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YOUR HOME FOR QUALITY PEDIATRIC CARE • SPRING 2021

Welcome to The PediaMag.............. 2 COVID-19 VACCINATIONS We We Chose the COVID-19 Vaccine........................... 4 CHILDREN’S HEALTH Empowering Children to Participate in their Health Care.... 6 ALLERGY TREATMENT Spring Allergies Have Sprung.......... 8

Why We Chose the COVID-19 Vaccine

FOOD AND RESOURCES Food Insecurity: A Health Issue........ 10 SUN PROTECTION The Importance of Sunscreen.......... 12

Publication Provided by:


Welcome

Welcome to The PediaMag Welcome to the Spring 2021 issue of The PediaMag. It has officially been one year since the start of the COVID-19 pandemic. We have learned so much and come so far in a year. We have a COVID-19 vaccine and the country is working diligently to get as many People vaccinated as possible. It is also Spring allergy season and now is the time to look at how we diagnose allergies and determine your treatment plans. And as the temperatures are getting warmer, the days are getting longer, and the sun is shining. Don’t forget sunscreen for the whole family when you are enjoying the outdoors. From food insecurity to empowering children to participate in their health care, and much more, The PediaMag has information and suggestions to help keep your families safe, healthy, and happy. Have an idea or suggestion for a topic you would like to see covered in a future issue of The PediaMag ? We want to hear from you. Send your thoughts to us by private message through our Facebook page at www.facebook.com/ahnpediatricalliance.

About Us: Pediatric Alliance was formed in 1996 when eight individual practices joined together to provide quality health care throughout Southwestern Pennsylvania. Over the years, Pediatric Alliance grew to be the largest physician-owned group pediatric practice in the area. In 2019, Pediatric Alliance joined with Allegheny Health Network to allow expansion of resources in order to stay abreast of the latest technology and advances in health care. Our board-certified pediatricians offer primary care to children and adolescents in 16 different office locations including two specialty care offices for allergy, asthma, and immunology and pediatric endocrinology. We are proud to offer personalized, patient-centered care to patients from birth to 21 years of age. We strive to meet your family’s pediatric needs, provide convenient access to care, and build strong relationships with families to maximize your child’s health. To learn more about AHN PediatricsPediatric Alliance, visit our website at www.ahnpediatrics.org.

AHN Pediatrics-Pediatric Alliance 1100 Washington Ave., Suite 219 Carnegie, PA 15106 www.ahnpediatrics.org

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The PediaMag is published quarterly, copyright 2020. All rights reserved. Publisher AHN PediatricsPediatric Alliance

Editor Rebecca Scalise

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

Art Director Brent Cashman


All classes are free and conducted online via Zoom. Login information is provided up on confirmation of registration. Visit www.growinguphappyandhealthy.com for class schedules and registration.

BABY BASICS

BREASTFEEDING 101

Expectant parents can meet with a physician and receive basic information about the care of their newborn and what to expect while they are in the hospital.

Expectant moms and their partners can meet with a Board-Certified Lactation Consultant and gain knowledge on how to successfully initiate breastfeeding from day one.

JOURNEY TO TABLE FOOD

BREASTFEEDING: REWARDS AND REALITIES

Starting solids can be scary! There is so much information about what to feed baby, when to feed baby, and how to feed baby, that it can be overwhelming. This fun and informative discussion will help you understand the role of complimentary foods in your baby's first year of life and navigate the best feeding choices for your baby and family.

Learn all about the how-to’s and benefits of breastfeeding, both short-term and long-term, for Mom, Dad, and baby. Be aware of some challenges you may experience breastfeeding to be prepared for your journey and make decisions about your baby's feeding.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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COVID-19 Vaccine

Why We Chose the COVID-19 Vaccine

Arcadia Providers: Dr. Susie Saunders, Annette Lucas CRNP, Alanna Ellis CRNP, Dr. Leslie Soloshatz,

Dr. Aleksandra Gabryel-Grudziak: Greentree

Dr. Anthony Kovatch, Arcadia: My mission was the same as all the rest of us at AHN: To make our civilization ready again for the pursuit of happiness – individual and global.

