My Blog
By Blaine E. Tolby, MD
June 29, 2020
Tags: Brushing  

So, your child’s teeth just started to come in. We know that this can be an exciting milestone for parents. Of course, this also means considering your child’s oral health. Just as you brushingbrush and floss your teeth every day, you will now need to begin brushing your child’s teeth. While the techniques and practices will be a bit different and probably less time-consuming (seeing as your child probably only has one or two teeth at the moment), here are some tips for how to brush your child’s teeth properly,

  • Even before your child’s teeth start to erupt it’s important to keep their gums healthy and clean by wiping them with a soft, damp cloth after each feeding and right before bedtime. Your child will get their first tooth between 6-14 months.
  • Yes, even children’s teeth can develop decay. As soon as the tooth is formed it can develop decay, so it’s important that you start brushing it as soon as you see it.
  • Purchase a child-sized toothbrush from your local drugstore and wet the soft-bristled toothbrush with water to brush your child’s tooth or teeth (at this point you don’t need toothpaste).
  • Your child won’t start needing toothpaste until they are 2 years old. From 2-3 years old your child only needs toothpaste the size of a grain of rice in order to clean their teeth. After 3 years old, you can upgrade to a pea-sized amount of toothpaste.
  • Just as you do for your own teeth, you should also brush your child’s teeth twice a day (once in the morning and again at night right before going to bed).
  • Use soft, circular motions when brushing the teeth and the gums. Again, just as you do your own teeth, you should brush for a minimum of two minutes. Don’t forget to brush their tongue and roof of their mouth, too.
  • We know that your child may not fully understand the brushing process, so it’s a good idea to tell them what you are doing and the importance of brushing their teeth. Even though they can’t brush their own teeth yet it’s still great to show them how to brush so that when it’s time to start brushing their own teeth they understand how to do it.
  • Most children can start brushing their teeth around 7-8 years old, but still need to be supervised by an adult until around 10-11 years old.

Have questions about caring for your baby’s developing smile? Keeping your child’s smile healthy is so important for their development and practicing good oral hygiene at home will ensure that your child’s smile stays healthy.

By Blaine E. Tolby, MD
June 01, 2020
Category: Children's Health
Tags: Autism  
Autism Spectrum Disorder (ASD) is a developmental condition that affects how a person views and interacts with the world around them, including other people. In most cases, differences become apparent by the time your child reaches 24 months. Mainly, parents notice behavioral differences and language delays. If you suspect that your child has ASD, schedule an appointment with your local pediatric office. We work with you to figure out what to do next.
 
Signs of ASD 
Every child with ASD is different. Not everyone will have the same symptoms or experiences. With that in mind, here are some summaries on social, communication, and behavioral differences. 
 
Social Differences
  • Your child doesn’t keep or make eye contact
  • They don’t respond to your facial expressions or smiles
  • Does not reciprocate facial expressions or have the appropriate ones
  • Doesn’t respond to parent’s pointing 
  • Has problems making friends
  • Shows a lack of concern for others
Communication Differences
  • Your child hasn’t spoken by 16 months
  • Repeats or parrots what others say
  • Doesn’t feel the need or want to communicate 
  • Starts missing language and social milestones after 15 months
  • Doesn’t pretend play but does have a good memory for numbers, songs, and letters
Behavioral Differences
  • Has an affinity for routines and schedules and does not like altering them
  • Likes to twirl their fingers, sway, rock, or spin
  • Has strange activities that they enjoy doing repeatedly
  • They are sensitive to sounds, lights, touch, textures, and smells
  • They are more interested in the parts of a toy instead of the whole thing
Common Examples
Don’t feel overwhelmed by the information listed above. As mentioned, a child can have a mixture of any of these behaviors. There are a few other common examples that your pediatrician sees. These give you insight into how a neurotypical child reacts in certain situations versus a child with ASD.  
 
By the age of 12 months, your child should turn their head when they hear their name. A child with ASD won’t respond even if their name is called multiple times.
 
By 18 months, a child with speech delays finds accommodations through gestures, facial expressions, or pointing. Children with ASD find no reason to compensate for speech. 
 
After 24 months, many children enjoy bringing their parents objects or toys to look at or play with. A child with ASD may bring their parent an object but will not play with their parent or respond to their reaction.
By Blaine E. Tolby, MD
May 04, 2020
Category: Children's Health
Tags: ADHD  
ADHDParents want the best for their child, which is why check-ups and appointments with their pediatricians are so important. Yet your pediatrician isn’t just available for when your child is sick or has physical ailments. They can also help with mental and behavioral conditions, including the diagnosis and treatment of ADHD. If your child struggles with focus, impulsivity, attention, or hyperactivity, schedule them for an evaluation. It’s also important to note that children must be at least four years old for a diagnosis.
 
The Three Facets of ADHD
There are three parts to pediatric ADHD: impulsivity, inattention, and hyperactivity. Each of them is signs and are necessary for a diagnosis. Here is some information about each of them.
 
Inattention: your child spends a lot of time daydreaming or not paying attention, struggles to listen, is easily distracted, makes careless mistakes, rarely finishes tasks, and is disorganized to the point of losing or forgetting important things. 
 
It’s important to understand that children with ADHD can pay attention, it’s just harder with topics that don’t interest them. They can tune out when tasks get repetitive. Working with them to organize their schoolwork and tasks is essential. Try to provide them with a quiet and calm environment to work in.
 
Impulsivity: your child can’t wait or acts without thinking, interrupts others, and has problems taking turns.
 
