May 2017
This Month's Newsletter

Memorial Day is here! We wish you a wonderful, unofficial start to Summer with friends and family. 

 

In this month's newsletter, we thank everyone for attending our Screenagers event. We include an article on the popular "13 Reasons" mini series and our thoughts on the topic. We also offer information on UTIs in children and provide Summer safety tips from the AAP.  We remind you our new patient portal is now available to patients! Please see the information below on how to enroll.  

Our goal is to further develop our relationship with our patients and create an open forum. We welcome your comments and ideas. If you would like to see something included in this newsletter, please email us at pedcenter.com@gmail.com  with ideas only, please no medical requests.

As always, we welcome you to share your experience with our practitioners with an online review. 

Sincerely,
The Pediatric Center Staff
Thank you to everyone who attended our Screenagers event on May 17th. It was a huge success and the discussion session was valuable and thought-provoking.

We will be looking into a second screening in the Fall. Please keep an eye out.
13 Reasons
By Clare Cardo McKegney, DNP APN C.P.N.P

This past March, "13 Reasons Why" was released on Netflix. If you are not already familiar with this mini-series, it was adapted from the novel "13 Reasons Why", by Jay Asher.  It is a story about a high schooler, Hannah Baker, who takes her own life and leaves recordings of herself to the 13 people who she felt were responsible for her decision. Producers of the film developed the 13 episodes to depict the novel's story line.  Generally, The Pediatric Center does not comment on Hollywood films however, this mini-series is more than provocative - it has the potential of being dangerous.

It is clear from talking with patients, parents and social media that our teens and tweens are flocking to the Netflix series "13 Reasons Why".
The Pediatric Center wants to ensure our families are aware of the film and are equipped with discussion points when talking with your children about teen age depression and suicide.

In the world of pediatrics, we are trained to evaluate and monitor our adolescent patients for mental illness including depression and anxiety. In 2015, an estimated 3 million teens experienced at least one major depressive episode in a year. Recent statistic reveal that number is on the rise. Therefore, any book, movie or social media outlet that targets youth glamorizing suicide is a major concern to all the practitioners at The Pediatric Center.

Suicide is now the second leading cause of death in children age 15-19 years of age. It is reported that 3% of all teen-age suicide is thought to be related to a copycat effect - meaning they are mimicking something they have seen or heard. The series "13 Reasons" commercializes the serious topic of suicide and presents it in a provocative way, rather than completely missing the opportunity to impact our youth in a positive way with tools to deal with this devastating decision.

The main character Hannah Baker produces a clear-cut plan over a long period of time, recording herself along her journey in a sarcastic, funny and at times, clear-headed way. Any mental health professional would challenge this portrayal as suicide is typically a result of an emotional crisis.  A depressed child who is experiencing hopelessness would not present in this way and the depiction is inaccurate. 

Often, there is no cause and effect to why one takes their own life. Our teens and tweens who are watching this movie are missing that big component.

The largest and most important failure of this mini-series is the lack of information given to the audience about teen suicide. The series almost glamorizes it and leaves the viewer feeling like there are not available outlets. The producers have an opportunity, with a captive audience, to show/teach our youth that suicide is not the answer to victimization. Our communities are full of wonderful resources that are available to prevent this form of death.

It is important to have discussions with our children about depression and suicide.  We should be encouraging our youth to discuss their feelings and emotions with adults, guidance counselors and primary care providers. We need to educate our children regarding how to handle their friends who appear to be depressed or suicidal. Mental illness should not be a silent illness. We need to promote kindness, inclusion, and speaking up when we see something that isn't right. 

If you have any concerns for your child or loved one, please reach out to our office.

UTIs In Children
Despite popular belief, urinary tract infections (UTIs) are common in kids and sometimes even in babies. They happen when bacteria (germs) get into the  bladder or kidneys . UTIs are easy to treat but it's important to catch them early. Undiagnosed or untreated UTIs can lead to kidney damage. 

What Are the Signs of a UTI?
Most UTIs happen in the lower part of the urinary tract - the urethra and bladder. This type of UTI is called cystitis. A child with cystitis may have:
  • Pain, burning, or a stinging sensation when peeing
  • An increased urge or more frequent need to pee (though only a very small amount of pee may be passed)
  • Fever
  • Waking up at night a lot to go to the bathroom
  • Wetting problems, even though the child is potty trained
  • Belly pain in the area of the bladder (generally below the belly button)
  • Foul-smelling pee that may look cloudy or contain blood
  • Babies may have a fever, throw up or become fussy
An infection that travels up the ureters to the kidneys is called pyelonephritis and is usually more serious. It causes many of these same symptoms, but the child often looks sicker and is more likely to have a  fever (sometimes with shaking chills), pain in the side or back, severe tiredness, or vomiting.

Who Gets UTIs?
UTIs are much more common in girls because a girl's urethra is shorter and closer to the anus. Uncircumcised boys younger than 1 year also have a slightly higher risk for a UTI.

