Pediatrics | Mount Sinai Today

Kids and the Sun: Tips on Sunscreen and Treating Sunburn

Updated on Jun 30, 2023 | Pediatrics, Your Health

With children, it’s never too early to start practicing good sun protection behaviors. In fact, exposure to ultraviolet radiation and a history of sunburns during childhood greatly increases your risk of developing skin cancer later in life.

Nanette Silverberg, MD, Director of Pediatric Dermatology, Mount Sinai Health System, shares some tips for protecting your child’s skin, which is especially important during the warmer months when they may spend so much more time outside in the sun.

Nanette Silverberg, MD, Director of Pediatric Dermatology

Here are five basic steps you should take:

Look for sunscreens that have a sun protection factor (SPF) of 30-50+ and that say they provide “broad spectrum” coverage, meaning they protect against both UVA and UVB radiation. UVA rays have less energy and are mostly linked to long-term skin damage, such as wrinkles, while UVB rays are the ones that cause sunburns, which are thought to cause most skin cancers, according to the American Cancer Society.
Sunscreens should be applied 30 minutes before going outside for the day and then reapplied every two hours.
Sunscreens should be reapplied after swimming or heavy sweating, as they are not waterproof.
In addition to sunscreen, children should wear a wide-brimmed hat and sun protective clothing (UPF 50) such as swim shirts or rash guard shirts. These shirts typically block 98 percent of ultraviolet radiation, according to the Centers for Disease Control and Prevention.
Stay in the shade as much as possible, and avoid the mid-day sun during its peak hours of intensity from 10 am to 2 pm.

Even if you apply sunscreen and practice good sun care, your child may still get a sunburn. What should a parent do to minimize the sting?

Dr. Silverberg, suggests applying a cold compress, or bathing your child in cool water. Over-the-counter hydrocortisone one percent cream can also be helpful to ease red, itchy, or tender skin and help with inflammation. Hypoallergenic moisturizers can soothe the skin.

If the sunburn is painful or widespread, talk with your pediatrician about whether taking ibuprofen is appropriate for older children. If you notice any blistering, you should consider consulting with a pediatric dermatologist. Follow up to check for sun damage and be extra careful with sun protection on healing skin.

Post-pool skincare is also extremely important, especially for young children. Dr. Silverberg says most children tolerate chlorinated water, but she recommends rinsing off after the pool and applying light emollients when coming indoors.

Skincare also includes applying therapies afterwards for children with eczema, and reapplying sunscreen for outdoor play. Additionally, shirts with UPF should be rinsed with water and left to air dry to help maintain their potency and soft feel.

Learn more about Mount Sinai Pediatric Dermatology

What Should I Do If My Child Has Norovirus?

Updated on Feb 24, 2023 | Adolescent Health, Featured, Pediatrics, Your Health

If your child has a stomach bug, it could be norovirus—a highly contagious stomach virus that causes diarrhea and vomiting. Cases of this virus are on the rise in New York City and much of the northeastern United States, according to the Centers for Disease Control and Prevention.

While typically mild in older children and adults, lasting usually only a few days, norovirus can cause severe dehydration in babies and kids with certain underlying conditions. Knowing how to care for them is crucial.

In this Q&A, Tessa Scripps, MD, a pediatrician at the Mount Sinai Kravis Children’s Hospital, and Assistant Professor of Pediatrics at the Icahn School of Medicine and Mount Sinai, answers your questions about the disease, including what to do if your child is sick.

What is norovirus, and what are norovirus symptoms?

Norovirus is a common contagious virus that inflames the intestines, causing nausea, diarrhea, and throwing up. Sometimes it can also cause fever. The disease is spread when particles from an infected person’s feces or vomit spreads to others, typically in bathrooms, but also by eating or drinking contaminated foods and beverages; using contaminated utensils; touching contaminated surfaces; or having any direct contact with someone who is infected. Norovirus is highly transmissible, and infected people can actually shed billions of norovirus particles at a time, but it can take fewer than 100 norovirus particles to make another person sick. People are most contagious when they actively have symptoms and in the few days after their symptoms have resolved.

Tessa Scripps, MD

How can I protect my child from catching norovirus?

The most common way norovirus is spread is through close contact with an infected person, so it’s a good idea to keep kids some distance from people who are sick, or who have recently recovered from being sick. Norovirus can infect an entire family at the same time, since even simple contact with others can lead to infection. So, the most important thing is for kids to wash hands frequently with soap and warm water, and for adults to do the same, especially if any of you have been in contact with a person who has symptoms. Alcohol-based sanitizers do not work as effectively against preventing transmission.

My child has norovirus. How does their age or health condition affect their risk for severe illness?

