Medical Musings from Kids First Providers

StethoScoop: Medical Musings from Kids First Providers

Potential Measles Exposure

We want to inform all our families that we were informed by the Illinois Department of Public Health (IDPH) about a confirmed case of measles. The person with measles was in our office building on January 10. We have called our patients who were potentially exposed to the person at that time in our office, but we do want to inform our entire practice in case individuals may have had contact with the person in other places.

This is the second case of measles reported by the IDPH, but the two cases are unrelated. These two individuals did not become infected while at O’Hare airport but had already contracted measles. There is not a measles outbreak at O’Hare airport.

The newly reported case, who was infectious at the time, was at the locations listed below.

Two hours have been added to the time after the individual left because the measles virus can linger in the air and on surfaces two hours after an infected individual leaves the area.

People who are considered to be close contacts and most at risk, including passengers on the inbound flight to Chicago O’Hare and others in the airport, are being contacted directly by local health departments. Hospitals and healthcare facilities are working to identify all possible areas of exposure and notify susceptible patients, staff, and visitors. IDPH is working with local health departments and hospitals during this investigation and information is subject to change. 
Most individuals are vaccinated routinely in childhood and are not at high risk. Of most concern are exposed people who have not been vaccinated. Individuals who think they have been exposed should check with us about their children’s protection through prior vaccination or the need for vaccination. We will determine the need for vaccination and/or testing. 
If infected, individuals could develop symptoms as late as February 1, 2018. Symptoms of measles include rash, high fever, cough, runny nose, and red, watery eyes. If individuals develop symptoms of measles, please call us before going to a medical office or emergency department. Special arrangements will be made for evaluation while also protecting other patients and medical staff from possible infection.

Welcome, Dr. Mimi Boren

Dr. Mimi Boren joins Kids First this July, after recently completing her residency in pediatrics at University of Chicago. She grew up in Madison, Wisconsin where she is one of five children. Dr. Boren comes from a family of doctors, and from a young age, she says, she felt the “call to medicine” as she saw her father make a positive impact in the lives of patients.

As an undergraduate at University of Notre Dame, she studied pre-medicine and Spanish. She studied abroad during junior year in Toledo, Spain, where she greatly improved her Spanish language skills, and she looks forward to seeing some exclusively Spanish-speaking patients at Kids First. She and her husband, Nate, welcomed their son, Charlie, into their family last December. She says, “He brings us joy every day, and he has given me a whole new perspective on being a pediatrician.” Now before she orders a blood draw or a medication, she says she thinks about if she would want her own son to endure that same routine. She has also done become passionate about breastfeeding through her own experience.

She is excited to join Kids First Pediatric Partners. She says, “When I first met Dr. Cathy DiVincenzo, I felt like I had known her for years. The first time I went to Kids First, I knew I would fit in well there. I truly feel lucky to be joining such a wonderful team, and I know it will be an honor to care for the families who choose us for their pediatric care.”

Dr. Boren says she hopes to see a lot of newborns so she can continue to care for them for years to come. “I’m excited to do what I set out to do when I started in medicine and really establish good relationships with families.”

When she is not working or caring for her baby, she enjoys running and being outside.

9 month visit

I have had lots of parents in recent weeks tell me that they are enjoying reading my posts.  I appreciate the positive feed back and I hope we can keep the momentum going.  Our baby is now 9 months old.  At earlier visits we were monitoring the early stages of development, but at 9 months this becomes a more formal and standardized part of our evaluation.  For Pediatricians, one of our most important roles is to monitor for appropriate developmental milestones – and if a child does begin to exhibit delays, to coordinate them getting the proper evaluation and therapy.  To aid in this process, Developmental Specialists created a series of highly standardized assessment tools called the Ages and Stages Questionnaires.  The ASQ as it is known, allows us to carefully and accurately track a child’s development over time.  It is a series of questions that parents answer regarding what tasks their child is doing – from communication to gross motor, fine motor, problem solving, and personal social interactions. We are able to quickly score the parents responses to give a really good picture of a child’s development in each category and we can then take steps to get that child the appropriate help to catch them up quickly.  As always, feel free to respond with any questions.  At our next check up, our child will be 1 year old –  they do grow up so fast.


