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  • Writer's pictureDr. Sally Smith

November 2023: RSV + Thanksgiving

I wanted to start this newsletter by extending a warm and heartfelt thank you to all my wonderful patients and parents. I am so grateful for the opportunity to be your children's pediatrician. I hope each and every one of you has a wonderful, fulfilling, peaceful holiday season. Now let's dive in to a couple relevant topics...

Virus Watch: RSV

Respiratory Syncytial Virus (RSV) is a common virus that affects people of all ages, but it hits children with the most severity. It's especially prevalent during the fall and winter months, usually starting in October and lasting until about April, peaking in January and February. But this can vary - last year, we started seeing cases in August and it peaked in November! RSV can cause mild cold-like symptoms in older children and adults, but it can be more severe in infants and young children, causing bronchiolitis, pneumonia, and the associated respiratory difficulties. 

Nearly every child has been infected with RSV by the age of 2, and reinfection with RSV is common. Unfortunately, previous infection with RSV does not help to prevent reinfection. RSV is the most common and serious cause of a lower respiratory infection - versus an upper respiratory infection, otherwise known as the common cold. 

RSV can cause severe respiratory symptoms, leading to hospitalization for oxygen therapy, primarily in young infants. Approximately 2-3% of healthy infants require hospitalized care for respiratory distress caused by RSV.

Children at the highest risk for severe RSV infection.

  • Infants under the age of 6 months, especially those born during RSV season

  • Young children attending daycare or those with older siblings (who can carry the virus but have no symptoms) 

  • Children with asthma or other underlying lung disease

  • Infants exposed to second-hand smoke

  • Infants born before 35 weeks gestation

  • Children with congenital heart disease or another underlying disease or illness

The Spread of RSV

RSV Symptoms in Children

Common symptoms of RSV in children include:

  • Runny or stuffy nose (usually lots of mucous)

  • Cough (can be wet and mucousy or dry and tight)

  • Sneezing

  • Fever (any increased temperature - mild or high)

  • Wheezing or difficulty breathing

  • Irritability, poor restless sleep

  • Decreased appetite

If your child exhibits any of the following symptoms, contact your pediatrician or seek immediate medical attention:

  • Difficulty breathing

  • High fever

  • Dehydration

  • Bluish color of the lips or skin

Prompt medical care is essential for younger children, especially infants, as RSV can progress quickly in these age groups.

RSV Testing and Treatment

Beyfortis (generic name nirsevimab), the New RSV Monoclonal Antibody Injection

Beyfortis, a brand-new immunoprophylaxis found to be safe and effective in preventing RSV infection, received approval from the US Food and Drug Administration in July, 2023. In October, it became available for purchase by medical practices (costing around $525), and by late October, it was sold out and unavailable (although a few days ago the CDC announced the release of 77,000+ more doses, so we’ll see)! 

This injectable antibody (not a typical “immunization”) is expected to provide RSV protection for a minimum of five months, making a single dose sufficient when administered during the RSV season, which typically spans from October through the end of March. It is approved and recommended for infants under the age of 8 months and is meant to be administered exclusively within the RSV season. Infants born during this period are advised to receive this Beyfortus injection within their first week of life, and are encouraged to get it even before leaving the hospital after birth, but so far, most hospitals are unable to stock it. Again, because this year’s supply is low, most eligible newborns and infants will not be receiving it, but I imagine in future years, Beyfortus will be a routine and expected medication.

I hope you find this RSV Awareness Edition helpful! Please remember to reach out to me if you have any concerns about your child's health. Stay strong and healthy!

Thanksgiving Concerns!

Food Allergies: It's crucial to be mindful of potential food allergies, especially when it comes to our little ones. With diverse dishes on the table, I encourage you to communicate any allergies your children may have to ensure a safe and enjoyable celebration. Double-check ingredient lists and communicate with the host to guarantee that allergens are avoided. Consider bringing a dish or snacks that align with your child's dietary needs, ensuring they have plenty of options. By fostering open communication and taking proactive measures, we can create a Thanksgiving gathering that is both delicious and safe for everyone at the table.

Protecting your (and your kids') Peace: Navigating family gatherings can be a mixed bag of joy and challenges. It's not uncommon for well-intentioned but frustrating comments to be directed at your children, especially regarding their eating habits. Dealing with criticism or having relatives insist on particular foods can be trying. In these moments, I encourage you to politely explain the reasons behind certain choices or kindly ask relatives to refrain from making specific comments to your child. Your advocacy for your family's well-being is important, and setting boundaries (even though it is SO darn hard) is an essential part of maintaining a positive atmosphere during these gatherings. (Here is a recent, short video of Dr. Julie Gottman that touches on this topic:) !

November Finds...

Something Educational: I've followed and really enjoyed the research and impactful work conducted by Drs. John and Julie Gottman. The Gottman Institute serves as an invaluable treasure trove of resources, guiding us on navigating life to become the best version of ourselves, particularly in terms of how we show up in relationships. Very recently, they announced new courses on toddlers! For my parents out there who love learning, these courses seem amazing! Find them here! If you are not familiar with the Gottmans, I encourage you to look into these courses, check out their books, or even listen to their podcast on spotify!

Something Festive: Speaking of Thanksgiving, did you know cranberries are a nutritional powerhouse? I’m sure you’ve all heard that drinking cranberry juice can help prevent or cure urinary tract infections, and it’s true! Cranberries' best-known benefits have been to treat urinary tract infections, which is due to proanthocyanidins (PACs). These tannins prevent Escherichia coli (E. coli) bacteria from attaching to cells in the urinary tract and causing infection. But in addition, this sour-ish little berry contains phytochemicals, anthocyanins, PACs, and flavonols which have a myriad of health benefits! They reduce and help prevent both viral and bacterial infections, promote a healthy heart, decrease inflammation associated with chronic disease and aging, and support digestive health. Cranberries also contain antioxidants, which can help prevent cancer, heart disease, and other degenerative diseases. I've recently heard that cranberries can also aid in getting a peaceful night's sleep, and who doesn't need that once in a while?!

Something my patients have taught me: Take “10” daily - just 10 minutes of sitting with your child, without your phone or electronics, just sitting there on the floor, fully interactive and engrossed, playing with your child, for a mere 10 minutes every day - or better yet, twice daily. It’ll mean the world to them!

Final Thoughts...

Have a wonderful and safe Thanksgiving, fully enjoying and appreciating others' company (even if you don't agree with them on some things :)), and getting your heart and soul fulfilled with laughter, love, warmth, and joy.

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