Puddle Dock Pediatrics is a welcoming, innovative, and patient-centered pediatric practice located in Portsmouth, NH.

Hold onto your hats: impetigo is back!!! 😱

We’re seeing crusty rashes popping up under noses and spreading onto the face and other body parts following prolonged runny noses. The skin breakdown around the nostrils and elsewhere allows bacteria that normally lives on the surface to penetrate deeper and cause infection.

The lack of humid air as we get into the cooler months of fall further contributes to disruption of our protective skin barrier.

The characteristic appearance of impetigo is “honey-colored crusting”. It can be itchy or painful, and grow from a single small area to larger and more numerous patches. Once diagnosed, it requires topical and/or oral antibiotics to clear up.

Moisturize your child’s skin, especially around their nose during colds, with a rich fragrance-free moisturizer like Vanicream. This will restore and protect the skin barrier and keep those pesky bacteria on the surface where they belong! Call our office if your child is showing any of the previously mentioned signs of infection 👻

THIS WEEK’S IN-HOUSE TESTING:
- 3 Flu A/B PCR’s (molecular/PCR), one was positive for flu A (33% positivity rate)
- 3 COVID PCR’s, all were negative (0% positivity rate)
- 3 RSV PCR’s, all were negative (0% positivity rate)
- 4 Strep tests, two of which were positive (50% positivity rate)

Allow us to introduce EMMA (Registered Nurse) and CHLOE (Medical Assistant) who joined us within the last month as we get deep into sick season! They are already fitting in so well as they get to know your kiddos 💛🌈 their bios will be coming to the website soon, and be sure to say hello to them the next time you’re in the office!

This week, our triage nurses have been coaching lots of families through managing vomiting and diarrhea at home. Often these symptoms are viral in etiology, and therefore self-limiting - the body is literally trying to “flush out” the germs! Top of order is pushing sips of fluid throughout the day and ensuring that your child is urinating regularly. Give us a call if your child is also experiencing:
🤒 High fever: flu can present with GI symptoms, too! Consider testing for flu sooner rather than later as Tamiflu (a prescription antiviral medication) is more effective when taken as close to the start of symptoms as possible.
🤢 “Uncontrollable” vomiting or diarrhea, accompanied by no wet diapers/urine output for >8-10 hours: your child may benefit from prescription anti-nausea medication and possibly IV fluids.
🤕 Severe headache or abdominal pain, blood in stool, lethargy in absence of fever, excessive thirst, labored breathing, or ANY other symptom that is concerning to you as their caregiver.

THIS WEEK’S IN-HOUSE TESTING:
- 5 flu A/B tests (molecular/PCR), one was positive for flu A (20% positivity rate)
- 4 COVID PCR’s, all were negative (0% positivity rate)
- 4 RSV PCR’s, all were negative (0% positivity rate)
- 2 molecular strep tests, both were negative (0% positivity rate)

If your child does catch a GI bug, don’t forget to have everyone at home wash their hands frequently. Kiddos in diapers should have a generous amount of barrier cream applied with each diaper change to prevent rashes from loose stools. And it can take a few weeks afterward for poops to go back to normal 💩

Today the WHOLE Puddle Dock team celebrated Catherine’s baby shower with lunch at @oarhouseportsmouth 👶🏼 can’t wait to have another practice mascot joining Lottie P! 💛

Pictured L to R: Emma (RN), Dr. Smith, Brooke (RN), Sam (MA), Catherine (Office Manager), Emily (RN), Dr. Hoerman

New slots for online booking have been released through end of October! Don’t forget to FLU BEFORE BOO 👻 and schedule your child’s seasonal respiratory immunizations before Halloween!

Respiratory season is here! Many calls about colds and coughs, and some little ones with wheezing and labored breathing. Ear infections can follow these, so we’re doing lots of ear checks in office too.

In terms of in-house testing, we are judicious about testing ONLY WHEN appropriate (e.g. avoiding strep testing if symptoms are more consistent with a virus, or in children under age 3 years) and ONLY IF testing will change management (e.g. positive strep = antibiotics, positive flu = Tamiflu, but most viruses have no treatment beyond supportive care).
- We ran 4 in-house COVID/fluA/fluB/RSV PCR’s, and ALL were completely negative (0% positivity rate)
- We ran 3 in-house molecular strep tests, and all three were negative (0% positivity rate)

October is a great month to get your child’s seasonal respiratory vaccines squared away - including an RSV antibody injection if they are under 8 months old, and flu/COVID shots for ages 6 months and up. Schedule your child’s immunization visit today! 💉🎃