Santa Cruz County Child Health and Disability Prevention Program The CHDP Newsletter A publication of HSA Public Health Children’s Medical Services-Summer 2000 Car Seat Safety Isn’t Just a Cinch Contributed by Katie Le Baron, MPH Perinatal Services Program, County of Santa Cruz Car seat safety - not a whole lot to it, right? Just use one, that's the main message. But according to findings of Safety Belt Safe, USA, a nationally recognized non-profit organization dedicated to child passenger safety; misuse of car seats may be as high as 95%. Based on a 1998 survey of 6,000 installed car seats, the most commonly found errors among users were: ♥ ♥ ♥ ♥ car seat not secured tightly by the safety belt (61%); harness straps loosely fitted (35%); rear-facing seats not reclined at a 45 degree angle (30%); harness retainer clips below or above armpit level (19%). Even the most conscientious parents are making mistakes that could cause significant injury or death to their children in a crash. While health care providers cannot be expected to be "car seat installation experts," having some basic car seat safety information at one's fingertips can help parents evaluate their own level of knowledge and take the needed steps to ensure their child's safety on the road. Here are some questions and answers to assist you in providing important information about car seat safety to your patients: Question: Where is the safest place to install a car seat? Answer: As a general rule, the safest place is in the middle of the back seat. If this is not possible, put the seat in one of the back window seat positions. Children under 10 years old should also ride in the back, especially if the car has airbags. NEVER, EVER put a rear-facing car seat in the front passenger seat in a car with passenger-side front airbags. Infants in this position have been killed by the force of airbags deployed in a crash. Question: How can I tell if a particular car seat is safe? Answer: Car seats that have been in a crash or are older than 10 years should not be used. Unless you know the history of a used car seat, don't buy it or use it; better to invest in a new one or get one through a community loaner program or some other reliable source. Check to make sure the car seat has not been recalled (manufacturer has this information or look up "www.carseat.org" for a list of recalled models and other general car seat information). The five-point harness style is generally recommended over either the T-shield or tray-shield by car seat experts, because the five-point style can be adjusted to safely fit most sizes of children up to 40 pounds, even newborns of five pounds or more. Question: Which is the right seat for the right child? Answer: This is a bit more complicated, but important enough to be worth the time to get it straight. Parents should know the weight of their child and choose the car seat accordingly. Children who are put in seats too big or too small for them are at risk of serious injury in a crash. While there are many different types of car seats, the main difference is rear-facing versus forward-facing seats. Babies up to 12 months and 20 pounds should ALWAYS ride in a rear-facing car seat. This is because babies under a year have relatively heavy heads and weak necks. A forward-facing baby's head is snapped forward during the impact of a crash, causing separation of the neck bones and even "ripping" of the spinal cord, resulting in permanent paralysis or even death. THE CHDP NEWSLETTER SUMMER 2000 By current law, children must be placed in a car seat until four years of age and 40 pounds (SB567 may soon change the age to seven years). If a child's shoulders are above the top setting of the harness slots or if the tips of his/her ears are above the top of the seat, the child has outgrown that seat and must "graduate" to a larger size car seat, a child-seat/booster or a regular booster. If a booster-only seat is chosen, shoulder belts must be used to prevent the child from doubling over and being injured in a crash. Question: How can I tell if the car seat is adjusted and installed correctly? Answer: The most common installation problem users have is not knowing how to secure the car seat tightly with the seat belt. Because there are different kinds of shoulder belts (automatic locking, emergency locking or switchable retractors), parents must find out what type they have and read the instructions carefully or have someone show them how to install the car seat properly. In some cases, the locking clip that comes with the car seat (found on the back) must be used to keep the belt from loosening during normal driving. Some cars have lap belts, especially in the middle position, which makes installation easier. Another common problem is not tightening the harness straps adequately. The harness straps should hold the child firmly against the back of the car seat, with no forward movement possible. Also, the harness clip should be at armpit level to keep the child from slipping out of the harness or being thrown out of the seat in a crash. Rear-facing seats should be installed at a 45-degree