Halloween Safety Tips

By Dr. Katy Ronin

CPA Halloween Safety Tips


Halloween may look a little different this year, but there are many ways to keep your family safe while having fun! Protect yourself and your family from influenza. We recommend yearly flu vaccines for children 6 months and older.  


Safe ways to celebrate:


  • It is recommended to avoid large gatherings or indoor events. Outdoor events are possible if masks are worn, and social distancing of at least 6 feet is possible. 
  • Use hand sanitizer frequently with at least 60% alcohol. 
  • Wash hand thoroughly before eating any treats.


Family Activities

  • Have a virtual Halloween costume contest. Use video chat to show off costumes to family members and friends.
  • Have a spooky movie night. Visit commonsensemedia.org for movie ratings based on age-appropriateness. 
  • Decorate pumpkins using non-toxic paint or markers.  
  • Bake holiday themed treats together.
  • Have a back-yard Halloween scavenger hunt. 
  • Visit a pumpkin patch or orchard. 


Costume safety:

  • Remember that a costume mask is not a substitute for a face covering. Instead, decorate your cloth face covering with markers. Make sure it snugly covers the mouth and nose and is made of several layers of breathable fabric. Do not put costume masks over face coverings. 
  • Wear well-fitting costumes and shoes to prevent trips and falls. Avoid any sharp or long objects as accessories 
  • Test any face-makeup on a small area of skin before applying broadly. 
  • Look for the words “flame resistant” on labels of costumes. 
  • Use a flashlight or glowstick to light pumpkins instead of candles.



Tips courtesy of the American Academy of Pediatrics (AAP) and CDC.gov. 



Don't Forget Your Well Checks

By: Keaton Mims MSN, APRN, CPNP

Has your child had their well check this season? It's easy to forget a well check if your child is generally healthy, is not due for vaccines, and does not have any forms that a physician's office needs to complete. But these are only a few of the many things we check and discuss at a well check!

  • Growth (weight and height on a trending curve from the AAP)

  • Development (physical, cognitive, and emotional)

  • Screenings

    ? EPDS for post-partum depression
    ? MCHAT autism screening
    ? PSC-17 Youth screening for depression, anxiety, or inattention ? Vision
    ? Hearing
    ? Lipid panel (9 years or over)
    ? HgA1c (BMI 96th% or above)
    ? Sexually Transmitted Infection Screening offered for 15+

  • Physical Exam
    ? Head to toe evaluation
    ? Scoliosis screening
    ? Pubertal development assessment

  • Anticipatory Guidance – we review things to expect for you child physically, developmentally, and emotionally to help you as a parent prepare for what is to come

  • Answer Questions – whether it is to provide information or give reassurance, that is what we are here for!

    Nervous to bring your child in for a healthy visit while Covid-19 is still an impending concern? Coastal Pediatric Associates is doing everything they can to ensure you and your child are protected when you come in for a well check. Here are some of the measures we are taking to provide the safest environment for your visit:

  • Virtual Check In (you won't be sitting in a waiting room)

  • Morning well check visits completely separate from sick visits

  • Staff all in DHEC approved personal protective equipment

  • Deep cleanings each evening to prepare for morning well visits

    Well checks exist to provide preventative care. We want early detection for any issues that your child may have to help prepare a plan with you to address it. Please call us with any additional questions!



Keeping your kids healthy as they go back to school.

By: Dr. Mohammed Al Gadban

A big question parents have right now is how students can go back to school safely during COVID-19?

The latest American Academy of Pediatrics (AAP) advice says children learn best when they are in school. However, returning to school in person needs careful steps in place to keep students and staff safe.


Why students should go back to school-safely:

The AAP guidance is based on what pediatricians and infectious disease specialists know about COVID-19 and kids. Evidence so far suggests that children and adolescents are less likely to have symptoms or severe disease from infection. They also appear less likely to become infected or spread the virus.

Schools provide more than just academics to children and adolescents. In addition to reading, writing and math, children learn social and emotional skills, get exercise and access to mental health support and other things that cannot be provided with online learning. For many families, school is where kids get healthy meals, access to the internet, and other vital services.

Information about COVID-19: 

COVID-19 is mostly spread by respiratory droplets released when people talk, cough, or sneeze. It is thought that the virus may spread to hands from a contaminated surface and then to the nose or mouth, causing infection. Therefore, personal prevention practices (such as handwashing, staying home when sick and environmental cleaning and disinfection are important. 

