germs. Do not use detergents, alcohol, or
peroxide. Apply an antibiotic ointment and a bandage that will not
stick to the wound.
Splinters Remove small splinters with tweezers, then wash
until clean. If you cannot remove the splinter ­completely, call
the pediatrician.
Puncture Wounds Do not remove large objects (such as a
knife or stick) from a wound. Call for help (911 or an emergency
number). Such objects must be removed by a doctor. Call the
pediatrician for all puncture wounds. The child may need a ­tetanus
booster.
Bleeding Apply pressure with gauze over the bleeding area
for 1 to 2 minutes. If still bleeding, add more gauze and apply
pressure for another 5 minutes. You can also wrap an elastic
­bandage firmly over gauze and apply pressure. If bleeding
­continues, call for help (911 or an emergency number).
Eye Injuries
If anything is splashed in the eye, flush gently with water for at
least 15 minutes. Call Poison Help (1-800-222-1222) or
the pediatrician for further advice. Any injured or
painful eye should be seen by a doctor. Do NOT
touch or rub an injured eye. Do NOT apply medicine. Do NOT remove objects stuck in the eye.
Cover the painful or injured eye with a paper cup
or eye shield until you can get medical help.
Fractures
and
Sprains
If an injured area is painful, swollen, or deformed, or if motion
causes pain, wrap it in a towel or soft cloth and make a splint
with cardboard or other firm material to hold the arm or leg in
place. Do not try to straighten. Apply ice or a cool compress
wrapped in thin cloth for not more than 20 minutes. Call the
pediatrician or seek emergency care. If there is a break in the
skin near the fracture or if you can see the bone, cover the
area with a clean bandage, make a splint as described above,
and seek emergency care.
If the foot or hand below the injured part is cold or discolored
(blue or pale), seek emergency care right away.
Burns
and
Scalds
General Treatment First, stop the burning process
by removing the child from contact with hot water or a
hot object (for example, hot iron). If clothing is burning, smother flames. Remove clothing unless it is firmly
stuck to the skin. Run cool water over burned skin until
the pain stops. Do not apply ice, butter, grease, medicine, or ointment.
Burns With Blisters Do not break the blisters. Ask
the pediatrician how to cover the burn. For burns on the face,
hands, feet, or genitals, seek emergency care.
Large or Deep Burns Call 911 or an emergency number.
After stopping and cooling the burn, keep the child warm with a
clean sheet covered with a blanket until help arrives.
Head Injuries
DO NOT MOVE A CHILD WHO MAY HAVE A SERIOUS HEAD, NECK,
OR BACK INJURY. This may cause further harm.
Call 911 or an emergency number right away if the child
■■
■■
■■
■■
■■
Loses consciousness
Has a seizure (convulsion)
Experiences clumsiness or inability to move any body part
Has oozing of blood or watery fluid from ears or nose
Has abnormal speech or behavior
Call the pediatrician for a child with a head injury and any of
the following:
■■ Drowsiness
■■ Difficulty being awakened
■■ Persistent headache or vomiting
For any questions about less serious injuries, call the pediatrician.
Poisons
If the child has been exposed to or ingested a poison,
call Poison Help at 1-800-222-1222. A poison expert
is available 24 hours a day, 7 days a week.
Swallowed Poisons Any nonfood substance
is a potential poison. Do not give anything by
mouth or induce vomiting. Call Poison Help right
away. Do not delay calling, but try to have the
­substance label or name available when you call.
Fumes, Gases, or Smoke Get the child into fresh air and
call 911, the fire department, or an emergency number. If the child
is not breathing, start CPR and continue until help arrives. (Please
see other side.)
Skin Exposure If acids, lye, pesticides, chemicals, poisonous
plants, or any potentially poisonous substance comes in contact
with a child’s skin, eyes, or hair, brush off any residual material
while wearing rubber gloves, if possible. Remove contaminated
clothing. Wash skin, eyes, or hair with large amount of water
or mild soap and water. Do not scrub. Call Poison Help for
­further advice.
If a child is unconscious, becoming drowsy, having convulsions,
or having trouble breathing, call 911 or an emergency number.
Bring the poisonous substance (safely contained) with you to
the hospital.
Fainting
Check the child’s airway and breathing. If necessary, call 911
and begin rescue breathing and CPR. (Please see other side.)
If vomiting has occurred, turn the child onto one side to prevent
choking. Elevate the feet above the level of the heart (about
12 inches).
Does your community have 911? If not, note the
number of your local ambulance service and other
important numbers below.
Be Prepared: Call 911
KEEP EMERGENCY NUMBERS
BY YOUR TELEPHONE.