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Dr. Ashley Loboda: St. Clair

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

Karen Kavanagh, CRNP: Northland


Dr. Amy McGarrity, St. Clair: I got the vaccine for me, my patients, and my family, and friends! Yea!!!!

Dr. Katherine Walczak: Chartiers McMurray

Dr. Hilary Garbon, Northland: I got the vaccine to protect my parents, in-laws and vulnerable patients. I am ready to return to pre-pandemic life and believe this is the best way. I trust the science behind this vaccine and have no reservations about getting it.

The Staff and Providers from our Jefferson Hills office: Received their vaccines as a team!

Dr. Kayllie Wang, Jefferson HIlls: I got both doses of the vaccine to protect my patients and family.

Rachel Raymond, PA-C, Jefferson Hills: I received the vaccine because I believe in the science! I want to protect my family, including both my toddler son and unborn son. I want to do my part to create a safer environment for my young patients. Together, we can overcome this.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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Children’s Health

Empowering Children to Participate in their Health Care By Bethany Ziss, MD - AHN Pediatrics Bloomfield

What is the perfect time to empower kids to take a larger role in their own health care? Of course, we don’t drop off a toddler alone to calmly describe their symptoms of an ear infection and commit to a week of amoxicillin. But how does a child get from there to the point where they are a young adult who knows how to make an appointment and contact the pharmacy for refills? Learning to participate in health care decisions is a skill that increases with maturity and improves with practice. In 2016, the American Academy of Pediatrics section on Bioethics recommended that children be increasingly involved in discussions of informed consent as they develop. While children cannot “consent,” they can often agree, or “assent” to treatment decisions.

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AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

Sometimes I find parents are surprised when I speak directly with children about their experiences at school, trouble falling asleep, or trying medication for focus. Many of my patients have disabilities which affect learning and communication, which can make involvement in health care decisions more challenging. It’s a challenge worth taking. Starting at a young age, I often tell


my patients that their input is vital because “you’re the only person inside your brain and your body.” Here are some tips to help children better understand their health and participate increasingly in making decisions about their brains and bodies.

Preschool children: Very young children cannot make informed decisions, and often advocate by saying “no." But there are ways to get even preschoolers involved before, during, and after a medical visit. Discuss the plan prior to a medical visit so your child knows what to expect. Young children are often most afraid of pain and separation from caregivers. Daniel Tiger has excellent episodes about going to a well visit, a sick visit, and getting a vaccination. Young children who can’t describe symptoms on their own may be able to nod or shake their head when asked specific questions. Pick two options so your child can make a choice (a good strategy in life in general): > Vaccine in which arm? > Sit on parent’s lap or on the table? Children this age can start to understand any chronic conditions in simple terms and advocate for their needs: > “Does this have eggs? I’m allergic to eggs.” If medications are needed, your child may be able to choose between a liquid or chewable, or pick a flavor to be added at the pharmacy.

Elementary aged children: Older children can be involved increasingly as they mature. They often have a lot of questions and curiosity about their health and what our medical terms mean. Ask your child ahead of time if they want to explain any problems or symptoms to the health care provider or if they want you to do the explaining Children this age may not want to talk about body parts or functions they think of as “private.” You may need to balance their request for privacy with the need to provide complete information.

they may be able to recommend a good book to help explain a chronic diagnosis.

Teenagers: Teens are better able to understand the risks and benefits of medical decisions, but may not have the impulse-control and judgment to make thoughtful choices, especially if they do not see an immediate benefit or problem. Teens may “know” they need to follow a specific diet or benefit from taking medication but not follow through, especially in social situations. Most teens will want to spend part of a health care visit speaking with the provider alone.

Older children can be involved increasingly as they mature. They often have a lot of questions and curiosity about their health and what our medical terms mean. Pain scales can be confusing. Another way to think about pain or other symptoms might be: > Does it make you stop doing fun things? > Is it better or worse than yesterday? > Does anything make it better? Elementary children can usually learn the names of any chronic condition they have and an age-appropriate explanation. They may be able to take increasing responsibility for management with support and supervision, for example carrying an inhaler at school and knowing when and how to use it. If your child sees a medical specialist,

Explain what confidentiality means and what a health care provider might have to disclose. Teens should know the names and reasons for any routine medications they take. If a teen is not able to remember, or if treatment plans change frequently, consider keeping a list in the wallet or phone. Many teens are able to take some responsibility for taking regular medication, but adult supervision is usually still needed. This is especially true for medications which need to be taken at specific times of day. Teens with chronic conditions may find in-person or online support groups helpful.