Schools and in collaboration with CDC implemented strategies and plans to reduce the risk of getting sick and spreading the virus.


Parents roles:

Parents should promote behaviors and standards to reduce the spread of the disease.  

1. Staying Home when Appropriate 

2. Hand Hygiene and Respiratory Etiquette

  1. Teach and reinforce handwashing with soap and water for at least 20 seconds.

i.     If soap and water are not readily available, hand sanitizer that contains at least 60% alcohol can be used (for older children who can safely use hand sanitizer).

b.    Encourage the students to cover coughs and sneezes with a tissue. Used tissues should be thrown in the trash and hands washed immediately with soap and water for at least 20 seconds.

             i.     If soap and water are not readily available, hand                         sanitizer that contains at least 60% alcohol can be used (for older children who can safely use hand sanitizer).

3. Cloth Face Coverings

Teach and reinforce use of cloth face coverings. Face coverings may be challenging for students (especially younger students) to wear in all-day settings such as school. Face coverings should be worn by staff and students (particularly older students) as feasible and are most essential in times when physical distancing is difficult. Individuals should be frequently reminded not to touch the face covering and to wash their hands frequently. Information should be provided to staff, students, and students’ families on proper use, removal, and washing of cloth face coverings.

a.    Note: Cloth face coverings should not be placed on:

 i.     Children younger than 2 years old

  ii.     Anyone who has trouble breathing or is unconscious

  iii.     Anyone who is incapacitated or otherwise unable to remove the cloth face covering without assistance.


4.  Wear your Mask Correctly

  • wash your hands before putting on your mask
  • Put it over your nose and mouth and secure it under your chin
  • Try to fit it snugly against the sides of your face
  • Make sure you can breathe easily


5. Shared Object:

  • Discourage sharing of items that are difficult to clean or disinfect.
  • Keep each child’s belongings separated from others’ and in individually labeled containers, cubbies, or areas.


6. Hydration System:

  • Encourage students to bring their own water to minimize use and touching of water fountains.


7. Food in school

  • Have children bring their own meals as feasible.
  • Allow students to eat lunches at their desks or in small groups outdoors instead of in crowded lunchrooms or follow the school rules. 


8. Immunization:

  • It is important as students return to school that they are up to date on their immunization. It will be critical that students and staff get their flu shot this year to reduce the spread of influenza this fall and winter.


9. Students at higher risk:

  • While COVID-19 school policies can reduce risk, they will not prevent it entirely. Even with safety steps in place, some students with high-risk medical condition may need to continue distance learning or other accommodations. Talk with your pediatrician and school staff (including school nurses) to determine if your child can safely return to school.


How to keep schools safe when reopening?

  1. Clean and disinfect high-touch surfaces
  2. Wash hands!
  3. Desk 3-6 feet apart
  4. Fewer students and staff in classroom
  5. Teachers move classrooms, not students
  6. Lunches at desk
  7. Use outdoor spaces when possible
  8. Masks for all adults and older students
  9. Flexibility to go virtual if virus surges



Water Safety

By Dr. Lauren Lucas 

-Children should always be supervised by a responsible adult when around a pool or other body of water, even when it is not time to swim. 

-The responsible adult should not be distracted and should not be under the influence. It is important for swimmers to take scheduled breaks from the pool so that the responsible adult can also get breaks or switch with another adult. Discuss the plan for breaks before swim time starts.

-Responsible adults and caregivers who monitor children swimming should be trained in CPR. 

-Set the rule early and remind children often that they should never get in the water without getting an adult’s permission immediately prior to stepping into the water. It is never too early to start discussing this rule! 

-Teach children to yell for help immediately if they see another child struggling or staying under the water for too long. 

-Ensure pools are surrounded by 4-sided fences and keep doors that access pool areas locked. The recommended height for these fences is at least 4 feet tall. Consider installing alarms on the doors so that adults are easily alerted when they open.

-Children should always have a life jacket on at all times on while on a boat, including while docked or on a dock. These life jackets should be Coast Guard Approved. 



Check out the following websites for more tips!







Insect Repellant Tips:

-The AAP recommends using bug sprays with DEET as the repellant.

