As a family doctor and mother of two, I love being an advocate for child health.
When I was recently asked to give a talk at my daughter’s preschool, I decided to present what I felt were the most important changes in pediatric primary care over the past year. You may find some of them quite surprising, as they seem to fly in the face of conventional wisdom.
As the parent of a child with food allergies, I find the new food allergy guidelines particularly challenging, but all of the changes have been rigorously studied and are evidence based. The only way medicine can move forward is if we can challenge our previously held notions and change how we practice.
So, here are my top 8 child health recommendations for 2014:
1. The focus of treating a child with a fever should be comfort rather than normalizing body temperature. 
If your child has a temperature of 103F but otherwise seems comfortable, you do not need to load them up with Tylenol and Motrin to try to bring the fever down. In fact, studies have shown that having a fever is beneficial to fighting the infection.
Instead of looking at the thermometer, you should pay attention to how your child is acting. If they are lethargic, eating and drinking poorly or seem to be having trouble breathing, you should seek medical attention – even if they are not feverish or only have a low grade fever
2. It is no longer recommended to use over the counter cough and cold medications in young children. 
Children under 6 should not be given OTC cough and cold medications. There is no good evidence that they work in young children and there have been several cases of overdose and death. Instead of Dimetapp, try honey (except under 1 year of age) for a nagging cough.
This is a change from the old guideline when it was recommended not to flip your child forwards until they were at least a year old and 20 pounds.
Studies of children aged 1-2 years showed that those in forward facing seats were more likely to be seriously injured than those in rear facing seats, particularly inside impact crashes.
This is the one I have the hardest time convincing parents of, but multiple studies show that most children over 2 will get better without antibiotics. In an age of increasing drug resistant strains of bacteria, often a watchful waiting is best.
5. There is no evidence to suggest that delaying introduction of solids beyond 4-6 months will prevent allergic disease. And, especially in the case of highly allergenic foods, may actually increase the risk of food allergy and eczema.
Forget what all the baby books say, you do not have to wait until any particular time to introduce eggs, peanuts, shellfish, etc. You can feed your baby whatever you want, apart from the obvious choking hazards. Delaying the more allergenic foods does not prevent your baby from developing a food allergy. My only caveat to this is that if you already have a child with a serious peanut allergy, you may want to have your baby tested prior to trying peanuts, as siblings of children with peanut allergies do carry a higher risk of having this same allergy.
Definitely do not introduce solids before 4 months, and try to wait until 6 months old. Your baby should be able to sit in a high chair, not push the food out of their mouth with their tongue, and show interest in food.
7. ADHD can now be diagnosed in children as early as 4 years of age.
This has raised a lot of eyebrows because we all fear over-labeling of children and worry about medicating small children. Studies show, however, that early diagnosis and treatment improves self esteem and school performance. At this age, the emphasis is on behavioral therapy and not medication.
8. Children participating in physical activity do not need sports drinks.
Parents of active children, especially those participating in competitive sports, often give them Gatorade or Powerade. But, these drinks are loaded with sugar and kids just don’t need them. Plain water is just fine.
Please feel free to comment on any of these recommendations or ask me questions. Your child’s health is very important to me and all of us at Nova Medical Group!
-Posted by Hannah Phillips, M.D.
 Fever and Antipyretic Use in Children, Sullivan and Farrar, Pediatrics 2011;127;580
 Child Passenger Safety, Pediatrics 2011;127;e1050
 Otitis Media: Diagnosis and Treatment, Harmes et al. October 1 2013 Vol. 88 Number 7
 Primary Prevention of Allergic Disease Through Nutritional Intervention, Fleischer et al, J Allergy Clin Immunol,2012 Volume 1, Number 1
 Timing of Solid Food Introduction and Risk of Obesity in Preschool-Aged Children, Huh et al. Pediatrics, March 2011; 127(3) :e544-e551