Fully Vaccinated? No Mask Needed with Exceptions

Children COVID-19 Infection Pediatrics Vaccines No Comments
Fully Vaccinated - No Masks with Exceptions
Photo by Ani Kolleshi on Unsplash

CDC’s Updated Mask Guidance for Fully Vaccinated People

On May 13, 2021, the CDC updated their Interim Public Health Recommendations for Fully Vaccinated People.  The CDC states the science shows that breakthrough COVID-19 illness in fully vaccinated individuals is limited and most breakthrough infections resulting in asymptomatic or mild disease. Hence, fully vaccinated individuals do not need to wear a mask indoors and do not need to socially distance, “except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.”
 

What is the Definition of Fully Vaccinated?

Full vaccination occurs ≥2 weeks after a person has received the 2nd dose of the Pfizer or Moderna vaccine or ≥2 weeks after a person has received the Johnson & Johnson vaccine.
 

What Can Fully Vaccinated People Stop Doing?

  • Stop wearing masks and social distancing, except as “required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.”
  • Stop testing before or after travel or self-quarantine after domestic travel
  • Stop testing before leaving the U.S. for international travel (unless required by the destination)
  • Stop self-quarantining after arriving back in the U.S.
  • Stop testing following a known exposure, if asymptomatic, with some exceptions for specific settings
  • Stop quarantining following a known exposure, if asymptomatic
  • Stop routine screening testing, if feasible

Where Are Masks Still Required for All?

Please keep in mind these CDC Guidelines do not apply in medical offices yet. Medical offices are places of higher risk. 
Other locations where mask use is still required are hospitals, other medical facilities, nursing homes, prisons, homeless shelters, and public travel.  In addition, it is still recommended that masks be worn in environments where there is a dense population, for example, at concerts.
 

What about Travel?

“All travelers are required to wear a mask on all planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.”
 

What about International Travel?

  • Fully vaccinated travelers do not need to get tested before leaving the U.S. unless required by their destination.
  • Fully vaccinated air travelers coming to the United States from abroad, including U.S. citizens, are still required to have a negative COVID-19 test result or documentation of recovery from COVID-19 before they fly to the U.S.
  • International travelers arriving in the U.S. are still recommended to get a COVID-19 test 3-5 days after travel regardless of vaccination status.
  • Fully vaccinated travelers don’t need to self-quarantine in the U.S. after international travel.

What If I’m Fully Vaccinated, Symptomatic, & I Get COVID-19?

The risk of breakthrough infection is very low for fully vaccinated people.  However, if this occurs, the fully vaccinated person who has COVID-19 symptoms should:
  • isolate themselves from others
  • be medically evaluated for a COVID-19 infection
  • get tested for COVID-19 infection
  • inform their doctor that they are fully vaccinated

What If I’m Fully Vaccinated, Asymptomatic, & Am Exposed to Someone Who Has/Might Have COVID-19?

The risk of breakthrough infection is very low for fully vaccinated people.  Isolation, quarantining, work restrictions, and COVID-19 testing are not required after exposure to someone who either has or is suspected of having COVID-19.  However, it is still necessary for them to self-monitor for 14 days after the exposure.
 

What If I’m Fully Vaccinated, Asymptomatic, Am Exposed to Someone Who Has/Might Have COVID-19, & I Work in a Prison or Homeless Shelter?

COVID-19 testing is required.  However, isolation, quarantining, work restrictions are not required after exposure to someone who either has or is suspected of having COVID-19.
 

What If I’m Fully Vaccinated, Asymptomatic, & Not Exposed to Someone Who Has/Might Have COVID-19?

Fully vaccinated people without COVID-19 symptoms, without known COVID-19 exposure “should be exempted from routine screening testing programs, if feasible.”
 

What If I’m Not Fully Vaccinated?  

