Preparing For A Visit With The Pediatrician

Regular visits to the pediatrician are a key part of preventive health care. At each visit, the pediatrician, pediatric or nurse practitioner will fully examine your child. This checkup will give your child’s pediatrician a chance to: 

• Make sure your child is eating well, growing well, and is healthy. 
• Update immunizations. 
• Track your childís growth and development. 
• Find physical problems before they become serious. 
• Help inform you on how to keep your child healthy and safe. 
• Answer all of your questions. 

Infants and children need frequent checkups during the frst 24 months of life. After 2 years of age most children do not need regular visits as often.

Your pediatrician will schedule visits based on your child’s own needs. Ask your pediatrician how often your child needs a checkup. 

Make sure you write down any questions you have before each office visit, so that you do not forget to ask them. Keep up-to-date records on your child’s growth and immunizations. Bring this information with you to each visit.

Asthma Management, What Can Parents Do?

Written by: Dr. Bridget Sweeney-Gotsch.

An important part of asthma management, is letting the doc know what causes your child’s asthma to flare up. It is important because your pediatrician can help prevent symptoms before they start. 

These triggers can be found everywhere. At school, on the playground, on the soccer field or even in and around the home. And that is because allergens like pollen, dust mites, pet dander, mold as well as environmental exposures such as cigarette smoke, strong perfume and cold air can trigger asthma.

I often tell parents to be a “detective” at home and keep a list of triggers which cause their child’s asthma to flare up. Common triggers are:

• Pollen
• Dust mites
• Pet dander
• Mold
• Cigarette smoke
• Exercise
• Cold air

If any of these triggers cause your child’s asthma to flare up, it is important to let me or Dr. Betancourt know during your next visit.

It is also important to keep a list of what happens when your child comes in contact with these triggers. Some common symptoms are:

• Coughs
• Wheezing
• Shortness of breath
• Uses a reliever medicine (an inhaler) more than 2 days a week

Plan a visit with Dr. Betancourt or me to review the list of triggers and list of symptoms. We can help you with a treatment plan that can help prevent asthma symptoms. Moreover, we can help manage triggers so that your child has fewer asthma symptoms.

Keeping your pediatrician aware and informed of which triggers cause your child’s asthma flare-ups can help us prevent symptoms before they start. And that could help your child enjoy a more active life with fewer missed days of school.

Gift For a Soon To Be Mom

"As a gift for a soon to be new mom, what do you suggest I could get for her set up the area where she will be breastfeeding? Her first child is 5."

Mothers are able to nurse just about anywhere which is one of the many benefits of breastfeeding.  After the first few weeks as she and the baby get to know one another and become a team, nursing often becomes second nature and many moms report feeling comfortable  with and being able to nurse discreetly just about anywhere.

However, since you are going to be helping her set up a place in her home for breastfeeding,  I would start with a comfy chair or love seat ( rockers, gliders work well too) and  a place next to the chair ( like an end table or some other type of table just so it is in moms reach) to set a glass of water or juice, burp cloths, receiving blankets, extra diapers,  and a telephone so that every time it rings, she doesn't have to get up . She will want to include her 5 year old as much as possible and this older sibling may need some special mom time or just to feel close. It would be nice if the area could accommodate some books or small toys for her 5 year old.

A foot stool or ottoman is nice for mom to put her feet up on and many mothers find this comfortable.  Medela makes a Nursing Foot stool which really adds comfort to a mom’s position if she is nursing sitting up and it is reasonably priced as well.

Nursing pillows are a nice addition and the type I recommend are The Boston Billow, My Breast Friend and the Boppy.  But honestly sometimes regular bed pillows work just as well.  There is not one perfect pillow and really it depends on the mother's comfort and her personal preference.

I would wholeheartedly encourage any mom considering breastfeeding to meet with a lactation consultant prior to having the baby to address any questions, concerns or special needs the mom may have.  Additionally, a lactation consultation in the first few days and weeks after the baby is born can really help to prevent so many common breastfeeding problems from occurring. 

