Summer Saturday Hours

We will start our summer hours for our Walk-in Clinic this Saturday, May 13. Saturday hours will be from 9am to 12pm. Weekday hours will remain 8am to 6pm.

Do not use codeine, tramadol in children: FDA

by Melissa Jenco · News Content Editor American Academy of Pediatrics News

Codeine and tramadol should not be used to treat pain or cough in children younger than 12 years as they could be fatal, the Food and Drug Administration (FDA) said Thursday.
The FDA unveiled several changes to the labels of the medications to protect children, adolescents and infants being breastfed.

“We are requiring these changes because we know that some children who received codeine or tramadol have experienced life-threatening respiratory depression and death because they metabolize (or break down) these medicines much faster than usual (called ultra-rapid metabolism), causing dangerously high levels of active drug in their bodies,” Douglas Throckmorton, M.D., deputy center director for regulatory programs in the FDA’s Center for Drug Evaluation and Research, said in a statement.

The FDA is adding the following new restrictions to the warning labels of codeine and tramadol:

  • Codeine is contraindicated to treat pain or cough, and tramadol is contraindicated for treating pain in children under 12.
  • Tramadol is contraindicated for treating pain after surgery to remove tonsils and/or adenoids for children under 18. Use of codeine for this purpose was placed under the same restriction in 2013.
  • Codeine and tramadol are not recommended for use in adolescents ages 12-18 who are obese or have conditions such as obstructive sleep apnea or severe lung disease.
  • Mothers should not breastfeed when taking codeine or tramadol.

Since 1969, codeine has been linked to 64 cases of serious breathing problems, including 24 deaths in children and adolescents. Tramadol is not approved for pediatric use but has been tied to nine cases of serious breathing problems, including three deaths in children and adolescents, according to the FDA. There also have been cases of breathing problems in breastfed infants whose mothers were taking codeine.

In September 2016, the Academy released a clinical report Codeine: Time to Say “No” that expressed concerns about the dangers of codeine use in children and called for more formal restrictions.
The FDA recommends physicians use other medications for treating cough and pain. Officials also encouraged parents to pay close attention to the ingredients in medication they give their children and seek immediate medical attention if children taking the restricted medications experience difficulty breathing, confusion, unusual sleepiness, trouble breastfeeding or limpness.


FDA Drug Safety Communication
FDA Q&A on the use of codeine and tramadol in breastfeeding women,
Consumer Update: Codeine and Tramadol Can Cause Breathing Problems for Children, information for parents on the use of codeine,


Childhood shyness is common and it causes concern for some parents.  A child may be shy because of many reasons, such as, harsh living situations, neglected or rejected.  In some cases, shyness can be disabling.  Extremely shy children can find it hard to socialize at school and the longer this goes on the more reclusive they can become.  Some children just need time to adjust to a new setting and they will do well in relationships and social settings.  Parents can guide their children into social situations and they can learn how to interact in a successful way.  Children want to be liked but sometimes are rejected by their peers.  When a child is rejected it could be because of their impulsive and disruptive behavior.  This can lead to a child being neglected.  Which often means they are ignored, forgotten, not invited to parties, or picked last for teams.  Successful socializing interactions require skills and special ways of interacting.  Parents should look for these skills in their children and help develop them.

  • Forgiving
  • Apologizing
  • Expressing  affection
  • Sharing
  • Asking for help
  • Helping others
  • Comforting someone
  • Doing favors
  • Keeping secrets
  • Sticking up for a friend

Hungry or Bored?

Children sometimes use food for reasons other than hunger to satisfy themselves.  These reasons may be in response to their emotions or feelings.  Many things can trigger hunger such as:

  • boredom
  • depression
  • stress
  • frustration
  • insecurity
  • loneliness
  • fatigue

One way to keep your child from eating out of boredom is to steer them towards activities that keep them busy.  Also make sure your child eats three well-balanced meals and one snack each day.

A few things to do instead of eating would be:

  • walk the dog
  • walk around the neighborhood
  • kicking a ball around
  • painting a picture
  • running through sprinklers

Showing your child love on Valentine’s Day!

Here are ways to show your child how much you love them on Valentine’s Day or every day.  

  1. Use plenty of positive and encouraging words with your child.
  2. Make an extra effort to set a good example about how to connect and talk with other people at home and in public.
  3. Respond promptly and lovingly to your child’s physical and emotional needs
  4. When your child is angry, grouchy, or in a bad mood, give him a quick hug, cuddle, pat, secret nod or other sign of affection he responds to and then consider talking with him about it when he’s feeling better.
  5. Use non-violent forms of discipline.
  6. Make plans to spend time alone with your young child or teen doing something she enjoys on a regular basis.
  7. Mark family game nights on your calendar so the entire family can look forward to having ways to enjoy spending time together.
  8. Consider owning a pet, if possible. Having a pet can help make some children, especially those with chronic illnesses and disabilities, feel better by increasing their physical activity, enhancing their overall feelings, and offering another way to connect with someone they care about.
  9. One of the best ways to have your child learn more about good food choices is to encourage him to cook with you.
  10. As your child grows up, she’ll spend most of her time improving upon a variety of skills and abilities that she gains in all areas of her life.
  11. Your child’s health depends a lot on the care and support you offer during his early years.
  12. Help your child foster positive relationships with friends, siblings and members of the community.
  13. One of your most important gifts as a parent is to help your child develop self-esteem.
  14. Don’t forget to say, “I love you” to children of all ages!

Mumps – What You Should Know

Mumps has been in the headlines lately, and for a good reason.  We are in the midst of a significant outbreak in several areas of our state, and cases of mumps have recently shown up in Northeast Arkansas. Here are a few facts about this disease:

  • Mumps is a viral illness spread by coughing and salivary contact.  It is present throughout the world and is uncommon in the USA because we immunize for it.  The virus infects our respiratory tract and salivary glands, lasts for several days, and usually resolves without complications. After a 2-3 week incubation period, children and adults typically develop cough and congestion, sometimes fever and headache, and about two thirds have salivary gland inflammation with tender, firm swelling over one or both cheeks.  When it is suspected, mumps can be tested with a cheek swab – the result may take several days.  
  • Thought the disease is usually relatively mild and self-limited, it can cause occasional severe complications including swollen testicles in adolescent or adult males, viral meningitis, encephalitis, arthritis, or other glandular inflammation.  For women in early pregnancy, there may be a slight increased risk of spontaneous miscarriages.
  • There is no specific treatment for mumps, so the only effective approaches are containment and prevention.  Infected children can pass on the virus well before, and for about 1 week after the symptoms show up, so isolation of sick or highly susceptible individuals is important.  Mumps vaccine is part of every child’s routine immunization regimen and is usually given at 1 and 4 years of age.  Most, but not all children who’ve had both doses are fully immune.  

More information, including detailed isolation advice, is presented in a recent Arkansas Department of Health Newsletter (see below), and you may feel free to contact us if you have questions or concerns.  


Front facing or Rear facing car seat?

Front facing or rear facing? Which one is the best?  When a child is placed front facing in the car seat injuries can be more severe.  This is because during a collision the child’s neck can be thrown forward, creating a stress on the spinal cord.  The spinal cord is very important and even the slightest damage can cause tremendous injuries, such as paralysis or even death.  When a child is rear facing in a car seat their bodies are cradled, supporting the head and neck securely. This keeps the head, neck, and spine fully aligned.  The longer a child can ride in the rear facing position, the better protected his or her spinal cord will be in a collision.