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Why Am I Developing Allergies, and How Can I Prevent Them?

Two to Three hundred years ago, very few people suffered from allergies. Nowadays, it’s common for people to be allergic to multiple things. What has changed? Why are people becoming more and more allergic to chemicals, foods, animals, and our natural environment? There are numerous reasons:

1. We have fewer bacteria in our intestines. We are exposed to cleaner water and more soap and hand sanitizer. C-section delivers more of us, so we are not exposed to our mother’s natural vaginal bacteria (1). We are exposed to more antibiotics, especially as children. Fewer bacteria diversity in the intestines has been shown to increase the risk of developing allergies.

2. For decades, doctors recommended waiting to introduce certain foods till later in childhood. We now know this increases the chance of developing a food allergy (4).

3. We are exposed to more acid-reflux medicines, which reduce stomach acid. Lower stomach acid affects food digestion and how our immune system is exposed to food (3).

4. We spend less time outdoors, especially as children and fewer of us grow up on farms, having less exposure to farm animals (5).

5. We have been exposed to more pollution and 1st or 2nd hand smoking. These have altered how our immune system interacts with our environment (5).

6. Our children wear shoes more when they play outside. When children’s feet have less exposure to bacteria and worms, the risk for allergies goes up (5).

We can control some of these risk factors now, some of them we can modify, and some we cannot. To decrease your and your children’s risk of developing allergies, you can do the following:

1. Eat various foods in your home, including milk, nuts, eggs, and soy. Expose your children to them starting at six months (see your allergist first if there is a family history of life-threatening food allergy). Eat these foods when you are pregnant. If your infant was born via C-section, give them a few different probiotic supplements in their first five years (2).

2. Keep your infant off acid reflux medicine unless necessary. Eat healthily and lose weight to avoid having to take acid-reflux medicine.

3. Avoid taking and giving your children antibiotics unless necessary.

4. Let your kids go outside in the backyard barefoot (within reason).

5. Limit kids’ screen time, and get them outside as much as possible, as young as possible.

6. If you have an opportunity to live on a farm in a less polluted area, take it.

7. Limit hand sanitizer and soap use (within reason) in your home.

8. Stop smoking/vaping.

9. Consider taking a daily probiotic with various strains in it.

By David Beckstead, MD

Sources:
1. Koplin J, et al. Is cesarean delivery associated with sensitization to food allergens and IgE-mediated food allergy: a systematic review. Pediatr Allergy Immunol. 2008;19(8):682.
2. Kuitunen M, et al. Probiotics prevent IgE-associated allergy until age five years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009;123(2):335.
3. Mitre E, et al. Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. JAMA Pediatr. 2018;172(6):e180315. Epub 2018 Jun 4.
4. Commins S. Food intolerance and food allergy in adults: An overview. UpToDate. Accessed 3/9/22.
5. Platt-Mills T, Commins S. Increasing prevalence of asthma and allergic rhinitis and the role of environmental factors. UpToDate. Accessed 3/9/22.

Do You Have Anemia?

Anemia is a word that you have probably heard many times, but maybe you aren’t exactly sure what it means. Perhaps you even know some of the symptoms, including feeling fatigued, or headaches. So, what is anemia? It starts with hemoglobin. Hemoglobin is a protein in your blood that carries oxygen. Iron is needed for your body to make hemoglobin. When hemoglobin is lower than normal, this is called anemia.

In nonpregnant females, hemoglobin less than 12 is considered anemic. Due to regular physiologic changes in pregnancy, a lower cut-off is used to diagnose anemia which varies by trimester. In the first and third trimesters, hemoglobin less than 11 is considered anemic, while 10.5 is used as the cut-off in the second trimester.

Anemia occurs in almost one-third of reproductive age women and up to 40% of pregnancies. The most common cause of anemia is not having enough iron available in your body to produce adequate hemoglobin levels. This is called iron-deficiency anemia.

The amount of iron your body needs in pregnancy varies a lot depending on your gestational age. At baseline, 1 mg per day is required for the normal turnover of red blood cells. In the first trimester, your needs increase to 2 mg per day and continue to increase up to 7 mg per day as you approach your due date. Iron can be found in many foods, including meat, lentils, beans, and spinach. Additionally, many foods are fortified with iron, such as fortified breakfast cereals and cream of wheat. Another good way to get more iron is through your prenatal vitamin.