P ediatrician
P ediatric
or
F amily D entist
Electrical Burns Disconnect electrical power. If the child is
P oison H elp 1-800-222-1222
still in contact with an electrical source, do NOT touch the child
with bare hands. Pull the child away from the power source with
an object that does not conduct electricity (such as a wooden
broom handle), only after the power is turned off. ALL electrical
burns need to be seen by a doctor.
A mbulance
Nosebleeds
Keep the child in a sitting position with the head tilted slightly
forward. Apply firm, steady pressure to both nostrils by squeezing them between your thumb and index finger for 5 minutes. If
bleeding continues or is very heavy, call the pediatrician or seek
emergency care.
E mergency D epartment
F ire
P olice
Address
(for
of and
Directions
to the
Location
babysitters, caregivers)
Teeth
Baby Teeth If knocked out or broken, apply clean gauze to
control bleeding and call the pediatric or family dentist.
Permanent Teeth If knocked out, handle the tooth by the
top and not the root (the part that would be in the
gum). If dirty, rinse gently without scrubbing or touching the root. Do not use any cleansers. Use cold running
water or milk. Place the tooth in clean water or milk
and transport the tooth with the child when seeking
emergency care. Call and go directly to the pediatric or
family dentist or an emergency department. If the tooth
is broken, save the pieces in milk and call the pediatric or
family dentist right away. Stop bleeding using gauze or a cotton
ball in the tooth socket and have the child bite down.
The information contained in this publication should not be used as a substitute
for the medical care and advice of your pediatrician. There may be variations in
treatment that your pediatrician may recommend based on individual facts
and circumstances.
HE0418
Copyright © 2011 American Academy of Pediatrics. All rights reserved.
5-65/Rev1210
CHOKING/CPR
LEARN AND PRACTICE CPR (CARDIOPULMONARY RESUSCITATION).
IF ALONE WITH A CHILD WHO IS CHOKING…
1. SHOUT FOR HELP. 2. START RESCUE EFFORTS. 3. CALL 911 OR YOUR LOCAL EMERGENCY NUMBER.
START FIRST AID FOR CHOKING IF
●●
●●
●●
The child cannot breathe at all (the chest is not moving up and down).
The child cannot cough or talk, or looks blue.
The child is found unconscious/unresponsive. (Go to CPR.)
DO NOT START FIRST AID FOR CHOKING IF
●●
●●
The child can breathe, cry, or talk.
The child can cough, sputter, or move air at all. The child’s normal reflexes
are working to clear the airway.
FOR INFANTS YOUNGER THAN 1 YEAR
INFANT CPR
INFANT CHOKING
To be used when the infant is UNCONSCIOUS/UNRESPONSIVE or when breathing stops.
Place infant on flat, hard surface.
If the infant is choking and
is unable to breathe, cough, cry,
or speak, follow these steps.
Have someone call 911.
1 START CHEST COMPRESSIONS.
●●
1GIVE 5 BACK BLOWS
(SLAPS).
●●
●●
ALTERNATING WITH
2 GIVE 5 CHEST
COMPRESSIONS.
Alternate back
blows (slaps)
and chest
compressions until
the object
is dislodged
or the infant
becomes
unconscious/
unresponsive.
If the infant
becomes
unconscious/
unresponsive,
begin CPR.
●●
Place 2 fingers of 1 hand on
the breastbone just below the
­nipple line.
Compress chest at least ¹/3 the
depth of the chest, or about
4 cm (1.5 inches).
After each compression,
allow chest to return
to normal ­position.
Compress chest at rate
of at least 100 times
per minute.
Do 30 compressions.
●●
●●
3 START RESCUE BREATHING.
●●
●●
●●
2 OPEN AIRWAY.
Open airway (head tilt–chin
lift).
If you see a foreign body,
sweep it out with your
finger. Do NOT do blind
finger sweeps.
4 RESUME CHEST COMPRESSIONS.
Take a normal breath.
Cover infant’s mouth and
nose with your mouth.
Give 2 breaths, each
for 1 second.
Each breath should
make the chest rise.
●●
●●
Continue with cycles of 30 compressions to
2 breaths.
After 5 cycles of compressions
and breaths (about 2 minutes),
if no one has called 911 or
your local emergency
­number, call
it yourself.
FOR CHILDREN 1 TO 8 YEARS OF AGE
CHILD CHOKING
(HEIMLICH MANEUVER)
Have someone call 911. If the
child is choking and is unable to
breathe, cough, cry, or speak,
­follow these steps.
1. Perform Heimlich
maneuver.
