Kelly Fradin MD

08/10/2025

I'm itchy - which means that you and your kids must be too. :-)

Eczema is commonly referred to as the "itch that rashes" and often xerosis or itchy skin without a rash is simply a mild form of eczema or atopic dermatitis. This is much more common when the skin barrier is weakened and can be triggered by temperature changes, irritants such as sunscreen, sweat, salt water, chlorine or detergent/soap.

It is important to treat the itch because it can disrupt sleep and the act of scratching can release more histamine causing worsening itch and sometimes predispose to infection.

Identifying the root cause and eliminating it can help - it's especially easy to eliminate fragrant soaps.

But sometimes it's impossible to avoid - ie. sweat. In these situations building up the skin's barrier will help to sooth the itch and prevent further inflammation.

To restore the skin barrier and sooth itch - moisturize!

After a short shower with mild soap and lukewarm water, pat dry and immediately grease up with a cream (typically comes in a tub / not a pump) or an ointment (vaseline / aquaphor). You should stay shiny even after 2-3 minutes.

Simple - but we know when the skin barrier is stronger it will be more resistant to irritants.

Have you tried this or had difficulty with your kids scratching and itching recently?

09/11/2024

Today a bit of a different message - I know I have a ton of pediatricians and pediatric trainees who follow my account. Thanks so much for your interest in my content... Today's message is mostly for those health professionals about the American Academy of Pediatrics's election for their new president. This role - leading more than 60,000 american pediatricians is an important one setting the agenda for public policy relating to children's health.

I have had the good fortune through my career to consider Dr. Andrew Racine to be a mentor. He is so smart and thoughtful, I could not have imagined anyone better to help me learn to be a pediatrician and now adjust to leading a health startup.

With a background in healthcare economics and as a leader of CHAM/Montefiore Medical center he understands the problem with scaling good pediatric care in markets that have social healthcare needs and depend on medicaid as payers. He understands the need to treat behavioral health needs in the medical home and in the power of preventive healthcare to support families.

Not only is he brilliant, but he's also a kind and lovely human. When I caught up with him this summer about what he would do if given the chance to serve as the leader of the aap, I was truly so excited by the potential to see his impact grow as a national leader of pediatricians.

So, my friends and colleagues who are members of the aap - please dig out your password, go to https://forms.aap.org/vote/ and let's make this happen.

If elected, Andrew D. Racine, M.D., Ph.D., FAAP, plans to use his influence to seek federal legislation to strengthen major drivers of child health, including Medicaid, the child tax credit and universal free preschool.

09/08/2024

08/17/2024

🦵🏽Growing Pains🦵🏽

15% (+/-) of children experience growing pains significant enough to require evaluation.

It’s amazing that more children don’t when you consider how fast they grow!

What are growing pains?
We actually DON’T KNOW, but ❌not growth. More likely they are muscle cramps. Pains are ❌not always during periods of rapid growth and ❌ not more common in taller children.

😢Growing pains tend to be:
symmetric / bilateral / both sides
Most common 4-5 years old with a range from 3-9.
Worse at the end of a busy day or at night.
Felt in the legs, particularly after intense activity.
Intermittent - most commonly they occur for a cluster of 3-5 days, then go away, then can come back lasting up to 3 months.

🛑The tricky thing about “growing pains” is that children with pain can have other serious medical problems that we don’t want to miss. 👩🏻‍⚕️ If you aren’t sure what’s going on and your child has pain please seek evaluation from your doctor.

🚩These features warrant further investigation (as it might be something else):
👀Something you can see - a rash, redness, swelling, or an abnormal gait.
🌡Something you can measure - Fever, weight loss.
😫Pain that is interrupting activity, severe, on one side, in the joints, or in the groin or back.

Growth pains typically improve with:
💪🏻Massage and stretching legs
♨️Heating pad or warm bath
💊Tylenol or Motrin along with adequate hydration.
🦴Consider if the child has adequate calcium, vitamin d.
🛁Consider magnesium, either via Epsom salts in a bath or as a supplement such as a powder.

Have your kids had growing pains? What helped?

08/12/2024

👅When to think strep🤒

As a parent, it can be confusing to decide whether or not your kid’s throat pain warrants a visit. These symptoms suggest strep:
🤮Belly pain or vomiting.
😵Throat pain and headache.
🤒Fever without significant cough or congestion.
😬Tender swollen lymph nodes in the neck.
🥵A scarlitiniform rash (think pale pink sandpaper).
👿Palatial petechia (purple spots on the roof of the mouth - if there very specific for strep but not always there if it is strep). See my stories for pictures.