Bethany Ziss, MD, began her career as the attending physician in Developmental and Behavioral Pediatrics at Greenville Health System in South Carolina. During her time at Greenville Health System, she cared for children with developmental disabilities and presented at Grand Rounds on various developmental pediatric topics. Dr. Ziss has a strong background in disability advocacy, and throughout her career she has worked to bring a neuro-diversity and disability community perspective to her clinical care.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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Allergy Treatment

Spring Allergies Have Sprung By Russell Traister, MD – AHN Pediatrics Bloomfield

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AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org


While for many, the arrival of spring means a thaw from a frigid winter and the sight of daffodils popping out of the ground, for allergy sufferers, spring can be a harbinger of worsening allergy symptoms. When trees start blooming, tree pollen becomes abundant triggering allergy symptoms in affected individuals. The range and severity of symptoms can differ dramatically from patient to patient. While some may be affected by a mild itchy nose easily remedied with and over-thecounter antihistamine, some are afflicted with intractable itchy, watery eyes and nose immune to medication. Contrary to popular belief, spring flowers are not a cause of seasonal allergies. Flowers are pollinated by insects, not the wind. While the smell of flowers may serve as an irritant to some leading to sneezing, they are not true allergens. Tree pollen, however, is wind pollinated and can travel far distances in the air and lead to allergic symptoms in sensitized individuals. Tree pollen counts have been increasing in recent years, likely leading to more or prolonged allergic symptoms. Grass and weed pollen counts can also start to rise later in spring and can contribute to allergy symptoms as well. Other allergens such as cat, dog, and dust mite are considered perennial, or year round allergens, and would be expected to cause symptoms throughout the year instead of seasonally. The number one goal in allergy treatment is avoidance of triggers. Unfortunately, when it comes to tree, grass, and weed pollen, that can be difficult given they are spread widely throughout the air. Keeping home and car

windows closed can help, but not eliminate, exposure. Given that pollen can travel miles through the air, it is not just about the vegetation in your local neighborhood. Treatment approaches should be discussed on an individualized basis with each patient. Medication options include intranasal steroids, antihistamines, allergy eye drops, and nasal saline irrigation. However, if those medications are not sufficient, or the frequent need for medications is bothersome, allergy shots are a potential treatment option. While medications may suppress allergy symptoms, allergy shots

lasting beneficial affect on allergy symptoms. It should also be noted that after starting shots it can take 6-12 months to start seeing symptom benefit. Additionally, if someone has asthma, the allergy shots may have a beneficial effect on that condition as well. When you visit your allergist, they may perform skin or blood testing to determine which allergens you might be sensitized to. Both tests are adequate for determining your allergies, but skin testing is more sensitive, and if you are considering allergy shots your allergist

The number one goal in allergy treatment is avoidance of triggers. Unfortunately, when it comes to tree, grass, and weed pollen, that can be difficult given they are spread widely throughout the air. have the potential to cure your allergies. Allergy shots are a big commitment, but can have long lasting benefits. The biggest commitment is in the first 3-6 months of treatment, as shots are required 1-2 times weekly in the office, followed by a mandatory 20-30 minute waiting period to ensure no reaction to the shots occur. After about 6 months the shots are spread out to once monthly injections, and shots are continue for a period of about 5 years, when they are generally stopped, ideally with a long

may suggest this route. Skin testing is a safe and nearly pain free procedure that involve a prick of the skin with various allergens. A typical environmental allergy panel consists of around 40 pricks, typically placed on the arms or back. The results can be read in about 20 minutes. Your allergist will use this information to provide guidance on treatment, avoidance measures, and to determine which allergens should be placed in allergy shot mixes, should that be the best route of treatment.

