Mental Health in Teenagers by Dr. Debbie Bauer, Pediatrician

Adolescence is a very difficult time for everybody, kids and parents alike. Teenagers are going through all kinds of changes such as: physical, emotional, intellectual and social. It can be hard to keep up with the way their feeling and finding ways to communicate with them. It’s a big challenge to try and not feel overwhelmed during these transitions. It’s very normal for a teen to feel moody, sad, or anxious, but when these feelings take over their life and start to affect how they think and act, it can become a serious problem. Mental health issues are much more common than you may think, about 1 out of every 5 adolescents has had a serious mental health disorder at some point in their life.

What parents need to know:

  • A mental health issue isn’t anybody’s fault. Just like with any other health complication, this is not a choice, it’s an actual problem with how the brain functions. The reason these issues develop is incredibly complicated and involves both genetic and environmental factors.
  • Mental health problems are common and treatable. There are many people and resources that are available to help your teenager. From pediatricians, to school guidance counselors, to mental health professionals – we’re all here to help. The sooner a concern is raised, the more time we have to address the issue, and get your teen the assistance they need. If you have any doubts, reach out!
  • It’s important to stay involved. Try to build a trusting relationship between yourself and your teenager. They should feel comfortable sharing information with you without fear of always being punished for bad choices. It can be helpful to share decisions that you have made or lessons you have learned from the past. Remember, they are still learning.

Signs of mental illness to look out for:

  • Loss of interest in past favorite activities
  • Sudden personality shifts that seem out of character
  • A sudden and/or dramatic change in grades
  • Isolation from friends and family
  • Big changes in sleep habits (more or less sleep then usual)
  • Dramatic changes in eating habits
  • Anything else that you think is concerning about their behavior

If you have any concerns about your teen’s mental health, talk to them. From there, you can schedule an appointment with their pediatrician. At NOAH, we address all aspects of your child’s health including their initial medical assessment. Other services that are available to you and your child include counseling and nutrition.

For more information, please visit:

www.healthychildren.org

Car Seat Safety by Dr. Amit Jain, Pediatrician

We here at NOAH care about your child’s health and safety not only at the clinic, but at home and on the go too. One very important part of this is Car Seat Safety.  We would like to remind you about the importance of Car Seats, and how to keep your child safe when on the go.

Especially for a new parent, the variety of car seats available today can be overwhelming! And it makes it more difficult to make sure your child is buckled in appropriately. We would like to help alleviate some of the confusion! Thinking about a car seat starts before your child is born. Most hospitals require an appropriate car seat for you to take your baby home and do car seat checks when your new baby is first allowed to go home from the hospital.

Unintentional injuries (including car accidents) are the leading cause of death in children and teens. Courtesy of the National Highway Traffic Safety Administration (NHTSA), we know that on average, 3 children were killed every day in traffic accidents. Of those, more than a third of the children were unrestrained. More than half of injuries and deaths were cases in which car seats and seatbelts were incorrectly used.

There are various types of car seats to consider based upon your child’s age, weight, and height including rear-facing, convertible (rear-facing that can become forward-facing), forward-facing, and booster seats (with or without back support). Below is a chart explaining the various car seats, separated by age group. To securely install these various car seats, you can either use the available seatbelts or the LATCH system. Nearly all vehicles and car seats built after September 1, 2002 include this LATCH system (Lower Anchors and Tethers for Children) which consists of a lower anchor where the seat cushions meet, and a tether which can be located on the panel behind the seat, on the back of the seat, the ceiling, or the floor.

