FLU MIST 

2016-2017 INFLUENZA SEASON

Advisory Committee on Immunization Practices (ACIP)

On June 22, 2016, the Advisory Committee on Immunization Practices recommended that Flu Mist not be used in the 2016-17 influenza season due to poor effectiveness.  The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) are supporting this recommendation.

PYAM will also be supporting this recommendation given by the ACIP, CDC, and AAP, and has cancelled all orders for Flu Mist.  We are reaching out to our vendors and hope to be increasing our supply of the injectable thimerosal-free influenza vaccine so that all PYAM patients can be vaccinated during the 2016-2017 influenza season.  At this time, we will receive a limited supply of the influenza vaccine this fall, and have been put on a waiting list with several vendors for more vaccine as it becomes available.

We understand that the absence of the Flu Mist is likely to be disappointing for many of patients.  PYAM strongly believes that every child should be vaccinated with the Influenza Vaccine.  Please watch our web site at www.pyam.com and our face book page for updates on the Influenza Vaccine.

Thank you,

PYAM Providers and Staff

Every parent sees it and every parent has to deal with it. It happens at home and it happens in public. That most feared behavioral issue, temper tantrums, happen. While similar to aggressive behavior (which starts to show up at about the same time) tantrums are slightly different. Aggressive behavior occurs when a youngster can’t or doesn’t know a better way to deal with a situation involving another child; tantrums on the other hand are nearly always a function of the child’s squaring off against parents or caregivers. In other words, when they don’t get what they want.

Why do children have such a tough time learning that they can’t have or do everything they want? Look at it this way. From the very moment of birth onward every adult in a child’s life diligently gives him whatever he needs— food, attention, toys, etc. but during the second year of life, the game abruptly changes—baby can’t have whatever he wants, he can’t do whatever he wants—like running into the street. The adults in baby’s world suddenly start imposing rules and expectations. In addition to this children of this age are beginning to develop a sense of self, a person separate from his parents. He wants to develop and use new skills and explore the world around him. This creates conflict and a normal healthy child will respond by occasionally lashing out or by launching a full-blown tantrum.

While this behavior is normal, it can be very unsettling and disruptive but there are many things parents can do to stop or ameliorate the behavior.

Parents themselves have to take the blame for some tantrums, the ones that happen when they have dragged a kid to the mall and missed nap time, meal time and whatever else is part of the child’s normal routine. A tired, hungry kid can explode in this situation. This sort of ‘tantrum’ is best recognized for what it is, an event that could have been avoided by better planning. All other tantrums are plain andsimple, power struggles.

Power struggles by age

Usually by 18 months children start testing the limits. They want to be free to explore the world and be independent— ‘me do it’. At this age, children can’t see another person’s point of view, only their own. When their actions or desires are checked, they react by crying, shouting, hitting or kicking.

It is pointless to try to reason with a child in this situation. At this point, parents have options but ‘talking them down from the ledge’ just doesn’t work and usually makes things worse. Strategies and tantrum-busters are discussed later.

By the age of three years, kids have better language skills and have learned to be less impulsive. Generally there are fewer and less dramatic tantrums at this age. At four years of age children can do many things by themselves; they have better language skills and have acquired some self-control. These abilities help kids keep it together. Still, when they are faced with challenging situations tantrums can flare up. In fact children of all ages can have an occasional tantrum, up to and including teenagers.

Temper tantrums are a lot like forest fires: they are easier to prevent than to control after they have started. Here are some ideas that can help you squelch a temper tantrum at its onset or at least ride one out, because sometimes, that’s just what you have to do.

Strategy, not screaming

Parents can start controlling tantrums by knowing their child’s triggers, those things that in the past have set the child spiraling out of control—hunger, fatigue, stress, interruption of an activity. Plan ways to head these off ahead of time so that you are prepared.

