Dr. Todd Harris

World Read Aloud Day 2017

Written by Dr. Todd Harris

litworldwrad17calendar copy

February 16, 2017 – “What can I do to help my child’s development?”

As pediatricians, we get asked this question about everyday.

Aside from the obvious – the things I categorize as “the stuff that comes naturally” – like providing appropriate shelter, nutrition and attention for your child – there is one thing that has shown to have a tremendous developmental upside. 

It is not ‘the latest thing’ – the answer does not involve anything electronic. It doesn’t need to be plugged in or charged. It requires no data plan.

The thing that can have a most profound affect is reading out loud to your child.

Technological advancement has not been able to duplicate the the incredibly positive impact of reading to your child.

It is never too early or too late to get started as long as you do it today.
Today is World Read Aloud Day – one of those few days without its own Hallmark card – a day that exists to promote awareness that giving our children all the advantages is within our grasp.

So long as that grasp is used to take hold of a book, open it, and read aloud.

For more details about World Read Aloud Day, check out the LitWorld website.

 

 


Dr. Todd Harris

From the AAP: Updated Safe Sleep Guidance

Written by Dr. Todd Harris

January 12, 2017 – Recently, the American Academy of Pediatrics (AAP) came out with some updated and expanded safe sleep recommendations.

They list 19 recommendations for a safe infant sleeping environment and it is definitely worth taking a look at the details.

The 19 recommendations for a safer infant sleep environment:

  • Small detail: The 19 recommendations are listed with their strength of recommendation at the bottom of this post
  • Some detail:  A listing that includes brief explanations is found here.
  • More detail: The official AAP policy statement is found here.
  • Lots of detail: The AAP technical report is found here.

What your pediatricians at RCAM think about these new safe sleep recommendations:

1. New recommendations reflect the best information available now

First of all, we don’t shy away from new recommendations. Not at all. That is one of the strengths of medicine.

We know that we don’t know everything, and there is a vast and constant pursuit of better information. When more complete, up-to-date knowledge about how to keep our children healthy comes available, we want to incorporate it into what we do.

That is why it is okay that we sometimes hear grandmothers say, “That’s not what I was told when you were a baby.

Medicine strives to recommend based on the best information available now.

2. Old habits are sometimes hard to kick

It has taken us a few months to comment as a practice because these 19 recommendations include some real game changers.

For example, consider #4 below: “Room-sharing with the infant on a separate sleep surface is recommended” (for the first 6-12 months).

As a practice, we have generally agreed that establishing a healthy, through-the-night sleep pattern is greatly aided by the move of your infant into a separate room. But, some studies have shown a 50% reduction in the incidence of Sudden Infant Death Syndrome (SIDS) in infants who room-shared (not bed-shared) for the first 6-12 months. That is what I mean by a game changer.

There are 19 recommendations. No one will be perfect and follow all of them 100% of the time for the first 12 months of life (if your child has ever fallen asleep in their car seat and you didn’t as quickly as possible move them to a firm, flat surface, then you haven’t followed all the recommendations all the time).

However, it is important that we assess what we do and change our habits to be as safe as we can with out most valued members of society – our children.

3. Some old habits do not need to change

Back to sleep for every sleep is still very important for a safe infant sleep environment.

Summary of Recommendations With Strength of Recommendation

The list below comes from the AAP (link). The linked article provides more information along with references with each recommendation. The recommendations are grouped based on the Strength-of-Recommendation Taxonomy (SORT) for the assignment of letter grades to each of its recommendations (A, B, or C).

A-level recommendations (Level A: There is good-quality patient-oriented evidence.)

  1. Back to sleep for every sleep
  2. Use a firm sleep surface
  3. Breastfeeding is recommended
  4. Room-sharing with the infant on a separate sleep surface is recommended
  5. Keep soft objects and loose bedding away from the infant’s sleep area
  6. Consider offering a pacifier at naptime and bedtime
  7. Avoid smoke exposure during pregnancy and after birth
  8. Avoid alcohol and illicit drug use during pregnancy and after birth
  9. Avoid overheating
  10. Pregnant women should seek and obtain regular prenatal care
  11. Infants should be immunized in accordance with AAP and CDC recommendations
  12. Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS
  13. Health care providers, staff in newborn nurseries and NICUs, and child care providers should endorse and model the SIDS risk-reduction recommendations from birth
  14. Media and manufacturers should follow safe sleep guidelines in their messaging and advertising
  15. Continue the “Safe to Sleep” campaign, focusing on ways to reduce the risk of all sleep-related infant deaths, including SIDS, suffocation, and other unintentional deaths. Pediatricians and other primary care providers should actively participate in this campaign

B-level recommendations (Level B: There is inconsistent or limited-quality patient-oriented evidence.)

  1. Avoid the use of commercial devices that are inconsistent with safe sleep recommendations
  2. Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly

C-level recommendations (Level C: The recommendation is based on consensus, disease-oriented evidence, usual practice, expert opinion, or case series for studies of diagnosis, treatment, prevention, or screening.)

  1. Continue research and surveillance on the risk factors, causes, and pathophysiologic mechanisms of SIDS and other sleep-related infant deaths, with the ultimate goal of eliminating these deaths entirely
  2. There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS

Note: “patient-oriented evidence” measures outcomes that matter to patients: morbidity, mortality, symptom improvement, cost reduction, and quality of life; “disease-oriented evidence” measures immediate, physiologic, or surrogate end points that may or may not reflect improvements in patient outcomes (eg, blood pressure, blood chemistry, physiologic function, pathologic findings). CDC, Centers for Disease Control and Prevention.


