December 2017
This Month's Newsletter
Happy holidays! It's hard to believe the year is coming to a close. A heartfelt thank you for entrusting us as your child's doctor of choice. It always gives us a sense of pride to see our patients grow and flourish over the years. We wish everyone a wonderful holiday season and look forward to continuing to build our relationship with your family in 2018.  

Reminder, on the weekends and during the holidays, we are open for  sick and emergency appointments for existing patients. Simply call when the phones open at 8:45 am for an appointment.

This month's newsletter is chock full! We are happy to announce our physicians were recognized as "Favorite Kids' Docs" once again this year!  We provide tips on traveling with your newborn. We also offer safe and effective teething remedies. Further, we discuss the importance of screen-time breaks. And, we share information on chest pain in children and the different causes. 

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
Favorite Kids' Docs
We are thrilled to share, our doctors at 
The Pediatric  Center have once again been selected as  New Jersey Family's Favorite Kids' Docs 2017  for Pediatrics. 

A grateful and warm "Thank you" to all of the parents and families for all of your support throughout the year and trusting us as your pediatrician of choice.  

We look forward to continuing to build our relationship with you and your children in 2018. 
 

Traveling With Your Newborn
Author: Clare Cardo McKegney, D.N.P., A.P.N., C.P.N.P
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Has this weather made you dreamy for sun and sand or maybe a nice mountain lodge?  Wherever you are going whether a warm or cold climate, the need to be organized when traveling with a baby is crucial.

It's important to first ensure your infant/baby has been cleared to travel by your primary care provider.  Babies under the age of 8 weeks should avoid crowded conditions, therefore air travel should try to be avoided before that age.  

While writing this article, the Flu virus is spreading all across the country. It is also a great idea to have you and those traveling with you, including babies 6 months and older, to get vaccinated against the influenza virus. 

Important travel tips
  • Know you baby's Tylenol and Benadryl dose
  • Pack a first aid kit including band-aids and Neosporin
  • Be prepared with over the counter medicines that can relieve fever and or allergic reactions (the best travel plans can be interrupted at any time with illness)
  • Review the signs of allergy with your primary care provider - be prepared if your baby will be trying new foods or is exposed to new foods while you're away 
  • Have a changing pad, extra clothing and diapering in your carry on
     
Sun Safety
Sun safety in the warmer climates is crucial. Make sure your baby's head is covered at all times. Infants 6 months and older should have sunblock SPF 50 on at all times. Reapply as the packaging directs you. If you have never applied Sunblock before on your child test an area on the baby's abdomen a few days before to observe for allergy/sensitivity. 

Car Seats/Strollers
You are most likely going to be traveling with a car seat and a stroller. If you are traveling by air, the safest way to travel is to have the baby in their own seat in their car seat. If you choose to travel with the infant as a lap traveler, make sure you are in a seat belt at all times. When you reach your destination you still need a car seat, make sure your rental car has the appropriate car seat before you get there.  Babies 2 and under need to be rear facing.

Ear Pain
Many new parents ask about how to reduce ear pain with air travel.  It is very common for babies to experience the discomfort we all experience. Some babies can be comforted by distraction, however some will tend to cry a lot. If your baby is nursing it is often recommended to nurse the baby while taking off and landing. However, if they are not a lap traveler, they should remain in their car seat. Offering their pacifier is sometimes helpful as well. There is no recommendation to give preventative medicine for pain. If your baby is sleeping during takeoff and landing, let them sleep!

When packing for your trip, here's a list of items to remember:
  • Car Seat
  • Stroller
  • Extra bibs/burp clothes
  • Carry sling
  • Sun screen
  • First aid Items
  • Diapering items
  • Travel size bath items
  • Small "favorite" toys
  • The baby's blanket/"lovey"
Some families find it helpful and sometimes economically, depending on location, to mail baby supplies ahead of time to the hotel they are staying at. It cuts down on how much room is needed for pampers, wipes, food items, and disposable utensils.

Planning ahead and thinking about how to make your stay more pleasurable is important. Travel with a baby is not always easy. Attempt to not over-schedule your first few days so your baby can get used to the routine and new environment. Most importantly have fun on your first family vacation!
Safe & Effective Teething Remedies
Teething is uncomfortable and exhausting for both babies and parents alike. But, like your yearly physical or your car's oil change - it's a necessary part of life no matter how much you yearn for a full night's slumber. 

Teething can occur at any time in the first year of your baby's life. But, it usually begins between 4-6 months of age. If you're a new parent, you might be overwhelmed when you find your baby a cranky, drooling, hot mess. 

Teething Remedies
It's certainly challenging for you when you stumble bleary-eyed into your baby's room at 4:00 am. But imagine the anguish your baby's feeling. It's not an easy time for anyone involved. Do you suspect your baby is experiencing teething? The  signs of teething are undeniable. Is your baby drooling, chomping, and restless? Chances are, they're cutting their first teeth. There are countless natural teething remedies that may be of help to soothe your baby.