For women diagnosed with iron-deficiency anemia, additional supplementation of iron either by mouth or intravenously (IV) may be recommended. Taking iron orally is easy and inexpensive but can cause a metallic taste, nausea, diarrhea, or constipation. Iron given through an IV is usually reserved for those who need more rapid iron replacement, such as those within a month of their due date, those who don’t tolerate oral iron supplementation, or those with a history of bariatric surgery, which can impair iron absorption.

Now that you know what anemia means and how common it is, you may feel a little worried about being anemic. You say to yourself, “I do feel tired! I do get headaches! Isn’t that part of being pregnant?” You are right! It might just be part of being pregnant. Rest assured, we routinely screen for anemia in pregnancy with your initial prenatal labs and again at the end of the second trimester when screening for gestational diabetes. This way, we can identify anemia appropriately and start treatment to resolve it.

Inspired by Heroes – Bennion Veterans Home

Hiking is one of the favorite recreational activities for my family and me. The scenic vistas and the peace of the trail are always refreshing. A few years ago, we ventured to the Redwood Forest and hiked amongst the giants of the forest. I marveled at the size of the redwood trees as they stretched toward the sky. You cannot help but feel that you are amid greatness.

In 2013, I had the opportunity to become the medical director of the Bennion Veterans Home in Payson and continue to serve in that capacity. The veterans home is a skilled nursing and rehabilitation facility for veterans and spouses of veterans.

There is a similar feeling of inspiration as I care for the veterans there. These veterans have been and continue to be heroes to freedom.

Many have visible signs of their sacrifice made in service to others. I am among giants as I walk those halls. I appreciate the chance to work with the veterans and their families. Their service and dedication inspire me.

Pathway to a Healthier Heart

Heart disease is the leading cause of death in the United States (causing one in four deaths each year) and is much more likely to affect our health than any infectious disease. Although both heart disease and infections are mostly preventable, there’s a lot we can do every day to live a heart-healthy life. In the past couple of years, with our focus on COVID, have we neglected some other basic lifestyle and wellness principles? 

Exercise: Exercise can be intimidating, and you can always think up a lot of reasons why you shouldn’t exercise—it’s hard, you don’t have time, you’ll get sweaty, people will laugh at you if you do it wrong, it’s boring, the gym is expensive, you don’t have the right shoes or clothing…the list goes on and on. Exercise is and should be challenging, which is why it benefits you. But work on making it fun and find the activity that’s right for you. Anything is better than nothing. Start small and work towards 30 minutes of physical activity at least five days a week with two days of strength training. If you can’t do 30 minutes in one block, do five minutes here and there throughout the day. Be fun and creative with your exercise. Organize a pickleball tournament with your co-workers, dance with your family, walk with a friend. You’ll get the most out of physical activities that you enjoy, and you’ll keep coming back for more. 

Eat better: As with exercise, start small. Work on improving your diet a little at a time. Planning is key. Plan a healthy menu and write a shopping list to take to the store. It’s easier to stick to your nutrition goals when you have healthy choices on hand and only buy what you need. Write it down. Keeping a food journal helps you focus on what you’re doing—good and bad. Be forgiving. You can’t change what you’ve eaten, but you can make better choices moving forward. Incorporate vegetables, fruits, and whole grains into your diet. Eat fish, poultry, beans, nuts, vegetable oils, and fat-free or low-fat dairy products. Try to cut down on foods high in saturated fat, sodium, sugar, and other sweeteners. Make better fast food choices—salads, smaller “meal deals.”

Strive for a healthy weight: Your best bodyweight range is one that promotes optimal physical and mental health. You should feel strong, energized, and confident at a healthy body weight. Being overweight taxes your heart and increases your risk of having heart disease, a stroke, high cholesterol, high blood pressure, and diabetes. Choose healthy foods and exercise regularly to achieve and maintain a healthy weight. Weight fluctuates with body size, so there’s no “ideal” body weight for all people. Everyone has a different body frame, body fat distribution, and height, all of which determine your healthiest weight range.

