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TRANSCRIPT
9 MONTH OLDThe Mobile Phase
Proactive in your child’s care.
Empowering families for over 50 years.
Please take the time to read through this material. We provide this information because
we see value in educating our patients.
Mansfield Office454 Chauncy StreetMansfield, MA 02048
(508) 339-9944
Westwood Office541 High Street
Westwood, MA 02090(781) 326-7700
www.wmpeds.com
VIDEOS
Let us help you be proactive and educated
in your child’s care!These following videos are just a few that we feel may help you and
your child at this specific age. Please view our website at
www.wmpeds.com for these and many more.
9 Months
Fever
Ear Infections – including information on Swimmer’s Ear
Rashes – information on a Basic Rash, Diaper Rash, Fifth Disease,
Hand - Foot and Mouth Disease and also Hives
Cough/Croup – information on when to worry and a demonstration
on Croup and Stridor
Vomiting and Diarrhea
Colds
Mansfield Office454 Chauncy StreetMansfield, MA 02048
(508) 339-9944
Westwood Office541 High Street
Westwood, MA 02090(781) 326-7700
www.wmpeds.com
9 Month Visit: Immunizations
Your child is due to receive the following screening tests at this visit:
Hgb (Hemoglobin Screen)
Lead (Lead Screen)
Your child is due to receive the following immunizations at this visit:
NONE
In addition, we strongly recommend that all patients 6 months of age
and older receive an annual Influenza (flu) vaccine.
Please review the enclosed Vaccine Information Sheets (VISs) prior to
your visit for more information.
For our complete immunization schedule:
wmpeds.com/immunizationschedule
Mansfield Office454 Chauncy StreetMansfield, MA 02048
(508) 339-9944
Westwood Office541 High Street
Westwood, MA 02090(781) 326-7700
www.wmpeds.com
Healthy Parents, Healthy Kids
“Example is not just one way to effect change, it is the only way.”
Dr. Albert Schweitzer
Children learn by watching their parents and caregivers. This is how they learn to talk and
how they learn manners, as well as how they learn to eat. The eating “culture” in a baby’s
house has a very strong influence on how that child grows and matures as an eater.
Having a baby who is learning how to eat is a great opportunity for each family member to
evaluate his or her own eating habits and to think about making healthy changes. While it
can be very difficult for us to change our habits, hopefully your baby can help motivate you to
become healthier!
Some of the most important changes many people can make include:
1) making a conscious effort to increase the amount of vegetables and fruits on your
grocery list
- “strive for five” servings of fruits and vegetables daily
- studies show that you have to introduce a new food up to 30 times before a
child will try it; be persistent and patient
- have fruits and vegetables at all meals, even breakfast; think outside of the box
2) reducing the processed foods (hot dogs, pizza, chicken nuggets, etc…) in your home
- processed foods are often a major calorie source for babies by the time they
turn 1 year of age
3) minimizing soft drinks and juice – less is more
- soft drinks and juice are very high in sugar and very low in nutrition
- sugared drinks are bad for your baby’s teeth and are leading causes of obesity
4) paying attention to portions – beware of “Supersizing”
- we have lost our sense of what is a normal sized portion; what was considered
a large portion twenty years ago is now considered a small portion
- use regular size or small plates (and not large plates) to control portion size
For some simple and easy to follow suggestions on how to approach healthy eating, we
strongly recommend the book “Food Rules” by Michael Pollan.
Mansfield Office454 Chauncy StreetMansfield, MA 02048
(508) 339-9944
Westwood Office541 High Street
Westwood, MA 02090(781) 326-7700
www.wmpeds.com
Developmental Poetry by Dr. Hartman
Croup: The Fears
Is it a dog?Is it a seal?
No, it’s my feverish child!
It makes my sleepy mind run wild!
Is it pneumonia, asthma, or bronchitis?
I did hear her with a little laryngitis!
Is that wheezing I hear?
Her throat could close up, I fear!
-Dr. Hartman
Croup: The Facts
Croup is caused by a virus that inflames the windpipe. It is most common in children under
the age of five. The symptoms of croup include fever and barky cough. Croup is almost always
worse in the middle of the night.