●
Place hand,
made into a
fist, and
cover with
other hand
just above the
navel. Place
well below
the bottom
tip of the
breastbone
and rib cage.
●
Give each thrust
with enough force to produce
an artificial cough designed
to relieve airway obstruction.
●
Perform Heimlich maneuver
until the object is expelled
or the child becomes
­unconscious/
unresponsive.
2. If the child becomes
UNCONSCIOUS/UNRESPONSIVE,
begin CPR.
CHILD CPR
To be used when the child is UNCONSCIOUS/UNRESPONSIVE or when breathing stops.
Place child on flat, hard surface.
1 START CHEST COMPRESSIONS.
●●
●●
●●
●●
Place the heel of 1 or 2 hands over the lower half
of the sternum.
Compress chest at least ¹/3 the depth of the
chest, or about 5 cm (2 inches).
After each compression, allow chest to
return to normal position. Compress chest
at rate of at least 100 times per minute.
Do 30 compressions.
1-hand technique
2 OPEN AIRWAY.
●●
●●
Open airway (head
tilt–chin lift).
If you see a foreign
body, sweep it out
with your finger.
Do NOT do blind
finger sweeps.
2-hand technique
3 START RESCUE BREATHING.
●●
●●
●●
Take a normal breath.
Pinch the child’s nose closed,
and cover child’s
mouth with
your mouth.
Give 2 breaths,
each for 1 second.
Each breath should
make the chest rise.
4 RESUME CHEST
COMPRESSIONS.
●●
●●
Continue with cycles of 30 compressions to 2 breaths until the object is
expelled.
After 5 cycles of compressions and
breaths (about 2 minutes), if no one
has called 911 or your local emergency
number, call it yourself.
If at any time an object is coughed up or the infant/child starts to breathe, stop rescue breaths and call 911 or your local
emergency number.
Ask your pediatrician for information on choking/CPR instructions for children older than 8 years and for information on an
approved first aid or CPR course in your community.
Turn Over for First Aid Treatment.
HE0418
Copyright © 2011 American Academy of Pediatrics. All rights reserved.
5-65/Rev1210
First Aid for Poisoning
Poison centers give expert advice fast,
over the phone. We can help you and
your family with poison emergencies
and with questions about poisoning
You can call day or night, 7 days a
week, any day of the year. Nurses,
pharmacists, doctors, and other
poison experts will answer your call.
We can help you in more
than 150 languages or
if you are hearing impaired.
There are many
poison centers across our country.
You can reach a poison center by
calling 1-800-222-1222
from anywhere in the US.
If a person
4 stops breathing
4 collapses, or
4 has a seizure
Call 911 right away.
Poison in the eyes?
Rinse eyes with running water.
Call your poison center at 1-800-222-1222.
Poison on the skin?
Take off any clothing that the poison
touched. Rinse skin with running water.
Call your poison center at 1-800-222-1222.
Inhaled poison?
Get to fresh air right away.
Call your poison center at 1-800-222-1222.
Swallowed poison?
Call your poison center at 1-800-222-1222.
Every 8 seconds someone
needs a poison center…
Could you be next?
Do not try home remedies or try to make
someone throw up. Call your poison
center first.
How Does
Your Poison
Center
Help You?
For more information visit www.aapcc.org
or call your local poison center.
© 2010 American Association of Poison Control Centers
Free, Fast,
Expert Help.
24 hours a day,
7 days a week
Do You Know?
Why Should You Call?
Poison Prevention Tips
We often think of children getting poisoned.
But most people who die from poisons are
adults! Poisoning is a danger for all of us.
Poisonings can happen to anyone and
poison centers are for everyone. The call is
free and private.
If you think someone has been poisoned,
call 1-800-222-1222 right away. Serious
poisonings don’t always have early signs.
We Help You Save Money and Time:
Seven of ten people who call their poison
center get help over the phone. They don’t
have to go to a doctor or hospital.
Almost anything can be
poisonous if it’s used the wrong way, in the
wrong amount, or by the wrong person.
Some poisons are:
Your Doctor Calls the Poison Center Too:
When doctors and nurses need help
treating poisonings, they call their local
poison center.
We are the experts.
• medicines (prescription, over-thecounter, herbal) and street drugs
• chemicals at your job
• bites and stings
• mushrooms and plants
• fumes and gases
• Always read the label and follow
any directions.
• Keep household products and
medicines locked up. Put them where
kids can’t see them or reach them.
• Never call medicine “candy.” Poisons may look like food or drink.
Teach children to ask an adult before
tasting anything.
