FDA Authorized Moderna and Johnson & Johnson Boosters
Today, the U.S. Food and Drug Administration took action to expand the use of a booster dose for COVID-19 vaccines in eligible populations. The agency is amending the emergency use authorizations (EUA) for COVID-19 vaccines to allow for the use of a single booster dose as follows:
- The use of a single booster dose of the Moderna COVID-19 Vaccine that may be administered at least 6 months after completion of the primary series to individuals:
- 65 years of age and older
- 18 through 64 years of age at high risk of severe COVID-19
- 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2
- The use of a single booster dose of the Janssen (Johnson and Johnson) COVID-19 Vaccine may be administered at least 2 months after completion of the single-dose primary regimen to individuals 18 years of age and older.
- The use of each of the available COVID-19 vaccines as a heterologous (or “mix and match”) booster dose in eligible individuals following completion of primary vaccination with a different available COVID-19 vaccine.
- To clarify that a single booster dose of the Pfizer-BioNTech COVID-19 Vaccine may be administered at least 6 months after completion of the primary series to individuals 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2.
“Today’s actions demonstrate our commitment to public health in proactively fighting against the COVID-19 pandemic,” said Acting FDA Commissioner Janet Woodcock, M.D. “As the pandemic continues to impact the country, science has shown that vaccination continues to be the safest and most effective way to prevent COVID-19, including the most serious consequences of the disease, such as hospitalization and death. The available data suggest waning immunity in some populations who are fully vaccinated. The availability of these authorized boosters is important for continued protection against COVID-19 disease.”
“The amendments to the emergency use authorizations to include a single booster dose in eligible populations are based on the available data and information and follows the input from the members of our advisory committee who were supportive of the use of a booster dose of these vaccines in eligible populations,” said Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research. “We are also taking action today to include the use of mix and match boosters to address this public health need. We will work to accrue additional data as quickly as possible to further assess the benefits and risks of the use of booster doses in additional populations and plan to update the healthcare community and public with our determination in the coming weeks.”
Authorization of Moderna COVID-19 Vaccine Booster Dose
To support the authorization for emergency use of a single booster dose of the Moderna COVID-19 Vaccine, the FDA analyzed immune response data from 149 participants 18 years of age and older from the original clinical studies who received a booster dose at least 6 months after their second dose and compared it to the immune responses of 1,055 study participants after completing their two-dose series. The antibody response of the 149 participants against SARS-CoV-2 virus 29 days after a booster dose of the vaccine demonstrated a booster response.
The FDA also evaluated an additional analysis from Moderna comparing the rates of COVID-19 accrued during the Delta variant surge during July and August 2021, which suggest that there is a waning of vaccine effectiveness over time.
Safety was evaluated in 171 participants 18 years of age and older who were followed for an average of approximately six months. The most commonly reported side effects by the clinical trial participants who received the booster dose of the vaccine were pain at the injection site, tiredness, headache, muscle and/or joint pain, chills, swollen lymph nodes in same arm as the injection, nausea and vomiting, and fever. Of note, swollen lymph nodes in the underarm were observed more frequently following the booster dose than after the primary two-dose series.
Ongoing analyses from the FDA and the Centers for Disease Control and Prevention (CDC) safety surveillance systems have identified increased risks of inflammatory heart conditions, myocarditis and pericarditis, following vaccination with the Moderna COVID-19 vaccine, particularly following the second dose. Typically, onset of symptoms has been a few days following vaccination. The observed risk is higher among males under 40 years of age, particularly males 18 through 24, than among females and older males.
The Moderna COVID-19 single booster dose is half of the dose that is administered for a primary series dose and is administered at least six months after completion of a primary series of the vaccine.
Authorization of Janssen (Johnson and Johnson) COVID-19 Vaccine Booster Dose
The authorization for emergency use of a single booster dose of the Janssen COVID-19 Vaccine is based on the FDA’s evaluation of immune response data in 39 participants from a clinical trial including 24 participants who were 18 through 55 years of age and 15 participants who were 65 years of age and older. The study participants received a booster dose approximately 2 months after their first dose, and the results demonstrated a booster response.
Overall, approximately 9,000 clinical trial participants have received two doses of Janssen COVID-19 Vaccine administered at least two months apart and of these, approximately 2,700 have had at least two months of safety follow-up after the booster dose. Janssen’s safety analyses from these studies have not identified new safety concerns.
Earlier analyses from the FDA and CDC safety surveillance systems suggest an increased risk of a serious and rare type of blood clot in combination with low blood platelets following administration of the Janssen COVID-19 vaccine. This serious condition is called thrombocytopenia syndrome (TTS). People who developed TTS after receiving the vaccine had symptoms that began about one to two weeks after vaccination. Reporting of TTS has been highest in females ages 18 through 49 years. In addition, safety surveillance suggests an increased risk of a specific serious neurological disorder called Guillain Barré syndrome, within 42 days following receipt of the Janssen COVID-19 Vaccine.
Authorization of “Mix and Match” Booster Dose
Today, the FDA is also authorizing the use of heterologous (or “mix and match”) booster dose for currently available (i.e., FDA-authorized or approved) COVID-19 vaccines. Following a presentation of clinical trial data from the National Institute of Allergy and Infectious Diseases, the Vaccines and Related Biological Products Advisory Committee’s discussion of information submitted for consideration, along with the agency’s evaluation of the available data, the FDA has determined that the known and potential benefits of the use of a single heterologous booster dose outweigh the known and potential risks of their use in eligible populations.
A single booster dose of any of the available COVID-19 vaccines may be administered as a heterologous booster dose following completion of primary vaccination with a different available COVID-19 vaccine. The eligible population(s) and dosing interval for a heterologous booster dose are the same as those authorized for a booster dose of the vaccine used for primary vaccination.
For example, Janssen COVID-19 Vaccine recipients 18 years of age and older may receive a single booster dose of Janssen COVID-19 Vaccine, Moderna COVID-19 Vaccine (half dose) or Pfizer-BioNTech COVID-19 Vaccine at least two months after receiving their Janssen COVID-19 Vaccine primary vaccination.
In another example, Moderna COVID-19 Vaccine and Pfizer-BioNTech COVID-19 vaccine recipients falling into one of the authorized categories for boosters (65 years of age and older, 18 through 64 years of age at high-risk of severe COVID-19, and 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2) may receive a booster dose of Moderna COVID-19 Vaccine (half dose), Pfizer-BioNTech COVID-19 Vaccine or Janssen COVID-19 Vaccine at least six months after completing their primary vaccination.
