Date issued: 02/09/23

The CDC issued the 2023 Immunization Schedule for children Birth-6 years.  Be sure to check out the CDC site for more information:  https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html

Date issued: 01/13/22

There has been a second recall of two baby sleepers due to additional infant deaths. Fisher-Price Rock 'n Play Sleepers and the Kids2 Rocking Sleepers.  Fisher-Price has urged their consumers to stop using the sleeper immediately.  The first recall came in April 2019.  The U.S. Consumer Product stresses the critical urgency to stop the use of these pieces of infant equipment.  

The Fisher-Price Rock ‘n Play Sleepers were sold nationwide at stores including Walmart, Target and online at Amazon from September 2009 through April 2019 for between $40 and $149.

Sudden Unexpected Infant Death (SUID)

SUID, which includes Sudden Infant Syndrome (SIDS), is the leading cause of injury death in infancy.  Sleep is a big challenge for families with infants, but following safe sleep recommendations can prevent many SUID fatalities.

The rate of sleep-related infant death declined significantly in the 1990s after the AAP and others recommended that babies be placed on their backs to sleep, but rates have since plateaued, and SIDS remains the leading cause of postneonatal mortality. Black and Native American/Alaska Native infants die at rates more than double that of white babies. Pediatricians should support all families in implementing recommendations that reduce the risk of sleep-related infant death:

• • Place infants on their backs for sleep in their own sleep space with no other people. 
  • Use a crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet. Avoid sleep on a couch or armchair or in a seating device, like a swing or car safety seat (except while riding in the car). 
  • Keep loose blankets, pillows, stuffed toys, bumpers, and other soft items out of the sleep space. 
  • Breastfeed if possible, and avoid smoking.

   

How to Keep your Baby Sleeping Baby Safe - AAP Policy Explained

• Use a firm, flat surface; a firm surface means that it should not indent when your baby sleeps on it.

• Place your baby in a crib, bassinet, portable crib or play yard that meets the safety standards on Consumer Product Safety Commission.

  Put your baby on their back for all naps and night sleep.

• Never sleep with your baby.

• Instead of bed sharing, room share
• Keep loose bedding and soft items out of your baby's sleep area.
• Don't let your baby get overheated.

Other Ways to Lower SIDS Risk

Feed your baby breastmilk -  

Evidence shows that human milk reduces the risk of SIDS. The longer you give your baby breast milk, the more protection it gives.

• Breastfeed or feed your baby expressed breast milk. The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months.
• Even after you add solid foods to your baby's diet, continue breastfeeding until they're at least 12 months, or longer if you and your baby desire.

Try giving your baby a pacifier at nap time and bedtime

This helps reduce the risk of SIDS, even if the pacifier falls out after your baby is asleep. But keep in mind:

• If your baby is breastfed, wait until breastfeeding is established before offering a pacifier. That means your milk supply is good, breastfeeding is comfortable and consistent, your baby is latching well and they're gaining weight like they should. If you're not breastfeeding your baby, you can start the pacifier whenever you like.
• It's OK if your baby doesn't want a pacifier. You can try offering again later, but some babies simply don't like them. If the pacifier falls out after your baby falls asleep, you don't have to put it back in.
• Don't hang a pacifier around your baby's neck or attach it to their clothing when they're sleeping.

Date issued: 12/14/22

Nearly everyone, including babies and young kids, can stay healthy while protecting their family and others from COVID. The original COVID vaccine and updated (bivalent) COVID-19 vaccines are recommended for kids age 6 months and older. Vaccination is the best way to protect your child against COVID.

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) strongly recommend that all eligible kids and teens get the COVID vaccine.

You or your child may have questions about COVID prevention. Your pediatrician is here to help. Here's what you need to know.

Which pediatric COVID vaccine should I choose?

• First your baby or young child will receive two doses of the original vaccine. Then, they will get a third dose of an updated vaccine. Receiving these vaccines helps your child's body develop immunity to protect them from serious illness. The updated COVID vaccine dose boosts immunity to the original virus and recent variants.

