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Thank you for continuing to read these blogs. Feel free to suggest any topics you would like to hear about in the upcoming year. 


 Dr. Rappaport




Have you noticed your child having frequent coughing at night, during the day, with colds or playing sports? It could be an asthma attack.

Asthma is a chronic inflammatory condition of the lungs leading to airflow obstruction and airway hyper responsiveness. This condition is characterized by symptoms of coughing, chest tightness, shortness of breath and wheezing.  As mentioned above triggering factors are often infections, cold air, allergies and exercise.

Asthma is the leading cause of chronic illness in children affecting 7 million in United States alone. It can begin at any age but most symptoms are seen early as young as 2 to 5 years of age and two thirds of asthmatics are diagnosed before the age of 18. Who are these children? Asthmatic children usually come from families that have a history of allergies Including food or environmental and live in an urban setting.They have other family members with asthma particularly on the mothers side. Common presentation is a young child between the ages of two and five with unexplained coughing and difficulty breathing with a common cold.

It can be difficult to determine whether your child is having asthma related symptoms particularly under the age of five. That's why it's important to track when, where and how symptoms present, keeping a diary for your doctor. A good history along with a physical examination and breathing tests for children over the age of six often secures the diagnosis. As well, children with asthma have a 90% chance of being allergic to environmental allergens such as pollen, dust mites or animal dander. Skin testing for allergies can also add more evidence towards the diagnosis and help with treatment.

Once your child is diagnosed with asthma he or she can live a normal, extremely active life which can include any aerobic sport. Newer medications which are extremely safe with few side effects have aided in complete control of symptoms. Your doctor and you can develop an individual emergency action plan to avoid symptoms and keep asthma silent.



Tic Disorders and Twitches

Has Your Child Ever Had Uncontrollable Facial Movements or Vocal Outbursts?

If the answer is YES they may have a common TIC DISORDER.Tic disorders and twitches

Parents who watch and hear their children repeat movements or vocalize noises worry something must be terribly wrong. In most cases the opposite is true! Tics are involuntary, cannot be controlled and are often a source of social embarrassment for both parent and child.

They present as involuntary:

  • blinking
  • twitches
  • movements
  • humming
  • shoulder shrugging
  • throat clearing
  • or a combination of all at various times

They often appear when a person is under high stress situations such as school pressures, family emergencies, peer pressures and even normal everyday stress associated with a growing body and mind. They are seen most often in boys. In severe cases genetics plays a role such as in Tourette’s syndrome. Tics may be simple or complex. A simple tic may be something like eye blinking, a grunt, muscle twitches, facial grimacing, or nasal flaring. These are purposeless movements. A complex tic consists of throwing, scratching or chewing. These are muscle movements with a purpose. A vocal complex tic produces a word not just a sound.

Tics fall into different categories such as:

  • Chronic Vocal or Motor Tic Disorder: Motor and vocal tic involvement that appear many times a day for a period of at least a year.
  • Provisional Tic Disorder: Tics of either vocal or motor in nature that lasts for less than a year and is eliminated when a stressful situation resolves.
  • Tourette’s Disorder: The presence of tics for at least a year, which are both vocal and motor in nature. They must be frequent and never stopping for a period of longer than 2 months. It is also usually associated with ADHD and obsessive-compulsive difficulties or certain diseases such as Huntington Disease or post viral encephalitis.

Tic and Twitching Disorder Treatment:

The first line of defense should be wait and watch. Most tic disorders are over as the individual matures.  It tends to resolve gradually even if medication is used to treat. Talk to your doctor, keep a log of your child’s tics from month to month, and most importantly try to ignore it. The more attention it is given the worse it can be! 

Talk to your doctor and have him/her evaluate the child before any further action is taken. 


Lice Treatment & Prevention

Author: Dr. William Rappaport
Date: November 2016

Has your child ever had head lice? If so you know just how irritating it can be to get rid of them!

What are Lice? hair lice identification

Lice and their nits are annoying frustrating little parasites that are not dangerous, but highly contagious if not treated. They do not spread disease. However, they are itchy on the scalp causing scratching, which can lead to infection on the head and the spreading of these bloodsuckers. Adult lice are wingless parasites that attach themselves to the hair shaft. They have claws that allow them to crawl and cling firmly to the hair. It is easy to spread lice from person to person. Children get them by sharing hats, laying head to head, and using pillows of someone infested with the bugs and nits. They are common at summer camps, schools, childcare centers, slumber parties, sports activities, and potentially seats on a train. Some schools will have lice checks at the beginning of the year. However if your child is itching or has been away in areas where kids are in close contact with each other you should always just do a head check.

Lice have an evolution like all living things in the universe. Lice start out as eggs called nits, which are laid close to the hair shaft on the scalp. The eggs hatch 1 or 2 weeks after they are laid. The newborn nymphs immediately start feeding and quickly develop into adults which can feed up to several times a day. Most lice infestations are caught when they are eggs or have just hatched.


