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Our Pediatricians
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842 Altos Oaks Drive
Los Altos, California
94024-5403

P: (650) 941-0550
F: (650) 941-6751

Altos Pediatric Associates
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In the News

September 2016
Altos Pediatrics has started vaccinating for the 2016-17 season.
The CDC and the AAP state only the injectable version of the influenza vaccine is available.
Parents and caregivers of children, especially those under six months, should also receive the influenza vaccine to help protect them.
Children with egg allergy may receive the flu vaccine .
Flu Shot In, Nasal Spray Out sums up the 2016-17 flu vaccination season and the AAP's HealthyChildren.org contains information on influenza and flu vaccines for families.

October 2015
AuviQ (Epinehprine Auto-Injectors) RECALLED
Sanofi is voluntarily recalling all strengths (.15mg and .30mg) of their AuviQ epinephrine auto-injectors because of concerns over potential inaccurate dosage delivery.
The recall includes lot number 2299596 through 3037230, which expire March 2016 through December 2016.
Parents should call our office to have an alternative epinephrine auto-injector phoned into a pharmacy.
The FDA statement provides additional details.

February 2015
MEASLES INFORMATION FOR PARENTS
The number of measles cases has risen to over 100 following outbreak originating in Disneyland.
At this point cases have been reported in both Santa Clara and San Mateo counties.
Parents have been calling to ask how to protect their children and infants under 12 months.
Keeping Baby Safe During the Measles Outbreak provides an up to date summary of what to consider with an infant during a measles outbreak.
At this time, the health department is NOT recommending change in the usual vaccination schedule for infants and children, although that could change if the outbreak moves to an epidemic.
The California Department of Health webpage provides updated information on the situation and has a link on how to find out the vaccination rate for your child's preschool or school.

January 2015
DISNEYLAND LINKED MEASLES OUTBREAK
So far nine cases of measles have been confirmed by California state health officials to be linked to an outbreak originating in Disneyland
Given the fact that 90% of unvacccinated individuals who are exposed to measles will contract the disease, more cases are anticipated
The measles vaccine can linger in the air following the cough of an infected person.
Read the USAtoday article We anticipate more updates from the California Health Department soon

June 2013
HEPATITIS A OUTBREAK
The CDC and the Santa Clara County Public Health Department have announced an outbreak of Hepatitis A from people who have consumed Townsend Farms Organic Antioxidant Blend Frozen Berry Mix. The item is distrubuted at Costco and other retailers.
If your child has had the Hepatitis A vaccine, then no action is needed. We rountinely give the vaccine at 18 months but as early as 12 months for families with international travel.
If your child has not had the Hepatits A vaccine and has been exposed, then they should receive the Hepatits A vaccine as soon as possible. There is a 2-6 week incubation period for Hepatits A, and the vaccine can PREVENT infection.
The vaccine is as effective as immmunoglobulin for prevention.
The CDC webpage is an excellent source of information for families
We anticipate more recommendations from the County Health Department soon

May 2013
Several schools in Santa Clara and San Mateo Counties have pertussis out breaks, and we have seen several children with pertussis in our office
Pertussis is highly contagious and the vaccination is not 100% effective (although vaccinated individuals who contract the disease have milder cases)
According to the CDC, "If pertussis is circulating in the community, there is still a chance that a fully vaccinated person can catch this very contagious disease. When you or your child develops a cold that includes a prolonged or severe cough, it may be pertussis. The best way to know is to contact your doctor."
The CDC recommendation that all parents and caretakers of young infants receive the Tdap is critical to follow during this time.
The CDC pertussis webpage is an excellent source of information for families
We anticipate more recommendations from the County Health Department soon

March 2012
Raising Well Balanced Children in a Fast-Paced World
Challenge Success, an extension of SOS (Stressed Out Students) Program at Stanford is offering both an on line and a live course to help parents address questions such as:
How can I raise healthier, happier kids?
How can my family feel more connected?
How much help is too much when it comes to homework?
Is it okay for my 13-year-old to be on Facebook every day?