-For infants and children older than 2 months, DEET with concentrations between 10-30% should be used.

-The percentage of DEET is related to duration and not strength - 10% provides protection for 2 hours while 30% can provide protection for 5-8 hours.

-Children should not use DEET with higher concentrations than 30%.

-Avoid using combo sunscreens and insect repellants - sunscreens will need to be reapplied much more frequently than insect repellant.

-Insect repellant should ideally only be applied once a day to children.

-Skin should be washed when outdoor time is over to remove the repellant.

-For babies, use netting or mesh screens over strollers for extra protection, especially for infants less than 2 months who should not have insect repellant applied on their skin.

-Avoid applying anything with strong scents – perfumes, body washes, etc. that may attract bugs before going outside.

-Insect repellants with alternate repellants like picardin or IR3535 are less effective than DEET.

Check out the following websites for more tips!









By Dr. Lauren Lucas

Sun Safety Tips:

-Stay in the shade and have kids wear sunshirts, hats and sunglasses as much as possible when outdoors.

-Plan outdoor activities for early morning and late afternoon/evening when you are able (before 10am and after 4pm).

-Apply mineral-based (titanium oxide, zinc oxide) sunscreen to babies and toddlers. These are safe to apply to babies less than 6 months if outside for extended periods, but these infants should really be kept out of the sun and in shade completely. 

-For older kids, use sunscreen that is at least SPF 15 and includes both UVA and UVB protection.

-Reapply sunscreen every 2 hours, or more frequently if swimming or sweating.

-Make sure kids have a water bottle readily available throughout the day and encourage them to stay hydrated.

-Never leave infants or kids in the car, even with the windows cracked for short periods. 

Check out the following websites for more tips!










By: Lauren Lucas. MD

In early April, the CDC released the first data set describing children who have tested positive for COVID-19 in the United States. This included about 2500 children less than 18 years old. Strikingly, kids only made up 1.7% of known cases (where age was reported) though they comprise 22% of our population.

The authors only had information on about 300 of those children’s symptoms, which demonstrated that 73% of these kids had the classic symptoms of fever, cough and/or shortness of breath versus 93% of adults. Breaking down each individual symptom, 56% had fever, 54% had cough, and 13% reported shortness of breath.

The hospitalization rate was estimated at 5.7-20% of pediatrics cases where hospitalization status was known, and the ICU admission rate was between 0.58-2% where status was known. Both of these numbers are lower than those for adults, out of whom up to 10-33% require hospitalization and 1.4-4.5% require ICU admission. These are all very rough estimates given the limitations in testing and the smaller portion of COVID patients whose hospitalization status was known.

Out of the children included, 345 cases reported presence or absence of underlying conditions. These cases demonstrated that a quarter of kids who tested positive for COVID had at least one underlying health problem, with the most common being asthma, cardiovascular disease and immunosuppression. This is actually lower than I expected, as I would anticipate these kids to be tested more frequently than kids with no medical problems.

Overall, these numbers coincide with those out of China last month. Kids are less likely than adults to have the classic symptoms, especially the triad of fever, cough and shortness of breath all together. About a quarter of children may have atypical or no symptoms. Kids are still at risk for hospitalization and ICU admission from COVID-19 complications, but they do seem to be at lower risk than adults.

We still have so much to learn about COVID-19 and kids, especially as we have the ability to test many more people. However, I hope this sheds a little bit more light on how our kids could be and have been affected.






By Dr. Lauren Lucas

We still have a lot to learn about COVID19, but the trends in children so far have put many of our minds at ease. Initial reports from China were encouraging, and now we actually have some early numbers to give us a better feel for how kids fare with this scary virus. If you have been in for a well check with me recently, you’ve probably heard me ramble off many of these numbers.

A few weeks ago, Pediatricians in China released an observational study before finalization to share their findings with other countries, and it was published in Pediatrics, one of our main sources of evidence-based medicine.  This study included 2,143 children up to age 18 with a mean age of 7. One of the downfalls of the study is that 1/3 of the children included had positive testing and the other 2/3 were suspected due to exposure but not confirmed cases.

This study found that the vast majority of these kids (94%) had none, mild symptoms (though mild symptoms were flu-like with fever, runny nose, cough, muscle soreness, and in some cases nausea, vomiting and diarrhea) or moderate symptoms (including pneumonia but not requiring oxygen therapy or hospitalization). About half of patients in each age group were classified as mild. One third of kids between ages 6-15 were asymptomatic.