The agency recognizes that health care providers and COVID-19 vaccine recipients will have questions about booster doses. The individual fact sheets for each available vaccine provide relevant information for health care providers and the vaccine recipients. The agency encourages health care providers to also follow the recommendations that will be provided by the CDC following a meeting of their Advisory Committee on Immunization Practices and formal recommendations signed by the CDC director.
Related Information
- Moderna COVID-19 Vaccine
- Janssen COVID-19 Vaccine
- Pfizer-BioNTech COVID-19 Vaccine
- COVID-19 Vaccines
- Emergency Use Authorization for Vaccines Explained
###
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
Mental Health During COVID-19: Signs Your Child May Need More Support
From American Academy of Pediatrics:
The ongoing stress, fear, grief, and uncertainty created by COVID-19 pandemic has weighed heavily on children and teens. Many are having a tough time coping emotionally.
More than 140,000 children in the United States have experienced the death of a parent or grandparent caregiver from COVID, for example. Children of racial and ethnic minority families have been hit especially hard. Research shows they’ve had up to 4.5 times the risk of losing a caregiver to COVID, compared to other kids.
Many families have also lost jobs and financial stability during the pandemic. At the same time,vital supports such as school, health care services, and other community programs have been interrupted. And many have experienced or witnessed a rise in racism and xenophobia during the pandemic, particularly toward families of Asian descent.
Pediatricians, child and adolescent psychiatrists, and children’s hospitals have declared a national state of emergency for child and adolescent mental health. Learn more here.
Since the start of the pandemic, hospitals have seen more mental health emergencies among kids. Between March and October 2020, the percentage of emergency department visits for children with mental health emergencies rose by 24% for children ages 5-11 and 31% for children ages 12-17. There was also a more than 50% increase in suspected suicide attempt emergency department visits among girls ages 12-17 in early 2021 as compared to the same period in 2019.
Even with the protection of the COVID-19 vaccines now available to children who are old enough for them, pandemic-related stress and traumas may have lasting effects on the developing minds of children and teens. Continue to check in with your child often and watch and listen for signs they are struggling. And remember that your pediatrician is here to help.
How is your child coping?
Invite your child to talk about how they are feeling. Feeling depressed, hopeless, anxious, and angry could be normal reactions to stress. However, if these feelings are constant and overwhelming–or if they affect your child’s ability to keep doing what they usually do, such as going to school, doing their work, or having fun–these may be signs they need more support during this difficult time.
Keep in mind that younger children may not know how to talk about these feelings, but may show changes in their development or behavior. Teens and young adults, meanwhile, may try to hide their feelings because they don’t want to bother others.
Recognizing signs of stress in your child
Signs of stress and mental health challenges are not the same for every child or teen, but there are some common symptoms.
Infants, toddlers and young children…
may show backward progress in skills and developmental milestones. They may also have increased problems with:
- fussiness and irritability, startling and crying more easily, and be more difficult to console.
- trouble falling asleep and waking up more during the night.
- feeding issues such as nausea and vomiting, constipation or loose stools, or new complaints of stomach pain.
- being anxious when they have to separate from their family, clinginess, not wanting to socialize, and fear of going outside.
- hitting, frustration, biting, and more frequent or intense tantrums.
- bedwetting after they’re potty trained.
- aggressive behavior.
Older children and adolescents…
may show signs of distress with symptoms such as:
- changes in mood that are not usual for your child, such as ongoing irritability, feelings of hopelessness or rage, and frequent conflicts with friends and family.
- changes in behavior, such as stepping back from personal relationships. For example, if your outgoing teen stops spending time or texting or video chatting with friends, this may be cause for concern.
- a loss of interest in activities previously enjoyed. Did your music-loving child suddenly stop wanting to practice guitar, for example? Did your aspiring chef lose all interest in cooking and baking?
- a hard time falling or staying asleep, or starting to sleep all the time.
- changes in appetite, weight or eating patterns, such as never being hungry or eating all the time.
- problems with memory, thinking, or concentration.
- less interest in schoolwork and drop in academic effort.
- changes in appearance, such as lack of basic personal hygiene.
- an increase in risky or reckless behaviors, such as using drugs or alcohol.
- thoughts about death or suicide, or talking about it (see “A word about suicide risk,” below).
How your pediatrician can help
Staying in touch with your pediatrician is more important than ever during this pandemic. If you have any concerns, ask us about checking on your child’s social and emotional health. This can be especially important for children facing higher rates of illness or risk from COVID-19, such as children of color, those living in poverty, special health care needs or developmental differences. Children who are refugees and those involved with the child welfare and juvenile justice systems may also be more at risk.
Our pediatricians can screen for depression and ask about other concerns like anxiety or trouble coping with stress. The doctor may also ask about these symptoms in other family members, as this can impact your child’s health, and whether they know anyone who has become sick with COVID-19. It’s important to offer your teen some time to talk one-on-one with the pediatrician during the visit to ensure they have the chance to speak as openly as possible. Many pediatricians are also offering telehealth visits during the pandemic.
Dealing with the loss of a loved one to COVID-19
Children, adolescents, and families who experienced the loss of a loved family member or friend to COVID-19 are at increased risk for mental health challenges and may need special attention and professional counseling to manage their loss and grief.
Supporting your child
Your pediatrician can give you guidance on ways to best support your child and help them build resilience. Always check in with your child, ask them how they are feeling, and remind them you are there to talk if they want to, when they are ready. Some children or adolescents may need more time and space to express their feelings. Some may do better with gradual conversations and other activities besides talking, such as painting or drawing to express themselves and manage stress. Others might be more comfortable with direct conversations or activities.
A word about suicide risk
Rates of suicide for both adolescents and adults increase during times of high stress. In addition to screening for depression, your pediatrician can screen for suicide risk.
Remember, not everyone who considers suicide will talk about it, and not everyone who talks about suicide will act on their words. However, any talk about suicide should be taken seriously. If you are worried about your child, it is critical to make your home safe by removing weapons and ammunition from the house and securing medications in a locked cabinet.
Seek help immediately by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or texting the Crisis Text Line by texting ‘TALK’ to 741741. Reserve 911 for situations where self-harming actions are happening or are about to happen. In a non-crisis situation, talk with your pediatrician about any concerns you have about your child’s mental health.
Self-care and setting the tone
Parents set the tone in the household. Expressing extreme doom or fear can affect your children. It can be challenging to stay positive, especially if you’re struggling with your own stress. But try to relay consistent messages that a brighter future lies ahead. It helps to set aside time to take care of yourself when possible, and seek the support you may need for your own mental health. Practicing mindfulness, focusing on the present moment, yoga or stretching can help the entire family build coping skills. Build in down time for the whole family to connect and relax, enjoying a nap, movie time or simply spending time together.
