Patient Health Education & Medical Information

As part of our patient resources, Chapel Hill Pediatric and Adolescents has provided the health education and  medical information on this page. The information on this pages covers some common children’s health concerns, including:

Our care coordinators can provide additional resources, pamphlets and information to our patients as well. Our advice nurses are also a great resources to our patients, and are available to help with health concerns and questions our patients may have.

Please contact us with your questions and we will do our best to answer them and provide you with the information you need! With two pediatric center locations in Chapel Hill and Durham, NC, we see many patients from surrounding cities, including Mebane, Raleigh, Butner, Hillsborough, Carrboro, Creedmor, Pittsboro, Leesville, Wake Forest and beyond.

Sun Protection & Safety Tips

When the warm weather arrives, we all head outdoors to enjoy the sunshine! While the warmth of the sun is enticing after a long winter, take precautions to protect your child’s skin. Following the guidelines below will let you and your children safely enjoy North Carolina’s sunny days.

Protect Infants from Sun

Infants under 6 months have skin that is more sensitive to the sun. Limit their exposure to sunlight. When out in the sun:

  • Clothe the infant in light-colored clothing that covers as much of the body as possible.
  • Use sunscreen sparingly on exposed body parts.
  • Avoid direct sunlight from 10 a.m. to 4 p.m.

Tips for Applying Kids’ Sunscreen:

  • Apply a waterproof sunscreen with SPF of 30 or above that protects against both UVA and UVB to all body parts not covered by the light-colored clothing.
  • Apply sunscreen generously! Avoid areas around and above the eyes.
  • Be extra careful to apply sunscreen to hands, ears, tops of feet, shoulders and the back of neck. Lift up your child’s bathing suit straps and apply sunscreen.
  • Wear lip protection with sunscreen.
  • Reapply sunscreen at least every 2 hours.

Other Sun Safety Suggestions:

  • Limit sun exposure around water (pools or beach), keeping in mind that the sun rays reflect off the water.
  • Remember to use sun protection on cloudy days as well as sunny days since ultraviolet rays can penetrate clouds.
  • Have your child wear a hat and light-colored clothing. Consider sun-protective clothing.
  • Have your child wear sunglasses with 100% UV protection to protect his/her eyes. Use head straps to keep the sunglasses on.
  • Ask your pharmacist or physician if the daily meds your child takes may increase your child’s sensitivity to the sun. If so, take extra sun precautions.
  • Take the same sun precautions for yourself that you do for your child!

Kids’ Tick Safety: NC Tick Prevention, Removal and Treatment

While tick bites are of great concern for most parents, it’s important to also remember that most tick bites are harmless. Understanding ticks, where they live, how to prevent tick bites, and how to remove a tick if a bite occurs will equip parents to comfortably care for their children during the outdoor months.

Ticks come in two different sizes, the small pinhead-sized deer tick and the larger dog tick, which may be the size of an eraser-head. Tick bites are painless, therefore they may go unnoticed for several hours or even days. Most tick bites are harmless.

The spread of disease by a tick is rare. An infected deer tick may transmit Lyme disease, an infected dog tick may transmit Rocky Mountain Spotted Fever. Ticks may be carriers of other diseases as well. An infected tick can only transmit Lyme disease after it has been attached to a person 12 to 24 hours, therefore nightly checks during high tick seasons are a must!

How to Prevent Ticks & Tick Bites in Children

To prevent tick bites, use these precautions when you are outdoors in suitable tick areas:

  • Wear light-colored clothing. (This makes it easier to see a tick.)
  • Wear long pants and tuck them into your socks.
  • Avoid long grasses and shrubby areas.
  • Remove brush piles in your yard.
  • For children over two years of age, use insect repellent that contains 10-30% DEET. For children under two years of age, use insect repellent (10-30% DEET) sparingly.
  • Keep long hair pulled back or pulled up in a cap when outdoors.
  • Check pets for ticks after they’ve been outside. Use a tick-repelling collar or medicine for your pet.
  • Wash all clothes after playing in woodlands.
  • Shower and wash hair after playing in woodlands. Check child’s body and scalp for possible ticks.

