best of all worlds... integrative pediatrics

Other ways, besides acetaminophen, to treat fever

2012-01-27T10:33:00.001-05:00

There is increasing evidence that acetaminophen use may be linked to childhood asthma. Even a single dose of acetaminophen can decrease the body's stores of glutathione, which is an important antioxidant that helps decrease oxidative stress within the lungs and throughout the body. Glutathione is also important in metabolism such as protein synthesis, as well as immune function, DNA synthesis and repair, amino acid transport, and enzyme activation. Perhaps, we should rethink the popular medications that have become rooted into our culture. Read this full New York Times article to learn more.

Acetaminophen, also known by the common brand name Tylenol, is often used for fever reduction in children. However, fever is one of the body's natural ways to fight off an infection. Should we really be treating the fever? We don't really have enough evidence either way. Yes, it is true that there are some circumstances in which the fever can reach 104 degrees Fahrenheit or above. The higher the fever, the more discomfort a person tends to experience, although kids tend to tolerate fevers much better than adults do. There are also some kids that are prone to febrile seizures, which may warrant more aggressive fever control. Each child and family is unique, and all these factors need to be taken in account when advising fever control.

Ibuprofen is not necessarily the solution to avoiding acetaminophen, because ibuprofen has its own slew of side effects including decreasing the good bacteria in our gut and increased risk of bleeding.

Consider more integrative approaches to fevers and illnesses. Homeopathic remedies, when chosen appropriately, can have amazing effects on fever. Perhaps some healing touch may help. Or, an osteopathic treatment to help open up the lungs and drain the sinuses. Or, antibacterial and antiviral herbals can decrease the burden of infection. And as always with a holistic approach, don't forget addressing the spirit with a bit of prayer, meditation, or deep breathing exercises.

Happy Thanksgiving Everyday!

2011-11-22T23:22:00.001-05:00

Each Thanksgiving, we often start to ponder what it is in our lives we are thankful for... from the sun and stars, to the warmth of a good meal, or just a random friendly face. We are thankful for just being. We can choose to smile, to laugh, to breathe deeply for the chance of a new day.

Sometimes when we get down in the dumps, or feel the holiday stress, it is easy to lose sight of what we could be thankful for. Consider taking the time during this Thanksgiving meal to let each person give thanks in his or her own way, whether out loud, in writing, or perhaps song, dance, or other expressive art. It is also a good idea to be thankful for yourself as well -- not in an egotistical way, but in a gentle way that lifts the soul.

When you are ready, consider bringing the spirit of Thanksgiving Day to everyday! A great way to do this is by starting a gratitude journal. If you tried out the practice above, then you already have your first entry. Write down or say aloud a few things you are thankful for everyday. Try it out with your kids and see what happens after a couple of weeks. Often, such a simple exercise can keep spirits high and help lift cloudy days.

Using your head... Concussions and other head injuries

2011-06-22T09:53:00.008-04:00

Concussions are a type of brain injury that are often caused by a bump or blow to the head. They may also result from jolts to other parts of the body, which then causes a whiplash injury in which the head moves rapidly back and forth. It's just plain physics. An injury to any part of the body can be felt by the whole, including the brain which can get jostled around. Even seemingly minor injuries can add up over time, as addressed in a health special in Time magazine entitled Kids and Concussions.

Cranial osteopathy can address the strains in the body and the head. Many of these strains can persist for months or even years. The effects of these strains may be more obvious such as in ongoing headaches or neck pain. Sometimes the impact of the strains may be subtle, causing a "fogginess" that goes unnoticed until it is cleared. See www.cranialacademy.org to look for a cranial osteopath in your area.

Lastly, don't forget our good friend arnica, which is useful after any bumps or bruises.

*Photo credit: National Institure of Health

Food Allergies On the Rise

2011-06-21T05:27:00.004-04:00

Many of us have suspected that allergies have been on the rise for some time now. A new study finds that about 6 million kids in the US have a food allergy. That is 1 in 13 kids. The severity of those allergies has also been increasing. Food allergies are not simply another nuisance to be brushed aside. We need to take them seriously because they can be life-threatening. For some, keeping an Epi-pen handy may save a life. Symptoms of a food allergy may range from an itchy rash (hives), itchy throat, swelling, difficulty breathing, nausea, vomiting, abdominal pain, diarrhea. If you suspect you or someone in your family has a food allergy, please discuss this further with your physician. If not, please be compassionate to others with food allergies and help them avoid a situation which may threaten their lives.

