In The News | Concierge Pediatrics

Head Lice in Kids: Facts, Myths, Symptoms, and Treatment Options

Did you know that each year, approximately 12 million people in the United States are afflicted with lice? Lice have been around for thousands of years, even found on the heads of ancient mummies.  A nuisance spanning generations of people with hair, these pests have a life cycle of 30 days, but left untreated, will continue to reproduce and cause a maddening itch. We connected with Russ Trichon of Lice Cops to get his take on everything you need to know about lice. Hear it from Russ himself!  

About Lice 

Lice are wingless insects that live on the hair of humans and feed on very small amounts of blood from our scalp. The lice cannot jump, but they can crawl from head to head, either by touching heads, sharing tools like hair brushes and combs, or possibly by laying on someone else’s pillow if a louse (singular form of lice) is crawling on it.  

If I was playing Family Feud and the question was “how do we get lice” the top answer would be hugging because heads often touch during a hug! The second most common answer is selfies with other people, because heads tend to touch then, too. I especially see this from kids at school and summer camp. They may not be sharing brushes, but there sure are a lot of hugs and selfies going around! The origin story of every lice meet-cute is all about people with hair meeting other people with hair. 

“Lice can affect anyone with hair. It does not discriminate by age, race, religion, or gender.

Lice eggs, called nits, do not fall out – the only way for a nit to fall out is if you pluck the actual hair on it. This is because the eggs have a glue-like sheath that attaches to the hair at about ¼ – ½” from the scalp. Nits have a cap called the operculum, which is like a lid on a metal trash can. 

Lice can affect anyone with hair. It does not discriminate by age, race, religion, or gender. However, lice is typically more common in girls, because they traditionally have long hair, and girls hug a lot more than boys. The long hair itself is not attractive to lice, but there’s more opportunity for it to latch on to a strand when heads are touching. 

The Lice Removal Process 

First thing’s first – I like to calm people down during the process and talk them off the proverbial ledge, then handle the situation which luckily is a straightforward solution. A lot of people come to me very worried about their situation and I tell them this: there are things in this world that are fixable and there are things in this world that are not fixable. Lice is fixable!  

A lot of people hear wrong information from family and friends and that is what brings them closer to the ledge. My job is to give them the facts and a lot of people are surprised when I don’t come with gloves or a hazmat suit because they’re thinking the worst. I like to remind them that houses do not get infested, only people get infested. More on that later. 

The best way to get rid of lice is to manually remove them with a tight tooth lice comb. There are cheap versions which don’t work as well, and good versions. A good lice comb is made of strong, stainless steel with tight teeth.  

At Lice Cops, I am certified in a method called the Shepherd Method, a method developed by Katie Shepherd (my hero!). This is a strand-by-strand technique that does not use chemicals nor pesticide shampoos. Lice have become more resistant to these pesticides, which is why this method is the preference of our team. Years ago, shampoos worked pretty well but we have begun to see the resistance in the form of super lice, which are increasingly unresponsive to the shampoo method. The over-the-counter products are designed to kill lice on contact, but I physically take them out. Another thing to consider is that the shampoos are not effective on nits, which use that glue-like sheath to adhere to the hair. My school of thought is that the only way to beat the bug (and their eggs) out is take them out physically. 

Here’s the stainless steel, tight-tooth lice comb I like to use.

With the Shepherd Method, one treatment is usually all it takes, but I will always encourage a re-check. Although the treatments are highly effective, it is always possible for a residual nit or a baby louse to remain as part of the natural lifecycle of lice. One single louse or nit does not worry me because if they have no opportunity to reproduce, they die in about 30 days, but they may still cause an itch. Post-treatment combing, preventative sprays, and follow ups are encouraged to keep heads lice-free. It is important to remember that overcoming a case of lice is not the same as overcoming a viral illness. You cannot become immune to lice after you’ve had lice. All these things are important to think about, because you may have gotten lice from someone you’re close with, and if they don’t get checked, they may not know that they have it and can give it back to you. This highlights the importance of transparency, quick treatment, and having no shame in a lice diagnosis! The more we know, the better we can do to fight it together. 

“It is important to remember that overcoming a case of lice is not the same as overcoming a viral illness. You cannot become immune to lice after you’ve had lice.

After I give kids a treatment, I let them know that they can go back to school right away. I like to teach the parents to always follow up with the comb, use preventative sprays to reduce the possibility of reinfestation, and monitor their child for itchiness.  

Lice Symptoms and How to Spot Them 

Once a school sends home a notice about lice in the classroom, I am often asked by parents how to even know if a child has lice. Scalp itchiness is usually the identifying factor. If you see a little bit of redness on the nape of the neck or behind the ears, that can also be an indication of a louse bite. You can also sometimes see the lice on your child’s head. It’s better to use a good lice comb to really tell if what you’re looking at is lice. 

Lice have 6 legs and adults can be seen moving with the naked eye. Babies can also be seen but are a lot smaller. Adults can be as large as the size of a sesame seed.  Nits will be smaller, found within an inch from the scalp. Picture how a tiny bead of water would look on a strand of hair – that’s almost how an egg would look. It will be on one side of the strand, not wrapped around. If you run your fingers over the strand of hair and feel what is like a speedbump, it’s probably a nit. Remember that nits have a glue-like sheath that adheres them to a hair strand. If it flakes, then it’s just a dandruff flake. As I tell my clients, a flake’s gonna flake (cue Taylor Swift’s “Shake It Off”). 

If you’re suspicious of possible lice, look at the scalp up to the first inch or two of hair. Because lice live off human blood, they will be found closer to their food source – the scalp. I am often asked if people should cut their long hair to reduce or prevent future lice, to which I say no. Because lice like to live in the first few inches of your hair from your scalp, cutting hair will not be effective and it will probably make you unhappy. Unless you’re excited about the prospect of a new haircut, in which case I say: do what makes you happy!   

Lice Prevention Tips for Families 

After someone has been treated for lice, I am often asked about lice living in the house. Since lice are topical creatures only, they will not burrow into mattresses, pillows, or cushions. I am a fan of a vacuum cleaner, which is sufficient for getting rid of possible bugs that could have fallen off hair and on to pillows, mattresses, cushions, clothes, you name it. Whatever you decide put in the washing machine will most likely be eliminated of lice, but a word of caution: as you are transferring things from the wash to the dryer, a single louse could still be alive in there, so be sure to use high heat in the dryer to be sure you’ve killed any remaining bugs. The water temperature does not matter, but the intensity of heat in the dryer will make a difference!  

If you can’t put something through the dryer, be sure to separate it from everything else for a few days. A lot of people think they can “suffocate” lice and put everything in a tightened contractor bag. There’s nothing wrong about doing that, but the reality is that lice aren’t suffocated – they’re starved. Remember that lice thrive on human blood so when you have removed their food source, they starve to death in a matter of 2-3 days. You also don’t need to fumigate your home.  