Although the symptoms of croup can be frightening, it is almost always a mild illness. While
about 6% of children under age five will contract croup, only 0.4% of children will behospitalized. Croup is a self-resolving illness. The nighttime cough and fever can last for 1-3
days, and a mild daytime cough may last for up to 10 days.
Croup: The Plan
Croup can often be treated at home without medications. If the croupy cough is persistent,
croup can be treated with a one day course of Orapred (prednisolone), an oral steroid.
Orapred decreases the swelling in the windpipe and quiets the barky cough of croup.
If your child comes down with croup this season, please refer to our “Nighttime Croup Attack
Plan”. As always, please contact us with any questions!
By: Dr. Hartman
Follow Dr. Hartman on Twitter @DrHartmanWMPEDS
Mansfield Office454 Chauncy StreetMansfield, MA 02048
(508) 339-9944
Westwood Office541 High Street
Westwood, MA 02090(781) 326-7700
www.wmpeds.com
Nighttime Croup Attack Plan
Please follow this plan in the event that your child awakes in the night with a fever and a
barky cough.
1) If your child is under six months old, call the office. If your child is drooling unusually, is
difficult to wake up, or if his/her lips, hands or feet are blue, call 911 and then follow
steps 2 and 3 below.
2) Take your child into a warm steamy bathroom for 10 minutes.
3) If the cough does not clear, take your child into the cold night air or open a freezer door to
breathe the cold air for 10 minutes.
4) If the cough clears, consider running a humidifier in the room or opening the bedroom
window. If your child sleeps in a bed, you may want to prop him/her up on extra pillows.
5) If your child still has the barky cough or stridor (a wheezy sound made when they breathe in),
give your child a dose of Orapred according to the dosing table (see next page). Continue to
use the steamy bathroom or cold air therapy. The Orapred takes about two hours to work.
6) CALL THE OFFICE IMMEDIATELY IF THIS PLAN DOES NOT WORK.
7) Contact our office in the morning if you use the Orapred.
a. It is important for us to document this in the child’s medical chart.
b. Please contact us by phone or through the patient portal.
8) AS ALWAYS, PLEASE CALL US AT ANY TIME WITH YOUR CONCERNS.
Orapred (prednisolone) dosing table for croup
Child's Weight (Pounds) Dose (teaspoons)
15 lbs ½ teaspoon twice a day for one day
20 lbs ½ teaspoon twice a day for one day
25 lbs ¾ teaspoon twice a day for one day
30 lbs 1 teaspoon twice a day for one day
35 lbs 1 teaspoon twice a day for one day
40 lbs 1 ¼ teaspoons twice a day for one day
45 lbs 1 ¼ teaspoons twice a day for one day
50 lbs 1 ½ teaspoons twice a day for one day
55 lbs 1 ½ teaspoons twice a day for one day
60 lbs 1 ¾ teaspoons twice a day for one day
This dose should be given twice a day for one day.
Contact our office in the morning if you use the Orapred.
a. It is important for us to document this in the child’s medical chart.
b. Please contact us by phone or through the patient portal.
ChooseMyPlThe website featurtips to help Americ
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food, but eat less.
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meals—and choose foods with lowernumbers.
Drink water instead of sugary drinks.
ChooseMyPlate.gov1 includes much of theconsumer and professional informationformerly found on MyPyramid.gov.
Also on the web Sample Menus for a Week
Food Group Based Recipes
Historical Development of FoodGuidance
Nutrition Communicators Network forPartners – Application Forms
All print-ready content
Skin WoundSMake sure the child is up to date for tetanus vaccination. Any open wound may need a tetanus booster even when the child is currently immunized. If the child has an open wound, ask the pediatrician if the child needs a tetanus booster.
Bruises Apply cool compresses. Call the pediatrician if the child has a crush injury, large bruises, continued pain, or swelling. The pediatrician may recommend acetaminophen for pain.
Cuts Rinse small cuts with water until clean. Use direct pressure with a clean cloth to stop bleeding and hold in place for 1 to 2 minutes. If the cut is not deep, apply an antibiotic ointment, then cover the cut with a clean bandage. Call the pediatrician or seek emergency care for large or deep cuts, or if the wound is wide open. For major bleeding, call for help (911 or an emergency num-ber). Continue direct pressure with a clean cloth until help arrives.