February 2012
AAP News Radio
Healthy Children talk show is a weekly interactive show with input from physicians, pediatricians and other experts on array of health matters.
The archives contain shows on subjects such as Breastfeeding Basics, Healthy Sleep Habits for Children, The New Cholesterol Screening Guidelines for Children, and Are Tanning Salons Safe for your Teenager.
Listen in or join in and become part of the conversation.

January 2012
FDA renews warning about liquid acetaminophen (Tylenol)
Since the availability of different concentrations of acetaminophen (Tylenol) contributed to accidental overdoes that resulted in illness or fatal liver damage, the FDA recommended moving to a SINGLE concentration of liquid acetaminophen of 160mg/5ml. The infant drops (80mg/ml) are no longer manufactured, but the may still be found on pharmacy shelves and in your home medicine cabinet.
To avoid errors during this transition time: CHECK THE DOSING ON CONCENTRATION on the bottle first (located on the front of the bottle)
Base the dose on the child’s WEIGHT using the bottle or a dosing chart.
If you have any questions call and ask!

December 2011
New California Booster Seat Law
As of January 1, 2012, a new California law will require children to use a booster seat in a vehicle until they are at least 4 feet 9 inches tall OR 8 years old.
Many other states have already instituted similar laws. Fines of $475 can be issued to drivers, who fall to comply.
Although these guidelines may appear to be inconvenient for families, they are based upon safety data

September 2011
Influenza Recommendations for 2011-12
The American Academy of Pediatrics reviews recommendations for the prevention of influenza as well as stress the recommendations for annual influenza vaccine for all children. Options include traditional injectable vaccine as well as the nasal flumist. New recommendations include the ability to vaccine children with egg allergy.

August 2011
Recommendations for Young Athletes and Heat
As children across the country gear up for fall sports, the AAP publishes guidelines for preventing heat illness based on recent research. Recommendations during hot periods include:
- Gradual acclimation to heat and exercise over a 10-14 day period
- Sufficient hydration(3-8 oz every 20 min for 9 to 12 year-olds and up to 34-50 oz per hr for teens)
- Two hour recovery periods between multiple session/game days
The position statement appears in the journal Pediatrics

April 2011
AAP Issues New Car Seat and Booster Recommendations
The American Academy of Pediatrics has issued new recommendations on the use of car seats and boosters.
- Infants should ride in rear-facing car safety seats until age two or until they reach the height and weight limits specified by the manufacturer.
- After that, they should ride in forward-facing car seats with a harness until age four or until they have outgrown the seat.
- Then they should be switched to a belt-positioning booster seat until they can use the seatbelt alone (typically between 8 and 12 years, or when they've reached 4 feet 9 inches).
- Kids who are big enough to use the seatbelt alone should sit in the rear of the car until age 13.
Although these guidelines may appear to be inconvenient for families, they are based upon safety data as discussed in this Chicago Tribune article
The Healthychildren.org website has updated several articles to reflect the new recommendations.
Car Safety Seats: A Guideline for Families 2011
Car Safety Seats Product Guide 2011
Car Safety Seat Check Up
Airbag Safety

March 2011
New Books Dispell Myths About Vaccines
Unfortunately, much parental anxiety about vaccines stems from wide spread myths and fears about vaccines, but two new books by pediatrician Paul Offit and journalist Seth Mookin help address concerns as covered in USA today

Feb 2011
No Link Between MMR and Autsism
Andrew Wakefield's study that began the MMR vaccine Autism scare was retracted in 2010 by the Lancet (where it was published), and Dr Wakefield's medical license was revoked in Great Britain. Last month, the British Medical Journal editorial went a step farther to suggest that the article was an elaborate fraud and that he benefited from the fraud. ABC New Profile Link gives the details. Nancy Schneiderman has more commentary on the Today Show.

Examine the evidence yourself. The AAP has complied a compiled a brief summary and link to thirty significant studies that support the concept that there is NO link between Autsim and MMR vaccine. Go to the Altos Pediatrics Immunization Page(scroll down to Additional Resources).

