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:

Why Get Your Child a Flu Shot by Dr. Amit Jain, Pediatrician

It’s that time of year again! The fall and winter seasons are approaching. Along with exchanging presents during the holiday season, everyone, especially children, are passing around germs and illnesses between each other. We here at NOAH want to inform you about the flu and why it is important to protect your child against the flu with the flu vaccine.

The Flu is short for Influenza – a virus that most often causes an illness that affects our breathing and airways. There are many different viruses that can cause common cold symptoms, but influenza is different in that it is more contagious, and often causes worse symptoms, lasts longer (a week or more) and has more severe problems that it can cause compared to other common cold viruses including pneumonia (an infection of the lungs), and a bacterial infection.

The flu is highly contagious, and most often spread via droplets, meaning it is most often caught from being near when a person with flu coughs or sneezes. It can also be caught when a child touches something contaminated with the flu virus, then touches their eyes, nose, or mouth.

The symptoms of the flu include:

  • Sudden, often high fever
  • Chills
  • Body shakes
  • Muscle aches
  • Headache
  • Being more tired than usual
  • Runny or stuffy nose
  • Sore throat
  • Dry cough
  • Some children may even throw-up (vomit) and have diarrhea

Although the likelihood of getting the flu is high, the children who would suffer the greatest problems from getting the flu are:

  • Those with chronic medical conditions – especially respiratory conditions including Asthma and chronic lung disease
  • Heart problems
  • Diabetes
  • Sickle cell disease
  • Weakened immune system
  • Disorders of the brain or nervous system

How can you prevent or decrease the risk of your child getting this scary flu virus? The best way to protect against the flu is the influenza vaccine. All infants and children 6 months old and older can get the flu vaccine every year. Since babies younger than 6 months cannot get the influenza vaccine, the best way to protect them is that everyone around and taking care of the baby get the flu vaccine. Along with this, frequent, good hand washing with soap and water is especially important. If you cough or sneeze, be sure to do so into your elbow (like a vampire holding their cape!) or into a tissue, but not directly into your hands. Teach your children these good habits from a young age as well! Sanitize toys that your children play with frequently as well.

Along with this, it may be a good idea to keep your child home from daycare or school if they are having the following symptoms:

  • Fevers (usually a temperature greater than 101F)
  • Chills and shaking of the body
  • Headaches
  • Body aches
  • Tiredness / sleepiness
  • Sore throat
  • Runny nose / congestion
  • Dry cough

Do not hesitate to bring your child in to your NOAH clinic to evaluate your child and determine if any treatment would be helpful. 

The side effects from the flu vaccine are few, and generally much less severe than getting infected with the flu. These include:

  • A low-grade fever
  • Some redness and soreness around the site that the injection was given.
  • The flu vaccine is made using eggs. Those who have a severe allergy to egg (anaphylactic reaction) should have a discussion with their doctor before getting the flu vaccine.

At NOAH, we are here to help you and your child get through the cold and flu season safely and healthily. Please call today to make an appointment to get you and your child the flu vaccine!

For more information, please visit:

  1. https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/The-Flu.aspx
  2. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Prepare-Your-Family-for-Flu-Season.aspx
  3. https://www.cdc.gov/flu/index.htm
  4. https://www.cdc.gov/flu/prevent/vaccinations.htm

Newborn Screening Awareness

By Dr. Patricia Avila, Pediatrician

What is Newborn Screening?

The state of Arizona screens for 31 disorders including genetic and metabolic conditions, hearing loss, and specific heart problems.  Newborn Screening includes a 2-part blood test, hearing screening, and screening for Critical Congenital Heart Disease.

Why are these tests important?

All babies are at risk.  Newborns can look healthy but can develop serious medical problems within the first weeks of life if not diagnosed and treated early.  If these conditions are not treated early, they can lead to developmental problems, slow growth, blindness, and sometimes death.  The Newborn Screening tests help to make sure all babies are tested for conditions at birth that need treatment early.  They save and improve the lives of more than 12,000 babies across the US each year.