It is great that the medical journals are now clearly recognizing a true increase in food allergies. However, we also need to look more closely at the WHY as well. What has changed in our world that is different from decades ago? One, the toxic chemicals we are inundated with has also risen astronomically with little regulation. Many of these chemicals can affect our immune system in adverse ways. Second, the food that we eat is different. There is an abundance of processed foods, sugary foods, and artificial additives. Even produce has been genetically modified. Third, our interaction with the natural environment has changed. We live in highly sanitized areas with its obvious benefits. We do find that allergies are more common in city kids than farm kids. Are we lacking in exposure to beneficial bacteria?

Although we do not have all the answers yet, we need to continue to ask the question well-known to our kids: "Why?"

Austin Robin O'Brien is one mother who refused to stop asking why. She talks about the truth she uncovered in this succinct, empowering video. Please watch this video.

*Photo credit: National Institute of Health

Cell Phone Radiation

2011-06-02T23:16:00.000-04:00

With the convenience and entertainment of our modern gadgets -- cell phones, computers, TVs, microwaves, and other electronics -- we sometimes receive more than we bargain for. It is true that radiation can be a natural phenomena, such as radiation from the sun or the earth. However, with our cell phone obsession, we are increasing our chronic exposure to low doses of radiation. Children and young adults are more susceptible to damage from cell phone radiation due to their small skulls and developing brains. The World Health Organization now recognizes cell phone radiation to be just as carcinogenic as lead, engine exhaust, and chloroform. To reduce cell phone radiation exposure, keep the phone at least an inch away from the body, place the phone on speaker, use an earpiece, and decrease time spent on the phone in general.

Junk Food in Hospitals

2011-02-14T00:28:00.005-05:00

I am amazed that our hospitals, which are supposed to be places of healing, serve junk food. One of the hospitals I trained in had a McDonald's, which I thought was a fluke. Then I happened to deliver in another hospital in a different area of the country which also had a McDonald's. Why do our hospitals not place more value and support on prevention? Here is an interesting article by a UK cardiologist entitled I mend hearts. Then I see my patients served junk food by our hospitals.

I would also highly recommend the documentary Super Size Me, which examines the influence of the fast-food industry. The film is available for viewing and download for free.

Photo credit http://lcvending.net/vend.php?id=vending_machine_customization

Simple Black Beans

2010-07-15T13:32:00.000-04:00

This is a great easy recipe to learn how to cook beans. Place 3/4 cup of dried black beans in a pot or bowl. Pick through to remove any small stones. Add water to cover the beans by about two inches. Add a splash of vinegar (~1 Tablespoon) or squeeze of lemon to help break down the phytic acid in the beans. Phytic acid can interfere with the absorption of valuable nutrients. Soak beans overnite for about 8-10 hours. After the overnite soak, rinse and drain the beans. Then add 3 cups of water and simmer beans for about 1.5-2 hours. I usually keep the pot covered for the first 1-1.5 hours then uncovered to boil off the remaining water. Once the beans are soft, add 1/2 jar (~6 oz) of your favorite peach or mango salsa. I use the peach salsa from Trader Joe's. You gourmets can also make your own if you prefer.

Voila! These beans are ready to use as a dip, burritos, tamales, salad, as a side dish or hearty meal with brown rice and greens.

Black beans in particular are packed with antioxidants, fiber, protein, magnesium, folate, and iron.

Preventing Swimmer's Ear

2010-06-28T20:03:00.000-04:00

Swimmer's ear is a painful infection of the ear canal. The ear tends to be tender when tugged or touched. It occurs more often after swimming as water gets trapped in the ear and promotes growth of certain germs. After a prolonged bout of swimming, consider a simple step of prevention: Place 2-3 drops of a 1:1 solution of plain vinegar and rubbing alcohol. The solution helps restore the slightly acidic pH of the ear which helps ward off infection. It also encourages the ear to dry more quickly. Do not place this solution in your child's ear if he or she has ear tubes, a perforated ear drum, or any ear drainage. Also, keep in mind swimmer's ear is different from a middle ear infection which tends to be associated with colds and/or allergies.