We do not want to test children without symptoms suggestive of strep. 15-25% may test positive but just be carriers of the bacteria - not sick or at risk of rheumatic fever.

Testing on day 1 of throat pain can often be misleading, because day 2-3 cough and congestion can occur suggesting another source, but if you "caught" strep on the swab you can be stuck treating it.

❌ Mostly, the way the throat and tonsils look isn’t helpful at knowing whether or not it’s strep. Viruses especially mono/EBV can give you terrible looking throats.

💊Antibiotic treatment for strep reduces symptoms by about a day, reduces the complications, and reduces how contagious you are. But the real reason to treat it is to prevent rheumatic fever and the ❤️consequences in children over age 3.

🤯 Rheumatic fever is a dangerous complication of strep that can affect the brain and heart. Treating before day 5 can prevent it. Scarlet fever is just a little rash that happens often with strep and not a big deal. Everyone gets these mixed up.

👶🏻Because of this testing kids under 3 can be helpful sometimes as part of an evaluation to know what’s wrong or when the risk of strep throat is high, but isn’t AS important because for whatever reason they don’t typically get rheumatic fever. Best to ask your doctor.

Having strep often, more than 7 times in a year or 5 times two years in a row can be an indication to get the tonsils out. But it’s important to know it’s real strep not just a carrier.

Questions? Do your kids get strep often?

06/08/2024

I am a day late but it’s important!

04/10/2024

Today is an exciting day! Advanced Parenting, my paperback, is finally out! I couldn't be more grateful for the support of my husband, editors, and colleagues who helped me bring this book to life.

It wasn't easy to write a book while launching a healthcare startup and raising two kids. I wrote and revised most of the content in the early hours of the morning or late at night. But the hard work paid off when I read the comments from those who entered my Instagram giveaway. A few of them had read my book at the library and wanted their own copy to reference at home as they navigated their journey with children with Cancer, Cerebral Palsy, or ADHD/ASD. It's humbling and amazing to know that my book is helping families in need.

I hope that Advanced Parenting can help even more parents feel prepared and confident as they lead their families through challenges. If you haven't already, please check it out and spread the word. You can find it here: https://a.co/d/fXVq9Zt

02/14/2024

How to identify misinformation in parent research

I enjoyed speaking with about how parents can get overwhelmed and distracted by misinformation when trying to navigate their children's health challenges.

Check out the podcast we recorded (link in stories / on my substack) and let me know your thoughts.

Despite being a pediatrician, as a parent I have fallen down internet rabbit holes about crib mattresses, miralax, and supplements. And I'm curious where you've encountered misinformation.

Fear-mongering is another topic we cover... so much parenting content out there makes you think as a parent you're incapable without ... the help of whatever they are selling you.

Hope you'll listen!

12/03/2023

❤️ Last night I celebrated 40! It’s a particularly special birthday for me because I met my husband at 20 so we have been together half our lives! Med school, his business school, 2 kids, 1 schnoodle, 2 books, 2 careers and all the celebrations, trips, fantastic fun, and challenges too. I feel so grateful to be sharing life with him and to have the thousands of you following along too ❤️ excited for the next 40 years.

12/01/2023

I have had a lot of parents reach out worried about the news reports that trickled in about children being sick in China.

This prompts a lot of fear in many given the trauma that we all went through with COVID. However, I would like to share my opinion that there is no flag to cause additional concerns.

Some news media would have you think we have no data, but the China cdc just like the American cdc published weekly influenza like illness trackers for the various provinces. I translated these and reviewed them and they are remarkably similar to what we have seen in the US.

Every year before the pandemic there are peak times when respiratory illnesses, mostly RSV/flu flood Children’s hospitals. We are pretty much there in NYC now and the southeast peaked a few weeks ago. Some areas on China are already on the down trend whereas some areas are peak now.

Immunity debt does seem to be a thing in practice. The idea that most kids missed 6-12 respiratory illnesses due to pandemic lock downs means that the following 1-2 winters they have an extra few illnesses on top of the 6-8 viruses most kids get every year. Getting things for the first time is always worse than subsequent years.

Mycoplasma has always caused pneumonia in school age children and tends to surge every 5ish years and I suspect this is a surge year as I have seen more pneumonia already in NYC than an average year prepandemic.

All to say I wouldn’t worry. What questions do you have about this?