Some important points when using these systems:

  • Most rear-facing car seats do not use the tether for installation, just the lower anchor and/or seatbelt.
  • You should not use both the lower anchor and seat belt together unless specifically instructed in the car seat installation instructions. However, the tether can and oftentimes will be used along with the seatbelt to securely install the seat.
  • To get a tight fit using the seatbelt, the seatbelt should lock. For most modern cars, the seatbelt can be locked by pulling it out all the way, and then letting it retract as it clicks.
  • When possible, the middle back seat is the safest. However, the middle seat often doesn’t have a LATCH system, or is too small, or uneven to safely support a child. It is most important that wherever the child may be seated, that the seat is securely and tightly installed in the vehicle.
  • Infants and children should wear thinner clothes when buckled into car seats as bulky clothing such as jackets can leave the straps too loose, increasing the risk for injury. 
  • The American Academy of Pediatrics recommends that all infants be placed in rear-facing car seats starting from their first ride home from the hospital.
  • All infants and toddlers should ride rear-facing as long as possible (even if their legs are bent), until the highest weight or height allowed by their car seat.
  • When children outgrow their rear-facing only car seat, a convertible car seat installed rear-facing should be used.
  • A forward-facing car seat should be used only once a child has reached the weight or height limit for their convertible rear-facing car seat. Similarly, a forward-facing car seat should be used until the weight or height limit for that specific car seat has been reached (this is usually listed on the label of the car seat).
  • A belt-positioning booster seat is the next step and should be used until a child’s seatbelt fits properly across their shoulder (without riding up to their neck), which is typically at a height of 4 feet, 9 inches or taller, and 8-12 years of age.
  • The safest place for all children younger than 13 years old is the backseat.
  • Do NOT use the car seat after it has been in a moderate to severe crash, such as if any of the following are true (according to the NHTSA):
    • The vehicle could NOT be driven away from the crash
    • The vehicle door closest to the car seat was damaged
    • Anyone in the vehicle was injured
    • The airbags went off
    • There is any significant damage to the car

And remember, always be a good role model by buckling your own seatbelt every time you’re in the vehicle! Set a reminder whenever you buckle your child’s car seat to help you remember never to leave your child in or around your car when you leave.

If you need help installing your child’s car seat, or just want to make sure it is secure, below are some great options for you to reach out to:

  • Your local fire department
  • Parent partners plus
  • Phoenix Children’s Hospital car seat safety program

For more information, please visit:

Back to School Health Tips

By Dr. Patricia Avila, Pediatrician

Summer vacation has come to an end and it is now time to get BACK TO SCHOOL!! Here are some ways you can help your children and teens have a healthier school year. We’ve got 5 tips to help your child get off to a great start this school year!

1 – Annual Well Check and Vaccinations

Having an annual well check is the perfect opportunity to make sure your child/teen is developing and growing normally. Part of the well check is to detect health conditions that you may not be aware of such as:

  • Checking their heart and blood pressure.
  • Vision/hearing screenings.
  • Obtaining labs checking for anemia, cholesterol, and diabetes.

During their well check the doctor also has an opportunity to educate you and your child/teen and for you to address any concerns/questions you may have. Vaccinations are also an important part of your child’s annual well check. They are one of the simplest and most proven ways to protect your child/teen from preventable diseases.

2 – Establishing healthy sleep habits

No matter their age all children and teens need proper sleep to stay focused and to learn. Sleep is just as important as eating healthy and exercising. Establish a regular sleep schedule to allow adequate sleep.

  • Toddlers – young children ages 3-5 years need 10-13 hours of sleep per night.
  • School age children ages 6-12 years need 9-11 hours of sleep per night.
  • Teenagers ages 13-19 years need 8-9 hours of sleep per night.

AVOID all use of electronics 1-2 hours prior to bedtime. Electronics including cell phones, TV, tablets, video games, and computers if used prior to bedtime can interfere with your child/teens ability to fall asleep and stay asleep. Instead, try having them read a book or choose a quiet activity prior to bedtime instead.

