blog twincity pediatrics

Have you met our nurse practitioners?

We are delighted to have two extraordinary nurse practitoners, Danielle Keever and Whitney Ewing, as part of our team at Twin City Pediatrics. These wonderful providers are beloved by our patients and deliver quality and compassionate care to each child they see. For those of you who are unfamiliar with what a nurse practitioner does, here is a brief explanation.

A nurse practitioner (NP) is an advanced practice registered nurse (APRN) who is qualified as a medical provider having completed a Master's degree in nursing (MSN) and an additional two years of required clinical education. NPs diagnose medical problems, order treatments, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. NPs tend to concentrate on a holistic approach to patient care, and they emphasize health promotion, patient education/counseling, and disease prevention. Most NPs maintain close working relationships with doctors and consult them as needed.


February 13, 2016

Dr. Brown's Top 10 Tips for a Healthy Summer

 School's out!  Summer is here!  We here at Twin City Pediatrics hope that all our school age patients are enjoying these early days of summer.  In order to help you all stay healthy and make the most of your summer vacation, we are sharing our TCP Healthy Summer Tips with you all. 


1. Go outside every day.
The American Academy of Pediatrics says children should spend at least 60 minutes of unstructured playtime doing physical activity (ideally outdoors) each day. Outside time can reduce stress and anxiety. You're actually at risk for something called Nature Deficit Disorder if you don't get outdoors enough. The types of physical activity should be moderate to vigorous. Vigorous activity is activity that makes you breathe hard and sweat. During vigorous activity, it would be difficult to have a talk with someone. Some activities, such as bicycling, can be of moderate or vigorous intensity, depending upon level of effort.

The 60 minutes does not need to be done all at once. Physical activity can be broken down into shorter blocks of time. For example, 20 minutes walking to and from school, 10 minutes jumping rope, and 30 minutes at the playground all add up to 60 minutes of physical activity.

2. Wear sunscreen and/or sun protection
• Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that provide 97% -100% protection against both UVA and UVB rays), and clothing with a tight weave.
• Consider rash guards to protect shoulders and arms from intense midday sun
• On both sunny and cloudy days use a sunscreen with an SPF 15 or greater that protects against UVA and UVB rays (BROAD spectrum)
• Be sure to apply enough sunscreen -- about one ounce per application for a young adult and reapply sunscreen every two hours, and after swimming or sweating.

3. If you'll be in the woods, also apply insect repellent.
• Insect repellents containing DEET are most effective against ticks and mosquitoes.
• The concentration of DEET in products may range from less than 10 percent to over 30 percent. 30 percent DEET is the maximum concentration currently recommended for infants and children. DEET should not be used on children under 2 months of age. 10% DEET provides protection for about 2 hours, and 30% protects for about 5 hours. Choose the lowest concentration that will provide the required length of coverage.
• Only apply insect repellents on the outside of your child's clothing and on exposed skin.
• Spray repellents in open areas to avoid breathing them in.
• Use just enough repellent to cover your clothing and exposed skin. Using more doesn't make the repellent more effective. Avoid reapplying unless necessary.
• Wash your skin with soap and water to remove any repellent when you return indoors, and wash your clothing before you wear it again.

4. Hydrate!
Before outdoor physical activities, children should drink freely and should not feel thirsty. During activities less than one hour, water alone is fine.
Children should drink 12 ounces of fluids 30 minutes prior to activities and take fluid breaks every 20 minutes while playing.
Be sure to look out for thirst, dry mouth, headache, muscle cramping, irritability, fatigue, weakness, dizziness or decreased performance which can all be signs of dehydration.

5. Moderate screen use
Limiting screen time does not mean banning electronics altogether. But know that being in front of a screen does switch your child's brain to passive mode. That's why it's important to schedule screen time strategically. Save the morning hours for imaginative activities because that's when minds are sharper. When it comes to allowing screen time, afternoon is best. This is when the sun is at its hottest and children have already exhausted themselves. Also try to make sure that the screen time your child does have comes in short intervals. I recommend aiming for 30 minutes and drawing the line at an hour, at most. Remember to have all electronics stashed away at least two hours before bedtime.

5. Avoid Shifting Sleep Schedules
For teens, allowing them to sleep in is okay, but within reason. Many pediatric sleep experts recommend shifting 1-2 hours later than during the school year.  For example, try to have your teen up no later than 9:00 or 10:00 a.m.  This will make the transition back to school a lot easier.  Then two to three weeks before school starts, begin working on shifting your child's or teen's sleep schedule to help them get ready for school. The easiest way to do this is to have a set bedtime and wake time that allows for enough sleep, and then move both the bedtime and wake time 15 minutes earlier every 2-3 nights until the desired sleep schedule is reach.

6. Healthy snacking
To prevent all-day munching, help your children maintain a regular meal and snack schedule that includes three meals and one to two snacks per day. Outside of meal and snacks, "close" the kitchen.
Limit your child's consumption of juice, soda, fruit punch, sport/energy drinks, and any other sweet drinks to one cup per day. Instead offer water all day!
Check out the app Fooducate, which allows you to track calories and exercise, but one of the app's special features allows you to scan a product's bar code and see invaluable information about that product. Overall, Fooducate teaches you how to eat for health

7. Wear Helmets if Wheels are involved
Summer is a great time to be more active, which may include biking, skateboarding, rollerblading, etc. Be sure to protect your head during these activities and wear a helmet. Remember that Moms and Dads need helmets as well as kids!
Consider adopting the "No helmet, no wheels" rule to prevent against bicycle or skateboarding injuries.

8. Swim with a buddy
•Less experienced swimmers and children under age 5 in or around water should have an adult - preferably one who knows how to swim and perform CPR - within arm's length, providing "touch supervision."
•Never swim alone. Even good swimmers need buddies!
•Designate a "water watcher" when you are in, on or around water.Because drowning can be quick and quiet, the water watcher should pay constant attention, be undistracted, not involved in any other activity such as reading, playing cards, on the phone, while supervising children, even if lifeguards are present.?

9. Know your plants.
Nothing ruins summer fun like the itchy and uncomfortable rash of poison ivy!  As a general rule of thumb, avoid eating berries or fruits you may find in the woods and be sure to avoid plants, such as poison ivy and oak. These plants typically have three leaves ("leaves of three, let them be")

10. Schedule that overdue checkup!
Make sure you're up to date on your checkup (so we can easily complete school and sports forms for 2017).  If not, the summer is a great time to come in to see us!  Call for an appointment today