The CDC recommends continued mask use and social distancing for anyone who is not fully vaccinated.  Masks are recommended for those children and adults, ages 2-years-old and up who are not fully vaccinated. Discuss your concerns about the vaccine with your doctor. Please consider getting a COVID-19 vaccine.  It is life-saving for the person vaccinated and the people around them.
 

When Will Fully Vaccinated People Be Able to Stop Wearing Masks in Your Office?

We will be able to relax some of our office’s mask requirements for fully vaccinated individuals, once the Overall New Percent Positivity is consistently (at least 2 weeks) <5% in BOTH Pasco & Hillsborough counties, as we serve both of these counties in Florida. New Percent Positivity refers to the percent of the population that has tested positive for COVID-19 for the first time in the past two weeks.  
 
Currently, as of 05/12/21, Pasco County’s Overall New Percent Positivity has been below 5% for two days. Hillsborough County’s Overall New Percent Positivity is 6.26%.  In addition, Pediatric Overall Percent Positivity has continued to increase through May 2021. Pasco’s Pediatric Overall Percent Positivity is 13.4% and Hillsborough’s is 14.7%. The Florida Department of Health does not release Pediatric New Percent Positivity. As always, we are watching these numbers very closely.
 

Do Children Still Need to Wear a Mask in Your Office?

Children ages 2-years-old and up and their parents who are not fully vaccinated against COVID-19 need to wear a mask throughout their office visit.  COVID-19 vaccine is not available for children 2 to 11-years-old at this point.  Trials are ongoing for children ages 6 months to 11-years-old.  The trials are expected to yield results in September 2021.  Please stay tuned.  We will keep you posted as updates occur.
 

How Can I Request to Not Wear a Mask in Your Office?

Fully vaccinated individuals that show their COVID-19 vaccination status as fully vaccinated will not need to use a mask in our office. For those who are uncomfortable sharing their vaccine information, mask use will be necessary throughout the visit.
 

How Can I Get More COVID-19 Updates?

Please feel free to search this blog for general non-COVID-19 health updates like car seat safety.  COVID-19 information changes daily.  We are happy to serve our community and others in this rapidly changing world we currently live in.  Please consider following us on our Small World Pediatrics Facebook page for frequent updates.  We also have weekly Facebook Live Videos on Sundays at Noon focusing on COVID-19 discussions where this week we discuss many updates and answer questions, including but not limited to the CDC’s mask guidance for fully vaccinated individuals.
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Positional Asphyxia | Death Asleep in a Car Seat

Children Parenting Pediatrics Safety Sleep No Comments
Positional Asphyxia: Death Asleep in a Car Seat

Could a Baby Die Asleep in a Car Seat on the Floor?

Tragedy struck a North Dakota family when one of their twins died at daycare in his sleep.  The daycare workers usually took the babies out of their car seats.  At drop off, Linnea was taken out of her car seat.  But her twin brother, Anders Jungling fell asleep.  Just a few hours later, his mom, Rachel, got the phone call.  He died quietly in his sleep … in his car seat.  Rachel didn’t understand why he was still in his car seat.  The daycare workers didn’t know that a baby could die in a car seat placed on the floor. So, they let him sleep.

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Why Does Any Mother or Caretaker Leave a Baby Asleep in the Car Seat? 

 

The reasons are many … 

“I’m just so tired.” 

“He finally fell asleep.”

“He has such bad colic & has been crying all day. He needs the sleep.”

“I’ll leave him there for just 30 minutes.”

“If I take him out, it’ll take forever to get him back to sleep.”

“I’ve always heard to let sleeping babies lie.”

And many, many more.

 

 

How Many of Us Have Left Our Baby Asleep in a Car Seat? 