Jan 2011
FDA Announces the Recall of Albuterol Solution
The Ritedose corporation has issued a voluntary recall of some vials of albuterol solution for the nebulizer because the vials were labeled incorrectly with the wrong concentration. The correct concentration is labelled on the foil package, but the recall was issued to avoid any possible mis-dsoing. Parents refer to the FDA website to check the affected lot numbers. No other albuterol formulations such as inhalers were affected or recalled

Nov 2010
AAP Offers Symptom Management Tool
The American Academy of Pediatrics has sponsored an interactive tool to assist families in evaluating symptoms in children. Kids Doc Symptom Checker is based upon the widely used Pediatric Telephone Protocols by Barton Schmidt, MD, which is also used by the advice nurses at Altos Pediatrics. Parents can search according to symptom and then follow a decision chart to the appropriate action which could be home care, a visit to the pediatrician or emergency care. The tool is found on the AAP parent website Healthychildren.org and as an iphone app called KidsDoc for families on the go.

Oct 2010
National Teen Driver Safety Week
This week is National Teen Driver Safety Week. Click on the above link for a Today Show interview on the subject. The National Transportation Safety Board urges us to educate our teen drivers with a few safety tips (*don't drink and drive, *don't speed, *hang up the cell phone, *limit passengers to the number allowed, *free yourself from distractions), and also to "remember that our teens our watching us, and we need to model the behavior we wish them to replicate." To learn more visit, AAA for an excellent teen driver safety program as well as a parent-teen driver agreement.

Sept 2010
Similac Recalls Certain Products
Abbot Nutrition has recalled certain lots of Similac powdered infant formula due to an isolated incident of a small "harmless" beetle found in a product produced in the Michigan plant. The recall does NOT apply to the specialty products such as Alimentum and Neocare. To learn more and to check specific lot numbers visit the Simiac Website or call their consumer hot line at 1-800-986-8850.

August 2010
Hearing Loss in Teens on the Rise
The number of U.S. teens who suffer from hearing loss increased significantly from the early nineties to the middle of this decade, especially in boys. The reason may be linked to the use of earbuds and the use of electronic media. We are screening the hearing of pre-teens and teens at the their annual physicals.

July 2010
Pertussis Outbreak in California
California health officials report that five infants have died from whopping cough, which is at epidemic levels in the state as the number of cases has quadrupled over the same time last year. Several cases of pertussis have been reported in Santa Clara County. Relatives and caregivers of infants should get boosters of Tdap, the updated tetanus booster that also includes pertussis vaccination. If you don't have a provider who can administer this vaccine, we can help.

June 2010
AAP Issues New Recommendations on Swimming Lessons
The American of Pediatrics has revised its policy on swimming lessons. New research shows that swim training for children one to four years of age may reduce drowning risk. Listen to commentary on Good Morning America. To read about other pool safety tips refer to the article in Healthykids.org

April 2010
McNeil Recalls Tylenol, Motrin, Benadryl and Zrytec Products
McNeil Consumer Healthcare announced a voluntary recall of several medications including certain Tylenol, Motrin, Zyrtec and Benadryl products. The products are being recalled as they may contain a higher concentration of active ingredients than specified on the label or because the inactive ingredients may not have meet internal testing requirements. The recommendation is to discontinue use of any products listed on the site referenced. No adverse affects to patients have been reported to date. The FDA has posted a frequently asked question list on the FDA Medwatch site

March 2010
AAP Launches HealthyChildren.org Website
The American Academy of Pediatrics has launched a comprehensive site for child health information. HealthyChildren.org provides support, resources and a host of interactive features such as videos to help parents quickly find the relevant information they are looking for.

February 2010
First Lady Highlights Campaign Against Obesity
Michelle Obama highlights obesity a major childhood concern. Listen to the video of her spreading the message that small changes in lifestyle can make a big difference. Ask your pediatrician about your child's BMI and how to keep him/her on track at the next well visit. Also check out the resources on overweight and obesity from the CDC's Obesity in Children site and the AAP's Prevention of Overweight and Obesity site

February 2010
Lancet Retracts Article Suggesting Link Between MMR and Autism
The medical journal, The Lancet, formally retracted the 1998 paper that first suggested a link between the MMR vaccine and autism. Dr Andrew Wakefield was called "irresponsible and dishonest" by a British disciplinary panel for the way he present his research.

