Tuesday, August 28, 2018

Child's Play: It's Fun, and So Much More

From the desk of Shelly Flais, MD

Children learn through play. Whether playing peekaboo with a parent, playing outside with a sibling, or playing make believe with a preschool classmate, playtime boosts brain power, physical activity, social bonds, and can buffer against stress. The American Academy of Pediatrics, seeing trends of increased screen use as well as reduced time set aside for recess within schools, has issued a new clinical report, "The Power of Play: A Pediatric Role in Enhancing Development in Young Children," to remind all of us who interact with babies and young kids to protect screen-free, open-ended playtime.

Pediatric Health Associates' Dr. Shelly Flais spoke with CBS Chicago this week about the importance of child's play; you can watch it here:

Read more about the power of play here:

Friday, August 17, 2018

Updated Car Seat Law and Texting app info

Still need a school sports physical?  We still have available appointments before school activities start!  Don't forget that immunizations need to be up to date as well!

Construction of the new North Aurora office is rapidly being  completed!  We anticipate the office will open on or about Thursday October 18th.  The new office is located at 98 Miller Drive, Suite 101.  Our doctors who will work there are Drs. Gronli, Thomas, Kanabar, Shakir, Doman and Wall and Nurse Practitioner Kim Gubbins will be opening the Lactation Center there.

The American Academy of Pediatrics offers a wealth of free information on HealthyChildren.org.  It covers every age and stage in your child’s development.   Get the app today!

and now..... for our latest blog.....

Our kids are our greatest blessing.  We want the very best for them whatever their age.  For infants there is new car seat legislation in effect in Illinois.  For teen and adult drivers distracted driving is at epidemic proportions. So what’s a parent to do?

The new car seat law requires children under the age of 2 to have a rear-facing car seat unless they are at least 40 pounds or 40 inches tall.

Did you know that auto accidents are one of the leading causes of death for children?  Statistically 11.5% of kids 1-4 years of age die from injuries suffered in a car accident.  Studies have found that rear-facing car seats have reduced auto related deaths by 75% for children in this age group.

Think it’s just a minor occurrence?  Well less than 50% of parents have their babies in rear-facing seats for the proper period of time.  This significantly increases the risk of whiplash.  And 70% of parents don’t anchor the top tether of forward-facing seats.  The tethers hold the top of the seat back an additional 4-6 inches during a crash reducing the risk of a child impacting the front seat or center console.  We think the old adage “better safe than sorry” is appropriate in this situation.

After you install a car seat it is best to have it checked by your local police or fire department to ensure it’s been installed properly.  There is generally no cost for the inspection.

If your child is involved in an accident you will be advised to buy a new car seat. Even though your current seat doesn’t look damaged, small cracks could have developed that may impact just how safe the seat will be.

And for our teens and adult family members….believe it or not texting is responsible for 1 out of 4 crashes and six times more than drunk driving.  While it may only take a few seconds to check a text, you will cover about the length of a football field if you are going 55 mph.  If you must check a text, pull into a parking space to read it.   Many people tend to just stop in the middle of traffic to read a text putting other drivers at great risk of pile ups. 80% of all crashes are from distracted driving.

To reduce the temptation of using the phone to text or call while driving, there are cell blocking apps that prevents the phone’s ability to be used while in motion.  Most wireless carriers offer this type of app for your phone.  It does not prevent a driver from being able to call 911.

For more information about distracted driving please visit:

Thursday, July 19, 2018

RE: Important PHA Policy Change and Summer Safety

PHA Policy Change regarding No Shows

Effective August 1, 2018 our no show policy will change.  Families will be allowed 4 NO SHOWS within 2 years before being dismissed from the practice.  A $35.00 no show fee will be charged for missing Check-Ups/Sports Physicals and $25.00 for all other appointments. 

This charge is per patient, not per family.  

You can avoid this charge by cancelling your appointment minimally 4 hours prior to your scheduled appointment time.

From the desk of Nishat Nasrullah, DO

Nishat Nasrullah, DO
Now that summer is in full swing, one of my family’s favorite pastimes is to go to the swimming pool!  It’s a great way to cool off on these hot summer days, but a fun day can turn tragic very quickly with drowning and nearing drowning events.  That is why it is essential as parents that we go through all of the preventative measures to keep ourselves and our kids safe in the water. Today, I will discuss some of the safety guidelines on the prevention of drowning as highlighted by the American Academy of Pediatrics. Furthermore, I will discuss what is dry and secondary drowning, what are the signs and symptoms to look for, and when to seek care.

According to the CDC (Centers for Disease Control) Injury Report drowning is the second leading cause of unintentional injury death, and the number one cause of death amongst 1 to 4-year old’s. Drowning rates vary with age, gender, and race, but research has shown that the groups at greatest risk are toddlers and male adolescents.

Drowning, dry drowning and secondary drowning.
You may have heard of the term ‘dry drowning,’ but in order to understand what this actually means it is important to know the definition of drowning. The World Congress on Drowning states that drowning is “the process of experiencing respiratory impairment from submersion/immersion in liquid.” In other words, drowning occurs when water goes into the lungs and causes impairment in breathing through suffocation. In contrast, in dry drowning your child may swallow and choke on only some water, but then his/her vocal cords will spasm and close up. This will prevent water from going into the lungs, and instead is swallowed. Therefore, in dry drowning liquid does not actually get into the lungs, so there is no damage to the lungs or impairment in breathing.