 

I’ve been guilty of that.  I remember constantly checking, every 2-5 minutes if my sleeping son was okay in the car seat.  Then, it finally dawned on me that the little bit of sleep he would get in his car seat was causing me extreme stress and additional mental unrest.  Why was I doing that to myself?  He had horrible colic.  He was only getting a maximum of 3 hours daily.  In the end, I couldn’t reconcile his much-needed sleep with my ever-increasing madness.  I’m sure my sleep deprivation made me think unclearly.  Mentally, I just couldn’t take the risk anymore.  And so, I took him out of his car seat.  And he cried.  A lot.  I hated it.  Praying he would just fall back asleep each time, but he didn’t.  So, many a night, I would drive with him until he slept in the car.  I can understand why anyone would leave a baby in a car seat.  However, we just can’t because they could die of positional asphyxia.

 

 

 

What is Positional Asphyxia?

Positional asphyxia happens when an infant stops breathing when they are either placed or fall asleep in an unsafe sleeping environment or an unsafe position.

 

 

How Can Positional Asphyxia Occur in a Car Seat?

A baby can sleep safely in a car seat placed in a car because the car seat is placed at an angle.  when the car seat is at an angle, a baby’s heavy head remains backward and their airways remain open.  On the floor, the baby’s head tilts forward and closes their airway.   The baby will not fight the asphyxiation.  They will die quietly in their sleep.  

 

 

What are Some Unsafe Environments for Baby’s Sleep?

Car Seat

Bed-sharing

Objects in the bed, such as blankets, pillows, stuffed animals

Sofas

Waterbed

Beanbag Chair

 

 

What are Some Unsafe Positions for Baby’s Sleep?

Side sleeping

Sleeping facedown

Sleeping with the head covered (in a car seat)

Face against a soft surface (bed bumpers, parent’s chest)

 

What are the ABCs of Safe Sleep?

Alone – Babies need to sleep alone in a crib without anything that could suffocate them (bed bumpers, blankets, pillows, stuffed animals, pacifiers made with attached plushies).
Back – Babies need to sleep on their backs (no side sleeping or face down sleeping).
Crib – Babies need to sleep in a crib or a flat bassinet (not a car seat, swing, adult bed, etc).

 

Is This Rare?  Why Change if Nothing Bad Has Happened to Anyone I Know?

 

You may not hear or know someone whose baby died of positional asphyxia, but it’s not worth taking the risk.  In my pediatric career, in over 20 years, I’ve had 3 children that I’ve cared for die from positional asphyxia.  If it happens to you or someone you know, it’s life-changing.  You have to live with the pain and regret, forever wondering, if you had only changed, would life have been different?  It’s just not worth it.  

 

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Lavender and Tea Tree Essential Oils | Abnormal Breast Growth in Girls & Boys

Children Health Natural Pediatrics No Comments
Lavendar & Tea Tree Essential Oils | Abnormal Breast Growth in Girls & Boys

Lavender and Tea Tree Essential Oils – Use in Children

Lavender and tea tree oils may have negative side effects in children.  These oils may increase estrogen activity while inhibiting androgen activity.  Estrogen is the female sex hormone. Androgen is the male sex hormone.  Essentially, lavender and tea tree essential oils imitate estrogen and block testosterone.

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The potential negative side effect in these lavender and tea tree essential oils are abnormal breast growth & breast growth before puberty.  Essential oils are being used widely, but not enough studies have been done to evaluate their negative side effects.  This is extremely important, as so many people are using essential oils due to the benefits of their antimicrobial properties, relaxation, and overall improvement and prevention of ailments.

 

Latest Study Published in Endocrine Journal

This groundbreaking study was published on August 8, 2019, in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism. The study also revealed that breast development resolved shortly after these lavender and tea tree essential oils were stopped.

 

Essential Oils in Many Children’s Products?

Do you use these essential oils on your children?  Even if you don’t use essential oils on your kids, you may be doing so without realizing it.  May common skin products, especially for babies contain lavender, such as lavender lotion or lavender baby bath products.

 

Should I Stop Using Essential Oils on My Children?

At this point, it’s probably best to hold off on using these lavender and tea tree essential oils on children, at least until after puberty is complete.