Dr. Traister attended The University of Pittsburgh School of Medicine and received his MD and PhD (Immunology) in 2008. After finishing residency training in internal medicine and fellowship training in allergy and immunology, he worked part-time at UPMC, Children's Hospital of Pittsburgh, and Pediatric Alliance. Subsequently he was employed at Wake Forest Baptist Health in Winston-Salem, NC. His research interests include vocal cord dysfunction, hypogammaglobulinemia in lung transplant patients, and rush immunotherapy. He is an author on over 20 peer-reviewed publications and over 25 abstracts. He currently resides in Blawnox with his wife and two children. Moving back to the area allows Dr. Traister to be closer to his extended family, who also reside in Western Pennsylvania.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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Food and Resources

Food Insecurity: A Health Issue By Jennifer Yoon RDN, LDN, IBCLC

Food Insecurity is the state of being without reliable access to a sufficient quantity of affordable, nutritious food such as fruits, vegetables, lean proteins, and whole grains. More than 15 million households nationwide live every day with hunger or food insecurity as their constant companion. According to the Greater Pittsburgh Community Food Bank, food insecurity affects more than 350,000 people – or one in seven adults – in our region. Food Insecurity exists not only due to financial constraints, but also food accessibility. A ‘food desert’ is defined as a general unavailability of healthful food at a reasonable price, and may exist in urban or rural areas. A ‘food mirage’ or ‘food swamp’ refers to an area where the available food is of low nutritional value. Much of the food available in these areas is high fat junk food with limited nutritional content.

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AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

Vulnerable populations such as children, the elderly, ethnic minorities, and low-income households are disproportionately affected by food insecurity, despite the extensive private and public food safety net in the United States, according to a new report by RTI International. Food Insecurity results in poor diet quality which increases risk for obesity, chronic disease, and healthcare expenditures. In children, food insecurity has a negative impact on


growth and development, ability to learn, and future employability. With so many proven negative outcomes, Food Insecurity goes beyond a social issue. It is a health issue. In October 2015, the American Academy of Pediatrics released a policy statement, recommending that pediatricians screen all children for food insecurity. Two simple questions, known as the Hunger Vital Signs, can identify children in need of services and change long-term health outcomes: > Within the past 12 months we worried whether our food would run out before we got money to buy more.” > Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.”

Food Insecurity results in poor diet quality which increases risk for obesity, chronic disease, and healthcare expenditures. It is time we stop assuming that children in our communities have adequate access to food and resources. If one in seven adults in our region is struggling, we each provide care to several of their children each day. We must overcome the stigma and start the conversation about Food Insecurity. With a growing body of evidence showing the profound effects of Food Insecurity on children’s long term growth, development, and ability to learn, more resources and are available to help families with healthy food for their family.

Allegheny Health Network created the Healthy Food Center to make sure our patients have access to healthy foods and nutrition counseling to help manage their overall health, no matter their income or budget. The Healthy Food Center partners with the Greater Pittsburgh Community Food Bank to provide healthy food choices to people in need. Healthy Food Centers are now open in three locations- West Penn Hospital, Allegheny General Hospital, and Jefferson Hospital. Website: www.ahn.org/services/medicine/center-for-inclusion-health/ healthy-food-center

The Supplemental Nutrition Assistance Program (SNAP) provides benefits to eligible low-income individuals and families via an Electronic Benefits Transfer card. This card can be used like a debit card to purchase eligible food in authorized retail food stores. Website: https://www.benefits.gov/benefit/361, Phone: 1-800-221-5689

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. Website: https://www.fns.usda.gov/wic, Phone: Allegheny County (412) 350-5801, Washington County (724) 222-5405

South Hills Interfaith Movement (SHIM) provides food, clothing, utility assistance, and services to people in need in Pittsburgh’s southern suburban neighborhoods. Food pantries are open twice monthly at 3 locations including seasonably available fresh produce from community gardens. Website: https://shimcares.org, Phone: (412) 854-9120

The Greater Pittsburgh Community Food Bank feeds people in need in a variety of locations through multiple programs including Pop Up Foodshare, Produce to the People, Summer Food Programs, and Green Grocer. Assistance with SNAP applications and nutrition education are also provided. Website: https://www.pittsburghfoodbank.org, Phone: (412) 460-3663