Newborn babies and children who have underlying chronic illnesses such as kidney disease and diabetes are at higher risk for becoming dehydrated and severely ill because excessive fluid losses can affect their kidney and their liver function. It’s important they get medical attention right away if symptoms last longer than three days or if they’re unable to keep hydrated.

What symptoms might indicate my child needs medical help?

Watch for symptoms of dehydration, such as decreased or less frequent urination and small volume- or very dark or strong-smelling urine. If it has been more than eight hours from when your child has had a wet diaper or used the toilet to pee, reach out to your doctor for advice. A rapid heart rate or a significant change in your child’s activity can also be a sign of dehydration. If you notice that your child seems very lethargic and listless, you should seek medical advice right away.

What can I do to help my child recover from norovirus?

Once the virus has passed and the vomiting and diarrhea have subsided, make sure they are well hydrated and rested. For newborns and infants, you can give them small amounts of breast milk or formula. Toddlers, older children, and adults should drink small volumes of fluids—about one to two ounces every one to two hours—to ensure fluids get absorbed and to prevent recurrent vomiting. Drinking water and electrolyte fluids like Pedialyte^®, Gatorade, or watered down apple juice can be very useful to maintain hydration, and can help prevent complications from norovirus. They can also have bland foods like rice, dry cereal, applesauce, bananas, and crackers.

Are there any medications I can give my child to ease their norovirus symptoms?

There are no over-the-counter anti-diarrheals or anti-nausea medicines that are recommended for children. In rare cases, pediatricians may prescribe Zofran, an anti-emetic, to help children stop vomiting so they can re-hydrate without the need for intravenous fluids.

How do I prevent norovirus from spreading to my other kids?

It is important that everyone in your house washes their hands regularly with warm water, and avoid sharing food and drinking cups with anyone who is sick. You should also wipe down any contaminated surfaces with a bleach-based disinfectant, especially toilets and sinks after an infected child has used them. And everyone should try to maintain some distance from infected household members while they’re actively sick.

Is there a test for norovirus I can give my child?

Testing is available. However, norovirus is similar to other types of stomach infections, such as rotavirus, and symptom management is the same, so testing isn’t useful. If there has been an outbreak at your child’s school and they are sick, there is a good chance they have norovirus.

What Is the Safest Way for My Baby to Sleep?

Updated on Oct 26, 2022 | Pediatrics, Your Health

Just a few important tips: Infants up to one year old should sleep on their backs, in a crib free of loose bedding and toys.

Did you know that because of the special shape of babies’ throats, they have much less risk of choking while lying on their backs? This is one of many safe sleep facts that pediatricians want parents and other caregivers to know.

Every year in the United States, about 3,500 babies die during sleep due to unsafe sleep environments, and SUID (Sudden Unexpected Infant Death) is the leading cause of death among infants between 1 month and 12 months of age.

“It is imperative that safe sleep is practiced, especially for preterm and low-birth-weight infants, who have a higher risk of sleep-related deaths,” says Malorie Meshkati, MD, a physician in Neonatal Intensive Care at Mount Sinai Kravis Children’s Hospital. The American Academy of Pediatrics (AAP) has a longstanding policy on safe sleeping environments for infants, Dr. Meshkati says. In this Q and A, she explains the basics.

What exactly is a safe sleep position?

Infants should be placed on their backs for every nap and sleep on a surface that is firm and flat. The sleep area should be clear of soft objects such as pillows, pillow-like toys, quilts, comforters, mattress toppers, fur-like materials, and loose bedding such as blankets and non-fitted sheets. Infant sleep clothing, such as a wearable blanket, is preferable to blankets and other coverings. Swaddling is okay until three to four months of age, when babies may start to roll. You should not swaddle your baby once they start showing signs of rolling. Avoid overheating and head coverings such as hats at home.

My baby has reflux. Can I still put them in safe sleep position?

Yes. Sleeping flat and on their back does not increase the risk of choking or aspiration in infants, even in those with reflux who may often spit up. In fact, babies are at less risk for choking when they sleep on their backs because the shape of their throats keeps fluid from flowing into their lungs. The AAP recommends a video that explains this. You can view it here.

Should my baby sleep in bed with me?

No. The AAP recommends that infants sleep in their parents’ room, close to their parents’ bed, but on a separate surface designed for infants. Evidence shows that the risk of SIDS can be decreased by as much as 50 percent if infants sleep on a separate surface while in the same room as their parents. Room sharing without bed sharing is especially important in the first six months and continues to protect against SIDS for the first year of life.

How old should my baby be when I stop putting them in safe sleep?

The AAP recommends infants be placed in safe sleep, every time they sleep, until they are one year old.

What else should people know about safe sleep?