 

 

 

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Juice Recommendations for Children

Children Food & Drinks Health Pediatrics No Comments
Juice Recommendations for Children

Expert Panel: Milk, Water, & Juice Recommendations

for Children

Juice recommendations & recommendations for other drinks for children have been updated by a health experts panel. Under the leadership of nutrition research organization Healthy Eating Research, this panel formed to update parents, caregivers and health care providers on what should be provided with drink-wise for a healthy start for children from birth through age five (5) years old. The panel consisted of experts from the Academy of Nutrition and Dietetics, the American Academy of Pediatrics, the American Academy of Pediatric Dentistry and the American Heart Association. They reviewed current domestic and international policy statements and evidence-based recommendations.

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Breat Milk, Milk, Water & Juice Recommendations:

Birth to Five Years Old:

0-6 Months Old:
Breast milk or infant formula.
No juice.
 
6-12 Months Old:
Breast milk or infant formula
Small amounts of plain drinking water introduced once solid foods become part of diet.
No juice.
 
12-24 Months Old:
Whole milk
Plain drinking water.
Maximum 100% juice 4 oz daily.
 
2-5 Years Old:
Skim or low-fat milk
Plain drinking water. Maximum 100% juice 4 oz daily.
 

What About Soy Milk?

The panel did not recommend plant-based milk or non-dairy beverages for “exclusive consumption in place of dairy milk,” unless there is a medical necessity.  Non-dairy milks are missing of important nutrients that are typically obtained from dairy milk.

 

Fruit or Juice?

Are juice recomendations the same as for fruit?  Fresh fruit is always preserved over 100% fruit juice.  Furthmore, parents and children need to be educated about the benefits of the fruit as compared with juice.  Fruit has natural dietary fiber and less sugar than juice.  Juice has lots of sugar which has a tendency to add to excessive weight gain.
 

Fresh, Canned, or Dried Fruit?

Fruit recommendations are important.  While fresh fruit is best, it is not always practical, in that it doesn’t work for everyone.  Fresh fruit is healthier, but it is more costly than canned or dried fruit.  In addition, fresh fruit also takes time to ripen.  Another thing to consider is that some young children have food texture issues that makes eating fresh fruit more difficult that eating softened canned fruit.  Reality is that fruit in any form is healthier and preferred over drinking juice.

 

What About Flavored Water and Flavored Drinks?

The panel did not recommend offering young children any caffeinated beverages, beverages with low-calorie sweeteners, sugar-sweetened beverages, toddler milk or flavored milk – such as strawberry or chocolate milk – at any stage during early childhood as part of a healthy diet. Personally, I do make one exception to the recommendation against flavored milk.  If your child has food issues, refusing  unflavored milk and other dairy (cheese, yogurt), then flavored milk an  acceptable alternative, so as to ensure your child has at least three calcium servings daily.
These sweetened drinks are the large daily source of added sugar for most children, resulting in excess calories and weight gain.

 

Other Times Not to Use Juice

In addition, unpasteurized juice products are not recommended for children as there is an increase of life threatening infections, such as E.coli O157 and O111, Salmonella, Cryptosporidium, norovirus, Vibrio cholerae, Clostridium botulinum, yeast, and hepatitis A.

 

Children who take specific forms of medication should not be given grapefruit juice, as it could make the medication less effective.  There are many medications that can be less effective with grapefruit juice, many are for cardiac conditions.  However, a common allergy medicine, Allegra (Fexofenadine) is weakend by grapefruit juice.  It’s a good practice to ask the prescribing doctor your child’s medication could be negatively affected by grapefruit juice.

 

Tooth decay is common when anything other than water is kept in sippy cups, if they use them throughout the day.  Constant exposure to non-water drinks leads to the carbohydrates in them to cause tooth decay, as well.  Children should have their teetch brushed twice daily.  And especially before bedtime.  After brushing their teeth, they should only have water before bedtime to protect their teeth.

