Well Child Visits.
Childhood is a time of rapid growth and change. Children have more well-child visits when they are younger. This is because development is faster during these years.
Each visit includes a complete physical exam. At this exam, the health care provider will check the child’s growth and development in order to find or prevent problems.
The provider will record your child’s height, weight, and other important information. Hearing, vision, and other screening tests will be part of some visits.
Even if your child is healthy, well-child visits are a good time to focus on your child’s wellness. Talking about ways to improve care and prevent problems helps keep your child healthy.
At your well-child visits, you will get information on topics such as:
What to expect as your child grows
Write down your questions and concerns and bring them with you. This will help you get the most out of the visit.
Your provider will pay special attention to how your child is growing compared to normal developmental milestones. The child’s height, weight, and head circumference are recorded on a growth chart. This chart remains part of the child’s medical record. Talking about your child’s growth is a good place to begin a discussion about your child’s general health. Ask your provider about the body mass index (BMI) curve, which is the most important tool for identifying and preventing obesity.
Your provider will also talk about other wellness topics such as family relationship issues, school, and access to community services.
There are several schedules for routine well-child visits. One schedule, recommended by the American Academy of Pediatrics, is given below.
PREVENTIVE HEALTH CARE SCHEDULE
A visit with a provider before the baby is born can be particularly important for:
Parents with a high-risk pregnancy.
Any parent who has questions about issues such as feeding, circumcision, and general child health issues.
After the baby is born, the next visit should be 2 to 3 days after bringing the baby home (for breastfed babies) or when the baby is 2 to 4 days old (for all babies who are released from a hospital before they are 2 days old). Some providers will delay the visit until the baby is 1 to 2 weeks old for parents who have had babies before.
After that, it is recommended that visits occur at the following ages (your provider may have you add or skip visits depending on your child’s health or your parenting experience):
By 1 month
2 1/2 years
Each year after that until age 21
Sick Child Visit.
An appointment with your provider can help ease your mind if something just doesn’t seem right. You should seek medical care if your child is experiencing:
High or persistent fever
Any breathing problems, such as fast, labored, or noisy breathing from the chest
Persistent pain, such as an earache, sore throat, severe headache, or stomach ache
Eye discharge that is thick, sticks the eyelids shut, and doesn’t get better during the day
Additionally, you may need to have your child seen for:
Frequent vomiting or diarrhea, not being able to keep down enough liquids to produce urine at least once every six to eight hours, or dehydration (severe dehydration needs to be treated in the emergency room)
Vomit or diarrhea that contains blood
A stiff neck, extreme lack of energy, or illness seems to be getting worse rather than staying the same for more than four to five days
Exposure to a contagious illness, such as mono, influenza, chickenpox, or has traveled out of the country recently
It’s important to pay attention to how a child is acting with a temperature. If the child has a high fever but is playful and active, the illness may be less concerning. Paying close attention to a child’s respiratory symptoms is also important, as fast or labored breathing may signal that the child has a serious illness.
Children’s fevers may reach different heights (some tend to run high whenever they’re sick, while others rarely have high temperatures), so it is important to pay attention to how a child is acting and eating/drinking.
For newborns (under about three months), any fever over 100.4 F can be concerning and requires evaluation. For children three months to three years, a fever higher than 102 F can be worrisome. In general, there isn’t a set cutoff number for children’s fevers, but the symptoms occurring alongside the fever are very significant.
Common Sick visits: Links to Strep Throat, Otitis Media, Influenza, Upper Respiratory Infections, Constipation, Sore throat, urinary tract infections, rashes, pink eye, vomiting, diarrhea
We have the proper lab tests in house to accurately diagnose your child’s illness and provide appropriate treatment.
Whether you’re expecting a baby boy or have just welcomed your new little guy into the world, you have an important decision to make: whether to circumcise him.
For some families, the choice is simple because it’s based on cultural or religious beliefs. But for others, the right option isn’t as clear. Before you make a circumcision decision, it’s important to talk to your doctor and consider some of the issues.
