Crestwood  Pediatric  Associates

703-361-7131   Manassas

703-753-6184   Haymarket

Swimming pool safety!

Dr. Jennifer Bradford, DO, FAAP, June 1, 2018

School is out and it’s time for some summer fun! For most families, this includes lots of swimming in either community pools or a backyard pool on a fairly regular basis. Here are some key safety points to keep in mind to keep the kids safe while swimming this summer:

- An adult who is able to swim (and preferably who is CPR-trained as well!) should always be present at the pool actively watching older children swim and actually in the pool with infants and toddlers free from any distractions like smart phones, house/yard work, socializing, and alcohol.

- Remember that inflatable swimming aids (“floaties”) are not a substitute for approved life jackets and offer a false sense of security.

- It is a good idea to have a few rules for playing in the pool if you do have your own backyard pool. These might include no running on the pool deck, no diving, no electrical appliances near or in the pool, no toys near the pool when not using the pool, and no tricycles or bicycles near the pool, and of course, no using the pool without an adult physically present as mentioned above.

- If you do have your own pool, one of the best ways to protect children in addition to having adult supervision, is having a fence completely around the pool to prevent any accidents.

- Remember that children over the age of 1 may be at a lower risk of drowning if they have had some formal swim lessons, but such lessons should not be considered to “drown proof” any child. Adult supervision is always needed!

So, grab your swimsuits, have fun this summer at the pool, and always stay safe!

Nip Allergies in the Bud

Dr. Rachna Patel, MD, April 2, 2018

Spring means children playing outside, sunshine, flowers budding, and leaves on trees. It also means itchy eyes, itchy nose, sneezing, and congestion. Luckily, there are ways to help reduce allergy symptoms this spring season:


- Reduce exposure to triggers. 

- Remove clothes worn outside and shower at night. 

- Keep doors and windows closed when pollen counts are high.
- Vacuum/dust your home often. 

- Be sure to change bed sheets every week. 

- Keep your nose clean. 

- Clean out your nose with a nasal saline spray. For toddlers, use a nasal aspirator or bulb syringe to suck out their noses.
- Rinse nasal passages to help relieve congestion by using distilled or sterile water in a squeeze bottle or neti pot.

Using an over-the- counter allergy medication Antihistamines such as loratadine, cetirizine, and fexofenadine can help receive congestion, sneezing, itchy eyes and nose. Decongestants, both oral and nasal, help relieve nasal congestion. Some options are pseudoephedrine and oxymetazoline. There are many ways to treat allergies and usually can be controlled with the use of
supportive measures and medication. However, you may have to try several different approaches before you find what works best for your child. If allergies are still not under control, seeing the pediatrician is a great place to start!

Mumps Outbreak at James Madison University

Several confirmed cases of mumps has been reported at JMU in Harrisonburg, VA. Several more cases are suspected with test results pending. Mumps is a mild to moderate contagious viral illness that is spread through close (face-to-face) contact with an infected individual. Symptoms usually appear 12-25 days following exposure and include body aches, fever, and swollen or tender salivary glands. If you or someone you know is exhibiting these symptoms and has been exposed to mumps, you should contact your healthcare provider immediately. 

Up to 10% of people who have received two doses (the routine schedule) of the MMR vaccine are still susceptible to infection from the virus. The Advisory Committee on Immunization Practices (ACIP) recommends that individuals in an outbreak setting receive a third dose of the MMR vaccine to prevent against infection. This recommendation is supported by a study performed at a university with over 20,000 students during a mumps outbreak. 

To prevent the spread of mumps - or any virus - the following actions are recommended:

              - Wash hands with soap and warm water

              - Don't share food, drinks, or utensils

              - Limit your contact with people who show symptoms of illness

              - Clean surfaces that are frequently touched (doorknobs, tables, counters, bathrooms) with soap and water or other                                  disinfectant

Flu Facts
Dr. Katherine Abbott, MD, January 17, 2018

I’m sure everyone has been hearing in the news lately that influenza is peaking in the United States. We have never seen the CDC map of influenza showing it to be widespread throughout the continental United States.

This year we are having primarily Type A influenza of the H3 type. We are seeing some circulating type B as well. Clinically these two are indistinguishable presenting with headache, fever, body aches, chills, runny nose and cough. We would like you to call if you have these symptoms. We have an in office test , a nasal swab, that can show if your child has the flu that just takes about 15 minutes to perform.

If your child has the flu, we may recommend Tamiflu. This medication works best if we see your child within 48 hours of the onset of the fever.

The primary complication of the flu is pneumonia. If after the visit your child has increasing cough, shortness of breath, chest pain or increase in fever, we need to see them back in the office asap. We may need to do a chest x-ray or add additional medication to treat complications of the flu.

Of course, the best treatment is prevention. If your child has not had the flu vaccine, it is not too late. Please call and schedule to come in for one. We can even give flu vaccines to parents if you wish.

In order to prevent transmission of influenza, please remind your children to cover their cough.  Have them wash their hands often. Do not send your child to school if they have had a temperature over 100.5 in the prior 24 hours. Never give Tylenol for a fever in the morning and send them to school later that day. If you have any questions about the flu, please give us a call. We look forward to hearing from you. 