Fun in the Sun... Sunscreens

2010-06-25T16:29:00.002-04:00

Sunscreens can be tricky as the sunscreen industry is not as regulated as you may think. Some sunscreens, even those advertised for babies, do not protect from both UVA burning rays AND UVB cancer-causing rays. Some sunscreens also contain certain chemicals like oxybenzene which may be potential hormone disruptors. Check out these sunsafety tips from the Environmental Working Group. It includes a guide on what to look for in a sunscreen. I also recommend EWG's 2010 Sunscreen Guide to choose your sunscreen. You are more likely to find these sunscreens at your local health food store. Don't fret if you can't find the ideal sunscreen right away -- just use what you have in the meantime. In general, AVOID Oxybenzone, Vitamin A (retinyl palmitate), added insect repellent, sprays, powders, and SPF above 50+. LOOK FOR Zinc, Titanium dioxide, Avobenzone or Mexoryl SX, Creams, Broad-spectrum protection water-resistant for beach, pool & exercise; and SPF 30+.

Integrative Pediatrics on the Radio WATD 95.9

2010-05-26T16:22:00.001-04:00

It was my honor to be invited to discuss Integrative Pediatrics on the Natural Medicine and Nutrition hour with Suzanne Landry on May 23rd, 2010, 8pm, WATD 95.9. If you missed the show and would like to see it, please click here. A big thank you to everyone for your support!

A Word on Guilt

2010-05-23T23:12:00.000-04:00

There are so many ways that we can improve our lives. We're trying to avoid all plastics, buy all organic, exercise daily, sleep a solid eight hours a night, have no stress... just the thought of it is overwhelming! Well, just think, everyday is a new day and every little bit counts. Sometimes it takes many small steps to make leaps and bounds. There's no reason to feel guilty about the past. Guilt is just negative energy against yourself. Who needs that? So be guilt-free. If you recognize areas that need improvement or perhaps a wrong that you've done, then take the steps you need clean up and move forward. You can make a difference.You can do it!

Arnica and bruises

2010-04-16T02:32:00.002-04:00

Ok, I had a request to write about something immediately practical. So, I thought it would be very useful for everyone to know about arnica. Arnica is a perennial herb with a long history of traditional herbal and homeopathic uses. (See prior post below for an intro to homeopathy). Parents will find that it particularly handy this time of year when our kids are apt to get the occasional bumps and bruises as they head outdoors.

If your child does end up with a bump and the skin is intact, apply arnica cream or gel or tincture as soon as possible. You may find the bruising and swelling is completely different with arnica. The results can actually be quite impressive. If your child has a bump in which the skin is broken, do NOT apply topical arnica. Instead, try a dose of over-the-counter homeopathic arnica in the 6c, 12c or 30c potency once by mouth immediately. Check with a professional homeopath for more specific and individualized dosing. Arnica topicals and homeopathic remedies may be found in your local health food store and sometimes in regular drug stores. Arnica treatment of bruising is a gentle and easy introduction to both herbal medicine and homeopathy.

Don't forget about the usual icing and elevation of the bruised area to reduce swelling. And, of course, be responsible and see a physician ASAP if your child has a significant injury, laceration, head injury, loss of consciousness, headache, nausea, vomiting, or is otherwise not acting him- or herself.

Photo credit http://en.wikipedia.org

E = mc2

2010-04-09T01:40:00.000-04:00

E = mc 2. Energy = mass times the constant speed of light squared. This fascinating formula is one of Einstein's greatest accomplishments. Now you may be thinking, what exactly does this equation mean and what does this have to do with integrative medicine? With E= mc2, Einstein is basically pointing out that energy and matter are different forms of the same thing; that is, energy and matter are interchangeable.

If people are matter, and matter is a form of energy, then people are also energy. The equation E = mc2 just helps make this truth more tangible for me. We are more than just our physical bodies. We are matter and we are energy. Therfore, we must care for BOTH the physical and energetic parts of our being. In some cultures, our energetic bodies are addressed routinely in maintaining health. Energy medicine has the same goal -- to nourish and heal our energetic bodies as well as our physical bodies. In this way, there is the potential for a more in-depth healing process. By healing the energetic body we help the physical body and vice versa. If we neglect to treat the energetic body, we are leaving out an essential part of a person's health. Einstein was far ahead of his time in terms of his scientific genius. It is time for us to fully explore his insights and their implications within the field of medicine.

For you fellow physics enthusiasts that would like to learn more about Einstein's theory of relativity, take a look at his book Relativity: The Special and the General Theory. Einstein wrote this book for the general public, high school-aged and above.