• COVID vaccines made by two manufacturers (Moderna and Pfizer- BioNTech) are authorized for babies and young children. The AAP does not recommend one vaccine product over another. Children age 6 months through 4 years will receive the vaccine from the same manufacturer for all doses

  (If they received three doses of the original vaccine already (Pfizer), a fourth dose of the vaccine is not recommended for kids age 6 months through 4 years at this time.)
  

  Children will have highest degree of protection two weeks after they get the last recommended dose.

Where can babies and young kids get a COVID vaccine?

• If your child is not up to date on other vaccinations, ask to receive them with their COVID vaccine at the same visit. Immunizations help your child stay healthy, so their immune system is ready to respond to diseases like COVID, measles, polio, whooping cough and the flu.

• It is always best to begin with your child's pediatrician. Pediatricians are a trusted source, and they know your child best.

  If your child's pediatrician does not have the COVID vaccine, they can help you sort through options. Depending on your child's age, the vaccine may be available through public health agencies, many clinic settings and pharmacies.

  For help accessing COVID vaccines, text your Zip code to 438829, visit https://www.vaccines.gov, call 1-800-232-0233 or TTY 1-888-720-7489.

Will my baby have side effects after the COVID shot?

Most parents are familiar with minor side effects as their child's immune system learns to make antibodies against a disease. Side effects may include things like soreness and redness where the shot goes in. Some babies and children don't feel well later in the day of the shot or on the next day. A small number of children develop a fever—and very few get high fever. Usually, it lasts only a day or two while their immunity is building up.

If your child had a COVID infection, they should still receive a COVID vaccination according to CDC guidelines. It is possible to be infected again with the virus. Vaccines help protect your child by providing extra protection from COVID, even after they have had a COVID infection. People who already had COVID and do not get vaccinated after they recover are more likely to get COVID again than those who get vaccinated after they recover.

Remember

Just like the rest of us, babies and young kids deserve to get the same immune-boosting benefits against COVID. Plus, they are helping to keep others healthy! For example, infants under age 6 months are too young to get the vaccine. Between January 2020 and October 2022, there were 265 babies under age 6 months who died of COVID. And that is why it is very important for pregnant and breastfeeding people—and all other people who are around babies—to protect the baby by getting vaccinated.

More information

• COVID Vaccine Checklist for Kids
• v-safe (after-vaccination health check-in program from CDC)

Date Issued: 07/12/2023

Smoke from Canadian wildfires recently polluted the air, causing alerts for unhealthy air quality (code red) across PA!

Find out all about the Air Quality Index at airnow.gov and find out the AQI for your area by typing in your zip code.

According to the Allergy and Asthma Network, prolonged exposure to poor-quality air can cause respiratory problems for everyone. Babies and young children are groups that are considered at high risk. More information about ozone exposure and protective measures can be read here, and information about asthma can be found at healthychildren.org.

Watch this brief video from the asthma and allergy network about an asthma action plan; this plan can help ECE providers know how to respond to a child with asthma symptoms.

Date issued: 02/09/23

Based on current COVID-19 trends, the Department of Health and Human Services (HHS) is planning for the federal Public Health Emergency (PHE) for COVID-19, declared under the Section 319 of the Public Health Service (PHS) Act, to expire at the end of the day on May 11^th, 2023. The response by HHS to SARS-CoV-2, the virus that causes COVID-19, remains a public health priority.  The transition away from the emergency phase can begin.  For more information, read this informative fact sheet regarding the public health emergency transition roadmap for COVID-19.

Date issued: 01/12/23

Effective January 1, 2023 a new surveillance case definition for multsystem inflammatory syndrome in children (MIS-C) was implemented for reproting cases of MIS-C.

MIS-C is a rare but severe complication in children and young adults infected with SARS-CoV-2 the virus that causes COVID-19.