Quit smoking: Smoking harms your heart and blood vessels in many ways. Quitting is hard but possible and worth it. There is no single quit smoking plan that will work for everyone. Be honest about your needs. Set a quit date and ask your people for support. Stay busy. Avoid triggers. Stay positive. Consider starting a new hobby to keep your hands busy and connect you to others like sewing, knitting, woodworking, art, or music.

Reduce stress: Stress can contribute to heart risks. Practice meditation. Be physically active. Do relaxation therapy. Talk with someone you trust who might help you cope with stress. While smartphones, computers, and tablets are an unavoidable part of everyday life for many people, using them too often may increase stress levels. Cut down on caffeine. Consuming caffeine may increase your anxiety and stress if you’re sensitive to caffeine. Taking time for yourself is essential to living a less stressful, healthy life. Self-care doesn’t have to be elaborate or complicated. It simply means tending to your well-being and happiness. A sound social support system is essential for overall mental health. If you’re feeling alone and don’t have friends or family to lean on, social support groups may help. Consider joining a club or sports team or volunteering for a cause important to you. 

Improve sleep: Not getting enough sleep or regularly getting poor quality sleep increases the risk of heart disease and other medical conditions. Aim for 7 to 8 hours of sleep a night. Keep a routine—have a regular bedtime and don’t eat late at night. Stay active during the day. Optimize your sleeping place by minimizing external noise, light, and artificial lights from devices like alarm clocks or cell phones. Test different temperatures for your bedroom to find out which is most comfortable for you. Around 70°F (20°C) is best for most people. Your bed, mattress, and pillow can significantly affect sleep quality, so try to obtain high-quality bedding, including a mattress. Make sure your bedroom is a quiet, relaxing, clean, and enjoyable place. In general, the bedroom should only be used for sleep and intimacy. Relaxation techniques before bed, including hot baths and meditation, may help you fall asleep.

Know where you stand: Meet your goals by tracking how much you exercise, blood pressure, and cholesterol numbers. Seeing where you are and tracking progress is motivating.

Connect with others: These goals are more fun and achievable if families and friends work together. We tend to eat and play like our friends and family, so your healthy choices may inspire those around you. People who are connected with others in a plan are more successful. 

John Manwaring, PA-C

Canyon View Medical Group

References and Resources

https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/index.html

https://www.everydayhealth.com/hs/family-nutrition-guide/motivation-to-eat-healthy/

https://www.healthline.com/health/how-much-should-i-weigh#understanding-body-weight

https://www.healthline.com/nutrition/17-tips-to-sleep-better

https://www.healthline.com/nutrition/16-ways-relieve-stress-anxiety

https://www.health.qld.gov.au/news-events/news/30-ways-to-get-active-exercise-fun

https://www.nhlbi.nih.gov/sites/default/files/publications/HM-2022-TakingCare-of-OurHeartsTogether-508.pdf

https://www.verywellfit.com/creative-at-home-workouts-you-can-do-today-86023

Pregnancy Planning and Birth Defects Prevention

If you are planning to become pregnant, there are certain things you can do to increase the odds of good health for you and your baby. Some actions you take in advance can also significantly decrease the risk of certain birth defects. While some birth defects cannot be prevented, others are linked to the mom’s health and actions before and during pregnancy.

Folic acid supplementation

Every woman who might become pregnant should take a prenatal vitamin with 400 mcg of folic acid. Folic acid, also called vitamin B9, is an essential nutrient that helps develop the baby’s brain and spinal cord. This development usually happens early in pregnancy before a woman knows she is pregnant, so planning is essential. Some foods are also enriched with folic acid, such as fortified bread, pasta, and cereals. Eating a healthy, varied diet in addition to taking a prenatal vitamin will ensure that your body is getting the nutrients it needs for a healthy pregnancy.

Avoid alcohol, smoking, and drugs

There is no known safe level of alcohol, tobacco, or drugs like marijuana to consume during pregnancy. These substances can be harmful at all stages of pregnancy, including in the very early stages. It is best to avoid these substances altogether if you plan to become pregnant. If you need help to stop smoking or using a drug, please reach out to your healthcare provider.

