Vaccinations

Well Child Office Visits

Childhood Emergencies

Poisoning

Common Childhood Problems

Problems that May Require Extra Consultation

Suggested Readings

Vaccinations

2009 Child and Adolescent Immunizations Schedule

For Ages 0 - 6 Years	For Ages 7 - 18 years

Vaccine Safety

We are aware of the many parental concerns about the safety of vaccines in childhood. The following website is authored by the American Academy of Pediatrics and provides excellent research based information about childhood immunizations, www.aap.org/family/tippmain.htm

Vaccine Information Statements (VIS)

Vaccine Information Statements (VISs) are information sheets produced by the Center for Disease Control and Prevention (CDC) that explain to vaccine recipients, their parents, or the legal representatives both the benefits and risks of vaccine,
www.cdc.gov/vaccines/pubs/vis/default.htm

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Well Child Office Visits

Keeping the well-child well is one of the major goals of pediatrics. During a well-child visit, we are mainly concerned with observing growth and development, counseling and teaching parents, early detection of illness through screening exams and laboratory tests, immunizations and getting to know one another. Therefore, we recommend routine visits as follows:

These periodic visits give you a chance to ask questions about your child’s behavior and physical development that concern you. It helps to write questions down. During a sick-child visit, we limit our counseling to the problem at hand.

Childhood Emergencies

It is rare for children to become seriously ill with no warning. Depending on your child's symptoms, you usually should contact your child's pediatrician for advice. Early recognition and treatment of symptoms can prevent an illness or injury from getting worse or turning into an emergency.

What is an emergency?
An emergency is when you believe a severe injury or illness is threatening your child's health or may cause permanent harm. In these cases, a child needs emergency medical treatment right away.

Emergencies can result from medical (or psychiatric) illnesses or injuries. Your child may show any of the following signs:

Read more www.aap.org/family/tipp-ems.htm

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Poisoning www.poisoncontrol.org

Poison Control may be contacted 24 hours a day, 7 days a week at 1-800-222-1222. They carry detailed information regarding ingestions and treatment. Save any containers or any material that is left in the container for us. Give us the name of the product and its contents.

Keep SYRUP of IPECAC on hand, but do not use unless instructed by a physician or poison control. It can be obtained over the counter at any drugstore.

Do not induce vomiting if your child:

1. Is unconscious
2. Is having convulsions
3. Has swallowed kerosene, gasoline, furniture polish or lighter fluid
4. Has swallowed lye or toilet bowl cleaner, or other caustic ingredients

If your child has SWALLOWED LYE:
Give milk, water, orange juice, grapefruit juice or vinegar (one teaspoonful in a glass of water).
If your child has SWALLOWED ACID:
Give milk, water or beaten eggs
If your child has INHALED A POISONOUS GAS:
Carry him or her to fresh air. Apply artificial respiration if breathing has stopped. Keep the child quiet and warm.
If a TOXIC SUBSTANCE IS ON CLOTHING AND/ OR SKIN:
Remove contaminated clothing and rinse the area thoroughly with water. Wear rubber gloves if they are available.
IF IRRITATING SUBSTANCES GET INTO THE EYES:
Hold the eyelids open and wash with gentle stream of running water immediately. Remember, the best prevention is locking up your medicines and household cleaners to keep them out of reach.

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Common Childhood Problems

Asthma and Allergies (AAP) www.aap.org/healthtopics/asthma.cfm

Colds
Colds that involve a runny nose or congested nose or mild cough can usually be handled at home. Also some newborn babies have nasal mucous which can make it difficult for them to breathe through their nose. We prefer saline in each side of the nose followed by suctioning thoroughly with a bulb. They may be used four times a day for about 3 days. A cool mist humidifier can also be used at the bedside. Your baby may breathe more comfortably with the head of the bed elevated. Never elevate your baby’s head with pillows. Occasionally, you may give your infant oral decongestant drops, however, we recommend that you discuss this with your pediatrician first.

Cough
Over the counter medicine such as Robitussin may be helpful. For fever with severe cough call the office.Please check with our office staff for specific over the counter medication and dosages.   

Vomiting and Diarrhea
Vomiting may occur for any reason. If it is forceful or persistent, you will need to notify your pediatrician. When vomiting occurs stop giving formula and begin small frequent feedings of Pedialyte for no more than 12 hours. In most cases vomiting will stop without treatment. Once your baby tolerates the clear fluids, you may advance to half-strength formula as directed by your physician.

An occasional loose stool may be normal. However, if there is a sudden change in bowel pattern, such as stools that are loose, watery, or increase in frequency, then your baby may have diarrhea. Diarrhea is a symptom and we will need to be informed. Again, you may begin Pedialyte for 12 hours and then advance to half-strength formula. If breast-feeding, you may continue to breast feed and give Pedialyte between feedings.

Ear Infection
Ear infections are common in infants and children under the age of 3. Ear infections occur following symptoms of a cold, cough, and runny nose. Typically, infants will develop fever, fussiness, poor sleeping and decreased appetite. Your child would need to be examined to determine the presence of an ear infection.

Fever
Fever is a body’s response to an infection or illness and not an illness itself. Therefore it does not always need to be treated. Generally a temperature greater than 101 degrees rectally should be treated with one of the following medicines every 4 hours.

Tylenol
Motrin

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Problems that May Require Extra Consultation

Please let our office know the nature of the visit so that adequate time can be allotted.

1. Bedwetting
2. Poor School performance
3. Behavior Problems
4. Learning Disabilities
5. Hyperactivity
6. School phobias or other phobias

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Suggested Readings

The First Twelve Months of Life , Frank Caplan, ED

Families, Patterson (about behavior modification)

Your Child’s Health, Barton Schmidt

Feed Me, I’m Yours, Vicky Lansky

Child Health Encyclopedia

Caring for Your Baby and Young Child, Stewart Shelov, MD

New Mother's Guide to Breastfeeding, Joan Meek, MD

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