1 month visit


We are up to the one month visit – and this is a great time to explain the phrase you often hear us refer to: GROWTH PERCENTILES. From birth through the time they transition to an adult provider, we regularly monitor your child’s growth; height and weight, and during early childhood we also measure and track their head circumference. In order to assess growth patterns over time – these measurements get plotted on growth charts that give us the”percentile” for each measurement. The way I explain the percentile charts to parents is that they are a statistical tool to help us track a child’s growth pattern over months and years. For example, a one month old whose weight is at the 20th percentile would weigh more than 19% -and less than 79% – of other one month olds in the general population. For Pediatricians, we are watching the trend of the percentiles over time to make sure there is not a significant decline, whether over time, or suddenly. We are not expecting everyone to be average or at the 50th percentile, or at the top of the chart for their age; rather we use these values to gauge steady growth. If a 2 year old’s height is at the 15th percentile – are they too short? Well, if their weights have generally been in the 10-20 percentile range (or lower) at prior visits – then they are growing at a steady pace and as the Pediatrician I am happy – especially if their parents have a similar genetic make up. However – if that child previously measured at much higher percentiles, their growth has clearly slowed and we need to consider why there was this change. Interpreting and following these growth charts is not a simple process and it takes training and experience but I hope I was able to explain the basics. We also use percentile charts to assess Body Mass Index (BMI) as kids get older – but we will discuss that in the future. Later this week I will talk more about some of the other findings we assess at the 1 month visit. Have a great day…Dr Aronson

2 week visit

2 wk visit

For the next installation in my series focusing on “check-ups”, we will move on to the 2 week evaluation. As we discussed in my posts about the newborn visit – most babies lose weight in the 1st few days of life, and there is frequently an adjustment period as they learn to feed. When we have parents bring their babies back just a week or so after the initial visit – one of the most important things we are looking for is appropriate weight gain. As I joked in an earlier post – babies do not come with an instruction manual – some babies feed small amounts frequently, while others may take larger volumes less often. For babies that are nursing – the mothers can tell us about the schedule of feeds, but what volume is the baby drinking is typically not known. “Baby A” might drink 1 ounce every 2 hours, but “Baby B” feeds 2 ounces every 4 hours -the daily total will be the same, but the schedule is very different. Which is correct….whatever allows for regular wet and dirty diapers but also for steady weight gain, which at this age should be in the range of three quarters to one ounce per day. I often explain to parents that while there is plenty of time for a child to gain weight as they get older – the first weeks and months of a baby’s life are a critical time for growth and development of the brain, neurologic system and other organs. So if a baby is gaining weight properly , I can feel comfortable that they are getting enough nutrition for their brain, heart, lungs and so on. And if the pace of weight gain is too slow – or when they sometimes even lose more weight – we have some very important work to do. As always – feel free to post any questions or feedback on things you may have seen us do that you wanted to know more about. Check back in a few days as I continue this series. Dr. Aronson

Spring Is in the Air!

Despite the April cold temperatures, it is technically spring! We soon get to enjoy warmer weather, which unfortunately also brings spring allergies. 1 in 5 Americans have allergies, and the most common is hay fever, also known as seasonal allergies. After being cooped up for most of the winter, children cannot wait to get outside, where they are exposed to environmental allergens such as pollen, trees, grass, and mold. The most common signs and symptoms of seasonal allergies are similar to the common cold:

  • Itchy, watery, red, puffy eyes
  • Nasal congestion, sneezing, sniffling, runny nose, itchy nose
  • Post nasal drip
  • Clearing the throat
  • Itchy ears
  • Coughing

According to the American Academy of Pediatrics, allergies and asthma are the most chronic diseases among children in the United States. If your child has both asthma and seasonal allergies, spring may be a trigger season for them. You may see your child coughing more and/or using their rescue inhaler more frequently.   For asthmatics, by keeping their allergies well controlled; they in turn help prevent their asthma from flaring. Unfortunately, neither asthma nor seasonal allergies have a cure, but both are treatable and can be well managed with over the counter and/or prescription medication. Here are some other ways to help control allergies:

  • Keeping windows closed at home and in the car to keep allergens from settling inside
  • Staying outdoors for short periods of time when the pollen count is high
  • After spending time outside, washing your hands, arms, face; and changing clothes
  • Taking a shower or bath before bedtime

If you suspect your child is experiencing seasonal allergies, please call our office to discuss their symptoms and possible treatments so they could enjoy the spring weather!


Mumps: What Parents Need to Know

Mumps has been in the news recently after outbreaks at the University of Illinois in Urbana-Champaign and at a high school in Barrington, and more recently dozens of cases at Illinois State University.  