How to Safely Remove a Tick

If you find a tick on your child, remove the tick by following these steps:

  1. Using a fine-tipped tweezers, grasp the head of the tick close to the skin. Pull straight back, without twisting or rocking the tick.
  2. Kill the tick by placing it in alcohol.
  3. Cleanse the area with rubbing alcohol or another antiseptic right after tick removal.
  4. If the body is removed, but not the head of the tick, leave the head intact. The child’s skin will naturally slough it out. Trying to dig the head out will only increase the chance for a localized infection.
  5. Apply an over-the-counter antibiotic ointment to the site. It is not uncommon for a pink itchy bump to remain at the site of the bite for 2-3 weeks.
  6. Wash your hands with soap and water immediately following tick removal.

Health & Safety Tips for International Travel with Children

Are you planning international travel with your family in the near future? Will your child be studying abroad? Make the most of your trip by pre-planning for your health needs. Make an appointment with your NC pediatrician at Chapel Hill Pediatrics and Adolescents for a travel consultation as soon as you know your travel destination.

Some travel healthcare preparations require four to six months; at minimum, make an appointment two to three weeks before your trip. Your Chapel Hill or Durham pediatrician will be happy to consult with you to help make your trip as healthy and safe as possible.

Please check the health insurance policy prior to the appointment to ascertain coverage of appointments and children’s travel immunizations.

MiraLAX Safety and Alternative Laxatives

Concerns have been circulating through social media regarding the safety of Propylene Glycol 3350 (brand names MiraLAX and Glycolax among others).  The current medical literature (which includes studies and case reports) currently does not contain any evidence of serious side effects, besides bloating, abdominal pain, and diarrhea (which are side-effects of most all laxatives), which is impressive given that MiraLAX has been used in children for many years.  The longest study we found was 39 children maintained on MiraLAX for 1 year who only experienced common laxative side effects (though there was 1 allergic reaction to MiraLAX).  As some children are on MiraLAX for years, the FDA is sponsoring a large multi-year study to evaluate the safety of MiraLAX.  The “new” news is that this study has been ongoing at the Children’s Hospital of Philadelphia.

You may have also read that in 2015, the FDA revealed that some batches of polyetheylene glycol 3350 contained trace amounts of ethylene glyocol and diethylene glycol, which are both found in antifreeze.  This had resulted from the manufacturing process, and the amounts were below recognized safety standards, but this is part of the reason the FDA launched the new study.

As a group of physicians, we still feel comfortable using MiraLAX as a laxative, but we also feel it is reasonable to try a different laxative.   To try another laxative, see the information below for other options or schedule a visit with your pediatrician if you would like help switching.  If you switch, just be warned that each child responds to each laxative in his/her own way—most children can switch laxatives just fine, while others will become constipated or have explosive diarrhea.  If MiraLAX has been the only laxative that has successfully treated your child’s stooling difficulties, again we feel very comfortable that he/she continue MiraLAX.

How does MiraLAX work?  MiraLAX, like the other “osmotic” laxatives, is not absorbed by the body and attract or keep water in the stool to make the stool softer.  Osmotic laxatives do not act on the muscles or nerves of the gut, so they do not create dependence.

Alternative Osmotic Laxatives and their per pound dosing – for under 1 year-of-age schedule a provider visit

  • Magnesium hydroxide (milk of magnesia)
    • 1 to 11 years-old: 0.5 to 1.5 ml per pound daily of 400 mg/5 mL solution (maximum 60 mL daily, in single or divided doses)
    • 12 and over: 30 to 60 mL daily of 400 mg/5 mL solution (in single or divided doses) OR 15 to 30 mL daily of 800 mg/5 mL solution (in single or divided doses)
  • Mineral Oil (not in infants, children with reflux, or neurologically impaired)
    • 1 to 11 years-old: 0.5 to 1.5 mL per pound, once daily (maximum 45 mL daily)
    • 12 and over: 15 to 45 mL, once daily
  • Sorbitol (syrup, 70% solution)
    • 1 to 11 years-old: 0.5ml per pound, once or twice daily (maximum of 30 ml daily)
    • 12 and over: 15 to 30 mL, once or twice daily
  • Lactulose (only available by prescription)