Prevent infections

Some infections can cause pregnancy complications and birth defects if the mother has them during pregnancy. These infections include rubella, cytomegalovirus (CMV), toxoplasmosis, mosquito-borne illnesses like Zika and West Nile viruses, and many sexually transmitted diseases. If you are pregnant or planning to become pregnant, you should protect yourself from these diseases. Ensure you are up to date on your immunizations and talk to your healthcare provider to see if you need additional vaccines. Avoid travel to places where high-risk diseases like Zika are common. If you have a cat, you should avoid changing the litter box, which is a potential source of toxoplasmosis infection. And of course, it is a good idea to practice basic sanitation and infection prevention techniques like frequent handwashing and avoiding sick people. 

Check-in with your healthcare provider

Stay in close contact with your healthcare providers before and during pregnancy. If you have any chronic health conditions, you should make sure these are well controlled before becoming pregnant. For example, diabetes is a common health condition that can affect a baby’s growth and development if not controlled. Blood pressure problems, bleeding and clotting disorders, mental health conditions, and many other health problems can also affect pregnancy. Some prescription medications can cause birth defects and are unsafe to take during pregnancy. If you take any prescription medications and might become pregnant, you should make an appointment with your healthcare provider to discuss a plan for these medications.

Take care of yourself

Finally, take care of yourself! Pregnancy is an exciting time, but it can also be quite stressful. It may seem like everyone has an opinion about what pregnant women should and shouldn’t do. Make sure you get your information from trusted sources. Remember that some aspects of pregnancy are simply out of your control, and trying the best you can to care for yourself and your baby is enough. At Canyon View Women’s Care, our goal is to help women have happy, healthy babies. We would love to take care of you before, during, and after your pregnancy and answer any questions you have. Call us at 801-465-2559 for a preconception consult or pregnancy-related visit.

Alyssa Heath, PA

Canyon View Women’s Care

Tabitha’s Way – Making a Difference

My name is Hailey Wayland. I am a Medical Assistant and MA Supervisor in our Santaquin Family Medicine Office.

Outside of work, I volunteer at Tabitha’s Way, our local food pantry here in Spanish Fork. While I was there, I had the opportunity to pack meals for families and individuals in need throughout Southern Utah County.

This experience made me realize to be more grateful for the little things. The feeling of making a difference in someone else’s life is a feeling you can never forget! Also, we all need to go and experience this at least once in our lives.

By Hailey Wayland
Medical Assistant Supervisor

Preventing Cervical Cancer

Today, cervical cancer remains a significant cause of cancer morbidity and mortality among women. In fact, in 2020, cervical cancer was the fourth most common cancer in women worldwide. Fortunately, due to access to cervical cancer screening and prevention programs, the U.S experienced a significant decrease in cervical cancer deaths compared to the rest of the world. In the past 50 years, there has been a 75% decrease in cervical cancer incidence and mortality in countries that have implemented screening and prevention programs. For this reason, Canyon View highly encourages regular screening and vaccination against cervical cancer. 

You may be wondering, what exactly is cervical cancer? Cervical cancer is cancer of the uterine cervix and thus, occurs only in women. Cervical cancer is almost always caused by human papillomavirus (HPV) infection. On rare occasions, it can be due to other non-HPV causes such as genetics, cigarette smoking, and even oral contraceptive use. Because cervical cancer is so frequently caused by HPV infection, it is essential to understand HPV. HPV is the most common sexually transmitted infection in the United States and is spread by vaginal, anal, or oral intercourse with someone who has HPV. It can cause cervical cancer and cancer of the vulva, vagina, penis, anus, and oropharynx. Different strains of HPV can cause genital warts as well. Because cancer from HPV takes years to develop after getting infected, it is difficult to know when someone got infected if they have had multiple sexual partners over the years.  

You may now be wondering, how can I avoid contracting HPV and developing cervical cancer? You can do several things to protect yourself from developing cervical cancer. The first thing you can do is get the HPV vaccine. The CDC and American College of Obstetrics and Gynecology recommend HPV vaccination at age 11-12 and for everyone through the age of 26 if they have not yet been vaccinated. The HPV vaccine is recommended not only for females but also males since they can be carriers of the virus. HPV vaccination has been shown to work exceptionally well, as it is estimated to prevent more than 90% of HPV-attributable cancers.