Scrapes Rinse with clean, running tap water for at least 5 min-utes to remove dirt and germs. Do not use detergents, alcohol, or peroxide. Apply an antibiotic ointment and a bandage that will not stick to the wound.
Splinters Remove small splinters with tweezers, then wash until clean. If you cannot remove the splinter completely, call the pediatrician.
Puncture Wounds Do not remove large objects (such as a knife or stick) from a wound. Call for help (911 or an emergency number). Such objects must be removed by a doctor. Call the pediatrician for all puncture wounds. The child may need a tetanus booster.
Bleeding� Apply pressure with gauze over the bleeding area for 1 to 2 minutes. If still bleeding, add more gauze and apply pressure for another 5 minutes. You can also wrap an elastic bandage firmly over gauze and apply pressure. If bleeding continues, call for help (911 or an emergency number).
EyE injuriESIf anything is splashed in the eye, flush gently with water for at
least 15 minutes. Call Poison Help (1-800-222-1222) or the pediatrician for further advice. Any injured or
painful eye should be seen by a doctor. Do NOT touch or rub an injured eye. Do NOT apply medi-cine. Do NOT remove objects stuck in the eye.
Cover the painful or injured eye with a paper cup or eye shield until you can get medical help.
FracturES and SprainSIf an injured area is painful, swollen, or deformed, or if motion causes pain, wrap it in a towel or soft cloth and make a splint with cardboard or other firm material to hold the arm or leg in place. Do not try to straighten. Apply ice or a cool compress wrapped in thin cloth for not more than 20 minutes. Call the pediatrician or seek emergency care. If there is a break in the skin near the fracture or if you can see the bone, cover the area with a clean bandage, make a splint as described above, and seek emergency care.
If the foot or hand below the injured part is cold or discolored (blue or pale), seek emergency care right away.
BurnS and ScaldSGeneral Treatment First, stop the burning process by removing the child from contact with hot water or a hot object (for example, hot iron). If clothing is burn-ing, smother flames. Remove clothing unless it is firmly stuck to the skin. Run cool water over burned skin until the pain stops. Do not apply ice, butter, grease, medi-cine, or ointment.
Burns With Blisters Do not break the blisters. Ask the pediatrician how to cover the burn. For burns on the face, hands, feet, or genitals, seek emergency care.
Larg�e or Deep Burns Call 911 or an emergency number. After stopping and cooling the burn, keep the child warm with a clean sheet covered with a blanket until help arrives.
Electrical Burns Disconnect electrical power. If the child is still in contact with an electrical source, do NOT touch the child with bare hands. Pull the child away from the power source with an object that does not conduct electricity (such as a wooden broom handle), only after the power is turned off. ALL electrical burns need to be seen by a doctor.
noSEBlEEdSKeep the child in a sitting position with the head tilted slightly forward. Apply firm, steady pressure to both nostrils by squeez-ing them between your thumb and index finger for 5 minutes. If bleeding continues or is very heavy, call the pediatrician or seek emergency care.
tEEthBaby Teeth If knocked out or broken, apply clean gauze to control bleeding and call the pediatric or family dentist.
Permanent Teeth If knocked out, handle the tooth by the top and not the root (the part that would be in the gum). If dirty, rinse gently without scrubbing or touch-ing the root. Do not use any cleansers. Use cold running water or milk. Place the tooth in clean water or milk and transport the tooth with the child when seeking emergency care. Call and go directly to the pediatric or family dentist or an emergency department. If the tooth is broken, save the pieces in milk and call the pediatric or family dentist right away. Stop bleeding using gauze or a cotton ball in the tooth socket and have the child bite down.
GEnEral■■ Know how to get help.■■ Make sure the area is safe for you and the child.■■ When possible, personal protective equipment (such as gloves)
should be used.■■ Position the child appropriately if her airway needs to be
opened or CPR (cardiopulmonary resuscitation) is needed. (Please see other side.)