Remember
Keep lines of communication open between you and your child, and don’t hesitate to talk with your pediatrician about ways to help maintain your family’s mental health during this difficult time.
If you are concerned about your child’s mental health, please call your pediatrician.
As part of Austin Health Partners, we have Behavioral Health Consultants (BHC) that can help children with Behavioral and Mental Health concerns. Please speak to your pediatrician to see if one of our BHC’s is the right fit for your family.
From American Academy of Pediatrics:
The ongoing stress, fear, grief, and uncertainty created by COVID-19 pandemic has weighed heavily on children and teens. Many are having a tough time coping emotionally.
More than 140,000 children in the United States have experienced the death of a parent or grandparent caregiver from COVID, for example. Children of racial and ethnic minority families have been hit especially hard. Research shows they’ve had up to 4.5 times the risk of losing a caregiver to COVID, compared to other kids.
Many families have also lost jobs and financial stability during the pandemic. At the same time,vital supports such as school, health care services, and other community programs have been interrupted. And many have experienced or witnessed a rise in racism and xenophobia during the pandemic, particularly toward families of Asian descent.
Pediatricians, child and adolescent psychiatrists, and children’s hospitals have declared a national state of emergency for child and adolescent mental health. Learn more here.
Since the start of the pandemic, hospitals have seen more mental health emergencies among kids. Between March and October 2020, the percentage of emergency department visits for children with mental health emergencies rose by 24% for children ages 5-11 and 31% for children ages 12-17. There was also a more than 50% increase in suspected suicide attempt emergency department visits among girls ages 12-17 in early 2021 as compared to the same period in 2019.
Even with the protection of the COVID-19 vaccines now available to children who are old enough for them, pandemic-related stress and traumas may have lasting effects on the developing minds of children and teens. Continue to check in with your child often and watch and listen for signs they are struggling. And remember that your pediatrician is here to help.
How is your child coping?
Invite your child to talk about how they are feeling. Feeling depressed, hopeless, anxious, and angry could be normal reactions to stress. However, if these feelings are constant and overwhelming–or if they affect your child’s ability to keep doing what they usually do, such as going to school, doing their work, or having fun–these may be signs they need more support during this difficult time.
Keep in mind that younger children may not know how to talk about these feelings, but may show changes in their development or behavior. Teens and young adults, meanwhile, may try to hide their feelings because they don’t want to bother others.
Recognizing signs of stress in your child
Signs of stress and mental health challenges are not the same for every child or teen, but there are some common symptoms.
Infants, toddlers and young children…
may show backward progress in skills and developmental milestones. They may also have increased problems with:
- fussiness and irritability, startling and crying more easily, and be more difficult to console.
- trouble falling asleep and waking up more during the night.
- feeding issues such as nausea and vomiting, constipation or loose stools, or new complaints of stomach pain.
- being anxious when they have to separate from their family, clinginess, not wanting to socialize, and fear of going outside.
- hitting, frustration, biting, and more frequent or intense tantrums.
- bedwetting after they’re potty trained.
- aggressive behavior.
Older children and adolescents…
may show signs of distress with symptoms such as:
- changes in mood that are not usual for your child, such as ongoing irritability, feelings of hopelessness or rage, and frequent conflicts with friends and family.
- changes in behavior, such as stepping back from personal relationships. For example, if your outgoing teen stops spending time or texting or video chatting with friends, this may be cause for concern.
- a loss of interest in activities previously enjoyed. Did your music-loving child suddenly stop wanting to practice guitar, for example? Did your aspiring chef lose all interest in cooking and baking?
- a hard time falling or staying asleep, or starting to sleep all the time.
- changes in appetite, weight or eating patterns, such as never being hungry or eating all the time.
- problems with memory, thinking, or concentration.
- less interest in schoolwork and drop in academic effort.
- changes in appearance, such as lack of basic personal hygiene.
- an increase in risky or reckless behaviors, such as using drugs or alcohol.
- thoughts about death or suicide, or talking about it (see “A word about suicide risk,” below).
How your pediatrician can help
Staying in touch with your pediatrician is more important than ever during this pandemic. If you have any concerns, ask us about checking on your child’s social and emotional health. This can be especially important for children facing higher rates of illness or risk from COVID-19, such as children of color, those living in poverty, special health care needs or developmental differences. Children who are refugees and those involved with the child welfare and juvenile justice systems may also be more at risk.
Our pediatricians can screen for depression and ask about other concerns like anxiety or trouble coping with stress. The doctor may also ask about these symptoms in other family members, as this can impact your child’s health, and whether they know anyone who has become sick with COVID-19. It’s important to offer your teen some time to talk one-on-one with the pediatrician during the visit to ensure they have the chance to speak as openly as possible. Many pediatricians are also offering telehealth visits during the pandemic.
Dealing with the loss of a loved one to COVID-19
Children, adolescents, and families who experienced the loss of a loved family member or friend to COVID-19 are at increased risk for mental health challenges and may need special attention and professional counseling to manage their loss and grief.
Supporting your child
Your pediatrician can give you guidance on ways to best support your child and help them build resilience. Always check in with your child, ask them how they are feeling, and remind them you are there to talk if they want to, when they are ready. Some children or adolescents may need more time and space to express their feelings. Some may do better with gradual conversations and other activities besides talking, such as painting or drawing to express themselves and manage stress. Others might be more comfortable with direct conversations or activities.
A word about suicide risk
Rates of suicide for both adolescents and adults increase during times of high stress. In addition to screening for depression, your pediatrician can screen for suicide risk.
Remember, not everyone who considers suicide will talk about it, and not everyone who talks about suicide will act on their words. However, any talk about suicide should be taken seriously. If you are worried about your child, it is critical to make your home safe by removing weapons and ammunition from the house and securing medications in a locked cabinet.
Seek help immediately by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or texting the Crisis Text Line by texting ‘TALK’ to 741741. Reserve 911 for situations where self-harming actions are happening or are about to happen. In a non-crisis situation, talk with your pediatrician about any concerns you have about your child’s mental health.
Self-care and setting the tone
Parents set the tone in the household. Expressing extreme doom or fear can affect your children. It can be challenging to stay positive, especially if you’re struggling with your own stress. But try to relay consistent messages that a brighter future lies ahead. It helps to set aside time to take care of yourself when possible, and seek the support you may need for your own mental health. Practicing mindfulness, focusing on the present moment, yoga or stretching can help the entire family build coping skills. Build in down time for the whole family to connect and relax, enjoying a nap, movie time or simply spending time together.