As Pediatricians, some of the early data from China did give us pause about our littlest patients. Infants and toddlers may be more susceptible to COVID19 than initially suspected.  They may be more at risk for difficulty breathing, drops in their oxygen levels, and therefore hospitalization. 10% of the infant age group and 7% of the toddler age group had severe (difficulty breathing and changes in oxygen requiring hospitalization) to critical cases (Acute Respiratory Distress Syndrome requiring intensive interventions).  We still have a lot to learn about infants born to pregnant mothers infected with COVID19 as well, and whether transmission occurs across the placenta (studies are inconclusive so far).

One child in the 10-20 year old age range passed away in this group of Chinese children, and thankfully none less than 10 passed away. In the preliminary data from Italy (according to article in JAMA March 23, 2020), no children less than age 20 had died in Italy at that time.  Unfortunately in the US we have lost one infant who tested positive for COVID, but the cause of death has not been released.

What does this all mean? Thankfully, children are most likely to have no symptoms to mild symptoms. While this is very reassuring as a parent, this data reinforces the need for kids to social distance. Do not let children play with other children outside your home, even in the neighborhood or nearby park. Children can be shedding the virus with little to no symptoms. There is still risk to children, especially younger infants and children with co-morbidities, and even “mild” symptoms can be as severe as flu.  

Dong Y, et al. Epidemiological Characteristics of 2143 Pediatric Patients with 2019 Coronavirus in China. Pediatrics. 2020; doi: 10.1542/peds.




Go for walks and bike rides as a family. Trips outside are safe as long as you maintain social distance from neighbors. It is best at this time to avoid playdates and neighborhood parks. Teenagers are especially having a difficult time with social distancing from friends. This is a great opportunity to go for a walk with them and check in.

Cook a new recipe together as a family.

Have a picnic outside for a meal.

Write letters and draw pictures to mail to family members.

Schedule a virtual family reunion on platforms like Zoom or Google Hangout. 

Check artist websites for fun ideas – many are offering coloring pages and even art classes. South Carolinian Dorothy Shain is hosting weekly art classes for kids with a different featured artist each week.

Take virtual tours or lessons of museums or zoos. Our own South Carolina Aquarium has regular updates on their Facebook page. Many Zoos and Aquariums are offering virtual tours and live streams.

Check out the many educational Podcasts for kids.

For preschoolers, check out PBS Kids (https://www.pbs.org/parents), which is sending out a daily newsletter with show and activity ideas.    

Overall, maintaining some routine and structure will be helpful for children, but allow for some flexibility and grace. Create a schedule together distinguishing work hours and play hours. Kids might need more breaks than normal from their school work as well. Allow for frequent 5-10 minute breaks during their school time as able. For school time, try to have a quiet work area with minimal distractions.    
More Tips from the American Academy of Pediatrics: 




Best of MP

Mount Pleasant parents have spoken and the votes are in! Coastal Pediatric Associates has been named the Best of Mt. Pleasant from the readers of Mount Pleasant Magazine. Says the magazine, "Parents desire nothing but the most exceptional treatment when it comes to the health and well-being of their children and Coastal Pediatric Associates pride themselves on being compassionate, relentless advocates for all patients and their families.”

There are several reasons parents choose Coastal Pediatric Associates. The team has been caring for Charleston children for more than 20 years, and provides the most current, compassionate, and comprehensive care in the Charleston area. Coastal Pediatric Associates' team of skilled physicians, nurse practitioners, and staff are committed to delivering clinical excellence in an environment that is fun, kid-friendly, and sensitive to the unique needs of each child.

Our #CPAkid families benefit from:

Coastal Pediatric Associates is a designated Level 3 Patient Centered Medical Home with five convenient locations across the area. In addition, they provide research opportunities through Coastal Pediatric Research and newborn and breastfeeding care through the Breastfeeding Center of Charleston. To learn more about our team, https://www.cpakids.com/questions.php.




It is a common myth that cold weather causes colds, but it does not.  Colds are caused mainly by viruses that we are exposed to more often in the winter months.  These viruses are spread even more easily when children are in school and in close contact with each other, usually through respiratory droplets in the air and on hands.  Coach your kiddos to cover their mouths and noses when they cough and sneeze, and to also wash their hands often with soap and water.  These are the best ways to help reduce spread of infection. 