■■ DO NOT MOVE A CHILD WHO MAY HAVE A NECK OR BACK INJURY (from a fall, motor vehicle crash, or other injury, or if the child says his neck or back hurts) unless he is in danger.
■■ Look for anything (such as emergency medical identification jewelry or paperwork) that may give you information about health problems.
StinGS, BitES, and allErGiESSting�ing� Insects Remove the stinger as soon as possible with a scraping motion using a firm item (such as the edge of a credit card). Put a cold compress on the bite to relieve the pain. If trouble breathing; fainting; swelling of lips, face, or throat; or hives over
the entire body occurs, call 911 or an emergency number right away. For hives in a small area, nausea, or vomiting,
call the pediatrician. For spider bites, call the pedia-trician or Poison Help (1-800-222-1222). Have the pediatrician check any bites that become red, warm,
swollen, or painful.
Animal or Human Bites Wash wound well with soap and water. Call the pediatrician. The child may need a tetanus or rabies shot or antibiotics.
Ticks Use tweezers or your fingers to grasp as close as possible to the head of the tick and briskly pull the tick away from where it is attached. Call the pediatrician if the child develops symptoms such as a rash or fever.
Snake Bites Take the child to an emergency department if you are unsure of the type of snake or if you are concerned that the snake may be poisonous. Keep the child at rest. Do not apply ice. Loosely splint the injured area and keep it at rest, positioned at or slightly below the level of the heart. Identify the snake, if you can do so safely. If you are not able to identify the snake but are able to kill it safely, take it with you to the emergency department for identification.
Allerg�y Swelling, problems breathing, and paleness may be signs of severe allergy. Call 911 or an emergency number right away. Some people may have emergency medicine for these times. If possible, ask about emergency medicine they may have and help them administer it if necessary.
FEvErFever in children is usually caused by infection. It also can be caused by chemicals, poisons, medicines, an environ-ment that is too hot, or an extreme level of overactivity.
Take the child’s temperature to see if he has a fever. Most pediatricians consider any thermometer reading above 100.4°F (38°C) as a fever. However, the way the child looks and acts is more important than how high the child’s temperature is.
Call the pediatrician right away if the child has a fever and
■■ Appears very ill, is unusually drowsy, or is very fussy■■ Has other symptoms such as a stiff neck, a severe
headache, severe sore throat, severe ear pain, an unexplained rash, repeated vomiting or diarrhea, or difficulty breathing
■■ Has a condition causing immune suppression (such as sickle cell disease, cancer, or chronic steroid use)
■■ Has had a first seizure but is no longer seizing■■ Is younger than 2 months and has a temperature of 100.4°F
(38°C) or higher■■ Has been in a very hot place, such as an overheated car
To make the child more comfortable, dress him in light clothing, give him cool liquids to drink, and keep him calm. The pediatri-cian may recommend fever medicines. Do NOT use aspirin to treat a child’s fever. Aspirin has been linked with Reye syndrome, a serious disease that affects the liver and brain.
Does your community have 911? If not, note the number of your local ambulance service and other
important numbers below.
Be PrePared: Call 911KeeP eMerGeNCY NUMBerS
BY YOUr TelePHONe.
Pediatrician
Pediatric or Family dentist
Poison HelP 1-800-222-1222
ambulance
emergency dePartment
Fire
Police
address oF and directions to tHe location
(For babysitters, caregivers)
FIRST
AIDCall 911 or an emergency number for a severely ill or injured child.Call 1-800-222-1222 (Poison Help) if you have a poison emergency.
The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in
treatment that your pediatrician may recommend based on individual facts and circumstances.
HE0418 Copyright © 2011 American Academy of Pediatrics. All rights reserved.
5-65/Rev1210Turn Over for Choking and CPR Instructions.
convulSionS, SEizurESIf the child is breathing, lay her on her side to prevent choking. Call 911 or an emergency number for a prolonged seizure (more than 5 minutes).
Make sure the child is safe from objects that could injure her. Be sure to protect her head. Do not put anything in the child’s mouth. Loosen any tight clothing. Start rescue breathing if the child is blue or not breathing. (Please see other side.)
hEad injuriESDO NOT MOVE A CHILD WHO MAY HAVE A SERIOUS HEAD, NECK, OR BACK INJURY. This may cause further harm.
