National Youth Suicide Prevention Week

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Did you know suicide is the second leading cause of death for individuals ages 10-24? Youth suicide statistics cannot be ignored as they have greatly increased over the last decade. Ten teenagers out of 100,000 decide to commit suicide. Females attempt suicide at a rate of nearly 3-times that of males. However, males die by suicide at a rate of nearly 3-times that of females. Suicide prevention is a critical health topic for young people in the U.S.

Who is at high risk for suicide?

Adverse Childhood Experiences (also known as ACES) can include neglect, abuse, experiencing violence, substance abuse, divorce, incarceration of a family member, or poverty. Experiencing ACES has been shown to negatively affect physical and mental health over time and can occur across generations. This is particularly troublesome for youth who have had limited access to healthcare. Youth who have one or more ACES are at higher risk for suicide. Populations at a higher risk of experiencing ACES include minority groups, low socio-economic groups, and LGBT groups. Native Americans and Alaskan Indians have the highest rates of suicide by ethnic group.

What are the warning signs?

It is not always possible to recognize the warning signs in those thinking about suicide. Some common signs to watch for include: 

  • Talking or writing about death
  • Expressing hopelessness about the future
  • Withdrawing from family or friends
  • Increased drug/alcohol use
  • Giving away personal possessions
  • Engaging in self-harming behaviors
  • Participating in dangerous activities
  • Significant change in mood or behavior

How to support someone who is experiencing suicidal thoughts:

  1. Talk with them about their suicidal thoughts as it can help them process their emotions. 
  2. Try to acknowledge their feelings, fears, sadness, or pain.
  3. Provide reassurance but do not dismiss the problem. You may ask if they are thinking about hurting themselves or taking their own life, and if they have a plan.
  4. Be sure the person does not have access to any lethal weapons or medications and immediately inform adults or caregivers. 
  5. Try to avoid panicking or offering too much advice. 
  6. Provide contact information for the crisis line(s) and assist them to call if necessary. 

Professionals like the counselors or psychiatrists at NOAH are great resources for ongoing support and safety planning.

If you or someone you know is experiencing a crisis, reach out to one of the following resources for help:

  • National Suicide Prevention Lifeline: Call, text, or chat: 988
  • Crisis Text Line: text HOME to 741741
  • Maricopa County Crisis Line: 800-631-1314
  • Teen Life Line: Call or text 602-248-TEEN (8336)

Sun and Summer Safety Tips – Part 2

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By Amit Jain, MD FAAP MBA | Pediatrician

Summer has arrived, offering the perfect opportunity to enjoy the sun and water. Dive into these water safety tips for a fun and safe experience!

Water Safety Tips

Swimming is a great way to beat the summer heat here in Arizona and is a fun, healthy way to enjoy summer. However, water safety and drowning prevention are critical. Drowning is a very common cause of accidental, injury related deaths. Kids between 1 and 4 are at the highest risk.

General Pool Safety Tips

  • 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!)
  • If an unexperienced swimmer is near the pool, make sure there is a designated adult for supervision. This adult should not be under the influence of alcohol or anything else, should not have any distractions (cell phone turned off or handed to another adult), and preferably knows how to swim and perform CPR.

Home Pool Safety Tips

  • Talk to your pool operator to make sure your pool / spa and its drains are compliant with the pool and spa safety act.
  • Install a fence at least 4 feet tall around the pool, which should ideally surround the pool on all sides and completely separate 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 the pool that alerts you to anyone around the pool.
  • 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.

Swimming Lessons

  • Start swimming lessons early! Consider lessons for your child around age 1, but definitely by age 4. It may reduce the risk of drowning. Some neighborhoods that have pools have frequent swim classes for all ages.
  • Infant swim lessons are not advised because there is no evidence that swim lessons reduce a child’s risk of drowning under age 1 year old.

 Lastly, your NOAH pediatric team wishes you a safe and relaxing remainder of your summer!

Sun and Summer Safety Tips – Part 1

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By Amit Jain, MD FAAP MBA | Pediatrician

Summer is here and many of us will be out with our kids to enjoy the sun. NOAH’s Pediatric team has a few summer safety tips for safe fun in the sun!

The sun brings many great things, but it also brings harmful UV (ultraviolet) light. UV light can cause melanoma, a deadly form of skin cancer more common in people who have had bad sunburns when they were young. The sun can also cause other health risks and skin damage. Here are some precautions you can take to protect yourself all summer long.