Another term that is sometimes used is secondary drowning.  This is when a child or adult swallows water, coughs and sputters and then appears fine, but hours later may start to develop difficulty breathing. This occurs because some water actually did enter the lungs leading to irritation and swelling, otherwise known as pulmonary edema. The signs and symptoms of secondary drowning may include fast breathing, labored breathing, wheezing, and increased fatigue. These symptoms will usually occur within 6-8 hours from the initial incident and can continue to worsen through the next 24 hours. If something like this occurs, then medical evaluation is necessary as soon as possible.

When is the best time to start swimming lessons?
The American Academy of Pediatrics’ (AAP) initial stance for swimming lessons was to start only after 4 years of age, because there was no data to suggest that there was any benefit in starting swimming lessons earlier.  The concern was that starting at an early age may give children and parents a false sense of security around water. This stance has become more relaxed after new studies showed that there is a less likelihood of drowning accidents to occur in those toddlers (less than 4 years of age) who had formal swimming instruction vs. those that did not. The updated guideline is “Children need to learn to swim. The AAP continues to support swimming lessons for most children 4 years old and older. Because children develop at different rates, not all children will be ready to learn to swim at exactly the same age. For example, children with motor or cognitive disabilities may not be ready for swimming lessons until a later age. The evidence no longer supports an advisory against early aquatic experience and swimming lessons for children of any specific age.” There has not been enough research to state that children between ages 1 to 4 must have formal swimming training, however this is an individualized decision of the parent based on the child’s maturity, physical limitations and health concerns. It is also important to remember that just because a child has had swimming lessons, it does not make him or her “drown proof.”  Essentially, parents cannot let their guards down around water with little ones.

House pools and inflatable pools safety:
If you own a pool the best way to prevent drowning accidents is to have a 4-sided fence installed that surrounds the entire pool, and separates it from the rest of the yard. Studies show that isolating the pool from the rest of the yard has been effective in preventing more than 50% of swimming-pool drownings.  Having pool covers and pool alarms alone is not enough of a preventative measure, but can be used as an adjunct to the fence. The fence should be at least 4 ft in height and climb resistant, which means no chain-linked fences that can easily be climbed by young children.  In addition, the fence should have a secure self-latching and self-closing gate.

Parents should also be aware of the risks that come with inflatable pools. These pools are sometimes left out with a small amount of water, which can be just enough for a young child to fall into and drown. Furthermore, the soft sides of these pools make it very easy for children to lean forward and fall in head first. Even though they may seem small and insignificant, inflatable pools can pose a great risk for young kids, and they need to be emptied out after each use.

Drowning is preventable in most cases, so let’s review some useful water safety guidelines:
     1.     Touch supervision: All young and inexperienced swimmers need to be at an arm’s length from an adult swimmer in any body of water including tub, pool, beach, etc.
     2.     Older children and those who can swim still need constant attention while in the water, which means parents put your devices away, stop socializing or tending to chores, and keep your eyes on your kids!
     3.     If children will be swimming in summer camps or out-of-home daycares, parents need to inquire about the ratio of adults to students, lifeguards on site and other safety measures for the water.
     4.     Parents, caregivers and pool owners should learn CPR.       
     5.     All children should wear life jackets whenever they are riding in a watercraft. The best way to get children to wear life jackets is if adults are setting a good example by wearing them as well.
     6.     Avoid using the inflatable arm flotation devices in place of proper life jackets. These can easily come off and/or deflate and are not a safe alternative. 
     7.     Beware that drowning can also occur in cold seasons. Do not walk, skate or ride on weak or thawing ice or any body of water.
     8.     Children of any age with seizure disorders should always have a parent present when swimming or taking a bath. Showers are preferable to baths in situations when a child cannot be observed.
     9.     Make sure that the swimming pools or spas being used have proper drain covers to prevent drain entrapment and hair entanglement.

Thank you for taking the time to read this installment of the PHA blog. I hope that it was beneficial to you, and I hope that you and your family have a fun-filled and safe summer! For more helpful information on drowning prevention please refer to the websites below.

     1.     Center for Disease Control; https://www.cdc.gov/safechild/drowning/index.html

     3.     Safe Kids USA: www.usa.safekids.org/water

     4.     Consumer Product Safety Commission (CPSC) www.cpsc.gov  
Centers for Disease Control and Prevention National Center for Injury Prevention and Control. Web-based Injury statistic Query and Reporting System (WISQARS)

American Academy of Pediatrics Policy Statement---Prevention of Drowning. Committee on Injury, Violence, and Poison Prevention. Pediatrics Volume 126, Number 1, July 2010.

      Semple-Hess, J.  Behar, Sol. “Bonus Short—Dry Drowning.” Peds 
      RAP. July 2017


Pediatric Health Associates congratulates Nurse Practitioner Katie Parker on the birth of her first born son, Thomas!   Mom and baby are doing great!

Welcome to the World, Little One!

Tuesday, July 3, 2018

Are grandpa's medications stored safely?

Independence Day 2018
Have a safe 4th!

An important reminder from Shelly Flais, MD
Many grandparents take daily medications.  When the grandkids visit check to make sure those meds are out of their reach while visiting.  Read more at:

Shelly Flais, MD