Other risk factors for a UTI include:
  • a problem in the urinary tract (for example, a malformed kidney or a blockage somewhere along the tract of normal urine flow)
  • an abnormal backward flow (reflux) of urine from the bladder up the ureters and toward the kidneys
  • poor toilet and hygiene habits
  • family history of UTIs
How Are UTIs Diagnosed?
To diagnose a UTI, health care providers ask questions, do a physical exam and take a sample of urine for testing.

The sample may be used for a urinalysis (a test that microscopically checks the urine for germs or pus) or a  urine culture (which attempts to grow and identify bacteria in a laboratory). Knowing what bacteria are causing the infection can help your doctor choose the best treatment.

How Are UTIs Treated?
UTIs are treated with antibiotics. After several days of antibiotics, your doctor may repeat the urine tests to confirm that the infection is gone. It's important to make sure of this because an incompletely treated UTI can come back or spread.
Symptoms should improve within 2 to 3 days after antibiotics are started.

Treatment for More Severe UTIs
Kids with a more severe infection may need to get antibiotics by injection or intravenously in the hospital - however this is in rare cases. 
This might happen if:
  • the child has high fever or looks very ill, or a kidney infection is likely
  • the child is younger than 6 months old
  • bacteria from the infected urinary tract may have spread to the blood
  • the child is dehydrated (has low levels of body fluids) or is vomiting and cannot take any fluids or medicine by mouth
Can UTIs Be Prevented?
In infants and toddlers, frequent diaper changes can help prevent the spread of bacteria that cause UTIs.  When children are potty trained, it's important to teach them good hygiene. Girls should know to wipe from front to rear - not rear to front - to prevent germs from spreading from the rectum to the urethra.

School-age girls should avoid bubble baths and strong soaps that might cause irritation, and they should wear cotton underwear instead of nylon because it's less likely to encourage bacterial growth.

Teach children not to "hold it" when they have to go because pee that stays in the bladder gives bacteria a good place to grow. Kids should drink plenty of fluids and avoid caffeine, which can irritate the bladder.

When to Call the Doctor
Call your doctor immediately if your child has any of the following symptoms:
  • unexplained fever with shaking chills, especially if there's also back pain or any type of pain when peeing
  • bad-smelling, bloody, or discolored urine
  • low back pain or belly pain (especially below the belly button)
  • a fever of over 101°F (38.3°C) in children or 100.4°F (38°C) rectally in infants
  • lack of appetite
  • vomiting repeatedly
  • seems unusually irritable
Summer Safety Tips
The arrival of Memorial Day symbolizes Summer is just around the corner! The American Academy of Pediatrics (AAP) offers fun_beach_goggles.jpg the following Summer safety tips: 
 
Fun In The Sun
Babies under 6 months:
  • To prevent sunburn the AAP recommends that infants avoid sun exposure, and are dressed in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn. However, when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least 15 SPF (sun protection factor) to small areas, such as the infant's face and the back of the hands. If an infant gets a sunburn, apply cool compresses to the affected area.
For All Other Children:
  • The first, and best, line of defense against harmful ultraviolet radiation (UVR) exposure is avoiding sun exposure by covering up. Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.
  • Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that provide 97% -100% protection against both UVA and UVB rays), and clothing with a tight weave.
  • On both sunny and cloudy days use a sunscreen with an SPF 15 or greater that protects against UVA and UVB rays.
  • Be sure to apply enough sunscreen -- about 1 oz./application for a young adult.
  • Reapply sunscreen every two hours, and after swimming or sweating.
  • Use extra caution near water and sand (and even snow!) as they reflect UV rays and may result in sunburn more quickly.
Heat Stress During Exercise
  • The intensity of activities that last 15 minutes or more should be reduced whenever high heat or humidity reach critical levels.
  • At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of outdoor activities should start low and then gradually increase over 7 to 14 days to acclimate to the heat.
  • Before outdoor physical activities, children should drink freely and should not feel thirsty. During activities less than one hour, water alone is fine. Kids should always have water available and take a break to drink every 20 minutes.
  • Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated shirts should be replaced by dry clothing.
  • Practices and games played in the heat should be shortened and there should be more frequent water/hydration breaks. Children should promptly move to cooler environments if they feel dizzy, lightheaded or nauseated.
Heat Stroke In Cars
Infants and small children are not able to regulate their body temperature like adults. Every year, children die from heat stroke from being left in a hot car, often unintentionally, with the majority of these deaths occurring in children 3 and under. It's important to be aware of your children when driving. T he inside of a car can reach dangerous temperatures quickly, even when the outside temperature is not hot. Never leave a child alone in a car, even if you expect to come back soon. Lock your car when it is parked so children cannot get in without supervision.
 