Lice don’t like the smell of rosemary, tea tree, or peppermint because of their strong fragrance, but many people find them quite pleasant. I am personally a fan of rosemary. There is not enough rosemary in the world to get rid of lice altogether, but because they do not like the scent, spraying in the hair prior will reduce the odds. While I think the sprays are effective, just because you have spray in your hair doesn’t mean you will never get lice. During the summertime, the sprays are less effective because kids are sweating and swimming more, which dilutes or takes the spray out. Tea tree oil and peppermint can be effective, but I personally don’t like them as much because it often gives a burning sensation to the scalp. But you’ve got choices! 

If you have a friend that has lice, do not be unkind to them. Remember, lice isn’t a reflection of cleanliness or character – it’s simply a bug that anyone with hair can encounter. With the right knowledge, tools, and a little compassion, let’s remember that lice is not a crisis, it’s a problem with a solution. 

About the Author 

Russ Trichon is a lice removal expert and the owner of Lice Cops. Mr. Trichon was trained by head lice expert, Katie Shepherd, and has been certified through The Shepherd Institute. Lice Cops provides a kid-friendly approach, with a goal to serve, protect, and educate. Learn more about Russ Trichon and Lice Cops at licecops.com

Dr. Jonathan Jassey Honored with Excellence in Healthcare Award

Concierge Pediatrics is proud to share that our Founding Pediatrician, Dr. Jonathan Jassey, has been recognized by the LI Herald with the 2025 Excellence in Healthcare Award.

The Excellence in Healthcare Award honors individuals on Long Island whose dedication and commitment have made a meaningful difference in the health and well-being of others. Dr. Jassey’s lifelong mission to provide compassionate, personalized, and transformative pediatric care has not only shaped Concierge Pediatrics but has also impacted numerous families across our communities.

We congratulate Dr. Jassey on this well-deserved recognition and remain inspired by his leadership, expertise, and unwavering dedication to the children and families we serve.

logo for long island herald excellence in healthcare awards 2025.

Measles FAQ: What Every Parent Needs to Know

What is Measles?

Measles (also called Rubeola) is a highly contagious viral illness that spreads through the air when an infected person coughs, sneezes, or breathes nearby. The virus can linger in the air and on surfaces for up to 2 hours. It’s most recognizable by a red, blotchy rash and often begins with fever, cough, runny nose, and red, watery eyes.

How does Measles spread?

Measles spreads through microscopic respiratory droplets. It is one of the most contagious viruses, with a 90% transmission rate among unvaccinated individuals in close-contact environments.

What are the symptoms of Measles?

Symptoms usually appear 7–14 days after exposure:

  • High fever
  • Cough
  • Runny nose
  • Red, watery eyes
  • Tiny white spots inside the mouth (Koplik spots)

The Measles rash usually appears 3–5 days after initial symptoms, starting on the face and spreading downward. Fevers can rise above 104°F.

Is Measles dangerous?

Measles can be dangerous. While many recover without issue, 1 in 5 unvaccinated people in the U.S. who get Measles will be hospitalized. Serious complications include:

  • Pneumonia
  • Encephalitis (brain swelling)
  • Permanent hearing loss
  • Rarely, death

Infants, pregnant people, and those with weak immune systems are at higher risk.

Who is most at risk for Measles?

  • Unvaccinated children and adults
  • Infants under 12 months (too young for routine MMR vaccination)
  • People with weakened immune systems
  • Individuals in areas experiencing Measles outbreaks
  • Those exposed through international travel to areas where measles is more common

Why are we seeing Measles outbreaks again?

Although Measles was declared eliminated in the U.S. in 2000, outbreaks have returned due to:

  • Decreased vaccination rates
  • Misinformation about vaccine safety
  • Increased international travel to areas where measles is more common

Does the MMR vaccine protect against Measles?

Yes. The MMR vaccine (Measles, Mumps, Rubella) is very effective:

  • 1 dose = ~93% protection
  • 2 doses = ~97% protection

Most children in the U.S. receive:

  • 1st dose at 12–15 months
  • 2nd dose at 4–6 years

Can my baby get the MMR vaccine early?

In outbreak situations or before international travel, infants as young as 6 months old may receive an early dose. Talk to your pediatrician to see if early vaccination is appropriate.

What should I do if my child is exposed to Measles?

If your child is unvaccinated and may have been exposed:

  • Call your pediatrician immediately
  • You may be advised to get the MMR vaccine within 72 hours of exposure
  • In some cases, immune globulin may be offered for temporary protection

Vaccinated children who are healthy are unlikely to need any intervention.

Can vitamin A or cod liver oil prevent or cure Measles?

No. Vitamin A cannot prevent or cure Measles. However, for children already infected, a physician may recommend vitamin A to support recovery and prevent complications like blindness. Do not self-administer large doses—excess vitamin A can be harmful.

How can I protect my unvaccinated baby from Measles?

If your baby is too young for vaccination:

  • Avoid crowded places and public transport during outbreaks
  • Keep sick visitors away
  • Ensure all caregivers are vaccinated, including grandparents and older caregivers born before 1957 who may no longer be immune or have waning natural immunity. Your specific circumstances and concerns can be discussed with your pediatrician for tailored guidance.
  • Practice excellent hygiene: handwashing, disinfecting surfaces, covering coughs/sneezes
  • Continue breastfeeding if possible for added immune support
  • Ask your pediatrician about early MMR if travel or exposure risk is high

If I was vaccinated, am I protected from Measles?

Most likely. If you received 2 doses of MMR, you’re considered protected. If unsure, check your records or speak with your doctor. Adults born before 1957 are generally considered immune due to likely natural exposure, but they should speak with their physician to better understand their individual circumstances.


Where can I find reliable information about Measles?

Turn to trusted sources, such as:

  • Your child’s pediatrician
  • Centers for Disease Control and Prevention (CDC)
  • World Health Organization (WHO)
  • National Institutes of Health (NIH)
  • Local health departments

At Concierge Pediatrics, our board-certified pediatricians are here to answer your questions and help protect your family. Want more information on Measles? Read our blog. 


Need help understanding your child’s vaccination status?

We’re here for you. If you’re a Concierge Pediatrics member or parent seeking guidance, give us a call. Your child’s safety and well-being are our top priority.

young happy girl in a yellow dress sitting in the doctors office exam room with a female doctor looking into her throat.FAQ – Strep Throat

Strep Throat FAQ for Parents: Symptoms, Treatment & What to Know

What is strep throat?

Strep throat is a bacterial infection of the throat and tonsils caused by Group A Streptococcus. It leads to a sore, red throat, and is most common in children between 5 and 15 years old.

How is strep throat different from a regular sore throat?