• Learn about products and drugs
that young people use to get “high.” Talk to your teen or pre-teen about
these dangers.
Taking the wrong amount of medicine or
someone else’s medicine, accidentally eating
dishwasher soap, mixing cleaners, or
having too much alcohol to drink could
lead to poisoning.
Free, Fast, Expert Help.
24 hours a day, 7 days a week.
• Keep medicines and household
products in their original containers
and in a different place than food.
• Buy products with child-resistant
packaging. But remember, nothing
is child-proof!
• products in your home like
shampoo, bleach, bug and weed
killers, antifreeze, and lamp oil
• Put 1-800-222-1222 in your cell phone
and near home phones.
1-800-222-1222
• Have a
working
carbon
monoxide
alarm in
your home.
Westwood Office
Mansfield Office
541 High Street
Westwood, MA 02090
(781) 326-7700
454 Chauncy Street
Mansfield, MA 02048
(508) 339-9944
www.wmpeds.com
Postpartum Therapists
We strongly suggest you speak with your obstetrician if you feel you might be experiencing signs of
postpartum depression.
Janet Leibowitz, PsyD
345 Neponset St, Suite 6
Therapists
Canton, MA 02021
http://www.janetleibowitz.com/
JoAnn Feldstein, Ed.D.
781-258-3587
93 Union St, Suite 401
Newton Center, MA 02459
Christine Gardosik, LICSW
www.drjoannfeldstein.com/
21 Cohasset St, Suite 3
617-332-9887
Foxborough, MA 02035
Debra Greenberg, LICSW
15 Cottage St
Norwood, MA 02492
dgreenberglicsw@comcast.net
781-329-6696
Eda Spielman, Psy.D
6 Fairfield St
Newtonville, MA 02360
http://www.jfcsboston.org/
617-969-4117
Kathleen O’Meara, APRN
27 Mica Ln
Wellesley, MA 02481
781-431-0207
Ellis Waingrow, MSW, LICSW
24 Lincoln St
Newton Highlands, MA 02461
http://www.selfleadership.org/
617-244-8132
Wendy Hrubec, LICSW
275 Turnpike St, Suite 108
Canton, MA 02021
http://www.selfleadership.org/
781-821-2063
978-808-1635
Needham Psychotherapy Associates, LLC
992 Great Plain Ave
Needham, MA 02492
http://npaonline.com/
781-449-7522
Psychiatrist
Ann Briley, MD
18 Wareland Rd
Wellesley, MA 02481
781-237-7896
Allison Phillips, MD
27 Mica Ln
Wellesley, MA 02481
781-431-0207
VACCINE INFORMATION STATEMENT
Influenza Vaccine
What You Need to Know
1
Why get vaccinated?
Influenza (“flu”) is a contagious disease that spreads
around the United States every winter, usually between
October and May.
Flu is caused by the influenza virus, and can be spread
by coughing, sneezing, and close contact.
Anyone can get flu, but the risk of getting flu is highest
among children. Symptoms come on suddenly and may
last several days. They can include:
• fever/chills
• sore throat
• muscle aches
• fatigue
• cough
• headache
• runny or stuffy nose
Flu can make some people much sicker than others.
These people include young children, people 65 and
older, pregnant women, and people with certain health
conditions—such as heart, lung or kidney disease, or
a weakened immune system. Flu vaccine is especially
important for these people, and anyone in close contact
with them.
Flu can also lead to pneumonia, and make existing
medical conditions worse. It can cause diarrhea and
seizures in children.
Each year thousands of people in the United States die
from flu, and many more are hospitalized.
Flu vaccine is the best protection we have from flu
and its complications. Flu vaccine also helps prevent
spreading flu from person to person.
2
Inactivated flu vaccine
There are two types of influenza vaccine:
You are getting an inactivated flu vaccine, which
does not contain any live influenza virus. It is given by
injection with a needle, and often called the “flu shot.”
A different, live, attenuated (weakened) influenza
vaccine is sprayed into the nostrils. This vaccine is
described in a separate Vaccine Information Statement.
(Flu Vaccine,
Inactivated)
Many Vaccine Information Statements are
available in Spanish and other languages.
See www.immunize.org/vis
2013-2014
Hojas de información sobre vacunas están
disponibles en español y en muchos otros
idiomas. Visite www.immunize.org/vis
Flu vaccine is recommended every year. Children 6
months through 8 years of age should get two doses the
first year they get vaccinated.
Flu viruses are always changing. Each year’s flu vaccine
is made to protect from viruses that are most likely to
cause disease that year. While flu vaccine cannot prevent
all cases of flu, it is our best defense against the disease.