• Don’t expect a small child to go without eating or sleeping as long as you can. Restrict outings to times when your child is fed and rested and when he does tire, go home.
• Establish a routine for your child and then stick to it as much as possible. Respect his schedule. Some people can ‘switch gears’ more easily than others. If your child has difficulty transitioning from one activity to another, help him out by giving him a couple of notices that this will be happening. “Owen, in ten minutes you will need to stop playing with legos because it will be lunchtime.” Then repeat the warning again at 5 minutes. This way Owen has time to process and come to terms with the change that is coming.
• Give kids control over the little things in their life this helps them deal with times when they can’t be in control of a situation.
• Try not to say ‘no’ automatically. Up your game, say yes, avoid fighting over little things.
• Child-proof his environment so that he can explore and experiment without always hearing ‘no.’
• Redirect, distract or somehow change things up when you see your child on the edge. That oftentimes works to prevent a blow-out.
• Keep your expectations of your child’s social, academic and behavioral abilities at a realistic level, where he can meet them without becoming too frustrated. For example, you can’t expect the same things from a two year old that you can from a four year old.
• When doing something new or unfamiliar, tell your child ahead of time what your expectations are for his behavior.
• Keep your sense of humor, it will serve you well.

At all times, parents need to remain calm themselves. Losing their temper, shouting, or making threats is like pouring gasoline on a fire and is a sort of grown-up version of what their child is doing. Not the best message to send, is it? When a child is out of control reasoning and threats don’t work. Believe it or not, young children are often scared by their own behavior; someone has to be calm and that is the parents’ job.

One excellent strategy is to remove the audience from his performance by simply walking away and telling him that you will talk to him about the problem when he calms down. Make sure he can’t harm himself or others, then leave the room. Kids realize sooner or later that their actions are not yielding the desired results and the tantrum fizzles out.

At home, you can simply walk away from a tantrum in progress and wait for the child to settle down. This isn’t a realistic strategy in a grocery store or mall. If your efforts to head off the tantrum fail, then the best course of action is to remove the child from the store and go outside or to your car and let him have at it without any observers (again, making sure that he is safe)until he is in a more reasonable state.

It is beyond annoying to have to abandon your grocery cart or leave unpaid purchases behind, but by doing this the child learns that you mean what you say and that he can’t use tantrums for leverage. You, the parent simply aren’t buying into his demands no matter what.

One of the worst things a parent in this predicament can do is to give in to the child for the sake of convenience or out of embarrassment. That tells junior that he has the power to get what he wants by using these unacceptable behaviors. Forget about what others might be thinking, your job is to help your child grow emotionally as well as physically, not impress other people or worry about their disapproval.

Buy into a tantrum and the next ones will be harder to deal with; refuse to play along and the child learns that tantrums don’t work.

Sometimes, little and not so little kids can get so out of control they are in danger of hurting themselves or others. When this happens you have to step in and physically restrain the child, maybe with a ‘basket hold’ for safety sake, until calm is restored.

Time-outs can be useful by giving the child the time and space to get his control back. Don’t use it as a punishment but as an opportunity that he can use to help himself. Babies need to learn to self-soothe and children need to learn to regain and maintain self-control.

As mentioned earlier, parents can do a lot to teach their kids that tantrums aren’t the way to get what they want. Teaching them to ask nicely, be patient, and understand that they can’t always have what they want. Consistency is key, at home, at daycare and at school. Talk to teachers and caregivers; explain to them what methods you find work best for your child.

It is also very important to show your child that you dislike his behavior but you always love him.

Lastly talk to your child when things get back to normal. Discuss what happened and why the child responded as he did. Was he angry, frustrated, or simply confused? Talk about his feelings and what he can do to deal with them at other difficult times. Keep the evil twins, shame and blame, out of the discussion, that is unproductive and doesn’t help a child learn from his mistakes.

Physical growth doesn’t happen over night neither does emotional maturity or social skills. Step-by-step children work their way through the complexity of being human. You are their guide. They can’t make it without you. For their sake, learn how to deal with tantrums firmly and lovingly. Everyone’s life will be the better for it.

FINAL – Vaccine release

Please make sure your child has been appropriately immunized against Measles. The Measles vaccine is safe and highly effective.  http://www.cdc.gov/features/Measles/index.html?  s_cid=cdc_homepage_whatsnew_001