Natural Remedies:
Natural or non-toxic items and lifestyles are all the rage. And for good reason. Following are a list of several options:
  • Amber teething necklaces
  • Teething toys
  • Chamomile ice cubes
  • Chamomile Tincture
  • Homeopathic remedies
Every baby's response will vary to the different teething remedies. If one remedy doesn't work, don't give up. There are endless options. 

Cold Teething Remedies
Cold: a remedy for teething and pain as old as time. When you were a child, what was the first thing your mother did when you injured yourself? Right, she reached for ice. Your baby has red, inflamed, and irritated gums and is begging for relief. With their insistent cries, anything cold will be your baby's savior at this point.

Some options include:
  • Frozen washcloth
  • Cold spoon
  • Frozen fruits in mesh feeder
  • Ice cubes
  • Breastmilk ice cubes
These are all excellent options. But you'll want to ensure you offer age-appropriate options. If your baby is eating solids, you can offer fruit or frozen food in a mesh feeder. 

If your baby is too young, you can attempt a frozen washcloth to chomp on or other options that don't involve food. You can get as creative as you want. The cold will relieve the agony they're experiencing. Your baby and their tender gums will thank you.

Read more tips on our blog

Importance of Screen-Time Breaks
Children spend more time than ever staring at digital screens-on computers, tablets, TVs, smartphones, and other devices. All that screen time can take a toll on children's well-being , specifically taking a toll on their eyes.
 
What We Know:
Research shows children begin zooming in on digital media devices, such as their parents' tablets or smartphones, as young as 6 months old. By their teens, kids spend nearly 7 hours a day using screened-based media, watching TV, playing video games, and using social media; this doesn't include additional time spent using screens at school or for homework. Es pecially if they're having fun, children might keep playing and watching to the point of eye-rubbing exhaustion.

Staring at a screen for long stretches without taking breaks can cause symptoms such as:
  • Eye fatigue that results in concentration difficulties and headaches centered around the temple and eyes. If screen devices have poor lighting, fatigue can also result from squinting.
  • Blurry vision - gazing at the same distance for an extended time can cause the eye's focusing system to spasm or temporarily "lock up." Some studies also suggest computer use and other indoor activities may fuel rising rate of myopia (nearsightedness) among children, although this is not yet proven. 
  • Dry eyes - studies show that people blink significantly less often when concentrating on a digital screen, which can leave eyes dry and irritated. 
What Parents Can Do:
  • Monitor screen time. The American Academy of Pediatrics (AAP) reports target issues ranging from obesity to sleep problems linked with too much screen time. Parents can help keep kids' eyes and vision healthy by encouraging balance between the digital and real world. Two especially important aspects of this are making sure screens don't cut into:
    • Sleep. Not getting enough shut-eye leads to tired, sore eyes. The AAP recommends children not sleep with devices in their bedrooms, including TVs, computers and smartphones. In addition, the AAP recommends avoiding exposure to screens for 1 hour before going to bed. 
    • Exercise. The AAP recommends children age 6 years and older get at least 60 minutes of physical activity each day. Outside play can also be a great "workout" for children's vision-giving them a chance to focus at different distances and getting exposure to natural sunlight.
  • Take frequent breaks. The American Optometric Association recommends the 20/20/20 rule: look away from the screen every 20 minutes, focus on an object at least 20 feet away, for at least 20 seconds. In addition, children should walk away from the screen for at least 10 minutes every hour. 
  • Remember to blink. Research published in The New England Journal of Medicinesays staring at a computer can cut blinking rates by half and cause dry eyes.
  • Screen positioning. Make sure the screen on your child's desktop or laptop computer is slightly below eye level. Some experts suggest positioning device screens based on the 1/2/10 rule: mobile phones ideally at one foot, desktop devices and laptops at two feet, and roughly 10 feet for TV screens (depending on how big the screen is). 
  • Spotlight on lighting. To cut down on glare and eye fatigue, a study published in the Journal of Ophthalmology & Research says the level of lighting in a room when using a computer or other screen should be roughly half what it would be for other activities such as writing on paper or working on crafts. 
  • Get regular vision screenings. The American Academy of Ophthalmology and the AAP recommend children have their eyes checked by a pediatrician at well-child visits beginning at birth. If a problem is found during one of these routine eye exams, your pediatrician may refer you to a pediatric ophthalmologist.
Remember...
Children, especially younger ones, will likely need help and reminders to use digital screen devices in an eye-friendly way.

If you have any questions about keeping your child's eyes and vision healthy, talk with your pediatrician.
   
Source: Dr. Kathleen Chin / HealthyChildren.org 
Chest Pain - When To Worry
Chest pain has a variety of sources, and virtually any structure in the chest can cause pain. This includes the lungs, the ribs, the chest wall muscles, the diaphragm, and the joints between the ribs and breastbone. Occasionally, pain can be referred from another area (such as the abdomen).  Injury, infection or irritation to any of these tissues can be responsible for chest pain or it may be a manifestation of stress or anxiety.