The second thing you can do to protect yourself is to get screened for cervical cancer. Screening for cervical cancer is recommended for all women ages 21 to 65 years old. Early screening for cervical cancer helps prevent the disease altogether. This can be done by getting a Pap test and/or HPV test. A Pap test checks for precancerous cells or changes of the cells in the cervix that might develop into cervical cancer, while the HPV test checks for the human papillomavirus that often causes those cells to change. Both of these tests can be done in your healthcare provider’s office. An instrument called a speculum is inserted through the vagina so your provider can examine your cervix and collect some cells and mucus from that area. 

Screening with a Pap test is recommended every three years from age 21 to 29 years old. From ages 30 to 65, HPV testing is recommended every five years and a Pap test every three years. When both tests are done together, it is called “co-testing.” If your test results are typical for this test, your medical provider may recommend that you wait five years until your next screening. After the age of 65 or for women who have had a hysterectomy with removal of the cervix, screening is not recommended anymore if you have had normal previous results. 

Screening for cervical cancer is an effective way to detect precancerous lesions and cancer. Because early cervical cancer is often asymptomatic, regular screening and HPV vaccination are critical aspects of one’s comprehensive reproductive health. Talk to your provider about your recommended screenings and vaccination schedule today. 

Erin Tyrrell, FNP

Canyon View Family Medicine

Cervical Cancer: What should I know about screening? (2021). CDC. https://www.cdc.gov/cancer/cervical/basic_info/screening.htm

Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis. (2021). UpToDate. https://www.uptodate.com/contents/invasive-cervical-cancer-epidemiology-risk-factors-clinical-manifestations-and-diagnosis?search=cervical%20cancer%20&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1

Updated Cervical Cancer Screening Guidelines. (2021). The American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines

Utah Rotary Youth Exchange

My name is Aaron Lowe. I am the Practice Administrator for Canyon View Medical Group. I was fortunate to spend my junior year of high school as a foreign exchange student in Copenhagen, Denmark. That year abroad changed my life and has shaped many of my life choices. The organization that I went with was Rotary International. Rotary is a global network of 1.4 million neighbors, friends, leaders, and problem-solvers who see a world where people unite and take action to create lasting change – across the globe, in our communities, and in ourselves. 

As an adult, I have become involved in Rotary again. Locally, the Spanish Fork Rotary Club does many service projects to help the community, including raising funds to provide over 20 college scholarships per year or providing dictionaries to 3rd graders in Nebo School District. Internationally, Rotary has been working to eradicate polio for more than 35 years. Our goal of ridding the world of this disease is closer than ever. As a founding partner of the Global Polio Eradication Initiative, we’ve reduced polio cases by 99.9 percent since our first project to vaccinate children in the Philippines in 1979.

The role I am most excited by, with my involvement in Rotary, is through my services as the Outbound Coordinator for Utah Rotary Youth Exchange. We send approximately 20 students worldwide each year, some for just a summer exchange and some for an entire school year. I get to help students across Utah become foreign exchange students like I did when I was a youth. Students learn a new language, discover another culture, and truly become global citizens.

Caring For The Players

As a physician, it is often part of the calling to provide medical support and coverage for various community events outside of typical working hours. As a sports medicine specialist, it’s even more common, especially for game coverage. I’ve had many opportunities over the years, including several over the past year and a half since moving to practice in south Utah County.

I have been privileged to provide medical coverage and assistance at Spanish Fork Dons High School football games for the past two seasons. Thankfully, Spanish Fork has a superb athletic trainer, and there hasn’t been a need for anything too medically serious for the game. During medical event coverage, the hope is always that nothing major happens, yet still anticipate that anything can happen and to be prepared for the worst.

When I provide coverage at a sporting event, I have to remain mindful of the primary reason for being there. It’s sometimes hard to stay vigilant for injuries or medical concerns as I’m a sports fan in general and get into the game and have to fight my desire to get too involved in the action.

Sideline and game coverage typically provides plenty of opportunities for medical issues, from the routine to the fascinating, even bizarre. I have treated a myriad of conditions, including common orthopedic injuries, such as fractures and dislocations, to bee stings and bites (yes, human) to dislodged teeth and contact lenses to bleeding nipples while running and bleeding from the eyes (scary looking, but simply from a hard hit to the nose, sending blood up through the tear ducts) to complete loss of consciousness (always a concerning moment) and full toenail avulsion during a triathlon transition after somehow getting caught in the chain/gears. I’ve even been called into the stands to treat fans for issues, from a sprained ankle while jumping around on the bleachers (a little too excited) to a potential heart attack (way too excited).