The new case definition criteria can be viewed at Information for Healthcare Providers about Multisystem Inflammatory Syndrome in Children (MIS-C) CDC.

Key Changes to the Definition:

• 1. No required duration of subjective or measured fever.

• 2. A requirement of C-reactive protein greater than 3.0mg/dl to indicate systematic inflammation.

• 3. Adjustments to criteria of organ system involvement to include addition of shock as a separate category and elimination of respiratory, neurologic and renal criteria.

• 4. A new requirement on timing of a positive SARS-CoV-2 laboratory testing within 60 days of MIS-C illness.

Reporting:

• Healthcare providers must report suspected cases of MIS-C by faxing the 2023 case report form to 717-772-6975 or to your local health department or by securely emailing the form to This email address is being protected from spambots. You need JavaScript enabled to view it..

• Click HERE for the CASE REPORT FORM.  There is addtional case report guidance that can be referenced when completing the form. 

Date issued: 11/3/2022

The U.S. Food and Drug Administration (FDA) recommends that parents and caregivers do not use infant head shaping pillows intended to change an infant’s head shape or symmetry or claim to prevent or treat any medical condition. The FDA is not aware of any demonstrated benefit with the use of infant head shaping pillows for any medical purpose. The use of head shaping pillows can create an unsafe sleep environment for infants and may contribute to the risk of suffocation and death.

Infant head shaping pillows are not FDA-approved. The safety and effectiveness of these products have not been established for the prevention or treatment of flat head syndromeExternal Link Disclaimer (also known as positional plagiocephalyExternal Link Disclaimer or deformational plagiocephalyExternal Link Disclaimer), or the more serious condition where the developing infant’s skull bones join together too early (known as craniosynostosis).

Recommendations for Parents and Caregivers

• Do not use infant head shaping pillows due to the risk of sudden unexpected infant death (SUID), inclusive of sudden infant death syndrome (SIDS), and suffocation and death.
• If you own an infant head shaping pillow, throw it away; do not donate or give it to anyone else.
• Be aware that infant head shaping pillows are not safe or effective for preventing or treating flat head syndrome or other medical conditions.
• Be aware that, in most cases, flat head syndrome will go away on its own as an infant grows, it is not painful and it does not cause any developmental concerns.
• If your infant has an unusual head shape, talk to your infant’s health care provider about management options. Know that the use of infant head shaping pillows may delay the necessary evaluation and management of harmless conditions, such as flat head syndrome, or more serious conditions, such as craniosynostosis.
• To promote a safe sleep environment, the National Institutes of Health (NIH) and the American Academy of PediatricsExternal Link Disclaimer (AAP) recommend infants sleep on their backs in a bare crib on a flat (not inclined) surface without pillows, toys, soft objects, or loose bedding. The AAP guidelines regarding a safe sleep environment are intended to help reduce the risk of SUID as described in the NIH Safe to Sleep Campaign.
• Learn more about safe sleeping environments by visiting FDA’s Recommendations for Parents/Caregivers About the Use of Baby Products.
• If an infant in your care experiences an injury or adverse event when using a head shaping pillow, we encourage you to report it to the FDA and the manufacturer. Your report, along with information from other sources, can help the FDA identify and better understand the risks associated with medical devices.
• Be aware that infant head shaping pillows do not treat craniosynostosis.

Recommendations for Health Care Providers

• Discourage the use of infant head shaping pillows. Review this safety communication with your colleagues, care teams, parents, and caregivers who recommend, use, or may use infant head shaping pillows.
• Educate your care communities, regarding the association of head shaping pillows with an unsafe sleep environment, which is associated with SUID, SIDS, and other causes of infant death, such as suffocation, that may occur with the use of head shaping pillows.
• The FDA has cleared caps, helmets or head bands for use as cranial orthosis devices intended to improve cranial symmetry or shape in infants and toddlers from 3 to 18 months of age, with moderate to severe non-synostotic positional plagiocephaly. Some cranial orthosis devices are also intended for adjunctive use for infants from 3 to 18 months of age whose synostosis has been surgically corrected, but who still have moderate-to-severe non-synostotic positional plagiocephaly.
• Improve awareness and understanding among your colleagues and care communities regarding a safe sleep environment for infants, and etiologies and associated management options for flat head syndrome.
• If a parent or caregiver reports a problem with an infant head shaping pillow, advise them to discontinue its use and report it to the FDA and the manufacturer. Prompt reporting of problems can help the FDA identify and better understand the risks associated with medical devices.