 

Lastly, it important to know that if your child is dehydrated, then juice will make it worse.  Rehydration needs to be done without all the sugar in juice. Apple sauce is the only fruit product that is recommended depending on the cause of dehydration.

 

More On Healthy Lifestyle Choices

Healthy Choices Affirmation, Healthy Dining, and Healthy Eating & Steps at the Holidays are also provides additional information about healthy eating and drinking.
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Best Christmas TV Show Guide

Affirmation Children Entertainment Fun Holidays Home & Family Parenting Pediatrics Television No Comments
Christmas, Christmas TV, Rudolph, Rudolph the Red Nosed Reindeer, family time

Best Christmas TV Variety 2018

The best Christmas TV shows are a great time for family time. There are multiple opportunities to get together, share, and talk about family values and learn some valuable life lessons while watching them.  There are many options to choose from: Freeform’s 25 Days of Christmas, ABC, NBC, Disney Channel, Hallmark channel’s Countdown to Christmas, AMC, Lifetime & even Netflix has stunning Christmas original programming!  With so many options, where do you start?  Which are age-appropriate?  Moreover, Common Sense Media does a great review that includes their recommendations for age-appropriate viewing.  Therefore, I’ve included those links for many of the best Christmas TV shows and movies below.  Here’s my guide!       

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Netflix

The Christmas Chronicles

Netflix
Netflix

I’m going to start by telling you our first watched Christmas TV show for 2018.  I happened to see Netflix had a new Christmas show called The Christmas Chronicles starring a very entertaining Kurt Russel as Santa Claus.  I figured we’d take a chance with something new.   Plus it was an older brother & younger sister story.  Frankly, this was right up our alley as that is exactly our household sibling dynamic.  We LOVED it!  Why?  For instance, Santa rocks in the jailhouse while he has the brother-sister duo help save the very Christmas that they accidentally set on a course to be the Christmas that might not happen!  These siblings helping Santa while coming to some personal revelations about growing up & making us laugh along the way. 

Angela’s Christmas

Then, there’s Angela’s Christmas.  It’s a tear-jerker about the family, loss, poverty & the chaos created when a little girl tries to warm the Baby Jesus, taking it from the church.  She had good intentions, but things go awry.  Above all, her family is there to help and support her.  My little girl really loved this one.  That is to say, she connected with special little Angela’s her big heart and fierce determined personality.  

 

Other Netflix Christmas TV Originals

Likewise, some other entertaining Netflix originals include The Princess Switch and A Christmas Prince: The Royal Wedding.  

 

Freeform’s 25 Days of Christmas

Above all, Freeform has the best Christmas TV show schedule that is includes Christmas movies too!  I really like that there is a great variety of non-Christmas shows & movies.  They are shown on the Freeform Channel, ABC & the Disney Channel.  What programming do they offer?  Here’s a sampling of some of our family’s favorites!  On December 11, 2018, they are showing Mickey’s Once Upon a Christmas, Mickey’s Twice Upon a Christmas, & Disney’s A Christmas Carol.  On December 12, 2018, there are some repeats & a few different options such as Call Me Claus, Deck the Halls & The Santa Clause.  To sum it up, their schedule is great with a lot of variety aside from the Holidays, such as Disney’s Finding Nemo, Brave & Tangled.  The whole family has an opportunity to pick a couple of favorites.  