Most sore throats are caused by viruses, not bacteria. Only about 30% of sore throats in kids are strep. Unlike viral sore throats, strep:

  • Typically does not cause a cough or runny nose
  • Can be treated with antibiotics
  • May lead to complications if untreated for long periods of time

What are the symptoms of strep throat in children?

Look for these signs:

  • Sudden sore throat with red, swollen tonsils
  • Fever
  • Pain when swallowing
  • White patches on the throat or tonsils
  • Swollen glands in the neck
  • Stomach pain
  • Bad breath without explanation
  • No cold symptoms (like coughing or congestion)

How is strep throat diagnosed?

Diagnosis can only be made through:

  • A rapid strep test (results in minutes)
  • A throat culture (results in 24–48 hours if the rapid test is negative)

At Concierge Pediatrics, both tests are done in-house for quick and accurate results.

Should toddlers be tested for strep?

Usually, no. Children under 2–3 years old rarely get strep. Testing may be done if:

  • They’ve had close contact with someone who tested positive
  • Symptoms are severe or unusual (rash, high fever, difficulty swallowing)
  • A pediatrician sees cause for concern during an exam

Is strep throat contagious?

Yes. Strep spreads through respiratory droplets from coughing, sneezing, or sharing utensils. It can take 2–5 days after exposure for symptoms to appear.

How is strep throat treated?

Strep throat is treated with antibiotics, most commonly amoxicillin. Treatment helps:

  • Shorten the duration of illness
  • Prevent serious complications like rheumatic fever or kidney problems
  • Reduce the risk of spreading the infection

It’s critical to finish the entire course of antibiotics even if your child feels better.

Can antibiotics cause side effects?

Yes. Common mild side effects include:

  • Upset stomach
  • Diarrhea
  • Yeast infections

Probiotics (like those in Greek yogurt) can help restore gut balance. Call your pediatrician if symptoms are bothersome — and seek immediate care if your child has trouble breathing, facial swelling, or hives.

When can my child return to school or daycare?

Children with strep throat can return to school or other activities after 24 hours of antibiotics, as long as they’ve also been fever-free for 24 hours and are feeling better.

How can I help my child feel better at home?

In addition to antibiotics, try:

  • Warm saltwater gargles
  • Fluids, especially warm drinks
  • Acetaminophen or ibuprofen for pain or fever
  • Rest
  • Soft foods to avoid throat irritation

Can my child get strep more than once?

Yes. Some kids get strep multiple times a year. Children who frequently test positive might be strep carriers (they have the bacteria but no symptoms) or in rare cases, may be candidates for a tonsillectomy. Talk to your pediatrician or an ENT specialist if infections are frequent.

What is Scarlet Fever?

Scarlet Fever is a reaction to strep where, in addition to typical symptoms, your child may develop:

Scarlet Fever is a reaction to strep where, in addition to typical symptoms, your child may develop:

  • A bright red rash
  • A “strawberry” tongue

Scarlet Fever was once a worrisome disease but is easily treated with antibiotics today.

What is PANDAS and should I be concerned?

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Most researchers believe that PANDAS is an autoimmune reaction (i.e., the child’s immune system overreacting to the strep infection) that can appear during childhood, usually between 3 years old and the age of puberty. 

It’s a very rare condition where strep may trigger sudden behavioral changes, such as:

  • Obsessive-compulsive behavior
  • Tics
  • Anxiety or mood swings

Can I test for PANDAS?

There is no specific laboratory test to diagnose PANDAS – it is a diagnosis based on experience and the clinical examination of the healthcare provider, and it remains controversial. At Concierge Pediatrics, we can check 2 strep titers in the blood which, if high, is consistent with recent strep infection. If having new onset behavioral issues, this can help us can point to a possible PANDAS situation. It can be treated with cognitive behavioral therapy and sometimes medication. Importantly, a full course of antibiotics must be taken to eliminate the streptococcus infection that may have been the cause. 

There are many impassioned conversations among parents regarding PANDAS but it is important to speak directly with your pediatrician about any concerns you may have, to ensure you receive accurate and evidence-based information and an appropriate path forward for your child based on their personal history and circumstances. If you notice unusual symptoms after a strep infection, talk with your pediatrician. 

How can I prevent my child from getting strep throat?

Teach good hygiene:

  • Wash hands regularly
  • Don’t share drinks or utensils
  • Cover coughs and sneezes with elbows

When should I call the doctor?

Contact your pediatrician if:

  • Your child has a sore throat with fever or trouble swallowing
  • Symptoms don’t improve after starting antibiotics
  • Your child has a severe reaction to medication
  • Behavioral changes follow a strep infection

Still have questions?

At Concierge Pediatrics, we’re here to provide evidence-based answers and expert support every step of the way. Contact us directly to become a member or book a sick visit for fast, compassionate care. Want more information on Strep throat? Read our blog.

child sitting by the pool with sunscreen drawn into the shoulder representing the sun.FAQ – Sunscreen

Sun Safety & Sunscreen: FAQ for Parents

Want even more information on sunscreen? Read our blog.

Why is sunscreen important for my child?

Sunscreen protects your child’s skin from harmful UV rays, reducing the risk of:

  • Sunburn
  • Skin damage
  • Premature aging
  • Skin cancer (even though it’s rare in children)

Applying sunscreen daily builds healthy habits that last a lifetime.

What kind of sunscreen should I use?

Look for these three features:

  • Broad Spectrum – protects against both UVA and UVB rays
  • SPF 30 or higher – the American Academy of Dermatology recommends SPF 30+
  • Water Resistant – for pool days, beach trips, and sports

What does SPF mean?

SPF stands for Sun Protection Factor. It measures how well sunscreen protects your skin from sunburn caused by UVB rays.
Important: SPF does not tell you how long you can stay in the sun. Reapply sunscreen every 2 hours, or after swimming, sweating, or toweling off.

What’s the difference between mineral and chemical sunscreens?

  • Mineral sunscreen (like zinc oxide, titanium dioxide, etc.) sits on the skin and reflects UV rays as a physical barrier. It’s gentle for babies and kids with sensitive skin.
  • Chemical sunscreen (like oxybenzone, octinoxate, etc.) absorbs into the bloodstream, blocking UV rays. It’s effective, but some parents prefer to avoid it due to potential hormone concerns.

Both types are safe and effective when used correctly.

Are there ingredients I should avoid?

Consider limiting products with oxybenzone for young children. While FDA-approved, studies suggest it may affect hormone development. If no other sunscreen is available, it is OK to use sunscreen containing this ingredient, as it is safer than going without sunscreen. When in doubt, choose zinc oxide or titanium dioxide—both are considered safest by the FDA and environmentally friendly. 

Is sunscreen safe for babies?

  • Under 6 months: Avoid direct sunlight. Use shade and protective clothing instead.
  • 6 months and older: You can safely apply mineral sunscreen on exposed skin.