If you have a cold here are a few tips:

  • Fever – Fever is a common feature of colds.  A fever is any temperature greater than 100.4 F, and will usually be present along with other viral symptoms.  If a child has only fever, and no other symptoms for more than 3 days, the child should be evaluated by a healthcare provider. Likewise, fever longer than 5 days is a concern that warrants further evaluation.
  • Medication - Make sure that any medication you give your child is just for children.  Cold remedies are not a cure, and only sometimes help with symptom control.  Generally, suppressing a cough can do more harm than good, so most cold remedies are not recommended in young children.  Be sure to check with your doctor for dosage information for your child's age and weight. 
  • Staying Home - You should always keep your child home from activities (school, camp, daycare, etc.) when they are running a fever. That is when they are most contagious and likely to spread the illness to other children.
  • Keep Hydrated - Make sure your child has plenty of fluids to drink, but not soda or too much juice.
  • Rest – Perhaps the most important thing you can do, make sure your child gets plenty of rest.
  • Call the doctor when necessary – You can always call with concerns or questions, but here are a few red flags:  Your child likely needs to be seen by a healthcare provider if he/ she has fever more than 5 days, fewer than 3 wet diapers/ urination in 24 hours, cough more than 2 weeks, vomiting more than 2 days, diarrhea more than 2 weeks or bloody stools.

As for outdoor time, children should dress in layers for the school day.  We have wide variations in daily temperatures in this area, so having the ability to put on, or take off, extra layers can help.  Dress babies and young children in one more layer of clothing than an adult would be wearing in the same conditions.  If your child suffers from minor winter nosebleeds, use a cold-air humidifier in their room. Saline nose drops can help keep their nose moist.  Don’t forget to use sunscreen. Children and adults can still get sunburned, even in the winter.




Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs.  It can cause mild to severe illness, and in some serious cases, can lead to death. The best way to prevent flu is by getting a flu vaccine each year. A recent study by the CDC found that children 0-18 years old are the most likely target to get sick from flu.

Flu can be very dangerous for children. CDC estimates that between 6,000 and 26,000 children younger than 5 years of age have been hospitalized each year in the United States because of influenza. The flu vaccine is safe and helps protect children from the flu.

Coastal Pediatric Associates’ (CPA) recently announced that they will host flu clinics at all five locations starting in September, and it could not come at a better time! School is back in session, and the germs are spreading. A flu vaccine can help to keep your child healthy and flu free this school year.

Coastal Pediatric Associates' team of skilled physicians, nurse practitioners, and staff are committed to delivering clinical excellence in an environment that is fun, kid-friendly, and sensitive to the unique needs of each child. Dr. Steven Stripling highlights some important flu tips for parents.

CPA’s Top 10 Flu Tips:
1. Schedule your child’s vaccine! Flu shot clinics will be held at all CPA locations.
2. Look for symptoms: High fever, sore throat, headache and body aches. Dr. Stripling says, “The younger child should be seen quickly with a high fever.”
3. Avoid touching the face as hands often hold the germs!
4. There are several flu strains. It’s possible to get more than one strain in a season. Dr. Stripling explains, “Over the years there are several strains each season. It is possible to get two different strains. Vaccinate even if the child has had the active flu at the beginning of the season.”
5. See a physician when flu symptoms begin so that they can establish a treatment protocol for the patient.
6. Rest and fluids if diagnosed.
7. Ibuprofen helps with body aches.
8. Take care of the cough. Older children can take cough syrup as prescribed by physician.
9. Keep an eye out for complications: Fever after day six warrants another trip to the doctor. “If you have been in and diagnosed, doing supportive care, and still do not feel better after a week, we need to look out for secondary bacterial diseases,” Dr. Stripling explains.
10. Remember CPA is here to help! We offer 5 convenient locations as well as extended hours and availability seven days week.

CPA provides the most current, compassionate, and comprehensive medical care. CPA is a designated Level 3 Patient Centered Medical Home, recognized for providing the highest level of care in the three-tiered quality grading system. To schedule a flu vaccine appointment, please call the location closest to you. For more information: https://www.cpakids.com/contact.php.

View Flu Guide


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