Consider breastfeeding; this has been shown to be protective against sleep-related infant deaths. Avoid exposing your baby to nicotine, alcohol, marijuana, opioids, and other drugs. Stay up-to-date on routine immunizations. And let your baby have supervised tummy time every day. You can read more about safe sleeping on the AAP website or watch this helpful video.

Improving Diversity in Autism Genomic Research

Updated on Jun 30, 2022 | Community, Diversity and Inclusion, Pediatrics, Research

The Seaver Autism Center for Research and Treatment partnered with Centro Ann Sullivan Del Perú to serve children with autism spectrum disorder and their families. Above, Pilar Trelles, MD, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, conducting an evaluation with a family in Lima, Peru.

Genomic research is now an integral part of the study and treatment of autism spectrum disorder (ASD) and related neurodevelopmental disabilities, so it is crucial to include more ethnically and racially diverse populations, said Pilar Trelles, MD, a psychiatrist and researcher at the Seaver Autism Center for Research and Treatment, who was the featured speaker for a virtual talk hosted by the Office for Diversity and Inclusion (ODI) at Mount Sinai. The session, “Forming Community Ties to Improve Diversity in Autism Genomic Research,” is available here.

The talk was part of the Raising Disability Awareness Virtual Talk Series, launched by ODI in 2020, which featured speakers from around the Mount Sinai Health System and the community to raise awareness and promote an inclusive and equitable work place and health care environment for people with disabilities.

“Data contained in the National Human Genome Research Institute and European Bioinformatics Institute Genome-Wide Association Studies Catalog indicate that most of the individual genetic samples—78 percent—come from individuals of European descent,” said Dr. Trelles, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai. “And this is translating into clinical practice, because we are learning less about individuals of diverse ancestry.”

Pilar Trelles, MD, is a psychiatrist and researcher with the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai.

Dr. Trelles and other staff at the Seaver Autism Center are dedicated to caring for people of all ages with ASD, leading clinical trials, and furthering research into drug development, molecular targeting, neurology, and genomics. She said that disparities and barriers exist overall for people with ASD who belong to minority groups. Some of these barriers include lack of trust in research—often based on historic inequities in science and health care—limited representation of minorities in science, a lack of cultural competency among physicians and scientists, and a lack of infrastructure.

To combat disparity and increase the accessibility to care, Dr. Trelles collaborated with families and children with ASD in Peru, creating an international partnership between the nonprofit Centro Ann Sullivan Del Perú and the Seaver Autism Center. The partnership is intended to “promote family and caregiver empowerment, educational programs, and collection of bio-specimens for genetic analysis and clinical information,” she said. The goal for the future of health care for people with ASD and their families is to develop a strong partnership where there is a clear and direct benefit to the community.

“It cannot be a one-time thing, it has to be a sustainable model that will last over time,” Dr. Trelles said. As a result of increasing accessibility where possible, her team found that compared with 2016, there has been a significant increase of Asian, Black, mixed ancestry, and Hispanic people in research participation.

Dr. Trelles ended her talk on a hopeful note. “The idea is to work with communities that could benefit from the expertise that we have, where we can actually bring a clear benefit, and provide better care and education for families,” she said. “So that we can build trust and transparency moving forward.” For more information, visit the Seaver Autism Center site.

Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.

Prevalence and the Understanding of Autism Spectrum Disorder Are on the Rise

Mar 30, 2021 | Community, Diversity and Inclusion, Pediatrics, Your Health

The Seaver Center for Autism Research and Treatment at the Icahn School of Medicine at Mount Sinai is advancing the understanding of autism spectrum disorder.

Autism spectrum disorder (ASD) is increasing in prevalence, but so are options for evaluation and therapies, said Paige Siper, PhD, Chief Psychologist for the Seaver Autism Center for Research and Treatment, and Michelle Gorenstein, PsyD, Director of Outreach for the Seaver Center. “The interesting and exciting part about the work that we do is that we get to see toddlers through adults, and I think that is something very unique about this field,” said Dr. Siper, Assistant Professor of Psychiatry, Icahn School of Medicine at Mount Sinai. The virtual talk can be viewed here.

Paige Siper, PhD, Chief Psychologist of the Seaver Center

“Autism Spectrum Disorder Across the Lifespan” was hosted by the Mount Sinai Office for Diversity and Inclusion. It was part of a series featuring speakers from around the Mount Sinai Health System as well as the community to raise awareness and promote an inclusive and equitable health care environment for people with disabilities.

Dr. Gorenstein, Assistant Professor of Psychiatry, Icahn School of Medicine, said that an important tool in the field is Applied Behavioral Analysis, a class of interventions based on principles of operant learning theory—that is, providing positive reinforcement for observable behavior, like asking for a push on a playground swing, or making a choice. Another therapy, Relationship Development Intervention, is a family-based method that builds social and emotional skills. And there are a variety of therapies to treat conditions that can accompany ASD, such as anxiety, ADHD, or epilepsy.