Where should I apply sunscreen?

Apply 15 minutes before sun exposure to all exposed areas, including:

  • Face (don’t forget eyelids and lips)
  • Ears
  • Back of neck
  • Tops of feet
  • Hands
  • Scalp (especially with thinning hair or part lines)
  • Behind knees and under straps or swimsuit edges

How often should I reapply sunscreen?

  • Every 2 hours
  • After swimming, sweating, or toweling off

Even water-resistant sunscreen needs to be reapplied regularly.

Can sunscreen cause cancer?

No. Sunscreen does not cause cancer. In fact, it protects against the harmful UV rays that are proven to cause skin cancer. Online misinformation exists, but no credible studies support this claim.

How can I protect my child beyond sunscreen?

Sun safety also means:

  • Avoiding peak sun hours (10am–3pm)
  • Staying in the shade
  • Wearing wide-brimmed hats and UV-protective clothing
  • Staying hydrated

Does sunscreen block vitamin D?

Yes, sunscreen reduces vitamin D absorption—but not completely, especially if any part of your body is exposed to the sun without protection. Your child can get vitamin D through:

  • 15–30 minutes of sun exposure in April – October in the northeastern United States
  • Foods like eggs, fortified milk, yogurt, cereal, and fatty fish
  • Supplements (ask your pediatrician before starting)

Is it true that a base tan prevents sunburn?

No. A “base tan” does not protect your skin. Any tan or burn is a sign of skin damage. The best skin is protected skin.

What if my child gets sunburned?

For mild sunburn:

  • Use aloe vera
  • Apply cool compresses
  • Give acetaminophen (per dosing guidelines) for discomfort

Call your pediatrician if your child has:

  • Blisters
  • Fever, chills, vomiting
  • Severe pain or heat exhaustion signs

How can I tell if a mole is concerning?

Use the ABCDE Rule:

  • Asymmetry – one half doesn’t match the other
  • Border – irregular or jagged edges
  • Color – multiple or uneven colors
  • Diameter – larger than a pencil eraser (6mm)
  • Evolving – changes in size, color, or shape

If you notice anything unusual, schedule a skin check with your pediatrician or dermatologist.

Need Help Choosing the Right Sunscreen?

We’re here to support your family with trusted advice. Ask your pediatrician at Concierge Pediatrics for product recommendations that fit your child’s skin type and your lifestyle.


Still have questions?

At Concierge Pediatrics, we’re here to provide evidence-based answers and expert support every step of the way. Contact us directly to become a member or book a sick visit for fast, compassionate care.

Want more information on sunscreen? Read our blog.

Screen Time Guidance for Families

As parents, we want our children to grow up curious, connected, and emotionally healthy. But in a world filled with screens, ever-evolving social media, and a seemingly endless supply of dopamine-inducing content being served to our kids online, knowing how to protect our children and taking a modern approach can leave parents and caregivers feeling confused.

A recent study was published by the American Psychological Association, in which researchers conducted a meta-analysis of 117 studies of nearly 300,000 children across the world, revealing that too much screentime can lead to emotional and behavioral problems. This was especially prevalent in school aged children 6-10 years old, and a more significant impact was noted among girls of that age group.

So how do parents balance appropriate limitations to screen time while living in a modern world?

How much screen time is too much?

There is no one-size-fits-all option, as this is dependent on how your child and family interact with their devices, what content is being engaged, and how easy it is to put the device down. It has been generally recommended, however, to avoid screens (other than human engagement on a video call) for babies under age 2, as they learn best by exploring the world around them and interacting with other people. Most importantly, for all other ages, it is recommended to consider the quality of the content engagement over only looking at the time spent.

CommonSenseMedia, a non-profit organization that provides age-based ratings and reviews for media, categorizes screen time into 4 categories

To help you plan for your family, the American Academy of Pediatrics developed the 5 C’s of media use. When deciding what is right for your family, consider these 5 things:

Child

Who is your child and what are they like? How do they utilize their media devices? Are they exhibiting any anxiety or behavioral issues? Knowing your child’s individual situation will help you take next steps.

Content

What is your child engaging with on their screen?Do they use social media, watch educational videos, play games, a mix of it all? Are they scrolling, interacting, speaking with people they know or don’t know? What is the content like? Educational? Violent? Rude? Setting unrealistic expectations? Does the content have an end-point or is it designed for nonstop use? Understanding what your child is currently engaging with, as well as what they like to do, will help determine your path forward. Common Sense Media is a good place to help build your library of age-appropriate content and find alternatives to the content that is not benefiting your child.

Calm

How does your child chill out or fall asleep? If devices are how they unwind, and turning them off results in a meltdown, consider slowly implementing new methods to reduce their reliance on screens for comfort.

Crowding Out

Is your family screen time dominating time that can be spent doing other beneficial activities, like play time, making friends, family conversation, education, or sleep? Games, videos, and social media have a lot of ways to keep your child engaged on their devices – longer than they may have planned for – without them even noticing. Take this into account for your family screentime plan.

Communication

Make discussion about responsible use of media, screens, and time a regular conversation in your house. Ongoing, low-stakes conversation (not only when it becomes a problem) about responsible use will keep behaviors in check, and help children be mindful about their time spent by pausing to make better decisions over time. They may not always get it right, but ongoing communication is good intervention. Consider making a family media plan together. The American Academy of Pediatrics offers a tool to help you do this, linked here.

Can screentime be beneficial?

Yes! Our screen devices open our lives up to a worldwide library of information, creativity, and human connection. Screens can also help us engage with loved ones who we may not be able to see in person. The keys to safe screentime are moderation, curation of content, and boundaries. Seek out educational and interactive content, like puzzles, quizzes, creative outlets, reading, or language learning. Not sure where to start? Websites like Commonsensemedia.com, pbs.org, and sesameworkshop.org provide additional guidance for websites and apps suitable for children at various ages.

Tips for Avoiding Screentime dependency

  • Leave phones, tablets, and TVs outside of the bedroom and charge them in a universal space overnight. If your child needs an alarm clock, the “old-fashioned” kind can still be purchased!
  • Create a buffer between screen time and bed time. Consider turning off all screen devices at least 30 minutes before a child is expected to go to sleep.
  • Avoid giving screens when children are expected to be engaging with others, like at meal times or during social events. 
  • Continuously monitor what your child (of any age) is engaging with on their device. With many social apps providing the opportunity to engage with strangers, video streaming services automatically playing new videos, and endless availability of social media, it can be difficult to put devices down.
  • Make conversations about screentime and responsible media use an ongoing conversation among your family, ensuring that you and other adults in your home also model good behaviors when it comes to media engagement and device use.

What alternatives to screen time are recommended?