Photo credit: NOVA website: http://www.pbs.org/wgbh/nova/einstein/kaku.html

No processed foods week

2010-04-04T21:12:00.000-04:00

Imagine it... one week eating zero processed foods. That means nothing boxed, canned, or frozen; no food additives or preservatives or chemically-altered foods; no deli meats; no chips, breads, or pastas. Nowadays, that is quite a challenge for most families. However, just a few generations back, processed foods were not as widely available and most foods were freshly prepared from their whole food form. Whole foods are rich in nutrients, providing a rainbow of nourishment for our bodies and soul. Think of the dark green of kale, broccoli, or chard; oranges of sweet potato and butternut squash; the reds and purples of strawberries and blackberries; and the earthy yellows of brown rice and lentils. How much more alive and healthy would we feel if we ate real food?

If a whole foods diet sounds daunting to you, then try it in smaller steps. Pick a new vegetable to try each time you go grocery shopping. Get the kids involved and let them pick out a whole food. Give them some guidelines (something green or orange, not boxed or packaged) and see what they come up with.

Keep the cooking simple. Most dark leafy greens can easily be cooked in a quick saute with olive oil and onions or garlic on low-medium heat. See the photo for the red onion and swiss chard we sauteed with olive oil and then ate with a little brown rice or quinoa on the side. Now that's a power-packed breakfast! Or, you may opt to chop up and roast some squash or root veggies to bring out their wonderful natural sweetness. Try to keep your meals balanced with colorful veggies and a bean or whole grain.

Enjoy connecting with the earth as you explore new foods.

Introduction to Homeopathy

2010-03-20T00:01:00.000-04:00

Homeopathy is a system of medicine based on the laws of similars: "like cures like." Chosen remedies are infinitely small doses of a substance that at larger doses would produce similar symptoms of the illness. This is contrary to much of conventional or "allopathic" medicine which uses a substances (such as an antibiotic) that produce "different" symptoms than the illness at hand.

Think of homeopathy as a gentle nudge to the body to return to a healthy, balanced state. Within each of us is a natural tendency towards health. Our bodies are built to maintain balance -- a concept known as "homeostasis." Imbalances may present with specific physical and emotional symptoms, providing clues to how a person is trying to return to a state of balance. Remedies are then individualized for each person based on the precise details of the illness.

Homeopathic remedies are created from a starting substance by a series of dilutions and vigorous shaking (succussions) between dilutions. The "potency" of a remedy describes how many sequential dilutions and succussions have been done. Remarkably, in potencies of 12c or greater, it is unlikely that a single molecule of the original substance remains. The water molecules used in the dilutions hold an imprint of the original substance, possibly by the structures of the molecules, the electromagnetic properties, and other interactions that belong in the realm of quantum physics. Water (H2O) is a fascinating and unique molecule whose properties make life here on Earth possible. (I like to think of how no two snowflakes are completely alike to truly appreciate the gift of water.) Because the body is about 70-80% water, consider that an alteration in the body's water charateristics may potentially have a large impact on the whole.

Need more? I would highly recommend reading Dana Ullman's article on nanopharmacology and how homeopathy works. I also like Kellie Kirkpatrick's brief discussion of homeopathy and the vital force.

Get away from the TV, get into the real world

2010-03-11T15:29:00.000-05:00

As you may have heard, Baby Einstein is no Einstein. As a matter of fact, no video, TV show, or computer game can match the brilliance of the real world itself. Just step out into nature to engage all your senses. Nature on TV is still no comparison to the sights, sounds, smell, taste, and touch of our world outdoors. Take a look at this brief Patriot Ledger article I wrote a couple of years ago.

For those of you upset by the Baby Einstein debacle, Disney is offering a free refund. See this NY Times article. Here's to Turn of the TV week.

Should we eat organic?

2010-03-05T17:22:00.006-05:00

Pesticides are designed to be toxic in order to kill off living organisms, such as insects, plants and fungi that are considered "pests." Various pesticides are recognized by the government to disrupt the nervous system, to cause cancer, to alter the hormonal system, and adversely affect the eyes, skin, and lungs.

Although the government does have regulations, these regulations are too lax too protect the most vulnerable of us -- our infants and children, as well as developing fetuses. Companies will argue that the amount of pesticides found in food products are negligible. However, there is insufficient research to prove that these already known toxins are NOT harmful to our infants and children. Shouldn't we be more careful now rather than pay the price of our children's health later?