Water Safety
  • Never leave children alone in or near water, even for a moment; close supervision by a responsible adult is the best way to prevent drowning.
  • Less experienced swimmers and children under age 5 in or around water should have an adult - preferably one who knows how to swim and perform CPR - within arm's length, providing "touch supervision."
  • Never swim alone. Even good swimmers need buddies!
  • Designate a "water watcher" when you are in, on or around water.
  • Because drowning can be quick and quiet, the water watcher should pay constant attention, be undistracted, not involved in any other activity such as reading, playing cards, on the phone, while supervising children, even if lifeguards are present. 
Pool Safety 
  • A pool should have a fence at least 4 feet high around all four sides of the pool. The fence should not have openings or protrusions that a young child could use to get over, under, or through.
  • Pool gates should open out from the pool, and self-close and self-latch at a height children can't reach. Alarms on a gate are recommended. 
  • Rescue equipment (a shepherd's hook ­- a long pole with a hook on the end - and life preserver) and a portable telephone should be near the pool. 
  • Avoid inflatable swimming aids such as "floaties." They are not a substitute for approved life jackets.
  • The decision to enroll a child over age one in swimming lessons should be made by the parent based on the child's developmental readiness and exposure to water, but swim programs should never be seen as "drown proofing" a child of any age.
  • Avoid entrapment: Suction from pool and spa drains can trap a swimmer underwater. Do not use a pool or spa if there are broken or missing drain covers.  Ask your pool operator if your pool or spa's drains are compliant with the Pool and Spa Safety Act. 
  • Large, inflatable, above-ground pools have become increasingly popular for backyard use. Children may fall in if they lean against the soft side of an inflatable pool. Although such pools are often exempt from local pool fencing requirements, it is essential that they be surrounded by an appropriate fence.
  • If a child is missing, look for him or her in the pool or spa first.
  • Share safety instructions with family, friends and neighbors. 
Boating Safety
Children should wear life jackets at all times when on boats, docks or near bodies of water. Adults should wear life jackets for their own protection, and to set a good example. The life j acket should be the right size for your child. The jacket should not be loose and should always be worn as instructed with all straps belted.

Open Water Swimming
  • A lifeguard (or another adult who knows about water rescue) needs to be watching children whenever they are in or near the water. Younger children should be closely supervised while in or near the water - use "touch supervision," keeping no more than an arm's length away. 
  • Make sure your child knows never to dive into water except when permitted by an adult who knows the depth of the water and who has checked for underwater objects.
  • Never let your child swim in canals or any fast moving water.
  • Ocean swimming should only be allowed when a lifeguard is on duty.
  • Teach children about rip currents. If you are caught in a rip current, swim parallel to shore until you escape the current, and then swim back to shore.
For more tips on sun and water safety, visit  www.healthychildren.org
Patient Portal
The Pediatric Center's patient portal provides personal access  to your family's  medical records. You can access information such as immunization records, visit summaries, request appointments, view dates for upcoming appointments and pay your bill.

Sign up is quick from our website. Click here.
Do You Need A Pediatric Specialist?
woman_hand_butterflies.jpg
If you are in search of a pediatric specialist, please know we are here to guide you.

We have a wide network of doctors we can refer to ensure you are in good hands.

We specialize in developmental & behavioral health and focus on positive parenting practices. We can offer guidance on depression, eating disorders, developmental concerns and many other issues.

You are not alone. 
Please call to make an appointment to meet with one of our physicians:  
908-508-0400.
The Pediatric Center Online Bill Pay
Online Bill Payment
The Pediatric Center offers the ease and convenience of online bill baby_laptopbuying.jpg payment.   

Simply visit our " Bill Payment & Insurance" page on our website. 

Payments Over The Phone
If you prefer, you can still make a payment over the phone by calling The Pediatric Center's billing department, HealthCare Billing, Inc:  
Toll Free:  877-852-9092  or
Local:  908-237-9092
On-Site Lactation Support Center

Reminder, T he Pediatric Center offers an on-site Lactation Support Center.

Our modern and private on-site lactation suite provides a warm and relaxed environment for the mother and infant to enjoy a positive breastfeeding experience. 

We also offer a free prenatal class every month, open to the public. 

To schedule your lactation consultation, attend our free prenatal class or make an appointment please call us at 908-508-0400.

Vaccine Education Center

Did you know our website includes a Vaccine Education Center where you can find the immunization schedule for your child?

 

Reminder - we are offering the new meningitis vaccine Trumenba in our office. Insurance companies have started to cover this vaccine. It is recommended it be administered to all students starting college as part of their pre-college physical.

 

View all the details here.

We Love Your Feedback!

Your feedback is very important to us! We would love to hear about your positive experience with our doctors and nurse practitioners.  

 

Did you know you can write and post a review right on our website? Click here.

 

You can use this page to provide feedback, kudos, or just share thoughts. 

 

Thank you for your kind words!

Free Prenatal Class
We offer a free prenatal class on the 3rd Thursday of every month with our own
Dr. McKegney!
Click here to learn more.
It's A Partnership
Resources for breastfeeding, immunization schedules, what to do if your child is sick, online references & much more! Click here.
Read Our Blog!
Check out our blog to read about news and current events. Topics are relevant to our practice and patients. Click here.
Follow Us On Facebook!

Keep up to date with pertinent news information and important announcements on Facebook including time sensitive topics and office closings, etc.

 

Simply like us by clicking on the icon to the right!

 

Announcements will also be posted on the home page of our website under "What's New".

The Pediatric Center

556 Central Avenue, New Providence, NJ 07974

908-508-0400

www.PedCenter.com

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