Opt for a mix of structured and unstructured play for all ages. Taking a weekly course, sport, or other activity will keep them away from mindless use of screen devices and allow them to build relationships in person. If the activity requires practice, and the child is passionate about the activity, more time can be set aside to practice their skills alone or with a friend.

Unstructured play can be as simple as going out into the backyard, taking a walk, going to a playground, creating art, or playing make-believe. Unstructured play is an activity where the child determines what they will be doing without direct adult guidance, rules, or supervision (other than for safety purposes). Besides taking up time that could otherwise be occupied with a screen, promoting unstructured play time allows children of all ages to come up with their own solutions to combat feelings of boredom. People often turn to devices when they are bored, and unstructured play alternatives can help prevent screens from being the solution to boredom.

Should I throw away our devices?

You don’t have to throw away your devices. The modern solution is to understand your family’s and your child’s individual circumstances and develop guidelines and guardrails in moderation that meets you where you are. Most importantly, lead by example! The boundaries you set for your child should be boundaries that you set for the adults in your home as well. Modeling good behavior sets the foundation for your children to be able to enforce their own healthy behaviors and follow your guidance.

Setting boundaries, introducing educational and beneficial content, and modeling good behaviors will help us to set our children up for success in their emotional and social health. The most important thing to consider for your child and their media use is moderation and quality of digital media intake. Still need help navigating the journey? The pediatricians and team of pediatric professionals at Concierge Pediatrics are here to help you build a roadmap that works for your family.

rubber ducks on a bathtub edge. Photo by George Becker: https://www.pexels.com/photo/assorted-rubber-duckies-on-white-surface-122308/Your Ultimate Guide to Cleaning Your Baby’s Bath Toys

via Parents.com

By Sherri Gordon, CLC | Published on May 21, 2025 | Medically reviewed by Candice W. Jones, MD FAAP

If you’re like most parents, you might have your fair share of concerns about the bath toys your little one shoves into their mouth during bathtime. Maybe you have even seen the telltale signs of dirt and grime—and possibly even mold—when they squirt the toys at the wall of the tub. 

Fortunately, there are safe and effective ways to not only clean your child’s toys, but extend their life and prevent mold. Below, cleaning experts and pediatricians explain the best ways to clean bath toys as well as offer tips for keeping them fresh for as long as possible. 

Make a Bleach Solution

If you suspect your child’s bath toys have mold inside them, and you want to try to salvage them, the most effective cleaning option is using a diluted bleach solution. Just keep in mind that bleach is harsh and can damage toys.

“Bleach solution is effective because it kills bacteria and mold,” says Jonathan Jassey, DO, FAAP, a board-certified pediatrician and founder of Concierge Pediatrics.

For basic cleaning of toys, Kristin DiNicolantonio, MA, senior director of stakeholder communications at American Cleaning Institute, suggests making a solution of ¾ cup of chlorine bleach to one gallon of water. 

“Scrub the toys using this solution and be sure to wear protective gloves and old clothes to prevent bleach damage on your garments,” says DiNicolantonio. “Make sure your space is well-ventilated.2 For hollow toys or toys designed to fill with water, be sure to squeeze out all liquid. Once the toys have been cleaned, leave them wet for five minutes, then rinse the toys in a clean sink and let them air dry.”

Handwash With Soap and Water

For daily cleaning, you can still sterilize your bath toys with soap and water, says Dr. Jassey. Simply fill a disinfected sink, basin, or container with hot water and a few squirts of dish soap.

Karissa Whitman, a mom of two and motherhood blogger at MomAfterBaby.com says she often uses this method and recommends scrubbing each toy, rinsing it, and letting it air dry. If you submerge the toys in water, you should squeeze out any excess water as well. Also, if you are using extremely hot water, consider wearing gloves to protect your hands from the heat.

Create a Baking Soda Paste

Some people like to make a gritty paste with baking soda and use it like a scrubbing tool, says Dr. Jassey. One way to do that is to mix ½ cup of baking soda with a few tablespoons of water. You may need to adjust the ratio until you have paste that can be spread onto the toys. 

Baking soda makes a nice cleaning compound because it is non-toxic. Research also has shown that it is unlikely to trigger asthma or other respiratory issues.4 That said, it can be abrasive, so you should exercise caution when putting it on bath toys. You don’t want to damage the toys or scrub away any protective coating when cleaning them.

Risks of Mold Growing on Bath Toys

Generally, mold and mildew can make kids sick, says Dr. Jassey. “If a toy is moldy and your child is touching it, breathing it in, or getting water squirted into their mouth, it can lead to respiratory problems, rash, allergy issues, gastrointestinal infection, or eye infections.”

However, he says he has never seen a case of this in nearly 20 years of pediatric practice. Still, you may want to exercise caution. Dr. Jassey suggests looking for nonporous toys or machine washable toys because they are easy to clean and less likely to get mold.

“Parents often assume that if a toy looks clean, it is clean,” says Tkachenko. “But mold can easily grow inside squeeze toys where you can’t see it. When in doubt, it’s better to replace the toy than expose your little ones to mold.”

For the complete article, including more cleaning tips like using vinegar, hydrogen peroxide, or even your household dishwasher, click here to read more on Parents.com!

Is Sunscreen Safe for Kids? A Pediatrician’s Guide to Sun Protection

As we wave goodbye to a gray, chilly Winter and enter into the warmer, brighter months in the Northeast, families all around are sure to be basking in the sunshine every chance we can get. The sun can do many wonderful things, but we cannot ignore the harm it can also cause. 

While skin cancer in children is rare, it is the healthy habits we instill today that will set them up for a healthy future so they can reduce their likelihood of skin cancer.  According to a survey conducted by the American Association of Dermatology Association, 71% of Gen Z young adults are unfamiliar with the risks associated with sunburn. Did you know that you can even get a sunburn on a cloudy day? This is why daily sun protection is essential! 

At Concierge Pediatrics, we believe in being more proactive than reactive. Sunscreen and sun protection is a great way to proactively protect your family’s skin health to avoid sunburns, suspicious moles, and the risk of skin cancer. We understand there is much chatter online about sunscreen and safe use. We’re here to answer commonly asked questions about sunscreen and sun protection to help your family make a well-informed, healthy decision rooted in facts and science. 

What Are The Benefits Of Using Sunscreen?

Sunscreen helps protect all different skin types from the harmful effects of the sun. When you use a broad-spectrum sunscreen with SPF 30 or higher and water resistance, you can:

  • Reduce the risk of skin cancer
  • Avoid sunburn
  • Decrease signs of aging, like wrinkles
  • Reduce the appearance of dark spots

What Does Broad-Spectrum And SPF Mean?