Medicated over the counter lice treatments such as Pyrethrins (Rid, Nix) usually kill the lice, but it may take a few days for the itching to stop. Treatment consists of washing the hair with medicated shampoo and removing the lice and nits by hand using a fine toothcomb section by section. It must be done on wet conditioned hair. The combing must be repeated every day for at least 7-10 days. The use of oils, (Tee Tree, Olive) have varying results and are popular to use daily after combing. Lice are often resistant to OTC medications. If this should occur, Malathion (Ovide), Benzyl Alcohol (Olesfia), Spinosad (Natroba), and Ivermectin (Sklice) can be used on older children.

At home it is recommended all sheets, pillowcases, hats, stuffed animals, and clothes should be washed and dried on a high temperature to ensure the bugs die. Carpets and upholstery must be vacuumed. If you treat properly, follow the directions, and are vigilant each night the infestation should be over.


Caring for and causes of Allergies

Author: Dr. William Rappaport
Date: October 2016

Allergies and those pesky symptoms that accompany them can be kept under control with smart preventative measures. Symptoms are key to detection. Keep a diary in order to help your doctor discover exactly what may be causing the uncomfortable, sometimes dangerous, allergies you may be experiencing.

this young woman sneezing into a tissue either has a cold or really bad allergies

  1. Do you or your child find certain foods cause constant cramping or diarrhea?
  2. When you or your child touch furry animals do you experience a rash or uncontrollable sneezing?
  3. Does walking through a park during certain times of the year cause itchy watery eyes, runny nose, sneezing and/or coughing?
  4. How about those itchy, stopped up, popping and infected ears?

They can all be caused by allergies.


  • Skin Rashes (eczema) or Hives
  • Stomach Upset
  • Sneezing, Coughing, Runny Nose, Itchy Eyes
  • Breathing Difficulty (Asthma)


  • OUTDOORS: Tree and Plant Pollens, Insect Bites, Stings
  • INDOORS: Dust Mites, Mold, and Animal Fur
  • FOODS: Peanuts, eggs, shellfish, finned fish, milk, cheese, wheat, tree nuts, soy
  • IRRITANTS: Perfume, Cigarette Smoke, Exhaust from Vehicles, Paints


For dust control taking up the rugs, getting rid of old stuffed animals and encasing the bedding with dust mite covers is very helpful. HEPA filtration units are excellent to control animal dander and changing the air conditioning filters during the spring and fall hay fever seasons reduce the pollen burden in homes. For patients with severe food allergies such as peanuts or tree nuts, complete avoidance of these products in home is essential.


Immunotherapy can be a safe form of long-term treatment to decrease symptoms for people with allergic asthma, rhinitis, insect and conjunctivitis allergies.  These injections, given by an allergist, can be a cost effective long-term approach for most people. For people with food allergies, simply avoiding the trigger is the best way to deal with the situation.


Vitamin D - The Wonder Vitamin

Author: Dr. William Rappaport
Date: August 2016

Did you know it is important for kids to take this supplement as well as teens and adults?

We have all heard about the Vitamin D supplement craze for adults. For our kids, it plays an important role in the bone building process by helping the body absorb calcium. Unfortunately, our kids do not get enough and this could affect their body’s ability in the future to maintain strong bones and teeth.Vitamine D the Wonder Vitamin

Driven by the power of sunlight, vitamin D is synthesized starting in the skin and finished off by the liver and kidneys. Without sunlight the body’s level are very low. Living in the Northeast United States, without regular sunlight, leaves much of the population with insufficient levels of vitamin D in all age groups.

Supplements are needed starting in the infancy to ensure proper bone building for life. Infants and preschoolers should be taking 600 international units daily either as a liquid or chewable. Teenagers and young adults as much as 2000 international units daily to ensure rapid bone growth and bone density as adults.

The importance of Vitamin D supplements for your child go beyond just building bones. Not only is Vitamin D important for strong bones, it has been proven to be a very important part of maintaining a healthy immune system. It can also lower people’s chance of developing cancer, heart disease, arthritis, and diabetes.

You may think that because it is summer and kids are outside and playing in the sun that they are getting enough vitamin D. However, the opposite is true, especially if you are vigilant about using sunscreen. Sunscreen blocks UV rays that cause sun damage and cancer. It also blocks UV rays from penetrating the skin. UV rays set off the process in the body that produces the vitamin D.

Vitamin D can be found in many foods such as fatty fish, fortified milk, soy milk, some cereals, beef, liver, cheese, and egg yolks. Tell me how many of your kids are eating these foods daily. Also, remember our bones reach their maximum density by age 18 so it’s very important to take vitamin D daily.

It is recommended you give your kids this wonder supplement everyday.

Enjoy the summer and happy playing!


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