Proper clothing and lots of shade

  • Limit your time in the sun between 10 a.m. and 4 p.m. (the most intense time).
  • Take frequent shade breaks if staying in the sun for long periods of time.
  • Cotton clothing is best – it’s protective against the sun and keeps moisture low so you stay cool outside. Tightly woven fabrics are best.
  • Wear a hat: wide brimmed is best to protect your child’s entire face, including the nose, cheeks, chin, ears, and back of the neck.

UV protection

  • Kids sunglasses should have UV protection. They aren’t expensive and are sold everywhere, but make sure they’re labeled with UV protection.
  • Use SPF 15 (or higher) sunscreen on any skin not protected 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.
  • 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, because it takes this long to start working.
  • Reapply sunscreen at least every 1 hour.
  • If playing in the water, reapply sunscreen every half an hour, and use a waterproof sunscreen.

Babies under 6 months need more sun protection

  • Avoid direct sun exposure. Keep them in shade with a canopy or under a tree.
  • Use wide brimmed hats to cover their face, ears, and neck.
  • Dress babies in lightweight clothing that covers their arms and legs.
  • If a young baby is in the sun, apply small amounts of sunscreen SPF 15 or more to your baby’s face, hands, and legs.
  • Don’t forget to use sun protection even on cloudy days, as the harmful UV rays come through clouds.

Looking for more summer sun safety tips? Talk with your NOAH pediatrician today.

Get a Sports Physical for School

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The beginning of the school year means new opportunities. If your child is starting a sport for the first time, changing sports, or deciding to try a new physical activity outside of class, then it’s time for them to have a sports physical so a medical professional can make sure they are healthy enough to play their new sport or activity safely.

What is a sports physical?

  • Screening for safe and healthy participation in sports and activities.
  • Checking that your child’s body is ready for the physical demands of the activity.

Does my child need a sports physical?

  • Yes. In Arizona it is state law that a student gets a sports physical if they are playing a team or club sport at school.
  • And where it isn’t required, it is highly recommended because almost all kids are active in some way! This exam looks at the physical and mental demands of their sport or activity and can address any concerns related to their health.
  • To make life easier and to have less appointments, the American Academy of Pediatrics recommends scheduling a sports physical with your child’s next routine well-child visit.

What happens during the appointment?

  • Bring your child’s completed Pre-Participation Physical Evaluation form with you. Write down any important medical information like past surgeries, injuries, or illnesses, and any family history of heart disease should be reviewed. Write down any questions you may have to discuss with the doctor.
  • At the appointment, the doctor will check your child’s:
    • Vitals: height, weight, pulse, and blood pressure
    • Eyes: if your child may need corrective lenses or a new prescription
    • Medical history
    • Fitness: heart, lungs, abdomen, joints, flexibility, strength, and reflexes             
  • This is also a good time to talk with your child’s doctor about any concerns for your child’s new or ongoing activity or sport, such as:
    • Concussions
    • Special needs or disabilities       
  • Your NOAH provider may also request lab work for your child or refer them to a specialist for further evaluation. If needed, your NOAH Care Team will help set up the next steps for this, and most children are able to play after this extra clearance.

Safe and healthy participation in sports and physical activities is the goal, so get your child’s physical scheduled with your NOAH provider and enjoy watching them play and have fun.

Is Your Child Feeling Sick? When is a Cold Not a Cold?

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By Dr. Patricia Avila | Pediatrician

It’s that time of year again! The cooler weather is among us, nights are getting longer, and families are even busier than usual as the holidays approach. It’s also the time of year when children start coming down with symptoms of colds or other respiratory illnesses. While most of these symptoms will turn out to be simple colds and resolve on their own, there are some related illnesses that can be more serious.

The Common Cold: Also Known as an Upper Respiratory Infection

The common cold is caused by several different viruses and is the most common of all the respiratory illnesses. On average, children under the age of two will have three to five colds per year. Children who are in daycare or school-aged children are likely to get sick even more often, because they are exposed to lots of other children on a daily basis. Fortunately, most of these illnesses are just colds and will go away on their own. 

Symptoms of the Common Cold

  • Low fever (101-102 degrees F).
  • Runny nose, nasal congestion, and/or sneezing
  • Sore throat
  • Cough
  • Lack of appetite
  • Fussiness

Symptoms can last up o 14 days but most children feel better within 7-10 days.