Broad spectrum sunscreen means that it provides protection against both UVA and UVB sun rays – two types of ultraviolet (UV) radiation. UVA rays are more deeply absorbed into your skin (dermis) and are responsible for wrinkles and the appearance of aging, whereas UVB rays are absorbed into the epidermis layer of skin and are the cause of sunburns and skin cancer. 

sunscreen myth debunked: the SPF number on your sunscreen bottle does NOT mean the amount of time you are protected in the sun

SPF stands for sun protection factor.  SPF is associated with how much solar energy it would take to burn protected skin. Contrary to popular belief, the SPF number on your sunscreen bottle does NOT mean the amount of time you are protected in the sun. The intensity of the sun changes throughout the day, so, for instance, 1 hour in the sun at 9am could equate to the same amount of solar energy as 15 minutes in the sun at 1pm. There are other factors to consider like where in the world you are, the type of skin you have, and how often you reapply sunscreen. SPF should be used for protection, not a reason to remain in the sun longer. A higher SPF means higher UV protection, so reach for a bottle of broad spectrum sunscreen with at least SPF 30 or higher. 

What Are The Ingredients In Sunscreen?

Below is a list of commonly used active ingredients in products that are labeled as sunscreen:

  • Aminobenzoic acid
  • Avobenzone
  • Cinoxate
  • Dioxybenzone
  • Homosalate
  • Meradimate
  • Octocrylene
  • Octinoxate
  • Octisalate
  • Oxybenzone
  • Padimate O
  • Ensulizole
  • Sulisobenzone
  • Titanium dioxide
  • Zinc oxide

These ingredients are classified as “generally recognized as safe and effective” (GRASE) by the American government. The Food and Drug Administration (FDA) is responsible for ensuring the safety of the products we use in the United States. The 2020 CARES Act, passed by congress, reformed and modernized the way FDA regulates drugs like sunscreen. Although the FDA proposed that only zinc oxide and titanium dioxide qualify for GRASE, the CARES Act final report remained consistent with the original 1999 recommendation of the 16 listed ingredients as GRASE. 

What Ingredients Should I Look For?

When selecting a sunscreen, look for these 3 things
– Broad Spectrum
– SPF 30 or higher, as recommended by the American Academy of Dermatologists
– Water-resistant 

When possible, consider avoiding sunscreens containing the ingredient oxybenzone. While this ingredient qualifies as GRASE and is effective at protecting against the sun’s rays, it has been shown to be an endocrine disruptor, affecting hormone development in children. Any sunscreen is safer than no sunscreen, so it is still OK to use when your preferred sunscreen isn’t available.

EWG Sunscreen Report 2025

Every year, the Environmental Working Group (EWG) releases a publication reporting on the safety and effectiveness of sunscreen. The EWG is an influential American advocacy group who lobbies lawmakers on Capitol Hill to support or enact legislation that aligns with their mission and reform public health and agricultural laws. This year’s report included a recommendation of 500 sunscreens of the ~2,200 examined products, citing concern on the health and environmental effects of some chemical sunscreens. While their advocacy is rooted in scientific research and can be incredibly useful to consumers in making informed decisions, their methodologies and conclusions are sometimes considered controversial among the scientific community. Critics have previously claimed that the EWG has overstated risks and could needlessly cause consumers to avoid using sunscreens. The EWG report does not always align with the standards for effectiveness as set by the FDA, which emphasizes the importance of sunscreen use. However, both groups agree that ingredients like zinc oxide and titanium oxide provide effective use for consumers and are more environmentally friendly for the planet.

With this in mind, it is important to consume all studies with a critical eye and consider multiple expert sources when making a decision for your family. If you are ever unsure, your pediatrician is a great expert to partner with in making the most informed decision for your circumstances. Most importantly, the EWG agrees that “the best sunscreen is the one you wear and apply often” so no matter which brand you choose, you can use it with confidence of sun protection. The most recent sunscreen report from the EWG can be found here

When To Reapply Sunscreen

  • Every 2 hours 
  • When sweating, like during sports
  • After being in the water (water-resistant does not mean water-proof!)
  • After drying yourself with a towel (which may remove sunscreen)

Mineral Vs. Chemical Sunscreen

Mineral sunscreens sit on top of the skin, acting as a physical skin barrier. They contain ingredients like zinc oxide and/or titanium oxide, which reflect the UV rays from the sun. They are generally preferred for children and babies, as they are not absorbed into the bloodstream and are less irritating on sensitive skin. They are also the preferred choice for ocean lovers, as mineral sunscreen is safer for marine life. Some people complain that mineral sunscreens feel sticky on their skin. 

Chemical sunscreens absorb into the skin and filter out UV rays. They contain ingredients like oxybenzone and octinoxate. Being absorbed into the skin and bloodstream does not necessarily mean it is unsafe, but some people prefer the barrier method of mineral sunscreens for this reason. The FDA still recommends use of chemical sunscreens for their effectiveness against the sun’s harmful rays. 

Despite circulating online misinformation, there are no studies that conclude that sunscreen causes cancer. High amounts of sun exposure, like sun bathing, do have evidence of cancer risk. 

Balancing Healthy Vitamin D Levels And Sun Safety

 It’s true that vitamin D deficiency is common in the Northeastern United States, and sunscreen does reduce the absorption of vitamin D into the skin. Vitamin D helps promote good bone health, so it’s important to find balance in sun safety and vitamin D intake. 

In warmer months, about April through October, children can get their daily dose of vitamin D by spending 15 – 30 minutes in the sunshine. Vitamin D is also found naturally in some foods, both naturally and in fortified store-bought foods. 

In warmer months, about April through October, children can get their daily dose of vitamin D by spending 15 - 30 minutes in the sunshine. Vitamin D is also found naturally in some foods, both naturally and in fortified store-bought foods.

Vitamin D is found naturally in these foods: Hard boiled eggs, Salmon, Herring, Canned tuna, sardines, mackerel, Shitake mushrooms. Store-bought foods and drink are also often fortified with vitamin D, including: Milk, Cereal, Orange juice, Yogurt.

Vitamin D supplements are also available – speak to your pediatrician before beginning any new vitamin supplements. 

What About Getting A Base Burn/Tan?

Lots of people believe that getting a “base tan” will protect the skin in the future. Not true! A study conducted by the American Association of Dermatology found that 40% of surveyed young adults age 18-25 were unaware of tanning risks and 59% believing tanning myths, such as tanning is healthy, and a base tan will prevent sunburn. A base tan will not provide protection from future burns, and the best way to get gorgeous skin is by protecting it. 

What To Do If Your Child Gets A Sunburn 

Getting a sunburn can be a bummer for any age and cause discomfort. If your child has a first degree sunburn and feels uncomfortable, you can offer these home remedies:

  • Apply aloe to the skin for a cooling effect and reduce skin peeling.
  • Use cool compresses to help release heat from the skin.
  • Take acetaminophen (Tylenol, etc.) for any discomfort – follow instructions on the packaging. 