 Written by:

Colleen McKeown RN, IBCLC 
Lactation Consultant- Salud Pediatrics

Making the Right Healthy Food Choices

I have many parents that come to our clinic with concerns about their children’s weight. They complain that the children only snack on unhealthy things like chips and cookies and they don’t like to drink water or milk but rather drink sodas. 

I often ask parents, where do they get all this junk food and drinks? And they grin or smile back with a little bit of culpability because they know where I’m going with the question.  Parents buy all this stuff and put in the pantry. So, it isn’t a big surprise that the child prefers the junk food over the healthy foods.

It is no secret that if you give a child a choice between an apple and a chocolate chip cookie, most kids are going to prefer the cookie. 

A big part of living lifestyle is making the right food choices. And the responsibility lies within the parents, not the children, because the parents are the ones that make the food buying decisions.

The HealthyChildren.org site in an article provided some good guiding principles to keep in mind when planning and preparing meals for your family.

• Vegetables: 3-5 servings per day. A serving may consist of 1 cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, chopped raw or cooked.

• Fruits: 2-4 servings per day. A serving may consist of 1/2 cup of sliced fruit, 3/4 cup of fruit juice, or a medium-size whole fruit, like an apple, banana, or pear.

• Bread, cereal, or pasta: 6-11 servings per day. Each serving should equal 1 slice of bread, 1/2 cup of rice or pasta, or 1 ounce of cereal.

• Protein foods: 2-3 servings of 2-3 ounces of cooked lean meat, poultry, or fish per day. A serving in this group may also consist of 1/2 cup of cooked dry beans, one egg, or 2 tablespoons of peanut butter for each ounce of lean meat.

• Dairy products: 2-3 servings per day of 1 cup of low-fat milk or yogurt, or l'/2 ounces of natural cheese.

Of course, the idea is not to overwhelm your children with a drastic change. However, little by little you can make a difference. For example, if your children are eating chicken, it is better to “choose” to eat a baked or grilled chicken instead of a fried piece of chicken. Or when looking to a snack, consider pretzels or plain popcorn instead of potato chips.

Keep this in-mind when going to the grocery store next time. And remember making healthy food choices is part of raising a healthy child.

Written by: Joanna E. Betancourt MD., FAAP

Photo Credit: by lindaaslund

Success, One Child at a Time.

As you may know, First Lady Michelle Obama has decided to tackle a very important health issue that is affecting children in the US. That issue is Obesity. 

I’m glad she is bringing awareness with her “Let’s Move!” (http://www.letsmove.gov/) campaign because the data is staggering.

In America, more than 1 in 3 children and adolescents is overweight or obese. According to the U.S. Surgeon General, obesity in children under age 11 has tripled since 1980 from 6.5 to 19.6 percent, and obesity in adolescents (ages 12-18) went from 5 to 18.1 percent. Weight is the No. 1 health issue facing US children today, and with "data for adults suggesting that overweight prevalence has increased by more than 50 percent in the last 10 years” it is imperative that we address this issue.

In 2006, at age seven, we diagnosed a patient in our office with obesity. As part of our comprehensive care, we coordinated services with a nutritionist and a endocrinologist. The patient was showing signs of high insulin; which usually precedes the development of diabetes among other health concerns.

Four years later, countless visits to the endocrinologist, and numerous consultation with nutritionist, her BMI (body max index), which was above the 95^th percentile, came down to the 75^th percentile.

Today, I saw the patient in my office again where I shared and celebrated the progress she had made. After seeing her I felt, that after all, what we do is worth it.... 1 kid at a time!  Because of her progress and the effort of the clinical care team, the patient has a much lower risk of developing diabetes and a much higher chance of being a healthy adult.

Just like we ought to bring awareness to childhood obesity, we should also bring awareness to the children and their families that have worked hard to lose weight and adopt healthy lifestyles by celebrating their successes. Good for her and her family! Lots of hard work! But it is paying off.

Thank you to all of you who help educate our patients and help them make appointments with specialists, call parents for f/u, etc.....it does pay off! One child at a time.

Written by – Joanna E. Betancourt MD., FAAP