Remember
Keep lines of communication open between you and your child, and don’t hesitate to talk with your pediatrician about ways to help maintain your family’s mental health during this difficult time.
If you are concerned about your child’s mental health, please call your pediatrician.
As part of Austin Health Partners, we have Behavioral Health Consultants (BHC) that can help children with Behavioral and Mental Health concerns. Please speak to your pediatrician to see if one of our BHC’s is the right fit for your family.
Halloween & COVID-19: Have Fun While Staying Safe
From American Academy of Pediatrics:
For families fully vaccinated against COVID-19, the risk of being exposed to the virus during Halloween festivities may not be as scary as last year. But as COVID continues to spread, it’s still important to help keep trick-or-treating and other Halloween traditions safe—especially if your kids aren’t eligible for vaccines yet.
Trick-or-treating
Think outside
Try to stick with outdoor trick-or-treating in small groups. The virus is much less likely to spread outside than in poorly ventilated indoor spaces. Keeping a safe distance from others outside your household is another good way to reduce risk. Make sure your children know to avoid large groups of kids clustering at doorsteps or anywhere else the goodies are being handed out.
If you give out treats, consider sitting outside and lining up individually prepackaged goodies on a table for children to take. Non-edible treats are a good option, especially for children who suffer from food allergies.
Don’t forget other Halloween safety basics for outdoor trick-or-treating. If your kids will be out after dark, mark their costumes with reflective tape. Remind them to be careful around cars, as drivers may not see them. Also, make sure shoes fit well and costumes are short enough to prevent tripping or contact with flames.
Mask up indoors
If your children do attend an indoor trick-or-treat event or public festivities, be sure everyone wears face masks and observes safe physical distancing. Universal masking indoors continues to be important, since children under 12 years old are not yet eligible for COVID-19 vaccines. There may be a mix of vaccinated and unvaccinated children, teens, and adults at these events, and mask use reduces the risk of transmission of the COVID virus.
When children get home with their haul, remind them to wash their hands before eating any treats.
Costume parties, parades & community events
Again, remember that outdoor parades, parties and attractions are safer than indoor public events. Rather than a haunted house, for example, consider a haunted forest or corn maze. Look for programs focused on safe ways to have fun offered by a park district, arboretum, zoo or other outdoor venues in your area. Pumpkin patches and apple orchards are other good options. Just use hand sanitizer before and after touching what you pick.
For any indoor festivities, including events at school, make sure everyone wears face masks. This is important regardless of vaccination status for now.
Making masks part of the costume
Encourage your kids to use their face masks as part of their cos tume (think surgeon or superhero!). However, be wary of painting the masks, since some paints contain toxins. And keep in mind that a costume mask is not a substit ute for a mask that has multiple layers of breathable fabric, or a disposable surgical-style mask, that covers the mouth and nose snugly. Also, do not wear a costume mask over a COVID face mask, because it can make breathing more difficult.
Family fun
Don’t forget that some of the most memorable, and safest Halloween memories can be made at home together as a family. For example:
- Pumpkin decorating. This is one Halloween tradition that’s as safe and fun as ever. As always, just be careful to avoid pumpkin carving injuries. Children can draw a face with markers. Then parents can do the cutting. When the carving is done, consider putting a battery-operated light rather than an open-flame candle inside. Roast the seeds from the pumpkin for a healthy snack!
- Costumed movie night. Especially if you have young children, considering a movie night dressed as favorite characters. For tips on finding age-appropriate movies for your child, read more here.
- Halloween-themed treats. Make some fun Halloween treats as a family. Decorate a pizza with toppings in the shape of a jack-o’-lantern, for example, or make tangerine pumpkins (peel the tangerine and stick a thin slice of celery on top to look like a stem). Make sure the treats are not choking hazards if you have children under 3 years old.
- A scavenger “haunt” (hunt) for Halloween treats in your home or yard can be fun for the whole family. Add a spooky element by turning out the lights and using flashlights to for the hunt.
Remember
More than a year and a half into the pandemic, COVID-19 may seem like a horror movie monster that won’t go away. But as adults continue to get the vaccine, and more children become eligible for them, there’s more hope than ever that communities can return to normal. In the meantime, with some common-sense safety steps, there are still plenty of ways to have some Halloween fun.
Breast Cancer Awareness Month
October is Breast Cancer Awareness Month
It is that time of year again when we break out the pink clothes from the back of our closets. We wear them to acknowledge the continuous uphill battle for those recently diagnosed with breast cancer, those going through treatment, those in remediation, and those who have lost their lives because of this cancer.
What is Breast Cancer?
Breast cancer is when the cells located in your breast grow uncontrollably. There are different subtypes of breast cancer and the type is dependent on location of the uncontrolled cells. The breast is made up of three main parts: lobules, ducts, and connective tissue. Each of the parts have different function: the lobules make milk, the ducts carry the milk towards the nipple, and the connective tissue holds everything together. Majority of breast cancer start in the ducts or lobules.
Why is Breast Cancer important?
Breast cancer is the leading cause of cancer related death to women worldwide and is the second highest common cause of cancer for women in the United States. Majority of the time, breast cancer is identified with the female gender. However, males can be affected too. Breast cancer can be passed from one generation to the next. With increase awareness, annual preventative visits, and screening availability, clinicians have been able to detect breast cancer at an earlier age.
What can I do?
There are some modifiable risk factors that you may change to decrease your chances of developing breast cancer. They are: becoming more physically fit, not smoking, not being overweight or obese after menopause, not being on hormone replacement therapy after menopause, having your first child before 30 and breast feeding, and decrease alcohol intake.
Other things to consider is discussing your family history and personal medical history with your physician at your next wellness exam. You and your physician can weigh the risks and benefits of screening early at age 40, rather than at 50 years old (per USPSTF guidelines). The screening will start with a routine mammogram done every 1-2 years. If there is something abnormal found on the mammogram, we will help to coordinate your care with a referral to specialist.
If you have any concerns or questions, please book an appointment with your primary care provider at one of our locations.
Together, we can spread awareness about breast cancer.
Dr. Hannah Do, M.D. Family Medicine Physician
References:
1. https://www.cdc.gov/cancer/breast/basic_info/index.htm
Recommended Reading: Diverse & Inclusive Books For Children
From: American Academy Pediatrics
Reading diverse and inclusive books is a wonderful way to allow children to see themselves reflected, learn about other people and their experiences, imagine themselves in another place or time, imagine themselves in another person’s experiences, recognize our similarities, and celebrate differences.
Reading is more than fundamental. It provides the opportunity to teach our children about kindness, compassion, and empathy for others and that diversity of stories matter. All kids should be able to see themselves as the stars of their own stories. As there is not one type of child, there should not be one type of story.