The heart is rarely the source of chest pain in children.

Although chest pain may be a symptom of a serious underlying disease, most chest pain in children is caused by benign or self-limited illnesses. 

Listed below are some common illnesses that can cause chest pain.

Costochondritis
Costochondritis occurs secondary to inflammation of the "joint" between the breastbone and the ribs. It is particularly common in adolescent and pre-adolescent females, but can occur in anyone at any age.
  • Frequently caused by viral illness or by frequent coughing, upper respiratory symptoms often accompany this illness. It may last for several weeks.
  • There may be pain when inhaling or exhaling deeply, but true difficulty in breathing is rare and should generate concern for other diagnoses.
  • The hallmark of costochondritis is tenderness to pressure over the costochondral joint, which corresponds to the depression on the sides of the breastbone.
  • Treatment typically consists of a one- to two-week course of an over-the-counter anti-inflammatory medicine such as ibuprofen.
Injury
Injury to the muscles and bones of the chest wall can have many causes. Some are obvious such as a direct blow during a sporting event or a fall. Other less obvious causes include heavy lifting, frequent coughing or intense aerobic exercise that can all cause strain to the rib muscles.
  • Treatment is usually supportive with rest and over-the-counter pain relievers. Consult a physician when injury causes chest pain that is severe, persistent, or associated with difficulty breathing.
Stress or Anxiety
Although few people are willing to believe that stress can elicit such a worrisome symptom, stress-related chest pain is really no different than a stress-related headache. The pain is often dull or non-specific and worsens with stress or anxiety.
  • Common underlying stressors include loss of a relative, school examinations, and "breaking up" with a boyfriend or girlfriend. 
  • Often stress can make chest pain from another cause seem worse. It is important to decipher whether chest pain is the cause of anxiety or the result.
Precordial Catch Syndrome
A benign illness of unknown cause. It occurs most commonly in adolescents and is characterized by sudden onset of intense, sharp pain along the chest or back.
  • The pain occurs exclusively with inspiration (inhaling). A typical episode lasts several minutes and resolves spontaneously.
  • The pain can also be "broken" with a forced deep inspiration. Several episodes may occur per day.
  • Although its cause remains uncertain, precordial catch syndrome has no significant side effects. There is no specific treatment, and the frequency of events usually declines through adolescence.
Acid Reflux
Can cause stomach or chest pain. It sometimes manifests as a burning sensation below the sternum, though children may not be capable of accurately describing this symptom.

What should I do if my child has chest pain?
Don't panic. Remember, chest pain is usually due to a benign or self-limited illness. Heart disease or other serious illness is an unlikely cause.  However, if your child has severe chest pain or chest pain associated with troubled breathing, lightheadedness, fainting, fever, sweating, or a heart rate greater than 200, you should promptly consult with a physician or emergency room .

In the absence of these symptoms, most chest pain can wait for a convenient time to be evaluated. Call your doctor if you are unsure.

If I think my child needs to be evaluated, what kind of doctor should I see?
It is usually better to start with your pediatrician or family doctor rather than a specialist. Most children with chest pain do not require the services of a specialized physician.

Additionally, different causes of chest pain fall under the expertise of different types of specialists. If you do need to see a specialist, your doctor can decide which type of doctor is most appropriate.

What should I expect at the physician's office if my child is seen for chest pain?
The evaluation usually starts with a thorough history of the problem and a physical evaluation. After that, the evaluation may vary markedly depending on the initial findings.

Many children will require no further testing to establish a diagnosis and start treatment. In some cases, chest X-ray, electrocardiograms (ECG), breathing studies, or consultation with a specialist may be necessary.

What if my child specifically says that his or her "heart hurts"?
For many young children, the heart is the most identifiable organ in the chest, so they use this phrase to denote chest pain of any kind. 

The good news is that children are rarely able to distinguish between cardiac and non-cardiac chest pain, so they are unlikely to be correct in laying blame on the heart.  The bad news is that once parents and other caregivers hear this phrase, it can be extremely difficult to persuade them that the heart is not the culprit.
 
Children who complain of "heart pain" should be evaluated like other children with chest pain, with attention paid to severity and associated symptoms.
 
Source:
Our New Website
You may have noticed a new look to our website! We are excited to announce a new, more user-friendly design and layout. Stay tuned as we continue to develop the site. 























We invite you to take a look and browse through the different topics. We always welcome patient feedback.
On-Site Lactation Support Center
The Pediatric Center's on-site Lactation Support Center led by our own Director of Lactation Support, Clare Cardo McKegney, DNP, APN, CPNP, is here to support you in breastfeeding your child. Dr. McKegney is a board certified pediatric nurse practitioner and certified breastfeeding counselor with over 18 years of advanced practice in pediatrics. 

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.

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?
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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
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.
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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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