At Kids First Pediatrics, we like to keep our families informed and up to speed. Mumps is a viral infectious disease that can cause swelling and tenderness of the salivary glands found in the cheeks and jaw. This characteristic symptom is usually preceded by a few days of fever, headache, lethargy and muscle soreness. The infection spreads through contact with saliva or mucus  after an infected individual coughs  or sneezes. The symptoms of mumps typically last a few days, sometimes up to a week,  but a small percentage of infected individuals will develop more serious complications such as  deafness, meningitis, arthritis and painful swelling of the testicles. 

Although the only treatment for mumps is supportive care and hydration – there is a highly effective way to prevent the disease. That is  timely vaccination with the MMR vaccine at the 12 month check up and a second dose at age 4-5. Touch base with us for additional information, or check our website for links to trusted, reliable medical websites.   

Newborn Visit

I am REALLY excited about the opportunity to draw back the curtains so to speak so that families will have a better grasp on some of the many things we assess during check ups.  We will start with the newborn visit and in the coming weeks and months work our way through the pre college visits.   

I have been known to joke with parents that not much changes in the baby’s first few weeks – they eat, sleep, and poop. Sounds pretty simple- but  the reality is much more challenging! For a newborn and his/her parents, a lot of things have to happen during the first week. At the time of delivery – a newborn has massive transitions to go through; from breathing on their own, to being held and the feeling of clothes on the skin, to keeping warm and a series of changes in their heart and circulatory system. One of these major developments is learning to feed; how feeding is progressing is one of the biggest focuses of the first visit to the pediatricians office. Most of the questions the new parents have involve feeding issues, and from my perspective it is the primary thing I focus on at the first visit. So many of our families are breastfeeding their newborn, which of course is great, but it can sometimes come with a series of challenges. The babies need to learn to latch and swallow efficiently.  Every mother’s body is different of course – and the timing of milk production can be variable. “How often should a baby be feeding?” “How long should they be on the breast?” “How much formula should they be drinking?” “What about dirty and wet diapers?” We are here to help you with all of those questions. Babies do not come with an instruction manual (one of my other jokes that some have you have heard) and the newborn visit is focused on making sure the early transition is going reasonably well – and if not, we can help support and make adjustments to  ensure your newborns are healthy and safe.   

I look forward to reading your comments and thoughts. My hope is that these posts will give you a small insight into some of the things we do at “routine check ups”. Check back in a few days and I will review some other parts of the newborn visit before moving on the 2 week exam.  

Have a great day – Dr Aronson 


Staff Holiday Traditions

We reached out to our Kids First staff this week, asking what are some of their holiday family traditions. Here’s what we found out:

Dr. Aronson: Watching the movie, “A Christmas Story” over and over again – and teasing my wife that I will get our kids a “Red Rider BB gun” or that I will get a Leg Lamp for our living room

Dr. Shepherd: I am Swedish on my maternal grandmother’s side and growing up we always went to my great-grandmother’s place on the north side of Chicago for a big Swedish smorgasbord. My great uncles would always be happily sipping Glogg. There were always lots of Swedish meatballs, limpa bread, Swedish sausage, potatoes, rice pudding, and tons of delicious cookies. Now my grandmother and great-grandmother have passed on, but my uncle keeps up the tradition and we go to his house on Christmas Eve for the smorgasbord. Eating all the traditional foods always brings me back to happy childhood holiday memories!

Dr. Kim: Fighting over outdoor lights, begging our toddler to keep the ornaments on the tree, then stuffing ourselves with repeat Thanksgiving dinner on Christmas night.

Stephanie S.: Every year I look forward to my sister-in-law’s annual cookie exchange. Rules are you have to bake enough cookies to use up 1 lb. of butter. Lots of laughs and cookies to last through Christmas.

Yael: For my family tradition we enjoy lighting the Chanukah candles together and then we sing and dance around the Chanukah lights.

Lisa V: The Verdon family attends Christmas Eve Mass at St Mary’s in Evanston, where the kids participate in recreating the Nativity, dressing up as angels and shepherds! After Mass, we have family dinner and then get in pj’s to watch The Christmas Story as a family:)

Edith: I enjoy getting together with all my relatives on Christmas Eve. We play games and just enjoy each others’ company. I also look forward to my husband’s warm sorrel drink from his native Trinidad and Tobago. It’s full of spices and just tastes like Christmas.