Boys are born with a hood of skin, called the foreskin, covering the head (also called the glans) of the penis. In circumcision, the foreskin is surgically removed, exposing the end of the penis.
Approximately 55% to 65% of all newborn boys are circumcised in the United States each year, though this rate varies by region (western states have the lowest rates and the north central region has the highest). The procedure is much more widespread in the United States, Canada, Africa, and the Middle East than in Asia, South America, Central America, and most of Europe, where it’s uncommon.
Parents who choose circumcision often do so based on religious beliefs, concerns about hygiene, or cultural or social reasons, such as the wish to have their son look like other men in the family.
Routine circumcision can be performed in our practice up to 30 days old and is covered by most insurances.
If you decide to have your son circumcised, your pediatrician can perform this procedure right in the office with a local anesthetic with a procedure call the Plastibell Technique. The doctor can tell you about the procedure and the possible risks. Circumcision after the newborn period (30 days) can be a more complicated procedure and usually requires general anesthesia and therefore is not performed in our office.
In some instances, doctors may decide to delay the procedure or forgo it altogether. Babies born with physical abnormalities of the penis that need to be corrected surgically often aren’t circumcised at all because the foreskin may eventually be used as part of a reconstructive operation.
THE PROS AND CONS
On the plus side, circumcised infants are less likely to develop urinary tract infections (UTIs), especially in the first year of life. UTIs are about 10 times more common in uncircumcised males than circumcised infants. However, even with this increased risk of UTI, only 1% or less of uncircumcised males will be affected.
Circumcised men also might be at lower risk for penile cancer, although the disease is rare in both circumcised and uncircumcised males. Some studies indicate that the procedure might offer an additional line of defense against sexually transmitted diseases (STDs) like HIV in heterosexual men.
Penile problems, such as irritation, inflammation, and infection, are more common in uncircumcised males. It’s easier to keep a circumcised penis clean, although uncircumcised boys can learn how to clean beneath the foreskin once they’re older.
Some people claim that circumcision lessens the sensitivity of the tip of the penis, decreasing sexual pleasure later in life. But none of these subjective findings are conclusive.
Although circumcision appears to have some medical benefits, it also carries potential risks — as does any surgical procedure. These risks are small, but you should be aware of both the possible advantages and the problems before you make your decision. Complications of newborn circumcision are uncommon, occurring in between 0.2% to 2% of cases. Of these, the most frequent are minor bleeding and local infection, both of which can be easily treated by your doctor.
One of the hardest parts of the decision to circumcise is accepting that the procedure can be painful. In the past, it wasn’t common to provide pain relief. But the American Academy of Pediatrics (AAP) recommends it and studies show that infants undergoing circumcision benefit from anesthesia, so most doctors now use it. But because this is a fairly new standard of care, it’s important to ask your doctor ahead of time what, if any, pain relief your son will receive.
We utilize a local anesthetic, an injectable anesthetic (Lidocaine) that requires less time to take effect and may provide a slightly longer period of anesthesia to make the operation less painful for baby.
In addition to anesthesia, acetaminophen is given an hour prior to the procedure. This helps reduce discomfort during the procedure and for several hours afterward. Giving a pacifier dipped in sugar water and swaddling a baby also can help reduce stress and discomfort.
Caring for a Circumcised Penis Following circumcision, it is important to keep the area as clean as possible. Gently clean with warm water — do not use diaper wipes. Soapy water can be used if needed.
If there is a dressing on the incision, apply a new one (with Neosporin) whenever you change a diaper for the first day or two. Even after the dressing is no longer needed, put a dab of petroleum jelly on the penis or on the front of the diaper for 3 to 5 days. This can help avoid discomfort from rubbing and sticking to the diaper.
It usually takes between 7 to 10 days for a penis to heal. Initially, the tip may appear slightly swollen and red and you may notice a small amount of blood on the diaper. You also may notice a slight yellow discharge or crust after a couple of days. This is part of the normal healing process.