3 – Proper Nutrition

Studies show that eating a healthy, well balanced meal for breakfast improves your child’s/teen’s ability to do well in school by helping them focus and have increased energy to learn. Make sure to pack a healthy well-balanced lunch too! A well-balanced meal consists of:

  • 1-2 servings of fruits/vegetables.
  • A good source of protein (dairy – cheese, milk, yogurt, eggs, nuts/nut butters, lean meats, fish, beans/lentils, tofu).
  • Whole grains – whole wheat bread, whole wheat pasta, quinoa.
  • A good source of calcium and vitamin D like milk/milk products or almond/coconut/soy/rice/oat milk.

4 – Keeping your child/teen physically active

We have been seeing an increase in obesity over the past 30 years – the rate has
doubled-tripled in children and quadrupled in teens. Children and teens need 1 hour of physical activity per day. Exercise can be anything that keeps your children active including:

  • Sports.
  • Dancing.
  • Biking.
  • Swimming.
  • Hiking.
  • Jump rope.
  • Trampoline.
  • Chasing the family dog.
  • Hula hooping.

The key is to make it fun and enjoyable. It is also helpful to make exercise a family event to increase motivation. Making exercise a part of the routine early with children will help them continue to be active adults.

5 – Homework and Study Habits

Help your child/teen form good study habits by having a quiet space free of distractions to help them stay focused. Keeping this space free of distractions includes setting aside electronic devices including:

  • Phones.
  • Tablets.
  • TVs.

Set aside a designated time for homework to be completed. If you notice your child is struggling with learning and/or completing tasks, talk with your child’s teacher and doctor to help your child/teen succeed.

Summer Fun in The Sun

By Dr. Amit Jain, NOAH Pediatrician
“There’s nothing better than having fun outdoors during school vacations. However, especially during summer here in Arizona, we here at NOAH want to remind everyone of some safety tips to keep safe while having some outdoor fun,” says Dr. Amit Jain, NOAH Pediatrician.

Protecting yourself and your children from harmful ultraviolet light exposure is important to prevent melanoma, a deadly form of skin cancer, which often strikes those who have been severely sunburned, especially during infancy and childhood.

The first line of defense against the scorching summer sun is proper clothing and keeping in the shade.

• Try to limit sun exposure during the peak intensity hours between 10am and 4pm.

• Take frequent shade breaks if staying out in the sun for long periods of time.

• Cotton clothing is protective and can also help whisk away moisture to keep you cool while playing outside. Pick tightly woven fabrics for best protection.

• Wear a hat: wide brimmed for best protection of your child’s entire face, including the nose, cheeks, chin, ears, and back of the neck.

• Get your children sunglasses with UV protection. Those from the dollar store, Walmart, Walgreens, or similar stores are nice, economical options that can be easily replaced if they break or get lost. Just be sure they’re labeled as having UV protection.

• Protect your children with a sunscreen that has an SPF (Sun Protection Factor) of 15 or greater. SPF 15 or 30 should be enough for most common uses. Apply this to all areas not covered by clothing. Don’t forget the ears, back of the neck, arms, and legs. Carefully apply around the eyes, avoiding eyelids.

• Choose a sunscreen that has the words “Broad Spectrum” on it – that will cover both UVA and UVB rays. Try to avoid sunscreens that contain oxybenzone that may have hormonal properties.

• Before applying sunscreen for the first time, test a small amount on your child’s back for an allergic reaction.

• Apply sunscreen at least 30 minutes before sun exposure, as it can take this long to become active.

• Reapply sunscreen at least every 1 hour.

• If playing in the water, reapply sunscreen every half an hour, and use a waterproof sunscreen.

• For infants less than 6 months old, avoid direct sun exposure – keep them under shade with a canopy or under a tree. Use wide brimmed hats to help cover their face, ears, and neck. Dress babies in lightweight clothing that covers their arms and legs as well. If this is not available, apply small amounts of sunscreen with a minimum SPF of 15 to your baby’s face, hands, and legs.

• Don’t forget to use sun protection even on cloudy days, as the harmful ultraviolet rays from the sun can even come through clouds.

• Contact your pediatrician if you develop a sunburn, rash, or blistering.