Signs of a more serious sunburn include blistering and/or signs of heat stress, like fever, chills, nausea, and vomiting. If any of these symptoms develop, call your pediatrician for direct guidance. 

If your child’s mole meets any of the above criteria, it’s worth having a professional take a look. If you’re unsure, call your pediatrician or dermatologist to take a look and advise if a removal should be considered. 

Who Should Wear Sunscreen?

Almost everyone! All genders, all skin types, and nearly all ages. Although sunburn is not as likely for people with darker complexion, skin cancer is still a risk. The only exception to be made is for babies under age 6 months, whose skin is sensitive and fragile, making them at high risk for sunburn. Babies under age 6 months should always be kept out of direct sunlight and their sensitive skin covered. 

Where To Apply Sunscreen

About fifteen minutes before heading out into the sun, apply sunscreen to all exposed skin, and remember to apply under straps and on edges of clothing and swimsuits to avoid burn lines at the edge of the clothing. About 1 ounce should be enough to cover your body with sunscreen, but more can be used as needed to ensure full coverage. 

Pay attention to application on sensitive skin areas, like eyelids and lips. Sunscreen can be applied directly to the lips or you can buy lip balms containing SPF. Don’t forget to apply sunscreen to commonly missed areas including the scalp, behind the knees, and tops of feet! 

How Else To Stay Safe In The Sun

While sunscreen is an excellent protectant against the sun, there are more things your family can do to keep your skin safe, including:

  • Avoiding the sun when possible during peak times, 10am – 3pm.
  • Remaining in the shade whenever possible.
  • Wearing wide brimmed hats.
  • Covering your skin with cool, tight weave clothing – many swimsuits even come with long sleeves now, which is a great way to stay protected in the water. 
  • Keep babies under 6 months old out of direct sunlight at all times! 
  • Remember to reapply sunscreen every 2 hours. 
  • Drink lots of water – this is good for skin cell production and for keeping cool.

5 Things To Look Out For In A Mole 

A changing or strange looking mole can be an indicator of skin cancer. Although skin cancer is rare in children, it is a good idea to regularly monitor new or changing moles on the body. When identifying suspicious moles, remember the ABCDE check

  • Asymmetry
    • The mole doesn’t look the same on both sides.
  • Borders
    • The mole isn’t round and has jagged edges.
  • Color
    • The mole has multiple colors, has uneven color, or is changing in color. 
  • Diameter
    • The mole is larger than about the size of a pencil eraser (6mm).
  • Evolving
    • The mole is changing.


As pediatricians, we know that sun safety isn’t about limiting fun — it’s about empowering your family with evidence-based knowledge and healthy habits that carry you through life. Small choices today can make a big difference tomorrow, so as you head outdoors this season, make sun protection part of your family’s daily routine. If you ever have questions about sunscreen safety, sunburn management, or your child’s skin health, our team is here to help you make the right choice for your family. Enjoy the sunshine! 

Located in New Jersey or on Long Island? Concierge Pediatrics provides year-round guidance to protect your child’s health, from sun safety to skin screenings. Learn more about our pediatric practice and enroll your child here.

Concierge Pediatrics Short Hills Opening

Concierge Pediatrics Opens New Short Hills NJ Office with Ribbon Cutting and Community Celebration

SHORT HILLS, NJ – April 28, 2025 – Concierge Pediatrics, a leading provider of concierge pediatric care in Short Hills, New Jersey, hosted a ribbon cutting ceremony and grand opening celebration at its new practice located at 730 Morris Turnpike in Short Hills, New Jersey. The event marked the official opening of the pediatric office and brought together local healthcare professionals, business leaders, and community partners.

The evening featured opening remarks from founding pediatrician Dr. Jonathan Jassey, Millburn Mayor Annette Romano, Explore Millburn-Short Hills Executive Director Steve Grillo, and Dr. Debbie Goldenring, the lead pediatrician at Concierge Pediatrics of Short Hills. After the ceremonial ribbon was cut, guests were invited to a networking reception inside the newly designed pediatric office space.

Concierge Pediatrics of Short Hills is led by Dr. Debbie Goldenring, a board-certified pediatrician, and Dr. Nikhil Shah, board-certified pediatrician and pediatric emergency specialist, committed to delivering high-quality, accessible, and relationship-based care for children from birth through young adulthood.

Concierge Pediatrics offers a membership-based pediatric care model designed for modern families seeking personalized, on-demand healthcare for children. Key features include:

  • 24/7 direct access to your pediatrician
  • Same-day sick visits and extended appointment times
  • First time visits at home for newborns
  • Comprehensive care from infancy through young adulthood
  • Take-home telehealth device for convenience and around-the-clock access to care

By eliminating traditional barriers to care, Concierge Pediatrics provides a more personalized and convenient healthcare experience for modern families in the Millburn-Short Hills area and surrounding New Jersey communities.

To learn more about Concierge Pediatrics and the benefits of concierge pediatric care, visit myconciergepediatrics.com.

All About Strep Throat in Kids — Say AHHH!

Strep throat is a common childhood illness – if you’re reading this, chances are you’ve had strep throat at least once in your life. Not all sore throats mean a strep throat diagnosis, so let’s unpack the basics of what parents need to know about strep, including the different types of strep bacteria, symptoms, contagiousness, treatment, affiliated illnesses, and even some controversy.

Streptococcus –  The Bacteria Behind Strep Throat
Strep throat is a bacterial infection of the throat and the tonsils. “Strep” is short for streptococcus, which, to children, may sound like the name of a dinosaur, but is actually the name of the round bacteria that infects the throat. Directly translating to “twisted chain of berries”, streptococcus bacteria is identifiable under a microscope by its round, chain-like structure. There are many types of streptococcus, some harmless and others serious. Strep throat is most commonly caused by Group A Streptococcus which will be the focus of the information in this blog. 

Not all sore throats are bacterial infections, like strep throat. In fact, viruses are the common culprit for most sore throats, with only about 30% of sore throats in children being diagnosed as strep and even less in adults (about 10%). Strep throat is most commonly found in children between the ages of 5 and 15 years and is extremely rare in babies under 2-3 years old (more on this later in the blog). 

Some children with strep throat will develop a reaction called Scarlet Fever. In Scarlet Fever, children will have the typical strep throat  symptoms of fever and sore throat, but they also develop a bumpy red tongue (called “strawberry tongue”) and bright red rash that covers much of the body. Scarlet Fever may sound alarming to some people, as it was once considered a dangerous childhood disease. Parents may remember it as the cause of severe illness in older popular media and literature like Little Women, The Velveteen Rabbit, Frankenstein, and Little House on the Prairie. However, a diagnosis of Scarlet Fever is no longer nearly as worrisome due to the development of effective antibiotics as treatment. 

How Do I Know if My Child Has Strep Throat? 