If you notice any of the following problems, call your doctor right away:
persistent bleeding or blood on the diaper (more than quarter-sized)
other signs of infection, such as worsening swelling or discharge, or the presence of pus-filled blisters not urinating normally within 12 hours after the circumcision
However, with quick intervention, almost all circumcision-related problems are easily treated.
CARING FOR AN UNCIRCUMCISED PENIS
As with a penis that’s circumcised, an uncircumcised one should be kept clean. Also, no cotton swabs, astringent or any special bath products are needed — just warm water every time you bathe your baby will suffice.
Initially, do not pull back the foreskin to clean beneath it. Over time, the foreskin will retract on its own so that it can be pulled away easily from the glans toward the abdomen. This happens at different times for different boys, but most can retract the foreskin by the time they reach puberty.
As your son grows up, teach him to wash beneath the foreskin by gently pulling it back from the glans, rinsing the glans and the inside of the foreskin with warm water, then pulling the foreskin back over the head of the penis.
The Circumcision Decision After reviewing multiple studies on circumcision, the AAP reports that “the health benefits of newborn male circumcision outweigh the risks.” But at the current time, the scientific evidence is not strong enough for the AAP to recommend routine circumcision of all newborn boys. Instead, the AAP advises parents to learn the facts about circumcision and weigh the pros and cons.
In addition to considering the medical factors, religious and cultural beliefs might play a role. If these are important to you, they deserve to be seriously considered.
Talk to your doctor to help you make the choice that’s right for your son.
Sports and School Physicals.
These visits may be covered by your insurance company if done in correlation with your child’s annual well visit. If not there is a fee for this service. Please bring all paperwork required by your child’s school/daycare or sports team to your visit.
Asthma can take your breath away. The asthma program at Sunrise Pediatrics can help you get it back. Our team is committed to providing each patient with a personalized treatment plan and ongoing education to help them manage asthma and live life to the fullest.
TO LEARN MORE CLICK THE BUTTON BELOW
New moms need support and information when learning to breastfeed. Ask your pediatrician about our breastfeeding program, you will be scheduled with one of our providers who are also certified lactation consultants (a health professional who specializes in the clinical management of breastfeeding) for a one on one breastfeeding appointment to help you and your baby with all of the needed techniques, information, and resources needed to be successful with breastfeeding.
TO LEARN MORE CLICK THE BUTTON BELOW
Children with ADHD need guidance and understanding from their parents, families, and teachers to reach their full potential and to succeed. For school-age children, frustration, blame, and anger may have built up within a family before a child is diagnosed. Parents and children may need special help to overcome negative feelings. Mental health professionals can educate parents about ADHD and how it affects a family. They also will help the child and his or her parents develop new skills, attitudes, and ways of relating to each other.
TO LEARN MORE CLICK THE BUTTON BELOW
PARENTS: CLICK ON THE BUTTON TO BE ABLE TO PULL YOUR CHILD’S IMMUNIZATION RECORDS
Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger
Vaccination Schedule 7-18
Growing Up with Vaccines: What Should Parents Know?
Protect Yourself and Help Protect Your Baby: Information for New Moms on the Tdap Vaccine
Varicella (Chickenpox) Vaccine
MMR (Measles, Mumps, and Rubella) Vaccine
Meningococcal Disease—Information for Teens and College Students
Meningococcal ACWY Vaccines
Serogroup B Meningococcal Vaccine (MenB)
Hib (Haemophilus Influenzae type b) Vaccine
Hepatitis B Vaccine What Parents Need to Know
Hepatitis A Vaccine
Hepatitis B Vaccine
HPV (Human Papillomavirus) Vaccine
HPV Vaccine Information For Young Women
DTaP (Diphtheria, Tetanus, Pertussis) Vaccine
Td (Tetanus, Diphtheria) Vaccine
Tdap (Tetanus, Diphtheria, and Pertussis) Vaccine