Read on for a sampling of favorite titles collected by pediatricians to help families select and share books with young children. This list was created in collaboration between Reach Out and Read and the American Academy of Pediatrics (AAP) Section on Minority Health, Equity and Inclusion, the Book List Committee of the AAP Council on Early Childhood, and the Reach Out and Read Book Committee.
Birth – 12 MONTHS
I Will Talk to You, Little One by Phyllis E. Gran; illustrated by Tomie dePaola (English & Spanish)
I Love You Like Sunshine by Mariana Glusman, MD; photos by Marta Killner, MD (English & Spanish)
Global Babies by The Global Fund for Children (English & English-Spanish bilingual)
Reach: A Board Book About Curiosity by Elizabeth Verdick and Marjorie Lisovskis
Cradle Me by Debby Slier (English)
Baby Says by John Steptoe (English)
Kiss by Kiss / Ocetowina: A Counting Book for Families by Richard Van Camp (English, Plains Cree)
Toddler 12-36 MONTHS
My Heart Fills with Happiness by Monique Gray Smith; illustrated by Julie Flett (English English-Cree bilingual, English-Ojibwa bilingual, Spanish, French)
My Friends / Mis Amigos by Taro Gomi (English, English-Spanish bilingual)
Jazz Baby by Lisa Wheeler; illustrated by R. Gregory Christie (English)
Bee-bim Bop! by Linda Sue Park; illustrated by Ho Baek Lee (English)
Grandma’s Tiny House: A Counting Story by JaNay Brown-Wood; iIllustrated by Priscilla Burris (English)
Brown Baby Lullaby by Tameka Fryer; illustrated by A.G. Ford. (English with a sprinkling of Spanish)
Please, Baby, Please by Tonya Lewis Lee and Spike Lee; illustrated by Kadir Nelson (English, Spanish)
Welcome to the Party by Gabrielle Union; illustrated by Ashley Evans (English)
Say Hello! by Rachel Isadora (English with a sprinkling of other languages)
Preschool 3-5 YEARS
Be Who You Are! by Todd Parr (English, French)
Round is a Mooncake: A Book of Shapes by Roseanne Thong; iIllustrated by Grace Lin (English)
I Am Enough by Grace Byers; illustrated by Keturah A. Bobo (English)
Hair Love by Matthew A. Cherry; illustrated by Vashti Harrison (English, French)
Marisol McDonald Doesn’t Match by Monica Brown; illustrated by Sara Palacios (English, English-Spanish bilingual)
The Twins’ Blanket by Hyewon Yum (English)
Julian Is a Mermaid by Jessica Love (English, Catalan, Portuguese, Italian, Chinese, Danish, German, Spanish, Finnish, Norwegian, Swedish, French, Japanese, Dutch, Korean)
A Kids Book About Racism by Jelani Memory (English)
And Tango Makes Three by Justin Richardson and Peter Parnell; illustrated by Henry Cole (English, Spanish, Italian, Portuguese, Swedish, Czech, French, Polish, Basque)
Just Because by Rebecca Elliott (English, Russian, Ukranian, Polish)
Lubna and Pebble by Wendy Meddour; illustrated by Daniel Egnéus (English)
Mommy’s Khimar by Jamilah Thompkins-Bigelow; illustrated by Ebony Glenn (English)
You Hold Me Up by Monique Gray Smith; illustrated by Danielle Daniel (English, Cree)
More information
Talking with Children about Climate Change
From: American Academy Pediatrics
Your children may have questions about the changing climate. Many are hearing about or experiencing climate-change-fueled disasters such as wildfires and severe storms.
Climate change affects everyone, but it impacts kids the most. Children are especially vulnerable to environmental health harms since they are still growing and have higher exposure to air, food, and water based on weight.
While the climate crisis can feel like an overwhelming topic, there are healthy ways to talk with kids about it. We can communicate in a way that is honest, hopeful, developmentally appropriate, and action oriented. By helping kids understand the issue of climate change and how it affects their health and futures, we empower them to make a difference.
Toddlers and Young Children (age 1-5)
Toddlers are just beginning to learn about their relationship with the world. It’s a perfect time to introduce them to the joys of nature. Here are some ideas:
- Nature walks. Take walks to show how weather affects nature. Talk about how weather makes the seasons. You can point out bird nests, for example, and talk about how weather influences when and where birds make their nests. Talk about other wild animals and discuss how they all have homes that need protecting.
- Gardening. Pick out fruit, vegetable, or flower seeds to plant in your garden, or herbs to plant in kitchen boxes. Young children can help take care of plants, and get excited seeing something grow from nothing. Talk about how your child needs air to breathe and so do plants and animals. When pollutants get in the air, that affects their health.
- Local focus. Point out local effects of climate change depending on your location. Some areas may be more prone to wildfires, hurricanes and floods, while others may experience longer and more intense heat waves or an increase in illness from mosquitoes and ticks.
School-age Children (age 6-12)
Begin explaining concepts behind climate change in simple scientific terms. Ask what they know and fill in blanks or research it together. NASA has online resources to help parents go through each aspect of climate change.
Make connections
Discuss how personal choices can affect the environment and show respect for nature. Calculate your family’s carbon footprint together and ask them how they suggest lowering it. Examples include:
- Turn lights off after leaving the room.
- Try biking or walking, taking public transit or carpooling, when possible.
- Eat a more plant-forward diet.
Explain how people – including kids – can be powerful forces in protecting the environment. Point out that choices we make can help make our planet, and people, healthier.
Teenagers (age 13-18)
Teens are more aware of how issues may influence all aspects of their lives. Discuss show climate change can affect our economy and society. This can spark scientific curiosity and introduce the idea of civic responsibility.
Relate to recent events
Pick a recent or ongoing event and discuss how climate change might have contributed to the event and its the economic effects. For example:
- Talk about how climate change is causing longer and more severe wildfires in California, resulting in the loss of homes and businesses. Discuss how it is also causing air pollution that forces people indoors. Consider the mental health effects all of this can have on families.
- Explore how climate change doesn’t affect everyone equally, and the ways some communities experience more health risks. Discuss how everyone should have an equal opportunity to clean air and water.
Take action
Encourage your teen to come up with solutions and creative ways to express their ideas. Examples include:
- Use a science class presentation or a school, Scouts, 4-H or other project to educate peers about the need for climate change solutions.
- Form a club at school with other interested classmates and brainstorm how to help your local community.
- Write for local or state newspaper about why teens care about the climate.
- Join a national youth advocacy organization for more inspiration.