 

ABC

Elsa & Anna, Best Christmas movie, Olaf's Frozen Adventure, Christmas TV show
Elsa & Anna

ABC has their Christmas TV show schedule that includes some very special kid shows that are great to re-watch.  Here’s a sampling are some of my family’s favorites!  On December 19, 2018, the Disney geek in me is happy to see Olaf’s Frozen Adventure!  There will also be Dreamworks’ Shrek the Halls.  On December 20, 2018 there will be the classic A Charlie Brown Christmas.  On December 23, 2018, they will air Disney’s Prep & Landing and Prep & Landing 2: Naughty vs. Nice.  To sum it up, I  can’t resist those two elves.  One is funny & anxiety ridden & the other a bit of a daredevil in my opinion!                                                                          

NBC

It's a Wonderful Life, Christmas movie, family time
It’s a Wonderful Life

How the Grinch Stole Christmas is another absolute best Christmas TV show that NBC is scheduled to air on Christmas Day! To be honest, we own the cartoon original & the movie.  As a child, I was scared of the Grinch.  Then, my son came along.  As a result, I love the Grinch now.  Therefore, we plan to go see The Grinch movie soon too!  On December 24, 2018, NBC will also air It’s a Wonderful Life.  This is the best Christmas show in Black & White.  And it never gets old!  It teaches so much about life, love, struggle, self-worth, self belief, community & that one person really makes a HUGE difference in so many unknown ways.  I grew up watching this one.  

 

Tampa Theatre

Ultimately, this year we’re going to watch It’s a Wonderful Life at the Tampa Theatre with showtimes are from Friday, December 14th through Thursday December 20th.  The Tampa Theatre is a wonderful experience is known as Tampa’s Non-Profit Movie Palace & a National Historical Landmark.  My kids haven’t been there yet, so this will be an extra special magical treat.   

 

AMC

Elf, Christmas movie, family time
Elf

This year, AMC has achieved a great trifecta!  They are exclusively showing Elf, National Lampoon’s Christmas Vacation, & The Polar Express.  My family favorite filled with the magical ride to the North Pole is definitely The Polar Express.  Elf is one of the best Christmas TV movie comedies that makes me laugh and laugh!  AMC has a Christmas movie lineup of over 40 movies sure to satisfy the Christmas movie fan!                                                                                                                                                    

Hallmark & Lifetime Original Movies

Hallmark’s Countdown to Christmas lineup does not disappoint either!  They have a Christmas movie lineup of 22 new original movies!  Lifetime’s Christmas movie lineup has 14 new original movies!   While I wouldn’t call these the best Christmas TV shows, I would say they have some ice entertainment value.  In addition, they are family-friendly which is a plus!

 

The Original Christmas Specials

Rudolph, Rudolph the Red Nosed Reindeer, Christmas movie, family time
Rudolph the Red Nosed Reindeer

Three of the best Christmas TV shows are Rudolph the Red-Nosed Reindeer, Santa Claus Is Comin’ To Town (on Freeform Christmas lineup) & Frosty the Snowman.  A classic, Rudolph is the longest-running holiday special in TV history, broadcasting for 54 years!  I loved these every year since I was a little girl.  It was always special because I didn’t get a chance to spend much time with my dad since he worked nights.  Christmas movies with my dad will never be forgotten!  They give my inner child a special warmth and lifetime memories.      

FX

Christmas movie, Rise of the Guardians
Jack Frost from Rise of the Guardians

Rise of the Guardians is another one of the best Christmas TV movies.  However, it seems the FX channel is the only one playing it.  Magic is in the air when Jack Frost, the Easter Bunny, the Tooth Fairy, the Sandman and Santa Claus need to save the world from Pitch Black, the Boogeyman, who is the nightmare maker.  Will the children still believe?  There are scary parts for the little ones.  Consider this before allowing children to watch.  However, at the core of the movie is Jack’s search for his center  Santa’s is his sense of wonder.  While watch, it made each of us think, ‘What’s my center?’

Family Time

In conclusion, what matters most about Christmas TV shows & movies is not just their content or quality.  Most importantly, too much TV is not a good thing.  Certainly, a few good shows are all it takes to have some memories & some good times.  Family time is the best part!  We have movie nights with popcorn, blankets, and all lights off, except for the Christmas tree. How do you create Christmas TV & movie memories?  Do you still believe?  While you’re at it … What’s your center?  Please share it with yourself, your loved ones, and here as well.

 

 

 

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