angle to keep a baby's head from slumping forward. A rolled up towel under the car seat can be used to maintain the proper angle. If an infant's head tends to flop from side to side, a rolled up receiving blanket can be molded around the head. NOTHING, however, should ever be put around the baby's neck or behind the head, neck or body. Finally: a word of caution. The numerous "after-market" products sold in the stores that claim to increase comfort or security of car seats have not been crash tested, and some of them may actually increase injury to the car seat passenger during a crash. Advise parents not to waste their money on these products and instead, focus their time and attention on getting the right car seat and learning how to install it safely. Good luck in your educational efforts - you may be saving a child's life! Kudos and thank you’s to Dr. Arthur Dover’s office in Watsonville for PAGE 2 encouraging and providing Healthy Families applications to their clients. Unsecured Firearms Common in Homes With Kids One third of US homes with children have at least one firearm and nearly half of them keep the weapons unsecured, a study found. Forty-three percent of such homes kept one or more guns in an unlocked place and without trigger locks, and guns were kept loaded as well as unlocked in 9 percent, according to researchers at Rand Corp and the University of California, Los Angeles. The findings underscore the need to make adults more aware that firearms are accessible to many children and that they need to keep the weapons out of their hands, said Dr. Mark A. Schuster, a UCLA pediatrician and the study’s lead author. The study was reported in the April issue of the American Journal of Public Health, a publication of the American Public Health Association. The issue of children’s access to guns has become a national focus as schools repeatedly become scenes of violence, ranging from the killings at Columbine High School in Colorado last year to a 6-year-old shooting a classmate in Michigan recently. The study used information from interviews of 45,435 households for the 1994 National Health Interview Survey and additional questioning of 19,374 of those households in a supplement that included a section covering firearms, Schuster said. The surveys were administered by the National Center for Health Statistics. Firearms are present in 35 percent of US homes with children—representing more than 11 million homes with more than 22 million children younger than age 18, according to the study. The 9 percent of those homes that keep firearms unlocked and loaded would translate into homes with 1.7 million children, researchers found. Another 4 percent of the home have guns that are unlocked and with ammunition stored nearby. “Thus, a total of about 13 percent of homes—about 1.4 million homes with about 2.6 million children—had firearms stored in a manner most accessible to children,” the report said. Just 39 percent of homes with firearms had them locked, unloaded and stored separately from ammunition, it said. Smith and Wesson, the nation’s largest gun manufacturer, has THE CHDP NEWSLETTER SUMMER 2000 agreed to provide external safety locks on all its handguns within 60 days and internal locks within two years. PAGE 3 For more information, please call: Patty Morelli at 763-8932 Article taken from Santa Cruz Sentinel News, The Associated Press, by Bart Jones Free Immunization Clinic for Children of All Ages! Sponsored by VNA, WIC and AKT-IZ Coalition Monday, June 26th, 2000 2-6PM 1105 Water Street, Santa Cruz Thursday, June 29, 2000 1-5PM 18 W. Lake Avenue, Watsonville Miriam Shipp, M.D., M.P.H, will be presenting a Grand Rounds Talk: Call AKT for more info at 454-4645 “Children Run Better Unleaded” Introducing CHDP Roundtable Discussions th When: Monday, June 19 12:45-2:00pm Where: Watsonville Community Hospital 1st Floor, Conference Rooms 1 & 2 ♥ Learn which children need to be screened for lead poisoning, and about California’s Targeted Screening Plan. ♥ Learn about appropriate treatment and follow-up for lead poisoning in children. Dr. Shipp will also be available by appointment for a limited number of provider office visits the day of Grand Rounds. To schedule call Carol Sparks, Santa Cruz County Lead Program Coordinator, at 763-8937. CHDP Dental Clinic Schedule 2000: In July, CHDP will be continuing our quarterly roundtable discussions with office staff. We want to thank everyone who attended the first roundtable, helping make it a success! It was a great opportunity to meet staff from other offices, and problem solve. Our July presentation: Learn All About the Changes in WIC Eligibility Kelly Kramer, WIC Outreach worker, will be joining us to bring the latest information. Date: Time: Where: Date: Time: Where: Friday, July 7, 2000 (Santa Cruz) 12:30 p.m.