So, does it make sense to avoid pesticides? In short, yes. But you don't have to break the bank to do so. Try to shop from your local farm stand or look for local produce at the grocery store. First, local produce may have fewer pesticides, if any, as conventional products. Smaller farms are not always able to afford the cost and time of becoming certified organic. Second, you may find local produce fresher and therefore packed with more nutrients. Third, local produce consumes less petroleum which benefits our health from a more global environmental perspective as well.

When possible, avoid buying conventional produce listed in the "Dirty Dozen." According to the Environmental Working Group (EWG), by choosing organic for these fruits and veggies, you can reduce most of your pesticide consumption:

Apples
Celery
Strawberries
Peaches
Spinach
Imported Nectarines
Imported Grapes
Sweet bell peppers
Potatoes
Domestic Blueberries
Lettuce
Kale/ Collard Greens

The "Clean 15" are the least contaminated with pesticides. Choose local, conventional or organic for these fruits and veggies:

Onions
Corn* (*Buy non-GMO, See "Food Allergies on the Rise")
Pineapples
Avocados
Asparagus
Sweet peas
Mangoes
Eggplant
Domestic Canteloupe
Kiwi
Cabbage
Watermelon
Sweet potatoes
Grapefruit
Mushroom

You can visit the EWG site for a handy guide that you can print out or download. You might also want to check out this CNN article on pesticide residue.

Don't fret if all that is available is conventional produce. Just rinse it off as best you can. It's a good idea to rinse off all produce well as even organic produce can have trace pesticides.

Probiotics

2010-02-25T16:55:00.000-05:00

Probiotics are live, beneficial micro-organisms. They are similar to the "good bacteria" that already live in our gut. These friendly bacteria play an important role in our immune system, partly by guarding us from other substances like viruses, unfriendly bacteria, and allergens that may make us sick. These helpful organisms also aid in our digestion of food and absorption of nutrients. With such vital roles, it is important for us to maintain a healthy balance of these beneficial micro-organisms within our digestive tracts.

Some factors can alter this balance of organisms in our gut. For example, antibiotics tend to kill off the "good bacteria" along with the bad they are targeting. A diarrhea illness can also reduce the amount of beneficial bacteria. In these cases, trying to increase the amount of helpful micro-organisms in our gut with probiotics makes sense. Doing so can decrease the risk of diarrhea from antibiotics as well as prevent or lessen the severity of an infectious diarrhea illness. Recent studies have shown that probiotics may also help ward off and decrease the duration of cold and flu-like symptoms.

An easy way to increase the beneficial organisms in your digestive tract is to eat more probiotic foods. Probiotics are naturally found in cultured or fermented foods, such as yogurt, kefir, soy yogurt, miso, and vegetable pickles like sauerkraut. There are also many probiotic supplements available in various forms including tablets, powders, and drinks. The probiotic powders are a great option for kids since they can easily be mixed into a beverage. If you do choose a supplement, be sure it is not expired as there will be fewer live organisms.

Take note that not all probiotics are equal. There are different groups of probiotics, such as Lactobaccilus and Bifidobacterium, as well as many different species, such as Lactobaccilus acidophilus and Bifidobacterium bifidis, which are further subdivided into specfic strains. What may hold true for one strain may not be extended to all strains. As research continues, we will learn more about which strains may be most beneficial for certain illnesses.

Best in health,
Dr. Arlene Dijamco

Osteopathy

2010-02-19T10:56:00.000-05:00

Osteopathy is a safe and holistic way to evaluate and treat a multitude of ailments, including headaches, colic, reflux, recurrent ear infections, swallowing difficulties, strabismus (lazy eye), neck pain, back pain, sciatica, joint pain, coordination difficulties, low or increased muscle tone, hyperactivity, anxiety, and autism, just to name a few. Because osteopaths are also physicians, they may safely integrate these treatments with other therapies and recommendations (such as dietary and lifestyle changes) as necessary.

One of the main principles of osteopathy is that function is directly related to the "living anatomy" of the body, which includes the flow of fluids, motion of tissues, and mobility of joints and bones. The osteopath is highly trained to assess these subtle rhythms. Restrictions or strains on any part of the body can place pressure on nerves or cause alterations in blood flow or a myriad of problems. By applying a very precise amount of pressure, the osteopath can treat imbalances, gently encouraging the body to return to a healthier state. This type of treatment is called osteopathic manipulative medicine (OMM).