When to Worry with the Common Cold

While the majority of children will not need to be see a medical provider for the common cold, you should seek immediate assistance if your child:

  • Is an infant under 3 months old
  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Symptoms last longer than 10-14 days
  • Is dehydrated or not drinking or urinating well
  • Is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Treatment for the Common Cold

  • Antibiotics do not treat the common cold since it is caused by a virus
  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen
  • Nasal saline with suctioning for congestion
  • Honey for cough in a child OLDER than 1 year (NEVER give honey to a child under the age of 1)
  • Use of a humidifier may provide relief

The Flu: Also Called Influenza

The flu is also caused by respiratory viruses called influenza and can present very similar symptoms to the common cold.  However, children with the flu feel much worse and are sicker than with the flu than the common cold.  The flu can have very serious complications including need for hospitalization and sometimes death.   

Symptoms of the Flu

  • Rapid onset of high fever (above 101 degrees F)
  • Chills
  • Headache or other body aches
  • Runny nose, nasal congestion
  • Chest pain and cough
  • Sore throat
  • Poor appetite
  • Feeling tired and weak

Most children will get better after two weeks. Fevers from the flu can last up to seven days. 

When to Worry with the Flu

Flu symptoms can lead to serious complications that require immediate medical treatment. You should seek assistance if your child:

  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Is dehydrated or not drinking or urinating well
  • Is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Young children, infants, and children with high-risk medical conditions who are having flu symptoms should see their pediatrician as soon as possible. High-risk medical conditions may include:

  • Heart defects
  • Chronic lung issues
  • Asthma
  • Weakened immune system
  • Diabetes
  • Cancer

Treatment for the Flu

  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given honey to children under the age of 1)
  • Use of humidifier may provide relief

Outside of supportive care, there is an antiviral medication called Tamiflu which may be prescribed if the flu is diagnosed within the first 1-2 days of onset.

Bronchiolitis

Bronchiolitis is another respiratory illness that is common during the winter months.  There are several viruses that can cause this illness, but RSV, also known as Respiratory Syncytial Virus, is the most common.  RSV is an infection that will affect almost all children under the age of 2 at least once. It usually starts as a cold and within 3-5 days of the onset of the illness is followed by lower respiratory symptoms. For some children the illness can be severe, especially in younger infants, preemies, and those with heart or lung defects.   

Symptoms of Bronchiolitis

  • Cold symptoms with fever, runny nose, nasal congestion, and cough
  • Fussiness
  • Poor appetite
  • Wheezing
  • Difficulty breathing

When to Worry with Bronchiolitis

Bronchiolitis symptoms can lead to serious complications that require immediate medical treatment. You should seek assistance if your child:

  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Is dehydrated or not drinking or urinating well.
  • Child is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Treatment for Bronchiolitis

  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given honey to children under the age of 1)
  • Use of humidifier may provide relief

For infants who are high risk there is an injection that is given monthly during the winter months called Synagis that can decrease the risk of severe RSV infection. 

Croup

Croup is another respiratory illness that is common during the fall and winter months and is usually seen in infants and children under 5. Croup is caused by several different viruses including the flu virus and some cold viruses.  The illness is characterized by swelling of the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from croup are usually worse at the beginning of the illness. 

Symptoms of Croup

  • Fever which can be low grade or high
  • Cold symptoms with runny nose and nasal congestion
  • Hoarseness of voice
  • “Barky” or “seal like” cough
  • Noisy breathing called stridor, a high-pitched, turbulent sound when a child inhales or exhales

When to Worry with Croup

The swelling of the airway can sometimes be severe and need immediate medical attention. You should seek assistance if your child:

  • Has trouble breathing – struggles to catch their breath
  • Has noisy breathing that is getting louder and child/infant appears to struggle to breathe
  • Cannot talk because of difficulty breathing
  • Nails or lips turn blue
  • Is drooling and not able to swallow saliva
  • Is dehydrated or not drinking or not urinating well
  • Is too sleepy or very fussy and not consolable

Treatment for Croup

Steroids can decrease the swelling and can be given by mouth, injection, or in a breathing treatment. If given early steroids can help decrease the need for hospitalization and improve breathing.  For severe cases, a breathing treatment with epinephrine may be administered, but this requires careful observation in the emergency department or hospital setting.

Use of cold moist air can help improve mild symptoms as well and can be used at home with a cool mist humidifier.