Michelle Gorenstein, PsyD, Director of Outreach for the Seaver Center

ASD is characterized by difficulty with social communication, as well as the presence of repetitive behaviors or restricted interests. ASD is primarily a genetic disorder but can also be influenced by environmental factors. Dr. Siper said multiple studies have shown that vaccines do not cause ASD, dispelling a common myth.

One in 54 children in the United States are diagnosed with ASD, and boys are four times more likely than girls to receive the diagnosis. ASD can be identified in children as early as age 18 months, which makes early intervention very important in improving social, communication, motor, and daily living skills. “Early intervention can change outcomes,” Dr. Siper said. “It’s the opposite of watch and wait.”

The Seaver Center is dedicated to caring for people of all ages with ASD, furthering research into risk factors and drug development, and leading clinical trials. “One of the unique things about our Center is that it really does translate the basic sciences to the clinic,” Dr. Siper said. For more information, visit the Seaver Center site.

Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.

Enhancing Early Brain Development in Children

Updated on Jun 30, 2022 | Featured, Pediatrics

Kenneth L. Davis, MD, left, with Jackie and Mike Bezos of the Bezos Family Foundation.

A partnership between Mount Sinai Kravis Children’s Hospital and the Bezos Family Foundation aims to transform pediatric health care through an innovative program that provides science-based tips, tools, and activities to enhance a child’s early brain development during the critical years from birth to age five. The effort, a collaboration with the Mount Sinai Parenting Center, is based on a core premise—that everyday interactions between a child and a parent, caregiver, or health care providers can be turned into an opportunity to build cognition and language skills, and help form strong interpersonal relationships. It is the cornerstone of an early learning program, known as Vroom, that was developed by the Bezos Family Foundation.

“In a child’s early years, the brain makes more than 1 million neural connections on average each second, which means every moment you spend with a child is an opportunity for brain-building activities,” says Carrie Quinn, MD, Assistant Clinical Professor of Pediatrics, Icahn School of Medicine at Mount Sinai, and Executive Director of the Mount Sinai Parenting Center. “The health care environment offers a unique opportunity to reach parents during these formative years.”

The Parenting Center has saturated hallways, elevators, and exam rooms—in the prenatal, labor and delivery, postpartum, and neonatal intensive care units; and in the pediatric emergency department and the pediatric clinic—with easy-to-read signs that serve as canvases to convey more than 500 messages about parenting. “This prompts everyone to think about how they can make each interaction more meaningful, whether you are a parent in a waiting room, a pediatrician doing a consultation, or a security guard who is the first to greet families and typically the last person to say goodbye,” says Aliza Pressman, PhD, the Parenting Center’s Co-Founding Director and Director of Clinical Programming, and Assistant Clinical Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai.

“From using a sing-song voice called ‘Parentese’ while changing a diaper, to modeling backand- forth conversations with toddlers, each moment becomes an opportunity to promote healthy brain development,” adds Blair Hammond, MD, Co-Founding Director and Director of Medical Education for the Parenting Center, and Assistant Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai.

“The science we have funded for more than a decade clearly shows that children’s early development is dependent on parents and other caring adults in their lives,” says Mike Bezos, Vice President and Co-Founder of the Bezos Family Foundation. “Health care professionals like those at the Mount Sinai Parenting Center are natural partners.”

Adds Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System, “Mount Sinai has long recognized that the health of any child goes well beyond the immediate concerns that families present with and that we must always be holistic in our approach to facilitate their development and put them on a path of lifelong well-being.”

The initiative also offers a training component that includes video, e-learning, and in-person classroom support for all staff in the designated units to ensure they are well-equipped to apply the fundamentals of brain development science in their interactions with children and parents. More than 1,000 faculty and staff will be trained in clinical disciplines, such as Nursing and Social Work, an effort that also includes staff in nonclinical areas, such as Housekeeping, Patient Transport, and Security. The potential to influence thousands of children and their families is great. Each year, there are more than 50,000 primary care and emergency room visits, and more than 8,000 babies born at Kravis Children’s Hospital.

This initiative is the latest innovative effort by the Parenting Center. In 2018, it launched a pilot program with eight hospitals, including The Mount Sinai Hospital, to offer a free online curriculum for residents that integrates the science of early childhood development with pediatric training, teaching residents how to better inform, encourage, and interact with parents during well-child visits. Developed in partnership with Mind in the Making, a program of the Bezos Family Foundation, 76 hospitals around the nation have offered the curriculum to date, and an estimated 1,900 residents have enrolled.

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