Children with ADHD have trouble with self-control, which leads to the impulsive characteristics mentioned above. They have a harder time censoring themselves. This results in them invading people's personal space or asking overly personal questions. Impulsivity problems also lead to moodiness and overreactions. 
 
Hyperactivity: your child seems to constantly be moving, without being able to sit still without squirming. They also talk too much and loudly, often playing in areas that aren’t permitted. 
 
It’s normal for younger children to have high energy levels. It’s only when your child seems to be constantly moving that it could be an issue with hyperactivity. When they do sit still, they are still moving. They may tap their fingers, shake their legs, or move their feet. 
 
Diagnosing ADHD
A diagnosis won’t happen right away. There are many steps in the process before an accurate understanding is available. Your pediatrician will most likely want statements from not just you and your child, but other caregivers and teachers. 

At the appointment with your child’s pediatrician, they’ll want you and others to fill out a questionnaire about your child’s behavior. Symptoms need to be present in multiple settings, like at home and school and cause issues at both. 
 
The criteria change depending on your child’s age, so it isn’t one-size-fits-all. Your pediatrician will work with you to get an accurate picture of your child’s situation. 
By Blaine E. Tolby, MD
April 01, 2020
Category: Child Health Care
Tags: Warts  

Warts are common, benign bumps that develop on the skin as a result of a viral infection known as the human papillomavirus (HPV). Warts are pretty common in children and can develop just about anywhere on the body; however, they are most often found on the face, feet, and hands. Generally, warts usually don’t cause any problems and will go away on their own, but if you don’t want to wait a pediatrician can offer effective wart removal options.

Types of Warts

There are different kinds of warts that can develop. These warts include:

  • Common warts: these rough bumps are often found on the elbows, fingers, and hands and are usually gray in appearance. If you look closely at the bump you may also notice small black dots.
  • Flat warts: these smooth warts are often pink or light brown and most often develop on the face
  • Plantar warts: these warts develop on the soles of the feet, which can be very uncomfortable for your child, especially when walking
  • Palmar warts: just as plantar warts develop on feet, palmar warts develop on the hands

Treating Warts

While warts will go away without treatment it can take months or even years. If your child is embarrassed by the wart, if your child is dealing with multiple warts or if the wart is causing discomfort or pain then this warrants seeing a pediatrician. There are many ways in which a pediatrician can remove the wart.

Your child’s best treatment option will depend on the size, location, type, and number of warts. While there are certainly over-the-counter medications that you can try (these medications should not be used on certain areas of the body including the face), a pediatrician will be able to provide you with safe, effective treatment under proper medical supervision.

Common wart removal options include:

  • Cryotherapy: freezing the wart with liquid nitrogen (a very common wart removal technique)
  • Salicylic acid: a doctor can also provide a strong prescription solution that contains salicylic acid (this can be applied at home as per your pediatrician’s instructions)
  • Laser: sometimes laser therapy is used to target and destroy the wart

Usually the wart will fall off within a few days after treatment, but sometimes more than one treatment session is necessary to successful remove the growth.

If your child has plantar warts or warts in embarrassing places then they will most likely need to turn to their pediatrician to treat the problem. Call your children’s doctor today and let them know that you want to discuss wart removal options for your child or teen.

By Blaine E. Tolby, MD
February 28, 2020
Category: Child Health Care

Sneezing. Watery eyes. Stuffy nose. These could just be symptoms of a cold or these could be signs that your child has allergies. If you notice that your child’s symptoms flare-up during certain times of the year then this could definitely be a sign of seasonal allergies. Unfortunately, allergies can impact everything from performance in school to participating in outdoor activities such as school sports. If you suspect that your child may have allergies it’s important to talk with your pediatrician.

Childhood Allergy Symptoms

Allergy symptoms can also seem a lot like a cold or other upper respiratory problems. Common symptoms associated with allergies include:

  • Watery, red, and itchy eyes
  • Itchy nose
  • Dark circles under the eyes or puffy eyelids
  • Ear pain and chronic ear problems
  • Nasal congestion
  • Facial pain and pressure
  • Headaches
  • Sneezing
  • Persistent cough
  • Chest tightness

So, how can you tell that your child is dealing with allergies and not an infection? Some telltale signs include itchy eyes and nose, which are classic signs of allergies. If your child has a fever this is usually a sign of an infection and not allergies. Unlike a cold, allergy symptoms can last for weeks. You may also notice that your child’s symptoms come and go, appearing more often during the spring and fall months. Again, this is a trademark of childhood allergies.

Treating Childhood Allergy

There are many ways in which a pediatrician can help your child manage their allergy symptoms, and the treatments that are recommended will depend on the type and severity of your child’s symptoms. Most treatment plans include a variety of lifestyle changes and medication. Children with minor symptoms may find relief through over-the-counter antihistamines and decongestants, while other children may require a prescription-strength allergy medication to tackle more moderate to severe symptoms.

Lifestyle modifications may include using a dehumidifier in your child’s bedroom, wearing glasses instead of contacts during allergy seasons, bathing immediately after being outdoors, limiting outdoor activities during high pollen counts, and keeping pets out of bedrooms (if your child suffers from pet dander allergies).

For severe or unresponsive allergies, your pediatrician may recommend immunotherapy, or allergy shots. Allergy shots may be a good option for your child when other treatment options and medications have not been successful.

Are your child’s allergy symptoms impacting their daily routine? If so, our pediatricians can help them manage their symptoms so they can get back to enjoying days on the playground and time spent with family.





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