Resources:
American Academy of Pediatrics: https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Swim-Safety-Tips.aspx
Healthy Children: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Swimming-Pool-Safety.aspx

Pool Safety Tips

By Dr. Amit Jain, NOAH Pediatrician

“Swimming is a great way to beat the summer heat here in Arizona and is a fun activity for children to pass the summer by. Did you know, drowning is the third most common cause of unintentional – injury related deaths? The highest at risk are children ages 1-4 years old,” says Dr. Amit Jain, NOAH Pediatrician.

Our Care Team at NOAH will work with you and your #child to choose the best path for their overall #health and #wellness. Please call 480-882-4545.

  • Never leave children alone, even for a moment, in or near pool areas or other bodies of water (lakes, beaches, and even bathtubs or buckets of water!)
  • Install a fence at least 4 feet tall around the pool, which should ideally surround the pool on all 4 sides and completely separated the pool from your home and yard. It should not have any gaps that a small child could slip over, under, or through. The gate should be a self-closing and self-latching gate that cannot be opened / reached by a small child.
  • Newer technology offers alarms, both for the gate and within the pool, that can alert you to anyone around the pool.
  • When any unexperienced swimmer is around the pool area, make sure there is a designated adult for supervision. This adult should not be under the influence, should not have any distractions (cell phone turned off or handed off to another adult), and preferably knows how to swim and perform CPR.
  • Keep rescue equipment such as a shepherd’s hook and a life preserver to reach/throw for rescues.
  • Avoid inflatable swim aids such as floaties, as they are not a substitution for proper life-preserving equipment such as life jackets.
  • Consider swim lessons for your child if over the age of 1, as it may reduce the risk of drowning. Talk to your child’s pediatrician about your child’s developmental readiness to take swim lessons.
  • Talk to your pool operator to make sure your pool / spa and its drains are compliant with the pool and spa safety act.
  • Be safe and have a fun-filled summer!
    • Resources:
      American Academy of Pediatrics: https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Swim-Safety-Tips.aspx
      Healthy Children: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Swimming-Pool-Safety.aspx

How to Create a Smoke-Free Environment for Your Child

“#Parents need to make every effort to keep their #children away from #smokers & #secondhandsmoke,” says our friends at the American Academy of Pediatrics. Our Care Team at NOAH will work with you & your child to choose the best path for their overall #health & #wellness. To schedule an apt., please call 480-882-4545! #pediatrics #familymedicine #prenatalcare #counseling

7 Tips for Improving Work-Life Balance

“Finding balance between work & play, the ups & downs of life, physical #health & #mentalhealth, can be difficult,” says our friends at Mental Health America. Our Care Team at NOAH includes behavioral health #consulting & traditional outpatient #counseling providers that work alongside our medical team to assess, diagnose and effectively treat the core-symptoms of our #patients. To schedule an apt., please call 480-882-4545! #MentalHealthMonth #MHM2019 #4Mind4Body

The Measles – Are You Vaccinated?

By Chris Sweeney, RN – Quality Manager
“The measles is a serious and highly contagious disease that can spread quickly, so if you or your child are not vaccinated against the disease there is a risk of getting measles,” says Dr. Cara Christ, Director of the Arizona Department of Health Services.
Read more

Asthma – 5 Most Common Triggers to Avoid

May is #AsthmaAwarenessMonth. Did you know 24 million Americans live with #asthma, including 6 million #children? Learn to control this #chronicdisease that affects your #lungs by taking the right medicine & avoiding triggers that may cause an #asthmaattack. Our Care Team at NOAH will work with you & your child to choose the best path for their overall #health & #wellness. To schedule an apt., please call 480-882-4545!

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As you approach your 50’s, you may definitely notice signs of aging. Maybe your vision is blurry, or your hearing is muffled? Those small cuts you get in the garden or bruises that pop up out of the blue may not heal as quickly as they used to. Before you ignore these and other symptoms as part of the aging process, pay attention as they may be indicators of diabetes. Read more