Device Description

Infant head shaping pillows are typically small pillows, with an indent or hole in the center designed to cradle the back of an infant’s head while the infant lays face up, flat on its back. Sometimes these pillows do not have an indent or hole in the center and are rectangular shaped. These medical devices are marketed with claims to improve an infant’s head shape and symmetry and claim to prevent or treat flat head syndrome or other medical conditions. However, the safety and effectiveness of the use of these medical devices has not been demonstrated.

FDA Actions

The FDA is informing parents, caregivers, and health care providers of the risks associated with use of infant head shaping pillows. The FDA is working with stakeholders to increase awareness of the issue.

Recently, the FDA became aware of companies marketing infant head shaping pillows with claims for the prevention and treatment of flat head syndrome without FDA clearance or approval. The FDA has communicated our concerns about these promotional materials to these companies and will continue to monitor promotional materials and claims for these medical devices.

The FDA will keep the public informed if significant new information becomes available.

Reporting Problems to the FDA

If you experience adverse events associated with using an infant head shaping pillow, we encourage you to file a voluntary report through MedWatch, the FDA Safety Information and Adverse Event Reporting program. Health care personnel employed by facilities that are subject to FDA's user facility reporting requirements should follow the reporting procedures established by their facilities.

Date Issued: 10/28/2022

See full health advisory here. 

Summary: 

• Respiratory syncytial virus (RSV) activity is increasing in Pennsylvania and nationwide, and levels are higher than usual for this time of year.
• Clinicians and caregivers should be aware of age-related variations in the clinical presentation of RSV.
• Clinicians should consider testing patients presenting with acute respiratory illness who have a negative SARS-CoV-2 test for non-SARS-CoV-2 respiratory pathogens, such as RSV and influenza. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) is the preferred method of testing for respiratory viruses.
• Clinicians should report laboratory-confirmed RSV cases to Pennsylvania Department of Health (PA DOH) through Pennsylvania's electronic reportable disease surveillance system,
  PA-NEDSS. Outbreaks or clusters of severe respiratory illness regardless of etiology should be reported to PA DOH or your local health department.
• Administer prophylactic palivizumab to high-risk infants and young children per AAP guidance.
• Healthcare personnel, childcare providers, and staff of long-term care facilities should avoid reporting to work while acutely ill – even if they test negative for SARS-CoV-2.
• Encourage parents and caregivers to keep young children with acute respiratory illnesses out of childcare, even if they have tested negative for SARS-CoV-2.
• Encourage all individuals to receive influenza and COVID-19 vaccines as soon as possible to protect themselves against those respiratory viruses and avoid associated complications.
• Clinicians can review weekly updates to the NREVSS website and refer to surveillance data collected by local hospitals and health departments for information on RSV circulation
  trends in Pennsylvania.
• If you have additional questions about this guidance, please contact DOH at 1-877-PAHEALTH (1-877-724-3258) or your local health department.

Date Issued: 12/20/2021

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States - recent changes (updated 9-2-22)
Update posting 9-13-22.

Date Issued: 12/20/2021

(CDC) Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning updated 10-5-22:

• Removed the recommendation to cohort
• Changed recommendation to conduct screening testing to focus on high-risk activities during high COVID-19 Community Level or in response to an outbreak
• Removed the recommendation to quarantine, except in high-risk congregate settings
• Removed information about Test to Stay
• Added detailed information on when to wear a mask, managing cases and exposures, and responding to outbreaks
• Click here to read guidance.