Jennifer Yoon has a Bachelor of Science degree in Nutrition earned at the University of Texas Southwestern Medical Center in Dallas, TX. She spent 8 years as Director of Early Education at St. David’s and 10 years as a clinical dietician at Children’s Medical Center in Dallas, TX before joining AHN Pediatrics St. Clair. Jennifer was born in Dallas, and currently lives in Bethel Park. She has three children ranging in age from 11 years to 24 years, and a dog named Boswell.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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Sun Protection

The Importance of Sunscreen By Wendy Ripple, MD

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AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org


The sun is the life giving energy source for our planet. Without the sun, we would cease to exist. Its energy is necessary for our very being. But, like many things that are good for us, the sun with its powerful rays can be detrimental to our health as well. Too much exposure to the harmful UVA and UVB rays emitted from the sun can, over the years, cause irreparable skin damage and skin cancer. It is estimated that 1 in 5 Americans will, over their lifetime, develop skin cancer. These detrimental effects of the sun begin with exposure during childhood and accumulate with ongoing exposure over the years. Freckling, age spots, thinning of the skin that many adults have on their shoulders, chests, hands and faces are a result of years of ongoing sun damage. Precancerous skin lesions that develop around or after age 40 have their beginnings in youth. Pediatricians and others who care for young children know and understand these risks and often begin discussing approaches to sun protection as part of well child anticipatory guidance at a very young age. Despite ongoing education, the incidence of melanoma and other skin cancers is increasing in the United States, and the age at which we are seeing such is becoming younger and younger. Drawing on recent information and recommendations from the American Academy of Pediatrics (AAP) and the American Academy of Dermatology (AAD), this article will provide a brief overview and reference for parents and patients regarding sun protection plans for the whole family. Often patients say, “I wear sunscreen, but still get sunburn. What should I do? Sunscreen just does not work for me.” These are common complaints that stem from the common misconception that sunscreen is all that is needed to protect the skin from harmful effects of the sun. This is simply not true. Sunscreen is only one tool - and at that, an imperfect tool. When used properly and as a part of a comprehensive sun protection plan, sunscreen can be effective in protecting the skin from the sun’s harmful rays. Both the AAD and the AAP agree that the following are important first steps in protecting children from harmful effects of the sun: 1. Avoid the sun when the sun’s rays are strongest between 10 a.m. and 2 p.m: If your shadow is shorter than you are, seek shade, keep children under umbrellas, etc. Even on cloudy days, the sun’s UVA and UVB rays can be harmful to the skin. Prioritize outdoor events before 10 am or after 2 pm. 2. Wear sun protective clothing: Lightweight long-sleeved

shirts and pants, a wide-brimmed hat and sunglasses, neck gaiters, long-sleeved rash guards when swimming, etc. Many companies now make clothing with sun protective factors (SPF).

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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Sun Protection

3. Use extra caution near water,

snow, and sand: The sun’s rays are reflected from these and can increase the likelihood of too much exposure and sunburn. 4. Eat a healthy diet with a source

of vitamin D: Do not rely on the sun solely for vitamin D. Health food sources include (1) Fatty fish, like tuna, mackerel, and salmon, (2) Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals, (3) Beef liver, (4) Cheese, and (5) Egg yolks. Sunscreen, then, the other component to a comprehensive sun protection plan. The AAD stresses that EVERYONE should use sunscreen regardless of age or skin type; even those with darker skin tones that ‘never burn’ need to protect their

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skin. Remember, a suntan is evidence of sun injury. The AAP and the Food and Drug Administration (FDA), the agency that regulates over the counter medications including sunscreens, recommend the use of sunscreen with SPF 15 or higher. The AAD recommends the use of sunscreen with SPF 30 or higher that is water-resistant. Sunscreen with an SPF of 30 blocks about 97% of the sun’s harmful rays, and while higher SPFs exist, no agent will block 100%. Using an SPF greater than 30 may give one a false sense of security of added protection that prevents appropriate use.