- Work together to make changes at home, incorporating your teen’s ideas. Participate in advocacy as a family.
Focus on solutions
Pace your discussions to help prevent stress and anxiety. When disasters such as wildfires and hurricanes happen, be sure to limit your child’s media use to cut down on the amount of distressing footage they see and hear on the news. (See Talking to Children About Tragedies and Other News Events.) Take take nature breaks when possible.
When you talk with your child, stay hopeful and focused on solutions. We have tools to take climate action right now, remind them, and these can have immediate benefits for our health. Even if the climate crisis is accelerating, emphasize that together we can clean up our air and water and reduce our carbon footprint.
Be a role model
Think about ways you can advocate for a healthier environment for children.
- Ask your school district to incorporate a climate curriculum
- Share news of great climate advocacy work with your family
- Reach out to local, state and federal legislators with your family to encourage climate action
Youth leadership
Kids are the next generation of innovators and thinkers. Youth leadership is already making a huge difference. If we nurture a love for the environment early, children may just come up with the best solutions. Don’t be surprised if they teach you something, too, along the way.
Talk with your pediatrician
If you have questions about how climate change can impact your children, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.
More information
11 Common Conditions in Newborns
From American Academy of Pediatrics:
Some physical conditions are common during the first couple of weeks after birth. If you notice any of the following in your baby, contact your pediatrician.
Abdominal distension
Most babies’ bellies normally stick out, especially after a large feeding. Between feedings, however, they should feel soft. If your child’s abdomen feels swollen and hard, and if she has not had a bowel movement for more than one or two days or is vomiting, call your pediatrician. Most likely the problem is due to gas or constipation, but it also could signal a more serious intestinal problem.
Birth injuries
Babies can be injured during birth, especially if labor is long or difficult, or when babies are very large. While newborns recover quickly from some of these injuries, others persist. Occasionally a broken collarbone occurs, which will heal quickly. After a few weeks a small lump may form at the fracture site, but don’t be alarmed; this is a sign that new bone is forming to mend the injury, and it will soon be as good as new.
Muscle weakness is another common birth injury during labor, caused by pressure or stretching of the nerves attached to the muscles. These muscles, usually weakened on one side of the face or one shoulder or arm, generally return to normal after several weeks. In the meantime, ask your pediatrician to show you how to nurse and hold the baby to promote healing.
Blue baby
Babies may have mildly blue or purple hands and feet, which is usually normal. If their hands and feet turn slightly blue from cold, they should return to pink as soon as they are warm. Occasionally the face, tongue, and lips may turn a little blue when the newborn is crying hard, but once she is calm, her color should quickly return to normal. However, persistently blue skin coloring is a sign the heart or lungs are not operating properly. and the baby is not getting enough oxygen in the blood. Immediate medical attention is essential.
Unusual bowel movements
Meconium. After birth, the staff will watch for your baby’s first urination and bowel movement to make sure she has no problem with these important tasks. It may be delayed twenty-four hours or more. The first bowel movement or two will be black or dark green and very slimy. It is meconium, a substance that fills the infant’s intestines before she is born. If your baby does not pass meconium in the first forty-eight hours, further evaluation is required to make sure that no problems exist in the lower bowel.
Blood in stool. On occasion, newborns have a little blood in their bowel movements. If it occurs during the first few days, it usually means the infant has a little crack in the anus from stooling. This is generally harmless, but even so, let your pediatrician know about any signs of blood to confirm the reason, since there are other causes that require further evaluation and treatment.
Coughing
If the baby drinks very fast, she may cough and sputter; but this type of coughing should stop as soon as her feeding routine becomes familiar. This may also be related to how strongly or fast a breastfeeding mom’s milk comes down. If she coughs persistently or routinely gags during feedings, consult the pediatrician. These symptoms could indicate an underlying problem in the lungs or digestive tract.
Excessive crying
All newborns cry, often for no apparent reason. If you’ve made sure that your baby is fed, burped, warm, and dressed in a clean diaper, the best tactic is probably to hold her and talk or sing to her until she stops. You cannot spoil a baby this age by giving her too much attention. If this doesn’t work, wrap her snugly in a blanket or try some other ways that may help calm your baby.
You’ll become accustomed to your baby’s patterns of crying. If it ever sounds peculiar—such as shrieks of pain—or if it persists for an unusual length of time, it could mean a medical problem. Call the pediatrician and ask for advice.
Forceps marks
When forceps are used during delivery, they can leave red marks or even superficial scrapes on a newborn’s face and head. These generally disappear within a few days. Sometimes a firm, flat lump develops in one of these areas because of minor damage to the tissue under the skin, but this, too, will usually go away within two months.
Jaundice
Many normal, healthy newborns have a yellowish tinge to their skin, which is known as jaundice. It is caused by a buildup of bilirubin in the child’s blood. Mild jaundice is harmless. However, if the bilirubin level continues to rise and is not treated, it can lead to brain injury. Jaundice tends to be more common in breastfed newborns, most often in those not nursing well; breastfeeding mothers should nurse at least eight to twelve times per day, which will produce enough milk and keep bilirubin levels low.
Jaundice first appears on the face, then the chest and abdomen, and finally the arms and legs in some instances. The whites of the eyes may also be yellow. Most hospitals now routinely screen newborns for jaundice twenty-four hours after birth using a painless handheld light meter. If the pediatrician suspects jaundice may be present—based on skin color as well as the baby’s age and other factors—she may order a skin or blood test to definitively diagnose the condition. If jaundice develops before the baby is twenty-four hours old, a bilirubin test is always needed to make an accurate diagnosis. If you notice a sudden increase in jaundice when your baby is at home, contact your pediatrician.
Lethargy & sleepiness
Every newborn spends most of her time sleeping. As long as she wakes every few hours, eats well, seems content, and is alert part of the day, it’s perfectly normal to sleep the rest of the time. But if she’s rarely alert, does not wake up on her own for feedings, or seems too tired or uninterested to eat, you should consult your pediatrician. This lethargy—especially if it’s a sudden change in her usual pattern—may be a symptom of a serious illness.
Respiratory distress
It may take your baby a few hours after birth to form a normal breathing pattern, but then she should have no further difficulties. If she seems to be breathing in an unusual manner, it is most often due to blocked nasal passages. Using saline nasal drops, followed by suctioning the mucus from the nose with a bulb syringe, may fix the problem; both are available over the counter.