It’s that time of the year: Respiratory syncytial virus (RSV) and what parents need to know

Dr. Jennifer Bradford, DO, FAAP, December 1, 2017

RSV is the most frequent cause of bronchiolitis (inflammation of the small airways of the lungs) in infants and young children
It accounts for 60% of all acute respiratory infections in children. RSV season begins in November peaking in January or February

and ends in May. RSV is passed from child to child through respiratory (nasal discharge, cough) secretions (the virus can remain viable on hard surfaces for up to 6 hours!). The incubation period is from 2-8 days.

Most common first symptoms are nasal congestion, runny nose, and sneezing followed by cough with increased difficulty breathing.
Infants are usually more severely affected than older children and can also develop lethargy, fever (though not always!), poor feeding, ear infections, secondary bacterial pneumonia, and apnea (cessation of breathing), which can sometimes result in hospital admission
RSV can be tested for in about 10-15 minutes with a simple nasal swab in the our office.

Therapy for RSV includes ensuring adequate hydration status and preventing dehydration along with supportive respiratory care (nasal suction with nasal saline drops with bulb syringe or NoseFrida. Occasionally, a nebulizer treatment may be tried if the infant is wheezing or has a significant family history of asthma. There is no role for steroids or antibiotics in the treatment of RSV as they will not improve symptoms. 

Hand washing and use of alcohol-based rubs can help limit the spread of RSV; encourage and teach toddlers and older children to wash their hands frequently and cover coughs!

Respiratory Syncytial Virus Infection and Bronchiolitis
Giovanni Piedimonte, Miriam K. Perez
Pediatrics in Review Dec 2014, 35 (12) 519-530; DOI: 10.1542/pir.35-12-519

Healthy Snacks      

by Dr. Lisa Harnum, September 19, 2017

Parents are often wondering about healthy snacks for their children. Here are some ideas:

apple slices with peanut butter
baby carrots and fat-free ranch dressing
nutrigrain bars
cheese sticks
yogurt - Dannon Greek is lowest in sugar, watch other yogurt's sugar content which can be high, above 20 gms
Rx bars
KidsPerfectZone bars
Belvita bars or breakfast "cookies"
Any sliced fruits or vegetables
Whole grain crackers like Triscuits or wheat thins

Fruitables or Honest Kids drinks, water or 1% or skim milk if your child is over age 2 - avoid juice, soda and Gatorade or other sugary drinks except as a special treat occasionally.

Kids generally need 3 meals and 2 snacks per day. It is best to keep the snacks healthy, with only occasional junk food like potato chips, goldfish, white crackers, fruit snacks or candy.


We at Crestwood Pediatric Associates are concerned about the increasing use by our patients of retail based clinics or urgent care centers. Here are some important things to consider before you go:

  • The medical provider at an urgent care center does not have your child’s record. All children are not the same.  Having your child’s record allows us to define a treatment program specific for your particular child’s needs taking into account all prior treatments and diagnoses.
  • The medical provider at the urgent care center is unlikely to be a board certified pediatrician. This means that they are not specialists in pediatric care. They do not have the same level of experience and training.  They are much more likely to miss a diagnosis or overprescribe antibiotics as compared to a trained pediatrician.
  • Bringing your child to an urgent care center breaks up the continuity of care. Recurring conditions such as recurrent ear infections and recurrent strep throat may need referral to a specialist for consideration for surgery.  The number of episodes will not be accurately recorded. This leads to a delay in treatment.
  • The urgent care center does not have the immunization record. Every time we see your child in our office is an opportunity for us to review their immunization record and update needed vaccines. Since the urgent care center does not have this record, your child’s vaccines are much more likely to be delayed.
  • Since the urgent care center does not have your child’s record, they do not know about any chronic conditions, outstanding tests, and results of referrals that your child has had. We take the opportunity on every visit to catch up on these or to arrange follow up visits to discuss these issues. Parents that have chosen to have their children go to the urgent care center then have to make a separate visit in our office to address these issues. This results in delays in treatment and increased cost.

Parents are often unsure when a problem arises when our office is closed if it can wait till the office opens in the morning. We have 24/7 on-call physicians that can help you make the decision to go to an urgent care center or ER, or if it can wait till the office opens in the morning.

We understand that children get sick at night and on the weekend. Our office is open until 9 PM most nights and on Saturday morning to give maximum flexibility in scheduling to our patients.

We remain your partner in your child’s care. We want what is best for your child as do you. Please consider the above carefully the next time you consider going to an Urgent Care Center. 

Halloween Safety

Laurie Wolf, CPNP, October 9, 2018

It’s time to bring out the pumpkins and candy! Be prepared for a safe night out with your ghosts and goblins with these safety tips.

  • An adult should always accompany young children for trick or treating.
  • Each person trick or treating should carry their own flashlight with fresh batteries.
  • For older children without an accompanying adult, discuss the route they intend to take and a specific time to return.
  • Only visit homes with a porch light on.
  • Pick masks and costumes that don’t obscure vision to prevent trips and falls.
  • The most common injury to children on Halloween is pedestrian/car related. Discuss street crossing safety.
  • Inspect all candy before allowing children to consume it.

Have fun!

CPA hopes you and your family spirits enjoy Halloween!
Type your paragraph here.