Call 911 or an emergency number right away if the child
■■ Loses consciousness■■ Has a seizure (convulsion)■■ Experiences clumsiness or inability to move any body part■■ Has oozing of blood or watery fluid from ears or nose■■ Has abnormal speech or behavior
Call the pediatrician for a child with a head injury and any of the following:
■■ Drowsiness■■ Difficulty being awakened■■ Persistent headache or vomiting
For any questions about less serious injuries, call the pediatrician.
poiSonSIf the child has been exposed to or ingested a poison, call Poison Help at 1-800-222-1222. A poison expert is available 24 hours a day, 7 days a week.
Swallowed Poisons Any nonfood substance is a potential poison. Do not give anything by mouth or induce vomiting. Call Poison Help right away. Do not delay calling, but try to have the substance label or name available when you call.
Fumes, Gases, or Smoke Get the child into fresh air and call 911, the fire department, or an emergency number. If the child is not breathing, start CPR and continue until help arrives. (Please see other side.)
Skin Exposure If acids, lye, pesticides, chemicals, poisonous plants, or any potentially poisonous substance comes in contact with a child’s skin, eyes, or hair, brush off any residual material while wearing rubber gloves, if possible. Remove contaminated clothing. Wash skin, eyes, or hair with large amount of water or mild soap and water. Do not scrub. Call Poison Help for further advice.
If a child is unconscious, becoming drowsy, having convulsions, or having trouble breathing, call 911 or an emergency number. Bring the poisonous substance (safely contained) with you to the hospital.
FaintinGCheck the child’s airway and breathing. If necessary, call 911 and begin rescue breathing and CPR. (Please see other side.)
If vomiting has occurred, turn the child onto one side to prevent choking. Elevate the feet above the level of the heart (about 12 inches).
START FIRST AID FOR CHOKING IF
■● The child cannot breathe at all (the chest is not moving up and down).■● The child cannot cough or talk, or looks blue.■● The child is found unconscious/unresponsive. (Go to CPR.)
DO NOT START FIRST AID FOR CHOKING IF
■● The child can breathe, cry, or talk.■● The child can cough, sputter, or move air at all. The child’s normal reflexes are working to clear the airway.
LEARN AND PRACTICE CPR (CARDIOPULMONARY RESUSCITATION).IF ALONE WITH A CHILD WHO IS CHOKING…
1. SHOUT FOR HELP. 2. START RESCUE EFFORTS. 3. CALL 911 OR YOUR LOCAL EMERGENCY NUMBER.
FOR CHILDREN 1 TO 8 YEARS OF AGE
Turn Over for First Aid Treatment.
If at any time an object is coughed up or the infant/child starts to breathe, stop rescue breaths and call 911 or your local emergency number.
Ask your pediatrician for information on choking/CPR instructions for children older than 8 years and for information on an approved first aid or CPR course in your community.
CHOKING/CPR
HE0418 Copyright © 2011 American Academy of Pediatrics. All rights reserved.
5-65/Rev1210
FOR INFANTS YOUNGER THAN 1 YEAR
1. Perform Heimlich maneuver.
■ ● Place hand, made into a fist, and cover with other hand just above the navel. Place well below the bottom tip of the breastbone and rib cage.
■ ● Give each thrust with enough force to produce an artificial cough designed to relieve airway obstruction.
■ ● Perform Heimlich maneuver until the object is expelled or the child becomes unconscious/ unresponsive.
2. If the child becomes UNCONSCIOUS/UNRESPONSIVE, begin CPR.
CHILD CPRTo be used when the child is UNCONSCIOUS/UNRESPONSIVE or when breathing stops.
Place child on flat, hard surface.
CHILD CHOKING (HEIMLICH MANEUVER)
Have someone call 911. If the child is choking and is unable to breathe, cough, cry, or speak,
follow these steps.
2 OPEN AIRWAY.■● Open airway (head
tilt–chin lift).■● If you see a foreign
body, sweep it out with your finger. Do NOT do blind finger sweeps.
3 START RESCUE BREATHING.■● Take a normal breath.■● Pinch the child’s nose closed,
and cover child’s mouth with your mouth.