However, if your newborn shows any of the following warning signs, notify your pediatrician immediately:
- Fast breathing (more than sixty breaths in one minute), although keep in mind that babies normally breathe more rapidly than adults
- Retractions (sucking in the muscles between the ribs with each breath, so that her ribs stick out)
- Flaring of her nose
- Grunting while breathing
- Persistent blue skin coloring
Umbilical cord problems
Umbilical stump bleeding. As you’re caring for your baby’s umbilical cord, you may notice a few drops of blood on the diaper around the time the stump falls off. This is normal. But if the cord actively bleeds, call your baby’s doctor immediately. If the stump becomes infected, it will require medical treatment. Although cord infections are uncommon, you should contact your doctor if you notice any of the following:
- Foul-smelling yellowish discharge from the cord
- Red skin around the base of the cord
- Crying when you touch the cord or the skin next to it
Umbilical granuloma. Sometimes instead of completely drying, the cord will form a granuloma or a small, reddened mass of scar tissue that stays on the belly button after the umbilical cord has fallen off. This granuloma will drain a light-yellowish fluid. This condition will usually go away in about a week, but if not, your pediatrician may need to burn off (cauterize) the granulomatous tissue.
Umbilical hernia. If your baby’s umbilical cord area seems to push outward when she cries, she may have an umbilical hernia—a small hole in the muscular part of the abdominal wall that allows the tissue to bulge out when there is increased abdominal pressure (i.e., crying). This is not a serious condition, and it usually heals by itself in the first twelve to eighteen months. (For unknown reasons it often takes longer to heal in African American babies.) In the unlikely event it doesn’t heal by three to five years of age, the hole may need surgery. Don’t put tape or a coin on the navel. It will not help the hernia, and it may cause a skin rash.
Are holiday gatherings OK during the COVID-19 pandemic?
From American Academy of Pediatrics:
For many families, the holidays are about getting together with relatives and friends. But as the COVID-19 pandemic continues, gatherings with people outside your household continue to be risky this holiday season. Public health experts say that small household gatherings are some of the main ways COVID-19 cases spread so much again this fall.
With some extra planning and lower risk activities, though, your family can create lasting memories while lowering the risk of being exposed to or spreading COVID-19. Here are some tips I’m sharing with families in my practice this year:
- Celebrate with members of your own household. Limit any in-person celebration to people you live with. Cooking with your children and decorating your home are great ways to enjoy each other’s company while protecting your family and others from COVID-19.
- Find creative ways to share the experience remotely. Prepare a favorite recipe with extended family over video chat. Share what you are grateful for or light candles together virtually at the start of the holiday meal. Set up a group video call to sing songs, play instruments, share stories, open gifts together or count down to the New Year together.
- Consider a drop-off treat exchange. Another way to share the holiday spirit is to prepare cookies or other special holiday treats for family and neighbors. Instead of exchanging them in person, delight them with a doorstep drop-off.
- Shop online and help elderly or higher-risk loved ones. Do any grocery or gift shopping online with delivery and curbside pickup options, if possible. Consider holiday food deliveries to elderly relatives. If you need to shop in person, go when stores are not as busy.
| Tips for a virtual holiday gathering with grandparentsWith so many families turning to video conferencing platforms for their celebrations this year, the American Speech-Language-Hearing Association recommends finding different ways to communicate for older adults who may have difficulty hearing. Try using closed captioning or a larger screen, and make sure that they are closer to the computer and speakers to better hear and see facial expressions. Limit side conversations to give everyone a chance to speak and be heard. |
|---|
If you do have an in-person get-together…
Make sure everyone understands that gatherings with people outside your household can be risky. Here are some ways to help make them safer:
- Keep the gathering small and short. Keep your guest list as small as possible and reduce the amount of time you would usually visit.
- Wear cloth face coverings and keep your distance. People who live together can sit together, but arrange for those from different households to stay at least 6 feet apart—especially while eating. Remind everyone to wear cloth face coverings when they’re not eating.
- Open windows and stay outside when possible. Open windows for better ventilation. If weather permits, gather outdoors. Stay a safe distance apart from others and wear cloth face coverings with multiple layers or medical masks, even outside.
- Safer serving. Avoid buffet or family-style dinners and choose one person do the serving or get individual meals if ordering out. Remind children to wash hands often, and keep hand sanitizer within reach.
- Take safety steps beforehand. For two weeks before the gathering, remind guests to follow steps that lower the risk of COVID transmission. This includes wearing cloth face coverings, physical distancing, and limiting outings and social gatherings as much as possible. Consider offering your guests a “self-screening” checklist and ask them to join you virtually if they realize they are at higher risk of exposing the group to COVID-19.
- Safer travels. Guests traveling for the get-together should drive with family members in a private vehicle, if possible, and wear masks at gas stations and rest stops. Anyone who has to fly should be extra careful around groups clustered near security lines and concourses, wear masks in airports and on planes, and hang back until lines have thinned.
Remember
Do not host or participate in any in-person festivities if you or anyone in your household has been diagnosed with COVID-19 and is still at risk of spreading it to others; has had any symptoms of COVID-19 within 48 hours of the gathering; is waiting for viral test results; could have been exposed to someone in the last 14 days; or is at high risk.
Stay safe this holiday season and your family will be even more grateful for your traditions in the years to come.
Breastfeeding During the COVID-19 Pandemic
From American Academy of Pediatrics:
Breastfeeding can offer many perks, especially during the COVID-19 pandemic. You can even breastfeed if you test positive for COVID-19 or are not fully vaccinated, as long as you take extra safety precautions to protect your baby.
Benefits of breastfeeding during a pandemic
- Breastfeeding is good for babies. It protects them from many infections. It is not proven that breastmilk protects babies from SARS-CoV-2, the virus that causes COVID-19. However, several studies have found antibodies that target the virus in human milk. In addition, breastfed infants are generally less likely to have severe respiratory symptoms when they get sick.
- Breastfeeding is good for moms. Hormones released in the mother’s body during breastfeeding promote wellness and can relieve stress and anxiety.
- Breast milk is readily available. No purchase necessary! This can be important during public health emergencies, when it can be more challenging to buy formula and other feeding supplies.
Do I need to take extra precautions while breastfeeding if I’m vaccinated against COVID?
If you’re fully vaccinated against COVID-19, you do not need to take any special precautions when feeding your baby at the breast or expressing milk. However, if you have symptoms of COVID or have had close contact with someone who has the illness, the U.S. Centers for Disease Control and Prevention (CDC) recommends wearing a mask.
Can I get vaccinated while breastfeeding?
COVID-19 vaccines are considered safe for breastfeeding mothers and babies. Many lactating people have received the COVID-19 vaccine. Recent studies demonstrated COVID-19 mRNA vaccine antibodies in the breastmilk of vaccinated lactating mothers, which can potentially pass along protection to the breastfed infant. More studies are needed to determine how these antibodies protect the baby.