How are these tests done?

Newborn Screening Heel Stick

A small amount of blood (approximately 5 drops) is taken from your baby’s heel and placed on a special paper.  The first test is done in the first 24 -36 hours of life in the hospital.  The second test is ordered to be done by 5-10 days of life.  Repeating the tests helps to make sure the first test is accurate.  The tests are sent to the State lab to screen for different genetic and metabolic conditions.  It is important that they are done on time to prevent serious health consequences that can happen if the disorder is left untreated.  The results are communicated to your Pediatrician who will take the necessary steps to confirm the diagnosis and start treatment early with the help of specialty doctors.

Hearing Screening

This test is done usually in the hospital before the baby is discharged.  There are 2 different ways this test can be done.  The screening measures how your baby responds to sounds and is quick and painless.  Results from this test are available as soon as the testing is done.  If not passed it will be repeated in the hospital.  If it is not passed prior to hospital discharge, your Pediatrician will order repeat testing to be done a later date.

Critical Congenital Heart Disease Screening 

This screening test helps to detect if your baby has a heart condition that is critical and involves a Pulse Oximeter which measures the blood oxygen levels.  It is done in the hospital as well after the baby is at least 24 hours old before the baby is discharged.  This screening is painless as well.  A sensor will be placed on the Right hand and foot.  If is abnormal it will be repeated.  If it is persistently abnormal your Pediatrician will discuss with you what next steps need to be done to ensure your baby does not have a heart defect.

Resources
https://azdhs.gov/preparedness/state-laboratory/newborn-screening/index.php#info-for-parents-home
https://www.babysfirsttest.org/sites/default/files/Az%20Parent%20Brochure-2018.pdf
https://www.babysfirsttest.org/sites/default/files/Can%20My%20Baby%20Hear.pdf
https://www.healthychildren.org/English/ages-stages/baby/Pages/Newborn-Screening-Tests.asp
https://www.healthychildren.org/English/ages-stages/baby/Pages/Newborn-Pulse-Oximetry-Screening-to-Detect-Critical-Congenital-Heart-Disease.aspx

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.

Back-To-School Health Checks – Desert Mission Health Center

Our NOAH Desert Mission Health Center Back-to-School event was a success! A special thanks to our partners – Delta Dental of Arizona, BHHS Legacy Foundation, Credit Union West and Mercy Care for their support of our programs and services. Does your child need a well-child check, #sportsphysical, and/or #immunizations? Call to schedule at 480-882-4545. #NHCW2019 #ValueCHCs #Pediatrics #LoveMyAZCHC

Back-To-School Health Checks – Venado Valley Health Center

Our NOAH Venado Valley Health Center Back-to-School event was a success! A special thanks to our partners – Delta Dental of Arizona, BHHS Legacy Foundation, Credit Union West and Mercy Care for their support of our programs and services. Does your child need a well-child check, #sportsphysical, and/or #immunizations? Call to schedule at 480-882-4545. #NHCW2019 #ValueCHCs #Pediatrics #LoveMyAZCHC

Back-To-School Health Checks – Palomino Health Center

Our NOAH Palomino Health Center Back-to-School event was a success! A special thanks to our partners – Delta Dental of Arizona, BHHS Legacy Foundation, Credit Union West and Mercy Care for their support of our programs and services. Does your child need a well-child check, #sportsphysical, and/or #immunizations? Call to schedule at 480-882-4545 #NHCW2019 #ValueCHCs #Pediatrics #LoveMyAZCHC

Back-To-School Health Checks – Heuser Family Medicine

Our NOAH Heuser Family Medicine Center Back-to-School event was a success! A special thanks to our partners – Delta Dental of Arizona, BHHS Legacy Foundation, Credit Union West and Mercy Care for their support of our programs and services. Does your child need a well-child check, #sportsphysical, and/or #immunizations? Call to schedule at 480-882-4545. #NHCW2019 #ValueCHCs #Pediatrics #LoveMyAZCHC

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