Common symptoms of strep throat include: 

  • The telltale red and swollen tonsils
  • Discomfort and some difficulty when swallowing
  • Fever
  • Swollen lymph nodes in the throat
  • White patches in the mouth and on the tonsils
  • Abdominal pain
  • Unexplained bad breath (halitosis)
  • Lack of cold symptoms or coughing

Strep throat is a bacterial infection and as discussed, most sore throats are caused by viruses (which are not treated with antibiotics). Strep throat is definitively diagnosed by a throat culture, which is conducted by taking a long cotton swab and gently swiping the back of the throat by the tonsils. Afterwards, the swab is then placed in a culture container which allows the bacteria to grow if it is present. Clinicians will commonly also perform a quick-test called a “rapid antigen test” at the same time as they would perform a culture. These tests are very sensitive and if positive, the child will be treated with antibiotics and no further testing is needed. If it is negative, there is still a small chance that there might be strep throat so the culture is sent to a laboratory  to see if the bacteria grows in a petri dish. Most clinicians will not treat with antibiotics, though, unless the culture comes back positive (usually within a day). At Concierge Pediatrics, all strep tests are done at our in-house laboratory, where we have a throat culture incubator.

In addition, most clinicians will not test children less than 2-3 years old. This is because strep throat is extremely rare in this age group. In the rare case that it is strep, the risk of complications is extremely low. There are occasions where a child this age may be tested, including:

  • If the child has had close contact with someone who tested positive for strep
  • If the child has unusual or worsening symptoms, like a rash, high fever, or significant difficulty swallowing
  • If the pediatrician has other clinical concerns based on their exam

Strep is contagious and spreads through respiratory droplets, so it is best to teach children practice good hygiene including good hand washing practices, covering their mouth with their elbow when coughing or sneezing, and avoiding the sharing of straws, utensils, cups, etc. Once exposed to strep, it can take 2-5 days before symptoms appear. 

The Importance of Antibiotics for Strep Throat

If your child is over age 2 (sometimes age 3 in other practices) and tests positive for strep, they will be prescribed an antibiotic. It is important to take antibiotics to treat strep throat. When left untreated for long periods of time, strep throat can cause complications like kidney issues or rheumatic fever, an inflammatory disease that can affect a child’s joints and heart. These complications are rare in developed countries like the United States, but highlight the importance of treatment. 

Amoxicillin is the most common antibiotic used to treat Strep throat because it is most effective at fighting off the group A streptococcus bacteria and shortening the duration of symptoms. This antibiotic also has few and generally mild side effects and there has been no reported drug resistance. A doctor may sometimes choose a different antibiotic due to risk of allergic reactions or other specific situations related to the child. It is important to make sure your child finishes the complete course of antibiotics as directed by your prescriber, unless they tell you to stop. It can be tempting to discontinue antibiotics once your child is feeling better, but stopping too soon creates risk for antibiotic resistance in the future, meaning the bacteria could become stronger than the medicines we use to fight off the bacteria. 

Sometimes, antibiotics can cause mild side effects such as upset stomach or a secondary yeast infection. Eating greek yogurt can help to reduce these side effects, as greek yogurt is full of probiotics. Probiotics will not interfere with your antibiotic treatment and will help to restore gut balance, easing stomach discomfort and reducing the possibility of yeast infection. If your child is experiencing any other mild side effects, do not stop the antibiotics, but be sure to give your pediatrician a call to talk through solutions. If your child is experiencing life-threatening anaphylactic reactions like difficulty breathing, hives, or facial swelling after taking antibiotics, seek medical care immediately. 

Once your child receives a strep throat diagnosis, they should rest at home and begin their antibiotic treatment. After 24 hours on the antibiotics, if they are starting to feel better and have also been fever-free for at least 24 hours, they can return to school and most activities. 

In addition to antibiotics, home remedies and comfort measures (also called supportive care) can be taken at home to help relieve symptoms of strep or any sore throat, including:

  • Gargling with warm saltwater 
  • Acetaminophen (Tylenol etc.) and Ibuprofen (Motrin, Advil, etc.) for pain and fever management 
  • Drinking plenty of fluids, especially warm liquids like tea and soup
  • Plenty of rest, which will allow your body to heal
  • Eating soft, bland foods to avoid irritation

It is important to stress again that most sore throats are viruses and antibiotics will not treat a virus. Taking antibiotics unnecessarily is indeed problematic because, as discussed, they can cause side effects or other reactions as well as contribute to antibiotic resistance. 

Strep Can Come Back 

It is possible to get strep throat more than once a year. Sometimes kids will test positive for strep and be considered “strep carriers” meaning they aren’t showing symptoms of strep throat but pose a risk of infecting others because they are carrying the bacteria in their throat. If your child has 7+ strep throat diagnoses in one year or 5+ infections per year 2 years in a row, you may want to speak with your pediatrician or an ear, nose, throat (ENT) specialist about treating as a carrier or, if these are true repeated infections, the possibility of a tonsillectomy. A tonsillectomy is the removal of tonsils and while it is possible to get strep throat without tonsils, the likelihood is reduced. A tonsillectomy may also have other benefits like improved sleep and improved ease of swallowing. 

PANDAS

Many parents have been discussing a syndrome called PANDAS so we will briefly discuss it here. Recurrent strep infections can sometimes be associated with a rare condition called PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. This is often a controversial diagnosis, with more research needed to fully understand the potential link with strep infection. 

Most researchers believe that PANDAS is an autoimmune reaction (i.e., the child’s immune system overreacting to the strep infection) that can appear during childhood, usually between 3 years old and the age of puberty. Symptoms typically appear very suddenly following a strep infection, and can be significant. There is also thought that people with a family history of autoimmune diseases or rheumatic fever are at higher risk. Symptoms include obsessive-compulsive behavior or motor or vocal tics similar to someone with Tourette’s syndrome, sometimes paired with increased irritability or anxiety, difficulty sleeping, or bed wetting. There is no test to diagnose PANDAS – it is a diagnosis based on experience and the clinical examination of the healthcare provider. It can be treated with cognitive behavioral therapy and sometimes medication. Importantly, a full course of antibiotics must be taken to eliminate the streptococcus infection that may have been the cause. 

While the idea of PANDAS can understandably cause concern, it is considered a very rare condition. There are many impassioned conversations among parents regarding PANDAS but it is important to speak directly with your pediatrician about any concerns you may have, to ensure you receive accurate and evidence-based information and an appropriate path forward for your child based on their personal history and circumstances. 

It can be frustrating to navigate childhood illnesses, but with the right information, parents and caregivers can be empowered to take action towards the path to recovery. Remember, if you ever have questions about your child’s symptoms or care plan, don’t hesitate to reach out to your pediatrician — we’re here to guide you with expert, compassionate support every step of the way and help your child feel better, faster.