What if I am not fully vaccinated and want to breastfeed my baby?
SARS-CoV-2 (the virus that causes COVID-19 disease) spreads during close contact between people when an infected person coughs, sneezes, or talks. People without symptoms of or confirmed COVID-19, who have not been in close contact with someone with COVID, do not need to take special precautions. So far infectious SARS-CoV-2 virus has not been found in breastmilk. Breastfeeding has been shown to be safe when a mom has other viral illnesses like influenza.
How can I keep my baby safe while breastfeeding if I have COVID-19?
Yes, babies can still receive breast milk even if you test positive for COVID-19. The breast milk is safe and important for the baby.
- Direct breastfeeding. Wash your hands with soap and water before holding the baby and wear a face mask while nursing. Holding your baby skin-to-skin helps the baby latch on and helps trigger milk release.
- Pumping breast milk. Put on a face mask, wash your hands well, and clean any pump parts, bottles, and artificial nipples. Express milk as often as your baby eats, or at least 6 to 8 times per 24 hours. The expressed milk can be fed to your baby by a healthy caregiver. Remind all caregivers to wash their hands well before touching bottles, feeding, or caring for your baby. Remember to clean your breast pump after each use, following CDC guidelines.
If I have COVID-19, can I stay in the same room with my infant?
If you and your family decide to keep your baby in the same room as you, try to keep a reasonable distance away when possible. Wear a face mask and wash your hands whenever you directly care for your baby.
Continue taking these precautions until you have been fever-free for 24 hours without taking any fever medicines (acetaminophen or ibuprofen); at least 10 days have passed since your COVID-19 symptoms first started; and all your symptoms have improved. If you tested positive but have no symptoms, wait until at least 10 days after the positive test result.
How can I maintain my milk supply if I am sick with COVID-19?
Hand pumping and hand expressing breast milk is especially helpful in the first few days after your baby is born to get the milk supply going. Frequent pumping (or breastfeeding if you have chosen to directly breastfeed and are following the strict precautions noted above) should line up with your infant’s feeding demands, about 8-10 times in a 24-hour period.
Most medications are safe to take while breastfeeding, but always check with your doctor. While this may be a stressful time, try to stay optimistic and practice healthy habits to reduce stress as much as possible. This includes getting enough sleep, eating plenty of healthy foods, and getting regular exercise.
Ask your pediatrician for help with getting your baby to latch on again once you can restart breastfeeding. Do not hesitate to ask for help if you have trouble with feeding, nipple pain, low milk supply, or with any other concerns.Your pediatrician is here to help
After leaving the hospital, it is important that your baby’s first follow-up visit happen within 1-2 days in person so your baby can be examined, measured, and weighed. Many doctors are scheduling newborn visits during specific times (such as first thing in the morning) to limit exposure to sick patients. Your pediatrician also can help if you need more breastfeeding support, a lactation consultant, or help from local groups and resources.
Remember
The best way to protect your baby is to get the COVID-19 vaccine. If you aren’t fully vaccinated or test positive for COVID, it is still a good idea to breastfeed your baby if you can. Just be sure to take steps to minimize COVID-19 infection. Talk with your pediatrician about how to keep your baby healthy and what resources might be available in your community to help you.
More Information
- Breastfeeding Benefits Your Baby’s Immune System
- The Science Behind COVID-19 Vaccines
- First Droplets –Hand expression instructions and teaching importance of the first hour of life.
- Office of Women’s Health National Women’s Health and Breastfeeding Helpline – 1-800-994-9662 (leave message 9am – 6pm ET)
- La Leche League International (LLLI) – 1-877-4-LALECHE (1-877-452-5324)(messages will be returned by an LLL Leader in 24-48 hours)
- LactMed (National Library of Medicine) – A great resource and a free online database/mobile app with the most up-to-date information on which medications are safe for breastfeeding mothers.
Food Allergy Reactions
From American Academy of Pediatrics:
How do I know if my child has a food allergy?
A food allergy happens when the body reacts against harmless proteins found in foods. The reaction usually happens shortly after a food is eaten. Food allergy reactions can vary from mild to severe. Because there are many things that can be confused with food allergies, it is important for parents to know the difference.
Symptoms of A Food Allergy
- Skin problems
- Hives (red spots that look like mosquito bites)
- Itchy skin rashes (eczema, also called atopic dermatitis)
- Swelling
- Breathing problems
- Sneezing
- Wheezing
- Throat tightness
- Stomach symptoms
- Nausea
- Vomiting
- Diarrhea
- Circulation symptoms
- Pale skin
- Light-headedness
- Loss of consciousness
If several areas of the body are affected, the reaction may be severe or even life-threatening. This type of allergic reaction is called anaphylaxis and requires immediate medical attention.
Not A Food Allergy
Food can cause many illnesses that are sometimes confused with food allergies. The following are not food allergies:
- Food poisoning—Can cause diarrhea or vomiting, but is usually caused by bacteria in spoiled food or undercooked food.
- Drug effects—Certain ingredients, such as caffeine in soda or candy, can make your child shaky or restless.
- Skin irritation—Can often be caused by acids found in such foods as orange juice or tomato products.
- Diarrhea—Can occur in small children from too much sugar, such as from fruit juices.
Some food-related illnesses are called intolerance, or a food sensitivity, rather than an allergy because the immune system is not causing the problem. Lactose intolerance is an example of a food intolerance that is often confused with a food allergy. Lactose intolerance is when a person has trouble digesting milk sugar, called lactose, leading to stomachaches, bloating, and loose stools.
Sometimes reactions to the chemicals added to foods, such as dyes or preservatives, are mistaken for a food allergy. However, while some people may be sensitive to certain food additives, it is rare to be allergic to them.
Foods That Can Cause Food Allergies
Any food could cause a food allergy, but most food allergies are caused by the following:
- Cow milk
- Eggs
- Peanuts
- Soy
- Wheat
- Nuts from trees (such as walnuts, pistachios, pecans, cashews)
- Fish (such as tuna, salmon, cod)
- Shellfish (such as shrimp, lobster)
- Peanuts, nuts, and seafood are the most common causes of severe reactions. Allergies also occur to other foods such as meats, fruits, vegetables, grains, and seeds such as sesame.
The good news is that food allergies are often outgrown during early childhood. It is estimated that 80% to 90% of egg, milk, wheat, and soy allergies go away by age 5 years. Some allergies are more persistent. For example, 1 in 5 young children will outgrow a peanut allergy and fewer will outgrow allergies to nuts or seafood. Your pediatrician or allergist can perform tests to track your child’s food allergies and watch to see if they are going away.