68%

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

Importantly, all agencies recommend the use of a broad spectrum sunscreen. By definition, a broad spectrum sunscreen protects against both UVA (aging rays) and UVB (burning rays). Broad spectrum agents contain zinc oxide and/ or titanium dioxide which are minerals that physically block the sun’s rays from penetrating the skin by reflecting and scattering the rays from the skin’s surface. Zinc oxide and titanium dioxide are “generally regarded as safe and effective” by the FDA. These products are also the most hypoallergenic and suitable

of homemade sunscreen recipes do not afford adequate protection from UVA or UVB rays.


for sensitive skin or patients with skin conditions such as eczema. The type of sunscreen used is a matter of personal choice, and may vary depending on the area of the body to be protected: creams are best for dry skin and the face, gels are good for hairy areas, solid sticks are good to use around the eyes. Sprays are often seen as easiest to apply, but contain many more chemicals that are still under review by the FDA; they also pose inhalation risks and are best avoided in children. Nowadays, many cosmetics such as makeup and moisturizers contain sunscreen as well for ease of daily use. Sunscreen only works if applied in the proper amount and with the proper frequency. Applying too small of an amount is likely a major reason for failure. Adults and children should use 1 ounce of sunscreen, a shot-glass full, to cover the entire body. Smaller toddlers may require less. Sunscreen should be applied 15 minutes prior to going outside, and should be reapplied every 2 hours, or after swimming or sweating. Sunscreen should be applied to the ears, lips, tops of feet, head, back of the neck and other commonly forgotten areas. While the FDA and the AAD have concluded that all sunscreens currently available in the United States are safe and effective as part of a comprehensive sun protection plan (Wang SQ, Lim HW. J Am Acad Dermatol. 2019;81:650-651, https://bit.ly/2WWBSLm), sunscreen of any kind, should not be used in infants under the age of 6 months. Many companies market “Baby” formulations, and the AAP concedes that a small amount may be used and only in limited areas, but young infants should be

Sunscreen only works if applied in the proper amount and with the proper frequency. Applying too small of an amount is likely a major reason for failure. Adults and children should use 1 ounce of sunscreen, a shot-glass full, to cover the entire body. kept out of the sun and dressed in appropriate lightweight clothing when sun exposure is unpreventable. The AAP cautions against unproven sun protecting agents such as some sunscreen pills available online as they are not proven to be effective or safe and lack any regulation in their formulation, marketing and distribution. The AAP also cautions against homemade sunscreens. There are some studies of homemade sunscreens which show 68% of the recipes do not afford adequate protection from UVA or UVB rays. Some sunscreen recipes included unsafe ingredients and oils that can cause contact rashes.

In summary, who does not love the sun? Who does not feel better after time spent outdoors in its warmth? One can love and enjoy the sun responsibly with a mindset that includes a comprehensive sun protection plan. While total sun avoidance is not the goal, reducing the amount of sun exposure by timing outings, protecting skin with clothing and sunscreen makes for a healthier summer and reduces the risk of sun damage, photoaging, and even skin cancer into adulthood. Healthy sun habits during the early childhood years will provide a model for young adults to carry through their entire lifetime.

For more information on healthy sun habits for children and adults, please see the following links: www.fda.gov/drugs/understanding-over-counter-medicines/sunscreen-howhelp-protect-your-skin-sun www.aad.org/news/aada-statement-on-sunscreen-access www.aappublications.org/news/2020/06/01/focussunprotection060120

Wendy Ripple, MD, is a pediatric dermatologist who cares for young people’s skin conditions from the inside out. She treats acne, warts, and rashes and provides skin checks and mole biopsies. Dr. Ripple earned a medical degree from the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. She completed a residency and a pediatric fellowship at Children’s Hospital of Pittsburgh in Pittsburgh, Pennsylvania and is certified by the American Board of Pediatrics. Dr. Ripple is based in Erie, PA, and she sees patients from birth to age 26.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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MyChart

Now that Pediatric Alliance is part of Allegheny Health Network, we’re moving from Patient Portal to MyChart. MyChart is a secure online platform that gives you a quick and easy way to connect with our office: • Book appointments • View test results • Communicate with our care team • Request prescription refills • Review your child’s health history • Pay bills and view statements

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Follow these steps to register for MyChart now: 1. Visit mychart.ahn.org and click “Sign Up Now.” 2. O  n the next screen, under “No activation code?” click “Sign Up Online” and follow the onscreen prompts. 3. Once you’re logged in, click “Profile” in the top right and then “My Family Access.” 4. Based on your child’s age, follow the instructions to get proxy access.

AHN Pediatrics-Pediatric Alliance • Spring 2021 • www.ahnpediatrics.org

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