January 2010
H1N1 Vaccine Update
Updated 1/10/10
WE NOW HAVE LARGE SHIPMENTS OF BOTH H1N1 INJECTION AND MIST
We have injectable vaccines for children 6 - 35 months and 3 years and older.
We have H1N1 mist for healthy children ages 4 and up.

October 2009
Seasonal Flu Vaccine and H1N1 Vaccine Status
OUR LIMITED AMOUNT OF H1N1 VACCINE IS NOW GONE. We were able to vaccinate the majority of the patients with high risk conditions
The Santa Clara Public Health Department will be having its next H1N1 vaccine clinic on Dec 5. Click on the link to check for times and locations as well as definitions of high risk patients.
PLEASE continue checking our site for daily updates on the status of our H1N1 supply.

September 2009
Recall of Tylenol products
Johnson and Johnson has announced the recall of a variety of Tylenol products made between April and June due to possible bacterial contamination. To check what is in your medicine cabinet against the affected lot numbers refer to the J and J site

September 2009
H1N1 Swine Flu Vaccine will arrive late Oct/Early November
We will announce the arrival of the vaccine on the Altos Pediatrics website. The CDC has recommended the vaccine for children 6 months to 24 years. For ongoing information about H1N1, including what you can do to keep your family healthy, check out the CDC H1N1 (Swine Flu) Web site or the AAP Web site.

August 2009
AAP and AAO State No Proven Benefit for Vision Therapy for Learning Disabilities
Read about or listen to an audio report about how the American Academy of Pediatrics, the American Academy of Ophthalmology, and other vision organizations issued a joint statement in Pediatrics outlining that scientifically unsupported treatments, such as behavioral vision therapy, eye exercises and colored lenses don't have a proven role in treating dyslexia and other learning disabilities.

July 2009
Measles on the Upswing
As parents choose to decline or delay immunization, measles cases are on the upswing, especially as families travel abroad and then return to the US to spread the disease to other vulnerable unvaccinated or young children. Recent CDC data confirms this point.

June 2009
There is No Such Thing as a Good Tan---Summer Tips for the Sun
Professor Al Lane at Packard Children's Hospital gives tips for best practices for sunscreen in this article and video.

May 2009
Swine Flu Update
"Parents should be aware of what public health officials are saying, and then just be extra vigilant about the precautions they'd normally take to prevent the spread of germs," says Joseph Bocchini, M.D., chair of the American Academy of Pediatrics committee on infectious diseases and pediatrics chair of the Louisiana State University Health Sciences Center in Shreveport.

No. 1 on the list: washing hands more frequently. So take a deep breath, put down the surgical mask, and read on for all information you need to know. The best source is for information is the CDC website.

March 2009
Two Children Die From H-flu Disease
From the AAP breaking e-news: "The Philadelphia Department of Public Health has announced that five cases of Haemophilus influenzae type b (Hib) invasive disease occurred in children in Pennsylvania since October 2008, resulting in two deaths. All of these cases were in unvaccinated or under-vaccinated children. One of the children, an unvaccinated 4-year-old child whose family belongs to a religious community that eschews medical care, died of bacterial meningitis due to Hib in March 2009.

These cases, along with the five cases of invasive Hib disease reported in Minnesota in 2008, are a reminder of the severity of Hib disease and the risk to children who are unimmunized or partially immunized as reported in the CDC publication MMWR."

Feb 2009
The Problem with Dr Bob's Alternative Vaccine Schedule
In 2007 Dr Robert Sears published a popular, but controversial book, The Vaccine Book: Making the Right Decision for Your Child, which sets out a formula by which parents can delay, withhold, separate, or space out vaccines. Noted infectious disease expert, Dr. Paul A. Offitt, underscores the reasons for the book's popularity, deconstructs the rationale behind its recommendations, and concludes that "Sears' misrepresentation of vaccine science misinforms parents trying to make the right decisions for their children." The article appeared in the February edition of the journal Pediatrics.

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