Tips to Keep Your Child Healthy and Well

  • For all respiratory infections, the best form of prevention is to avoid exposing infants or young children to large crowds or people who are sick.
  • Breastfeeding infants as long as possible (at least 6-12 months) is also an important way to help prevent and fight infections because breastmilk provides antibodies. 
  • Practicing and teaching children good hand hygiene is key.
  • Use soap and water and scrub for at least 20 seconds (sing the ABCs, Baby Shark, or another fun tune).  Another option is the use of an alcohol-based hand sanitizer if hands are not visibly soiled. 
  • Teach children to cover their coughs and sneezes properly by using a tissue or coughing in their arm rather their hands. 
  • Keep children home from daycare or school when they are sick to avoid spreading the illness. 
  • Eating a healthy balanced diet high in fruits and vegetables can help boost the immune system and decrease the chances of getting sick.   

If you have questions about these or other common childhood illnesses, talk to your NOAH provider. If at any time you’re not sure what to do, you can also call our Nurse Triage for immediate advice.

5 Things to Know for Flu Season 2022-2023

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Flu season is around the corner and NOAH is ready to keep you and your family protected. We know that with COVID there might be additional questions about the virus, symptoms, and the vaccines. NOAH has you covered with these top five things to know about flu season.

1. Flu Season is Almost Here

Flu season officially starts in October and can last through May of the following year. But the peak of flu usually happens around December through March with February being the month that often has the most flu cases nationwide.

2. Try These Safety Measures Stop the Flu

Many of the things we continue to do to slow or stop the spread of COVID like extra hand washing, more antibacterial gels and wipes, staying home when sick, and wearing masks (especially if sneezing or coughing), will help reduce the flu as well!

3. The Flu Vaccine Helps

Every year, flu shot manufacturers identify the strains of influenza A and B that pose the most risk for the coming season. Flu shots also include H1N1, and because of flu shots, H1N1 isn’t causing outbreaks anymore. Flu shots are adjusted every year with new influenza (flu) strains because it mutates like all viruses.  

4. Flu Shots are Optimized by Age Group

Children are a high-risk group with flu so anyone 6 months and older should get the flu shot. When children under eight are getting the flu vaccine for the first time ever, they will need to have two doses, given four weeks apart. The following flu seasons will be just one dose.

A high-dose flu vaccine made specifically to support the more fragile immune system of people ages 65 and up is also available during flu season.

5. Flu Shots and COVID Shots Can Go Together

The CDC says that it is safe to get the flu and COVID vaccines/boosters at the same time.  If you have any concerns about potential side effects or changes in effectiveness of the vaccines if given together we suggest talking to your NOAH provider to come up with a vaccine plan that is right for you. NOAH is administering bivalent COVID boosters along with flu vaccines in all of our health centers.

Almost everyone can and should get the flu shot every year. Even people with egg allergies can talk with their healthcare providers about egg-free vaccine options. The only people who shouldn’t get vaccinated for the flu are patients under 6 months old or someone with history of an anaphylactic reaction to the flu shot or one of its components.

The CDC has a lot of information about flu season including updated flu cases and vaccine activity on their website here. If you have questions about the flu vaccine or want to schedule your appointment, contact NOAH today!

Back to School Wellness Bundle

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The demands for back to school can be overwhelming when it comes to backpacks, haircuts, and new outfits, but many students are also in need of required vaccinations, well child checks, or sports physicals.

NOAH is easing the stress of back to school health needs with our Wellness Bundle. This visit takes about an hour and is your “one and done” health exam for back to school. Schedule one appointment and see multiple providers who will examine your child’s health needs in the following areas:

  • Medical & Immunizations
  • Dental
  • Nutrition
  • Emotional Health
  • Community Resources

Any recommended follow-up care will be noted and then scheduled when it’s convenient for you.

Wellness Bundle appointments are available for children of any age at NOAH’s Desert Mission and Palomino Health Centers from 7:30 a.m. to 4:30 p.m. on the following dates:

Desert Mission Health Center

  • Saturday, August 13

Palomino Health Center

  • Thursday, August 4
  • Friday, August 5

Your family’s health is important to us and we know your time is valuable. Let NOAH help check a few items off your list this back to school season.

Call us at 480-882-4545 to book your Wellness Bundle or request an appointment online.

8 Tips to Help Prevent SIDS

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By Tyler Pascavis, MD

Sudden Infant Death Syndrome, or SIDS, is something that every parent should be aware of.  It is estimated that 3,400 sudden unexpectant infant deaths occur in the United States each year.  The good news is, there are multiple ways you can lower the risk of SIDS.