Additional event coverage included the Speedy Spaniard 10k, plus the unique opportunity to provide medical support at the Fiesta Days Rodeo, which involved lacerations, head injuries, and orthopedic injuries from being kicked, stepped on, or thrown by bulls (who signs up for this again?).

As an active individual and ‘weekend warrior’ myself, it is always fun and rewarding to be directly involved in community events.

What Your Pediatrician Has in Her Medicine Cabinet (For the Kids)

Is your medicine cabinet a jumble of bottles, with some expired medications drying up in the back? Have you ever had a child sick in the middle of the night and had to send someone out in the cold to pick up something for a bit of relief? Pediatricians often call the winter months “respiratory season” because of the seasonal spikes in viral illnesses, so consider doing a quick check on your medicine cabinet so you can be prepared. Here is what I have in my home, regardless of the time of year.

Multivitamins

Even with a varied diet, it can be hard to get all the recommended nutrients every day. The AAP recommends breastfed babies receive 400 IU of vitamin D supplementation, and all children and adolescents 1 year and older receive 600 IU of vitamin D. This is especially important for Utahns because while many Americans are vitamin D deficient, we are at even higher risk in the high latitudes of Utah. Bone density increases fastest during growth in childhood and adolescence, so take advantage of that by adding calcium too–especially during puberty! Consider providing these nutrients through a multivitamin, especially if your child has picky eating habits.

Acetaminophen (Tylenol)

Acetaminophen is great at reducing fevers and pain. Children as young as 3 months of age can safely take acetaminophen for teething, fevers with illnesses, or other fussiness you may think may be pain-related. Under 3 months of age, you should talk to your pediatrician first. A fever in this age group should be evaluated immediately. Also talk to your doctor first if your child has a history of liver disease or injury.

Ibuprofen (Motrin)

I am a fan of acetaminophen and an even BIGGER fan of ibuprofen. For children 6 months and older, I usually grab this one first. Ibuprofen also treats fevers and pain, and at higher doses has anti-inflammatory effects too. When kids have pain in their bones or muscles, I usually recommend this as the first-line medication offered. Talk to your doctor first if your child has a history of kidney disease or if you are concerned about them being severely dehydrated.

Diphenhydramine (Benadryl)

Diphenhydramine is a powerhouse medication with many uses. While I hope you don’t need it often, I have it in my medicine cabinet just in case. It can be used for allergies, itching, allergic reactions, motion sickness, severe sleep issues (clear this one with your doctor first), and even helps treat migraines.

Honey

Ok, this is not a medication, but have you ever had a bad cold and been soothed by a spoonful of honey either swallowed straight or mixed into warm tea? When prescription medications are not needed, it is so great to have other options, so try this for a cough or sore throat. Just remember, infants under 1 year of age should never be given any honey or honey products because of their risk for botulism.

Bonus: Nasal Aspirator

Another non-medication, but WOW, these are great for all of our sick and snotty babies! The Nose Frida and NeilMed Naspira are some of my favorites because you control the strength of the suction, and they disassemble easily for thorough cleaning between uses. A good nasal suction can sometimes keep a baby out of the doctor’s office, and while we love to see you, your sweet baby may rather stay at home. Pair its use with nasal saline drops or saline spray to break up that snot and increase your suction superhero powers. Nasal saline can also be very effective on its own for children who are older or do not tolerate suction.


For your child’s dosing of the medications listed, check out our Dosage Charts. And if you ever have questions or concerns about your child’s illness, the pediatricians at Canyon View Pediatrics are here for you. We can clarify your child’s appropriate dosing for medications, provide recommendations on how to use them, and determine if other treatments, such as antibiotics, are needed as well. And remember to always keep your medications (including those vitamins) in a safe and secure place away from your child’s reach. If you have a concern about accidental consumption, call us right away, or call Poison Control at 1-800-222-1222.

Sarah Tang, MD

Canyon View Pediatrics

Spanish Fork, UT

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