Inactivated flu vaccine protects against 3 or 4 different
influenza viruses.
It takes about 2 weeks for protection to develop after
the vaccination, and protection lasts several months to a
year.
Some illnesses that are not caused by influenza virus are
often mistaken for flu. Flu vaccine will not prevent these
illnesses. It can only prevent influenza.
A “high-dose” flu vaccine is available for people 65
years of age and older. The person giving you the
vaccine can tell you more about it.
Some inactivated flu vaccine contains a very small
amount of a mercury-based preservative called
thimerosal. Studies have shown that thimerosal in
vaccines is not harmful, but flu vaccines that do not
contain a preservative are available.
3
Some
people should not get
this vaccine
Tell the person who gives you the vaccine:
• If you have any severe (life-threatening) allergies. If
you ever had a life-threatening allergic reaction after a
dose of flu vaccine, or have a severe allergy to any part
of this vaccine, you may be advised not to get a dose.
Most, but not all, types of flu vaccine contain a small
amount of egg.
• If you ever had Guillain-Barré Syndrome (a severe
paralyzing illness, also called GBS). Some people
with a history of GBS should not get this vaccine. This
should be discussed with your doctor.
• If you are not feeling well. They might suggest
waiting until you feel better. But you should come
back.
4
Risks of a vaccine reaction
With a vaccine, like any medicine, there is a chance of
side effects. These are usually mild and go away on their
own.
Serious side effects are also possible, but are very rare.
Inactivated flu vaccine does not contain live flu virus, so
getting flu from this vaccine is not possible.
Brief fainting spells and related symptoms (such as
jerking movements) can happen after any medical
procedure, including vaccination. Sitting or lying down
for about 15 minutes after a vaccination can help
prevent fainting and injuries caused by falls. Tell your
doctor if you feel dizzy or light-headed, or have vision
changes or ringing in the ears.
Mild problems following inactivated flu vaccine:
• soreness, redness, or swelling where the shot was
given
• hoarseness; sore, red or itchy eyes; cough
• fever
• aches
• headache
• itching
• fatigue
If these problems occur, they usually begin soon after the
shot and last 1 or 2 days.
Moderate problems following inactivated flu
vaccine:
• Young children who get inactivated flu vaccine and
pneumococcal vaccine (PCV13) at the same time may
be at increased risk for seizures caused by fever. Ask
your doctor for more information. Tell your doctor if a
child who is getting flu vaccine has ever had a seizure.
Severe problems following inactivated flu vaccine:
• A severe allergic reaction could occur after any
vaccine (estimated less than 1 in a million doses).
• There is a small possibility that inactivated flu vaccine
could be associated with Guillain-Barré Syndrome
(GBS), no more than 1 or 2 cases per million people
vaccinated. This is much lower than the risk of severe
complications from flu, which can be prevented by flu
vaccine.
The safety of vaccines is always being monitored. For
more information, visit: www.cdc.gov/vaccinesafety/
if there is a serious
5What
reaction?
What should I look for?
• Look for anything that concerns you, such as signs of
a severe allergic reaction, very high fever, or behavior
changes.
Signs of a severe allergic reaction can include hives,
swelling of the face and throat, difficulty breathing,
a fast heartbeat, dizziness, and weakness. These
would start a few minutes to a few hours after the
vaccination.
What should I do?
• If you think it is a severe allergic reaction or other
emergency that can’t wait, call 9-1-1 or get the person
to the nearest hospital. Otherwise, call your doctor.
• Afterward, the reaction should be reported to the
Vaccine Adverse Event Reporting System (VAERS).
Your doctor might file this report, or you can
do it yourself through the VAERS web site at
www.vaers.hhs.gov, or by calling 1-800-822-7967.
VAERS is only for reporting reactions. They do not give
medical advice.
National Vaccine Injury
6The
Compensation Program
The National Vaccine Injury Compensation Program
(VICP) is a federal program that was created to
compensate people who may have been injured by
certain vaccines.
Persons who believe they may have been injured by a
vaccine can learn about the program and about filing a
claim by calling 1-800-338-2382 or visiting the VICP
website at www.hrsa.gov/vaccinecompensation.
7
How can I learn more?
• Ask your doctor.
• Call your local or state health department.
• Contact the Centers for Disease Control and
Prevention (CDC):
- Call 1-800-232-4636 (1-800-CDC-INFO) or
- Visit CDC’s website at www.cdc.gov/flu
Vaccine Information Statement (Interim)
Inactivated Influenza Vaccine
Office Use Only
07/26/2013
42 U.S.C. § 300aa-26