■● Give 2 breaths, each for 1 second. Each breath should make the chest rise.
4 RESUME CHEST COMPRESSIONS.
■● Continue with cycles of 30 compres-sions to 2 breaths until the object is expelled.
■● After 5 cycles of compressions and breaths (about 2 minutes), if no one has called 911 or your local emergency number, call it yourself.
1 START CHEST COMPRESSIONS.■● Place 2 fingers of 1 hand on
the breastbone just below the nipple line.
■● Compress chest at least ¹/3 the depth of the chest, or about 4 cm (1.5 inches).
■● After each compression, allow chest to return to normal position. Compress chest at rate of at least 100 times per minute.
■● Do 30 compressions.
2 OPEN AIRWAY.■● Open airway (head tilt–chin
lift).■● If you see a foreign body,
sweep it out with your finger. Do NOT do blind finger sweeps.
3 START RESCUE BREATHING.■● Take a normal breath.■● Cover infant’s mouth and
nose with your mouth.■● Give 2 breaths, each
for 1 second. Each breath should make the chest rise.
4 RESUME CHEST COMPRESSIONS.■● Continue with cycles of 30 compressions to
2 breaths. ■● After 5 cycles of compressions
and breaths (about 2 minutes), if no one has called 911 or your local emergency number, call it yourself.
1 GIVE 5 BACK BLOWS (SLAPS).
INFANT CHOKINGIf the infant is choking and
is unable to breathe, cough, cry, or speak, follow these steps.
Have someone call 911.
INFANT CPRTo be used when the infant is UNCONSCIOUS/UNRESPONSIVE or when breathing stops.
Place infant on flat, hard surface.
ALTERNATING WITH
Alternate back blows (slaps)
and chest compres-
sions until the object
is dislodged or the infant
becomes unconscious/unresponsive. If the infant
becomes unconscious/unresponsive,
begin CPR.
1 START CHEST COMPRESSIONS.■● Place the heel of 1 or 2 hands over the lower half
of the sternum.■● Compress chest at least ¹/3 the depth of the
chest, or about 5 cm (2 inches).■● After each compression, allow chest to
return to normal position. Compress chest at rate of at least 100 times per minute.
■● Do 30 compressions.
1-hand technique 2-hand technique
2 GIVE 5 CHEST COMPRESSIONS.
Every 8 seconds someoneneeds a poison center…
Could you be next?
Free, Fast,Expert Help.24 hours a day,7 days a week © 2010 American Association of Poison Control Centers
How DoesYour Poison
CenterHelp You?
Poison centers give expert advice fast, over the phone. We can help you and your family with poison emergencies and with questions about poisoning
You can call day or night, 7 days a week, any day of the year. Nurses,
pharmacists, doctors, and other poison experts will answer your call.
We can help you in more than 150 languages or
if you are hearing impaired.
There are many poison centers across our country. You can reach a poison center by
calling 1-800-222-1222 from anywhere in the US.
First Aid for PoisoningIf a person
4 stops breathing 4 collapses, or 4 has a seizure
Call 911 right away.
Poison in the eyes?
Rinse eyes with running water.Call your poison center at 1-800-222-1222.
Poison on the skin?
Take off any clothing that the poisontouched. Rinse skin with running water.Call your poison center at 1-800-222-1222.
Inhaled poison?
Get to fresh air right away.Call your poison center at 1-800-222-1222.
Swallowed poison?
Call your poison center at 1-800-222-1222.
Do not try home remedies or try to make someone throw up. Call your poisoncenter first.
For more information visit www.aapcc.org or call your local poison center.
�•��Put�1-800-222-1222�in�your�cell�phone�and near home phones.
•��Keep�medicines�and�household� products in their original containers and in a different place than food.
•����Always�read�the�label�and�follow� any directions.
•��Keep�household�products�and� medicines locked up. Put them where kids can’t see them or reach them.
•��Buy�products�with�child-resistant� packaging.��But�remember,�nothing� is child-proof!
•��Never�call�medicine�“candy.”�� Poisons may look like food or drink. Teach children to ask an adult before tasting anything.