-1:30 p.m. 1400 Emeline, Bldg. K., Rm. 207-Santa Cruz Tuesday, July 11, 2000 (Watsonville) 12:30 p.m. to 1:30 p.m. 1430 Freedom Blvd, Watsonville (across from Watsonville Health Clinic) June 24 RSVP: Nancy McDonald at 763-8820. Bring your lunch. Dessert will be provided. July 15th August 12th September 9th Parenting Expo – 2000 th The clinic is held, as always, at the Lutheran Community Church, 95 Alta Vista Avenue, Watsonville Sunday, September 17th at THE CHDP NEWSLETTER SUMMER 2000 PAGE 4 Santa Cruz Coconut Grove (Watch for more info in our Fall issue.) Getting Ready for Lyme Disease Season We’ve heard a lot about Lyme disease in recent years. This infection is caused by bacteria that are spread through the bite of a deer tick (despite its name, this tick is actually carried by mice). Though Lyme disease can be spread during most of the year, the peak times of risk are typically during the late spring and summer months. San Joaquin County Health Department recently identified some new sources of lead in Mexican candy. The candies are popular among Hispanic and Asian children. The candies identified are: Lyme disease often begins with a red circular rash at the site of the tick bite; the rash can last a few weeks, and may be accompanied by flu-like symptoms such as headache, fever, and muscle aches. It’s important to bring this illness to the attention of a health care provider, since early treatment (with antibiotics) can reduce the severity of Lyme disease. However, parents and others who care for children can do much to reduce the risk of Lyme disease in the first place—by simply reducing the likelihood of tick bites. ♥ Pica Limon Candy The first line of defense is to try to avoid areas where the ticks are common. Second, make sure that any ticks that might have become attached are removed. There’s no emergency to doing this, since it takes a couple of days for the disease to be transmitted by an infected tick. The best approach is to conduct a thorough “tick check” at the end of each day. Dog ticks and other relatively large ticks should not be confused with the small ticks that carry this disease. In May and June, deer ticks are about the size and color of a poppy seed, making them difficult to find, but a good place to look is the waist and thigh areas, where they commonly attach themselves. A shower can remove those that aren’t attached, and those that are attached can be removed with a tweezers by grasping the tick as close to the child’s skin as possible and gently, but firmly, pulling it off. Ira Schwartz, PHN and Senior Health Services Manager for the County of Santa Cruz, has stated that in Santa Cruz County, there have been three reported incidences of Lyme disease cases per year. Contributed by Child Health ALERT Volume 17, May 2000 ♥ Pelon Pelo Rico Candy ♥ Limon Candy ♥ Pulpitas Candy In response to the new information on lead in these products, the Food and Drug Association issued a bulletin to hold them at the border for further testing Lucas powders are also popular among Hispanic children. This Snack food contains very small amounts of lead, but also contains large amounts of salt, which can cause dehydration. According to health officials, the high salt content of Lucas powders is a greater health hazard than the lead content. Carol Sparks, Lead Program Coordinator Lynne Wittenberg, Health Educator Targeted Screening Journal Article An article on lead poisoning appeared in the April 1st issue of the Medical Board of California Action Report. The article is a summary of the California Department of Health Services recent statewide Targeted Blood Lead Screening Policy, and is titled “New State Policy on Blood Lead Screening Can Help Provider Find More Children with Lead Poisoning.” Enclosed in this newsletter is the “Practitioner Reference Card”, which was published with the article. Call Carol Sparks at 763-8937 for additional copies. Please note under “Up-Coming Events” (page 3), the Children Run Better Unleaded talk at this month’s Grand Rounds on 6/19, presented by Miriam Shipp, M.D. THE CHDP NEWSLETTER SUMMER 2000 PAGE 5 You may reach the Growth and Opportunity Program at 722-3337 and the Pajaro Valley Program at 728-6955. Norene Bailey, PHN, CHDP Program Nurse Nurse’s Corner CHDP PROVIDERS: “It’s Migrant Head Start Time, Again……..” The Migrant Head Start Programs provide a myriad of services to many of our families, the biggest being l2 hours of childcare, Monday through Friday, to families who are working in the fields. In addition to childcare, the families receive parent education, dental education and treatment, nutritional counseling, and the children receive a wonderfully enriching pre-school experience from a dedicated, trained staff. In addition, if a child is identified with a special need, such as speech therapy, this is also provided to them. Children ages 3 months to 5 years are eligible to be enrolled in the program and the families must meet the Migrant Program requirements. Unlike the Head Start Program, the Migrant Program normally operates from April 1 to October 30, the length of the growing season here in Pajaro Valley. There are currently two separate programs operating in Santa Cruz County. Growth and Opportunity provides childcare for 350 children in 40 family day care homes and one center and has a staff of approximately 70. The second program is run by the Pajaro Valley School District, which serves 320 children in 14 family day care homes and 12 centers, and has a staff of approximately l00. Things you need to be aware of when doing CHDP exams for these children: 1) The Program mandates annual exams for children 3 years and older and annual TB and anemia testing for all children. So please do these, if requested. The date of service must be exactly one year from the prior date of service. 