Dr. Todd Harris

UPDATE: Warmer Weather, Normal Schedule

Written by Dr. Todd Harris

IMG_2722.JPG

January 10, 2017 – Hopefully, our last weather-related announcement for awhile:

Both RCAM offices will be opening ON TIME tomorrow morning.

DON’T FORGET: We open an hour later typically on Wednesday so opening normally will mean Walk-In arrival time at our Duraleigh Office is 9:00 to 9:30am (as opposed to 8:00-8:30am on all other weekdays).


Dr. Todd Harris

Image result for interesting picture

January 9, 2017 – I’m a little tired of pictures of snow, ice or delays, so here is a picture that to me is a wonderful model for the times we live in.

Tuesday will operate similar to today with a not quite as delayed opening schedule:

On Tuesday BOTH the Duraleigh and Brier Creek Offices will delay their openings until 10:30am.

  1. There will be no walk in appointments on Tuesday.
  2. Our answering service will be taking calls until 10:30am. Please call before 10:30am ONLY IF you have an urgent medical need.
  3. Our Front Desk will begin picking up the phones in our office at 10:30am.
  4. If you had a previously-scheduled appointment before 10:30am, we will have to reschedule your visit.
  5. If you had a previously-scheduled afternoon appointment for 10:30am or later, we will plan to see you for that appointment.
  6. Our On Call Evening Clinic will be cut short.

The upcoming weather should support us opening up like normal on Wednesday. Thank you again for your patience.


Dr. Todd Harris

UPDATE: Delayed Opening Planned for Monday

Written by Dr. Todd Harris

delayed-opening

January 8, 2017 – Another weather-related update – this one pertains to Monday’s schedule:

On Monday BOTH the Duraleigh and Brier Creek Offices will delay their openings until noon.

  1. There will be no walk in appointments on Monday.
  2. Our answering service will be taking calls until 11:30am. Please call before 11:30am ONLY IF you have an urgent medical need.
  3. Our Front Desk will begin picking up the phones in our office at 11:30am.
  4. If you had a previously-scheduled appointment before noon, we will have to reschedule your visit.
  5. If you had a previously-scheduled afternoon appointment, we will plan to see you for that appointment.
  6. Our On Call Evening Clinic will likely be cut short.

Thanks you for your patience. Stay warm and safe! This one seems a bit more slippery than other winter storms.


Dr. Todd Harris

icy

January 8, 2017 – Our customary, post-snow, 60-degree weather did not happen yesterday. Instead, it got real cold.

As a result, we cannot safely staff our Sunday On Call Clinic and so it has been cancelled.

Stay tuned for news about tomorrow

  • As always, if you have a concern about your child’s health, we want to hear from you.
  • We will be available by phone for any urgent concerns.

After Hours Care

  • Our On Call Pediatrician manages our after hours care.
  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222

Dr. Todd Harris

January 7, 2017 – Well – this morning when I awoke and saw the sheen of ice surrounding my home – I immediately thought of this scene from the movie “Madagascar” when the penguins finally reach their much-longed-for homeland of Antarctica.

RCAM has cancelled Saturday clinic due to icy conditions. We will be available for phone calls if you have an urgent need relating to your child’s health.

Stay tuned for news about Sunday’s clinic. If we are unable to safely staff the office again tomorrow, we will update with another announcement.

By the way, I highly recommend “Madagascar” if your whole family is stuck in the house and looking for something to do – if offers something for all ages.


Dr. Todd Harris

RCAM is a BC BS Blue Value Provider

Written by Dr. Todd Harris

ampersand

January 5, 2017 – Now why would an ampersand be pictured above this post?

It’s one of those frustrating stories that is also a bit funny if you want it to be.

Let me make this point first:

RCAM would like to make it clear to those with Blue Cross Blue Shield Blue Value Health Insurance – Raleigh Children & Adolescents Medicine continues as a provider for 2017.

That brings us to the large ampersand pictured above.

When you are searching for us among providers, be sure to search our name as written above – Raleigh Children & Adolescents Medicine – using the ampersand (“&”) symbol and NOT using the word (“and”).

It seems you will not find us without keying in our name that includes the ampersand (“&”).

You could see how that could be frustrating. And – when you consider how sometimes tiny details become very important – it is a little bit amusing.

Don’t forget the ampersand.

 

BCBS Blue Value


Dr. Todd Harris

Banner Change: Winter Edition

Written by Dr. Todd Harris

2016-winter

January 1, 2017 – A common New Year’s Resolution revolves around getting “caught up.”

In that spirit, I would like to announce the arrival of our new winter-themed banner (from last week). Such mild weather – snow seems like a reach but we can always hope.

Here is a 5-word summary from the Farmer’s Almanac for winter weather in our region (I really don’t like the phrase “penetrating cold” though I am sure we could use the “very wet” weather):

winter-outlook

A few winter notes:

  • We still have flu vaccine available for everyone under 36 months old and for patients 3 years and older who receive state flu vaccine (includes those with Medicaid insurance)
  • Winter Safety tips from the American Academy of Pediatrics here.
  • Remember that tomorrow – Monday, January 2nd – our office will be closed for routine business in observance of the New Year’s Day holiday. Look here for details about office coverage if you have a concern about your child.

Dr. Lily Harris

2017-year

RCAM New Year On Call Pediatricians:

Patients are seen by appointment only

  • If you think your child may need to be seen this Saturday, Sunday or Monday call 919-781-7490 in the morning after 9 am and speak to the nurse working with the On Call Pediatrician
  • On the weekends and holidays, we see patients in the office in the morning and are available to speak anytime by phone about any urgent concerns you may have.
  • There are no walk-in appointments on weekends and on holidays

After Hours Care

  • Our On Call Pediatrician manages our after hours care.
  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222