•��Learn�about�products�and�drugs� that�young�people�use�to�get�“high.”��Talk to your teen or pre-teen about these dangers.
•����Have�a� working carbon monoxide alarm in your home.
Poison Prevention Tips If you think someone has been poisoned, call 1-800-222-1222 right away. Seriouspoisonings don’t always have early signs.
Why Should You Call?Poisonings can happen to anyone and poison centers are for everyone. The call is free and private.
We Help You Save Money and Time:
Seven of ten people who call their poison center get help over the phone. They don’t have to go to a doctor or hospital.
Your Doctor Calls the Poison Center Too:
When doctors and nurses need help treating poisonings, they call their local poison center.
We are the experts.
Do You Know?We often think of children getting poisoned. But�most�people�who�die�from�poisons�are�adults! Poisoning is a danger for all of us.
Almost�anything�can�be� poisonous if it’s used the wrong way, in the wrong amount, or by the wrong person.
Some poisons are:
� •��medicines�(prescription,�over-the-counter, herbal) and street drugs
� •��products�in�your�home�like� shampoo, bleach, bug and weed killers, antifreeze, and lamp oil
� •�chemicals�at�your�job
� •�bites�and�stings
� •�mushrooms�and�plants
� •�fumes�and�gases
Taking the wrong amount of medicine or someone else’s medicine, accidentally eating dishwasher soap, mixing cleaners, or having too much alcohol to drink could lead to poisoning.
Free, Fast, Expert Help. 24 hours a day, 7 days a week. 1-800-222-1222
Mansfield Office454 Chauncy StreetMansfield, MA 02048
(508) 339-9944
Westwood Office541 High Street
Westwood, MA 02090(781) 326-7700
www.wmpeds.com
Postpartum Therapists
We strongly suggest you speak with your obstetrician if you feel you might be experiencing signs of
postpartum depression.
Therapists
JoAnn Feldstein, Ed.D.
93 Union St, Suite 401
Newton Center, MA 02459
www.drjoannfeldstein.com/
617-332-9887
Debra Greenberg, LICSW
15 Cottage St
Norwood, MA 02492
781-329-6696
Eda Spielman, Psy.D
6 Fairfield St
Newtonville, MA 02360
http://www.jfcsboston.org/
617-969-4117
Kathleen O’Meara, APRN
27 Mica Ln
Wellesley, MA 02481
781-431-0207
Ellis Waingrow, MSW, LICSW
24 Lincoln St
Newton Highlands, MA 02461
http://www.selfleadership.org/
617-244-8132
Wendy Hrubec, LICSW
275 Turnpike St, Suite 108
Canton, MA 02021
http://www.selfleadership.org/
781-821-2063
Janet Leibowitz, PsyD
345 Neponset St, Suite 6
Canton, MA 02021
http://www.janetleibowitz.com/781-258-3587
Christine Gardosik, LICSW21 Cohasset St, Suite 3
Foxborough, MA 02035
978-808-1635
Needham Psychotherapy Associates, LLC
992 Great Plain Ave
Needham, MA 02492
http://npaonline.com/
781-449-7522
Psychiatrist
Ann Briley, MD18 Wareland Rd
Wellesley, MA 02481
781-237-7896
Allison Phillips, MD
27 Mica Ln
Wellesley, MA 02481
781-431-0207
VACCINE INFORMATION STATEMENT
Influenza VaccineWhat You Need to Know
(Flu Vaccine, Inactivated)
2013-2014
Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis
Hojas de información sobre vacunas están disponibles en español y en muchos otros idiomas. Visite www.immunize.org/vis
1 Why get vaccinated?Influenza (“flu”) is a contagious disease that spreads around the United States every winter, usually between October and May. Flu is caused by the influenza virus, and can be spread by coughing, sneezing, and close contact.Anyone can get flu, but the risk of getting flu is highest among children. Symptoms come on suddenly and may last several days. They can include:• fever/chills• sore throat• muscle aches• fatigue• cough• headache• runny or stuffy noseFlu can make some people much sicker than others. These people include young children, people 65 and older, pregnant women, and people with certain health conditions—such as heart, lung or kidney disease, or a weakened immune system. Flu vaccine is especially important for these people, and anyone in close contact with them.Flu can also lead to pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. Each year thousands of people in the United States die from flu, and many more are hospitalized. Flu vaccine is the best protection we have from flu and its complications. Flu vaccine also helps prevent spreading flu from person to person.