2) The family will be bringing the CHDP Head Start forms with them to their appointments. Please make sure that the Head Start grantee number is noted in the lower right hand corner of the PM l60. If it is missing, you may call the appropriate Head Start office to request this information. 3) Please return the goldenrod copy to the Head Start Program. They are required to have a copy of the exam in their records. Measles Comes Home (Various Times) to Santa Cruz County Santa Cruz County residents travel the globe for pleasure and business. An unintended consequence of leaving town for some persons has been to become exposed to measles and then carry home the virus to expose others. Some exposed persons in this county are susceptible and then become locally acquired measles cases. Sound improbable? It’s true! In 1999, two persons traveling to Asia returned home and to a home-schooling environment wherein several students (as well as the travelers) had not been immunized. Four others who had not traveled but who were exposed by the travelers developed measles, for a total of 6 persons in this cluster of cases. Earlier in 2000, some one traveled to a business meeting in Nevada that was attended by many persons, including several who had arrived recently from overseas areas that had ongoing measles problems. The local resident thought he’d been immunized, but the records were not in his possession. He became ill with a rash about two weeks after attending the meeting. The measles cases in both 1999 and 2000 were confirmed by laboratory analysis. Local physicians are the indisputable most important assets for prevention of measles. The immunization and counseling opportunities that occur during childhood and adolescent office visits can make the population less susceptible to measles. Physicians who suspect measles and report to the Health Services Agency can help initiate efforts to control an outbreak from disseminating to susceptibles. Physicians who are interested in materials (guides to differentiating between THE CHDP NEWSLETTER SUMMER 2000 rash illness, tools to help track immunization status, etc) can call the Immunization Program at 454-4646. PAGE 6 Contributed by Linda Kerner, IZ Coalition Contributed by Ira Schwartz, PHN, Senior Health Service Manager of County of Santa Cruz Health Care Provider Immunization Resource Packets Available from All Kids By Two All Kids By Two Immunization Coalition Mobilizes County-Wide Celebration of National Infant Immunization Week And Toddler Immunization Month All Kids By Two Immunization Coalition would like to thank the community of Santa Cruz for supporting the coalition’s efforts to promote National Infant Immunization Week (NIIW), the third week in April and Toddler Immunization Month (TIM) in May. Child care providers, health care providers, local business owners, and programs serving families with young children all joined together to get the message out to parents to “Immunize – On Time- Every Time!” AKT Coalition Coordinator, Linda Kerner, was kept busy responding to requests from the community for Dr. Seuss immunization posters to display in childcare centers, clinic waiting rooms and employee break rooms. Magnets, stickers, AKT brochures and other childhood immunization resources were also in high demand. AKT and Mid Coast Visiting Nurse Association combined efforts to offer free children’s immunization clinics at local WIC Program sites in Santa Cruz and Watsonville. In addition, AKT received proclamations from The County Board of Supervisors, and the cities of Watsonville and Santa Cruz designating the third week in April, National Infant Immunization Week and the month of May, Toddler Immunization Month. The tremendous countywide response in support of NIIW and TIM truly demonstrates that our community cares about the health of our youngest children. However, our guard must not be let down when Toddler Immunization Month is over. There still is plenty of work to be done to achieve the coalition’s goal of 90% of “all kids by two” up-to-date with their childhood immunizations*. If you are interested in becoming a member of AKT and joining in the Coalition’s efforts to protect and promote the health of children in Santa Cruz County, please call Linda Kerner at 454-4645. All Kids By Two Immunization Coalition has developed resource packets for health care providers to share the latest information on childhood immunizations and vaccine-related issues. Packets include several new resources developed by the Centers for Disease Control and Prevention including the following: ♥ A Guide to Contraindications to Childhood Vaccinations: A handy spiral bound guide designed to help providers decide what