8 Ways to Reduce SIDS Risk

  1. Your infant should always sleep on his or her back. Placing your infant on their side or stomach to sleep can increase the risk of SIDS.
  2. Use a firm sleeping surface that meets the safety standards set by the Consumer Product Safety Commission. Soft mattresses increase the risk of suffocation.
  3. Infants should sleep in their own crib or bassinet. Sleeping in a bed with others, such as co-sleeping with a parent, can increase the risk of SIDS.
  4. Your infant can sleep in the same room as the parent(s) on a separate, safe surface for at least the first 6 months of their life. This can reduce the risk of SIDS by up to 50%.
  5. Crib bumpers, loose blankets, and stuffed animals all increase the risk of sudden death and suffocation, and these items should not be placed in the infant’s sleeping area. 
  6. Tobacco smoke, alcohol, and illicit drug use in the household all increase the risk of SIDS. It is important to set boundaries with other family members and friends to not expose your child to secondhand smoke.
  7. Breastfeeding has been shown to decrease the risk of SIDS. It is recommended to breast feed until at least 6 months of age.
  8. Avoid overheating your infant.  Usually, an infant only needs one more layer of clothing than you do. If you are comfortable in a t-shirt for example, then the infant is likely comfortable in a onesie plus another layer, like their swaddle blanket. Signs of overheating include sweating or your infant’s chest feeling hot to touch.

Although there is no way to completely prevent SIDS, these things can greatly reduce the risk. If you have any questions about SIDS, your NOAH doctor is here for you and your baby. Click here to make an appointment today.

NEWS: COVID Vaccines for Children Age 5 – 11 at NOAH

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The Pfizer COVID-19 vaccine has been approved for use in children ages 5 to 11. NOAH has the vaccine available to begin scheduling COVID vaccines for children and is kicking this off with a vaccine event on Saturday, Nov. 20 from 8 a.m. to 12 p.m. at NOAH Palomino Health Center.

The approval came after the Pfizer-BioNTech vaccine was studied in approximately 3,100 children. The study shows the vaccine to be 90.7% effective in preventing COVID-19 in children 5 through 11 and there were no serious side effects found during the study.

While the same vaccine, the dosage children 5 to 11 will receive is 1/3 the dose those 12 and older receive. The second dose of the vaccine will be 21 days after the first dose. NOAH will schedule the second dose appointment when patients schedule the first dose for their child.

More Questions About COVID Vaccines for Children?

NOAH has put together some of the most common questions about COVID vaccines for children.

COVID Vaccine Q&A Age 5-11

Schedule An Appointment

Parents or guardians of patients ages 5 to 11 can request a vaccine appointment at NOAH. The first vaccine opportunity is:

Request a Vaccine Appointment

COVID-19 vaccines are free, and no insurance is required. For individuals under 18, parental consent is required. ID is required for parent or guardian and can include any government-issued ID.

If you have questions about COVID-19 or the vaccines, NOAH has answers here, or you can make an appointment to talk to your healthcare provider.

The Importance of Children’s Eye Health

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By Mitchell Ducett, DO | Family Medicine PGY-1

August is Children’s Eye Health and Safety Month and the perfect time to share one of the most common conditions of pediatric eye health, strabismus. Strabismus is the fancy medical term for when eyes don’t naturally look at the same place. This is also known as lazy eye and can cause issues like double vision that can negatively affect your child.

Tips to help children with eye health

  • Make sure you attend all your child’s well-child appointments, and all follow-up appointments with your family doctor or pediatrician to catch this issue early on.
  • Always feel comfortable asking your child’s doctor questions and telling them concerns like if you see something “funny” with the movement of your child’s eye. You know your child best!
  • If either parent had a lazy eye or was crossed eye, your child has a higher risk. Tell your child’s doctor of a family history of eye or vision issues.
  • Does your child bump into things when they are walking or crawling? That could be a sign that they have vision issues that you should talk to their doctor about.
  • The sooner you have it diagnosed, the better! Knowing if there is a problem and addressing it will help your child’s vision and development.
  • Treating a child can prevent amblyopia – where the brain favors the “good eye” making the lazy eye even worse.  Half of children with a lazy eye will develop amblyopia, which is still treatable. But the sooner, the better!
  • Treatments usually include eyeglasses, visual exercises, and/or an eye patch over the “good eye” to increase the use of the other eye. Occasionally, surgery is needed on the muscles in the lazy eye that help it move.

The best way to help your child with their eye and vision health is to catch it early. Knowing these signs and learning a few more here, will help parents, family, and any babysitters or caregivers. Vision and eye health is so important to their overall development, so keep an eye on your child’s eyes!