2 Inactivated flu vaccineThere are two types of influenza vaccine: You are getting an inactivated flu vaccine, which does not contain any live influenza virus. It is given by injection with a needle, and often called the “flu shot.”A different, live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement.
Flu vaccine is recommended every year. Children 6 months through 8 years of age should get two doses the first year they get vaccinated.Flu viruses are always changing. Each year’s flu vaccine is made to protect from viruses that are most likely to cause disease that year. While flu vaccine cannot prevent all cases of flu, it is our best defense against the disease. Inactivated flu vaccine protects against 3 or 4 different influenza viruses.It takes about 2 weeks for protection to develop after the vaccination, and protection lasts several months to a year.Some illnesses that are not caused by influenza virus are often mistaken for flu. Flu vaccine will not prevent these illnesses. It can only prevent influenza.A “high-dose” flu vaccine is available for people 65 years of age and older. The person giving you the vaccine can tell you more about it.Some inactivated flu vaccine contains a very small amount of a mercury-based preservative called thimerosal. Studies have shown that thimerosal in vaccines is not harmful, but flu vaccines that do not contain a preservative are available.
3 Some people should not get this vaccine
Tell the person who gives you the vaccine:• If you have any severe (life-threatening) allergies. If
you ever had a life-threatening allergic reaction after a dose of flu vaccine, or have a severe allergy to any part of this vaccine, you may be advised not to get a dose. Most, but not all, types of flu vaccine contain a small amount of egg.
• If you ever had Guillain-Barré Syndrome (a severeparalyzing illness, also called GBS). Some peoplewith a history of GBS should not get this vaccine. Thisshould be discussed with your doctor.
• If you are not feeling well. They might suggestwaiting until you feel better. But you should comeback.
4 Risks of a vaccine reactionWith a vaccine, like any medicine, there is a chance of side effects. These are usually mild and go away on their own.Serious side effects are also possible, but are very rare. Inactivated flu vaccine does not contain live flu virus, so getting flu from this vaccine is not possible. Brief fainting spells and related symptoms (such as jerking movements) can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries caused by falls. Tell your doctor if you feel dizzy or light-headed, or have vision changes or ringing in the ears.Mild problems following inactivated flu vaccine: • soreness, redness, or swelling where the shot was
given • hoarseness; sore, red or itchy eyes; cough• fever• aches• headache• itching• fatigueIf these problems occur, they usually begin soon after the shot and last 1 or 2 days. Moderate problems following inactivated flu vaccine:• Young children who get inactivated flu vaccine and
pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure.
Severe problems following inactivated flu vaccine:• A severe allergic reaction could occur after any
vaccine (estimated less than 1 in a million doses). • There is a small possibility that inactivated flu vaccine
could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.
The safety of vaccines is always being monitored. For more information, visit: www.cdc.gov/vaccinesafety/
5 What if there is a serious reaction?
What should I look for?• Look for anything that concerns you, such as signs of
a severe allergic reaction, very high fever, or behavior changes.
Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.
What should I do?• If you think it is a severe allergic reaction or other
emergency that can’t wait, call 9-1-1 or get the person to the nearest hospital. Otherwise, call your doctor.
• Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS web site at www.vaers.hhs.gov, or by calling 1-800-822-7967.
VAERS is only for reporting reactions. They do not give medical advice.
6 The National Vaccine Injury Compensation Program
The National Vaccine Injury Compensation Program (VICP) is a federal program that was created to compensate people who may have been injured by certain vaccines.Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382 or visiting the VICP website at www.hrsa.gov/vaccinecompensation.
7 How can I learn more?• Ask your doctor.• Call your local or state health department.• Contact the Centers for Disease Control and
Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) or - Visit CDC’s website at www.cdc.gov/flu
Vaccine Information Statement (Interim) Inactivated Influenza Vaccine
42 U.S.C. § 300aa-26
07/26/2013Office Use Only