There are various types of osteopathic manipulation. One of the most in-depth and gentle manipulations, cranial osteopathy, focuses on treating the subtle rhythms of the head (cranium) and tailbone (sacrum). Disruptions to these rhythms can cause fluid retention (such as in ear infections and sinusitis), or alterations in blood flow (such as in migraine headaches), or irritation on nerves (such as vagal irritation in reflux). Restoring the natural flow of fluids and rhythms in the body can improve symptoms and even restore function completely. It is important to note that cranial osteopathy is not “cranial sacral,” since osteopaths are physicians whose training integrates their professional medical background with fine-tuned palpatory skills and in-depth understanding of anatomy, including the intricacies of the nerves, brain, bones, vasculature, and connective dura and fascia layers. To find a cranial osteopath, please see http://www.cranialacademy.org/

Best in Health,
Arlene Dijamco, MD FAAP

KALE CHIPS

2010-02-11T13:05:00.000-05:00

This is an easy and delicious recipe to make crunchy kale chips that may just keep you grabbing for more. Kale is power-packed with antioxidants and anti-inflammatories and is also a good source of calcium.

Preheat the oven to 350 degrees. Tear or cut off leaves from stems. Break leaves into bite-sized pieces. Make sure leaves are dry, otherwise they do not crisp as well. You may want to spin them dry with a salad spinner. Drizzle with olive oil. Use your fingers to coat both sides of leaves completely. Place on a cookie sheet. Sprinkle with sea salt or kosher salt (careful, a little goes a long way.) Bake for 15-20+ minutes. Watch carefully, as leaves will brown quickly. Yum!

Energy Medicine & Reiki

2010-02-09T23:42:00.000-05:00

We are all energetic beings. For example, we emit heat (thermal energy), we can move (kinetic energy), and our nerves conduct electrical currents. Based on our energetic properties, scientific advances have led to high-tech medical tools and devices such as EKGs (electrocardiograms), pacemakers, and MRIs (magnetic resonance imaging.)

Somehow, we humans have always been aware of our energetic properties. Humans have known this for thousands of years even without all our modern equipment. We are filled with a basic form of energy which makes us feel alive. Some call it our life force, "chi" or "ki." When we feel happy, whole, and connected, our life force is flowing freely. However, the natural flow of our life force may be disrupted by a variety of reasons including acute and chronic stressors, potentially causing illness. Energy medicine focuses on restoring the balance to our life force.

There are many types of energy medicine. One of the simplest forms is Reiki. It is a non-invasive, hands-on treatment done fully clothed. Reiki can be used at any age for a variety of conditions from anxiety and depression to surgical recovery. Reiki was recently recommended by integrative cardiothoracic surgeon Dr. Mehmet Oz (see the video clip here). My teacher, Reiki master Pamela Miles, presents a brief introduction to Reiki on her website and video. Although Reiki treatments given by an experienced Reiki master may be more intensive, anyone can learn Reiki, even children. A regular self-Reiki practice for even a few minutes a day can have a remarkable effect on you and your family. Try it out for a couple weeks and see for yourself.

Best in Health,
Arlene Dijamco, MD FAAP

Walking On Sunshine... Vitamin D and You

2010-01-26T14:02:00.000-05:00

Vitamin D is taking center stage these days. It is important in bone health and calcium balance, preventing a bone-softening disease called rickets. Vitamin D also plays a role in optimal immune and neuromuscular function, anti-inflammatory effects, as well as the prevention of multiple sclerosis and certain cancers, including breast and colon cancer. Click here for details.

Unfortunately, our main source of Vitamin D - the sun - is not as accessible now that the days are short and we're bundled up for the winter. There are only a few food sources of Vitamin D, such as fish (salmon, tuna, mackerel), fortified milk and fortified orange juice. Recent studies have shown that over half of kids have insufficient levels of Vitamin D. Click here for more. Last year, the American Academy of Pediatrics (AAP) increased the recommended daily intake of Vitamin D from 200 to 400 units per day for infants, children, and adolescents. If you relied on milk alone for Vitamin D, you would have to drink 4 cups of milk a day. During the cold months, an efficient way to obtain Vitamin D is via a Vitamin D supplement, which is available in combination or alone. In addition, don't forget to get outside regularly! Even a little winter sunshine warming our faces will be better than none.

Arlene Dijamco, MD FAAP

General & Integrative Pediatrics