Sarah: One of our holiday traditions is to eat different types of fried food to commemorate the miracle of the festival of lights, Chanukah, when one vial of olive oil lasted eight whole nights! On Chanukah we gather for parties to light our menorah and share in potato latkes ( pancakes) and jelly donuts! Check out this fun spin on donuts to make and enjoy with your families!

Katie: Every year Phil, Tess and I pick out our Christmas tree and we come home and decorate it while drinking hot chocolate and listening to Christmas music. Always gets us in the Christmas spirit!

Jean: In the Russo family we have the traditional Italian Feast of Seven fishes on Christmas eve. My father and mother-in-law prepare seven different kinds of fish and seafood and we spend the whole afternoon and evening eating, laughing, and spending time together.

Debbie: Since Michael was a baby we do this on Christmas Eve: after we hang our stockings and make a plate of cookies and a glass of milk for Santa, we sit by the fireplace and read “The Night Before Christmas” together. I used to read it to Michael as a baby and ever since he learned to read, he reads it to us.  He is almost 17 and we still love doing it!

Another favorite is baking cookies. My husband and my son are my “official testers” and get to decide which ones I make again the following year. They always comment on how great the house smells at Christmas time from all the baking!

Winter Car Seat Safety Tips

Winter is a tricky time for car seats. As a general rule, bulky clothing, including winter coats and snowsuits, should not be worn underneath the harness of a car seat.

In a car crash, fluffy padding immediately flattens out from the force, leaving extra space under the harness. A child can then slip through the straps and be thrown from the seat.

These tips from the American Academy of Pediatrics (AAP) will help parents strike that perfect balance between keeping little ones warm as well as safely buckled in their car seats.

How to Keep Your Child Warm and Safe in the Car Seat:

Note: The tips below are appropriate for all ages. In fact, wearing a puffy coat yourself with the seat belt is not a best practice because it adds space between your body and the seat belt.

  • Store the carrier portion of infant seats inside the house when not in use. Keeping the seat at room temperature will reduce the loss of the child’s body heat in the car.
  • Get an early start. If you’re planning to head out the door with your baby in tow on winter mornings, you need an early start. You have a lot to assemble, and your baby may not be the most cooperative. Plus, driving in wintry conditions will require you to slow down and be extra cautious.
  • Dress your child in thin layers. Start with close-fitting layers on the bottom, like tights, leggings, and long-sleeved bodysuits. Then add pants and a warmer top, like a sweater or thermal-knit shirt. Your child can wear a thin fleece jacket over the top. In very cold weather, long underwear is also a warm and safe layering option. As a general rule of thumb, infants should wear one more layer than adults. If you have a hat and a coat on, your infant will probably need a hat, coat, and blanket.
  • Don’t forget hats, mittens, and socks or booties. These help keep kids warm without interfering with car seat straps. If your child is a thumb sucker, consider half-gloves with open fingers or keep an extra pair or two of mittens handy — once they get wet they’ll make your child colder rather than warmer.Pinch Test image
  • Tighten the straps of the car seat harness. Even if your child looks snuggly bundled up in the car seat, multiple layers may make it difficult to tighten the harness enough. If you can pinch the straps of the car seat harness, then it needs to be tightened to fit snugly against your child’s chest. See image right. 
  • Use a coat or blanket over the straps. You can add a blanket over the top of the harness straps or put your child’s winter coat on backwards (over the buckled harness straps) after he or she is buckled up. Some parents prefer products such as poncho-style coats or jackets that zip down the sides so the back can flip forward over the harness. Keep in mind that the top layer should be removable so your baby doesn’t get too hot after the car warms up.
  • Use a car seat cover ONLY if it does not have a layer under the baby. Nothing should ever go underneath your child’s body or between her body and the harness straps. Be sure to leave baby’s face uncovered to avoid trapped air and re-breathing. Many retailers carry car seat bundling products that are not safe to use in a car seat. Just because it’s on the shelf at the store does not mean it is safe!
  • Remember, if the item did not come with the car seat, it has not been crash tested and may interfere with the protection provided in a crash. Never use sleeping bag inserts or other stroller accessories in the car seat.
  • Pack an emergency bag for your car. Keep extra blankets, dry clothing, hats and gloves, and non-perishable snacks in your car in case of an on-road emergency or your child gets wet on a winter outing.

These precautions can make sure your child is as safe as can be when traveling to their next well-child visit or over the river and through the woods to grandmother’s house.