common symptoms and conditions should be considered contraindications to vaccination and which ones should not. ♥ What You Need To Know About Vaccine Information Statements (VISs): An informative booklet providing information on federal and state provider responsibilities for use of VISs and recording requirements. The booklet also includes frequently asked questions about VISs and camera-ready copies of current VISs. ♥ Six Common Misconceptions About Vaccination and How To Respond To Them: This booklet addresses misconceptions that are often cited by concerned parents as the reasons to question the wisdom of vaccinating their children. Included are accurate rebuttals to not only ease parents’ minds on these specific issues but also to discourage them from accepting other anti-vaccine “facts” at face value. Also included in the resource packets is a list of free resources available to help promote childhood immunizations, including reminder post cards, magnets, stickers, brochures on specific immunizations and many other items. The packets also include a new form, Immunization Record and History, created by the Department of Health Services, that can be placed in the front of medical charts for easy access to a patient’s immunization record. If you would like to receive a resource packet, contact All Kids By Two at 454-4645. Contributed by Linda Kerner, IZ Coalition THE CHDP NEWSLETTER SUMMER 2000 PAGE 7 *See “Up-Coming Events” on Page 3 about a free IZ Clinic on June 26 and June 29th, 2000. An Infant with Hearing Loss? What to do next….. Arts and Crafts Safety Working with “arts and crafts” is an important source of enjoyment and learning for children. However, because these materials may occasionally contain toxic solvents and other harmful ingredients, adults often have concerns about whether the materials they provide children are safe. The Art & Craft Materials Institute (ACMI), an association sponsored by art and craft suppliers, have developed an updated list of the many hundreds of products that are authorized to carry a seal that indicates they have met specific standards of safety. The ACMI also has published a booklet call “What You Need to Know About the Safety of Art and Craft Material”, which reviews a variety of issues concerning the safety of these products and explains how the federal labeling law applies to art and craft materials. Both the list and pamphlet are available free of charge by sending a #10 (business size) envelope with $.33 postage on it to: Art and Craft Materials Institute, Inc. Attention: CHA Request 80 Main Street Hanson, MA 02341-0479 Contributed by Child Health ALERT, Volume 17, May 2000 Migrant Head Start Growth and Opportunity announced that as of March 2000, their agency has received $20,000 in revenue for assisting families with MediCal– Healthy Families applications. Good going, guys! With the California Newborn Hearing Screening Program, more newborns with a hearing loss will be identified. By 2003, it is estimated that in the state of California, 1,800 newborns will be identified as having permanent significant hearing loss. These 1,800 children will join the 2 million deaf and hard of hearing individuals who currently live in the United States. Early identification is important in order for families to receive immediate benefits from support services. After a newborn is identified as having a hearing loss, families have a lot of decisions to make and many questions that need to be answered. To help families answer these questions; here are some important resources: ♥ Early Intervention Program-Through your County Office of Education, Special Education Department. This program is available for deaf and hard of hearing infants and toddlers age birth to 3. Call: 831-476-7140 ♥ Deaf and Hard of Hearing Service Center, Inc. (DHHSC) 330 Pajaro Street, Suite B, Salinas, CA 93901 831-753-6540 -Voice 831-7536541 TTY 831-753-6542. FAX or [email protected] ♥ Deaf Counseling, Advocacy, and Referral Agency, (DCARA) 14895 East 14th Street, Suite 200 San Leandro, CA 94578 510-209-6770 Voice/TTY San Jose Outreach Office www.dcara.org ♥ The American Society for Deaf Children – a resourceful website about deaf and hard of hearing children: www.deafchildren.org DHHSC and DCARA both provide the following services to deaf and hard of hearing individuals of all ages, their friends, families, and service providers; information and referral; communication assistance; advocacy; independent living assistance; employment assistance; peer counseling; and community education. Call today and receive the information that you need to answer any questions that you may have. Contributed by Rosemary Wanis, MSW, Outreach Director, DHHSC THE CHDP NEWSLETTER SUMMER 2000 Naomi Lobell has joined Children’s Medical Services as CCS PHN III. Naomi supervises the CCS case management team and replaces Barbara Rice, who accepted a position with Health Services Agency Field Nursing and Women’s Programs. (Best Wishes to Barbara!) Naomi obtained her nursing degree from Saddleback College, and her Bachelor of Science from San Jose State University. She has experience working in home health, acute care, and public health. She comes to CCS from Planned Parenthood where she worked in Family Planning and Reproductive Health Care Services. PAGE 8 You may have noticed, we have included a “Parent’s Corner” at the very back of the Newsletter. Each quarterly edition will include an article helpful to our families. We invite you to copy and distribute the article to your families. Contributed by Carol Kerfoot, LCSW, Senior Health Services Program Manager, CMS . Acknowledgement The CHDP Program wishes to acknowledge Dr. Robert Crook for the many years of dental services he has provided to the children of the CHDP Program. Dr. Crook has been practicing dentistry in Watsonville for more than 20 years and has recently gone into semiretirement. For this reason, he will no longer be providing treatment to our CHDP children. He has been a great asset to our Program. Thank you, Dr. Crook. We wish you well. The CHDP Staff CHDP Newsletter Staff: Editor: Elaine Glenn, PHN, CHDP Deputy Director Formatting: Patty Morelli, CHWII Contributors: Norene Bailey, RN, PHN Carol Kerfoot, LCSW Nancy McDonald, RN, PHN Carol Sparks, PHN, MPH Lynne Wittenberg, MPH Ira Schwartz, PHN Linda Kerner, IZ Coalition Rosemarie Wanis, MSW If you have any questions or contributions regarding our Newsletter, please call Elaine Glenn at 831-454-4772. ….and remember to fly a kite with a child this summer. THE CHDP NEWSLETTER SUMMER 2000 Summer is a season when children spend more time outdoors, but that doesn’t mean that there aren’t plenty of things to do that are both fun and educational. Few materials are as appealing to young children as playdough. Children enjoy playing with gooey things, and at the same time these materials can be highly educational because they meet children’s needs in four areas of development: physical, cognitive, emotional, and social. Physical Development: When children squeeze and mold playdough and other gooey materials, they are also working to develop their small muscles which they will later use for holding pencils and pens, turning pages in a book, or pressing the keys on a computer. Cognitive Development: Children who watch the changes in forms produced by rolling, dripping, squeezing, or pounding gooey materials begin to understand chemistry and physics—some of the principles of how our world works. In talking about their play, they get to practice words as they describe their experiences. Emotional Development: For many children, playing with gooey things can be a calming activity; it feels great to a young child to sense the coolness or smoothness of these materials, and to have adult permission to play with something “nicely messy”. Also, it’s a relief to young children simply to be able to play (enjoy the process!) and not to have to always make something (end up with a product!). Social Development: As children play with gooey things, they engage each other in conversation and get to practice sharing their excitement. “Look at my playdough!” “It looks like an apple pie!” or “You can sit next to me: I’m squeezing my playdough out as long as yours!” The combination of fun and educational values make playdough a terrific indoors PAGE 9 activity for young children in the summertime (or for that matter, any time of the year). Playdough and similar materials are widely available in stores, but here are recipes that can save money. Playdough Recipe: 2 cups flour 2 cups water ½ CUP SALT 2 TBLS vegetable oil 1 TBLS cream of tartar food color (optional) Mix all ingredients together in heavy saucepan until all lumps are gone. Heat mixture over medium-high burner, stirring constantly with a wooden spoon. Mixture will begin to thicken and form big lumps. Stir like crazy! When mixture is as clumped as you can get it and it resembles “wet” scrambled eggs, it is done. Dump warm mixture out onto clean surface (Formica is good). Allow to cool a bit while you clean the pot and spoon. Then begin to knead the playdough. DO NOT ADD FLOUR. Have faith; the playdough will become less sticky as it cools while you knead it. Thoroughly cool before storing in airtight container. “Oobleck” Recipe: 1.5 cups cornstarch 1 cup water Food color (optional) Mix the ingredients and allow children to play with the mixture. When “pushed” together, the mixture will appear dry and solid; as children let go of the mixture, it flows like a smooth liquid. Contributed by Mary Ucci, , A. B., M.Ed., Child Health ALERT, Volume 18, February 2000 THE CHDP NEWSLETTER SUMMER 2000 ü Standardized IZ Terms CHDP Child Health and Disability Prevention Program PO Box 962 Santa Cruz, CA 95061 (831)-454-2560 ~ (831)-763-8933 Look Inside! ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ Getting Ready for Lyme Disease Season Arts and Crafts Safety “It’s Migrant Head Start Time, Again….” Measles Come Home to Santa Cruz County National Infant IZ Week Celebrated Locally What’s New in Lead?…. Infant Hearing Loss Unsecured Firearms in Homes Parents Corner: “Playdough” Inserts: ü BLL-Practitioner Reference Card PAGE 10
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