Asthma Awareness in Children by Dr. Patricia Avila, Pediatrician

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“Asthma in children is one of the most common long term (chronic) diseases. It is estimated to affect 1 in every 10 children in the US. If your child has Asthma one of the most important things you must do is to learn as much as you can about Asthma. Being educated about your child’s Asthma will help you work together with your child’s doctor to control their Asthma and have the absolute best outcome.”

Dr. Patty Avila, Pediatrician

What is Asthma?

  1. It is a disease of the lungs that causes the airways or tubes that bring air into the lungs to become swollen and inflamed. The muscles around the airways become tight and it makes it hard to breathe. This leads to episodes of coughing, wheezing, feeling breathless, chest pain/chest tightness, and feeling more tired than usual.
  2. It is more common in children with a parent or sibling or close relative with Asthma, Allergies, and/or Eczema. Children with Asthma often develop Allergies or Eczema as well. These are sometimes present before they develop Asthma.
  3. There is no cure for Asthma. There are medications and things you as a parent/caregiver can do to help control it. Know what the signs/symptoms of Asthma are, how to avoid triggers, and follow your doctor’s treatment plan. This is especially important to prevent and decrease the damage to your child’s lungs. It will also help avoid your child needing emergency medical treatment.

What causes an Asthma Attack?

  • An Asthma attack happens when your child is exposed to “triggers” things that cause your child’s Asthma to get worse.
  • An Asthma attack also happens when a child does not take their medications as prescribed.

Common triggers include:

  • Allergens – including outdoor allergens like pollen, animal dander, dust mites, mold, and cockroaches.
  • Infections – including the common cold, the flu, sinus infections, and cases of pneumonia.
  • Irritants – including cigarette smoke or other smoke, pollution, strong odors like perfumes or scented candles, and cleaning products.
  • Changes in weather – cold and dry, very humid, or extremely hot weather.
  • Exercise.
  • Stress and strong emotions.

How can you help control your child’s Asthma and how is it treated? Avoid triggers. It may not be possible to completely avoid all possible triggers, but there are some changes you can make that will help.

  • Allergens. Have your child take their allergy medications during allergy season. Keep windows and doors shut during allergy season. Avoid outdoor activities when pollen counts are high.
  • Dust mites. Use mattresses and pillow covers. Vacuum and dust regularly. Wash bedding once a week. Limit and wash stuffed animals.
  • Furry pets. Keep pets out of your child’s bedroom. Wash pets more often.
  • Use HEPA filters.
  • Fix any water leaks that could lead to mold.
  • Infections. Make sure your child and family receive their yearly Flu vaccine. Having Asthma increases your child’s risk for severe Flu illness that can trigger an Asthma attack.
  • Use good hand hygiene.
  • Irritants. Do NOT allow anyone to smoke in your home or car. Avoid public places where smoking is allowed. Avoid the use of perfumes, scented candles, incense, paints, and cleaning supplies that can irritate your child’s lungs. Check your local forecast for air quality and keep your child indoors when the pollution is bad.
  • Weather. Avoid outdoor activities in extreme weather conditions.
  • Exercise. If your child’s Asthma is triggered by exercise have your child take his/her Albuterol 15-30 minutes prior to activity to prevent these symptoms. Encourage your child to exercise and participate in sports. Know what medications help control his/her Asthma so that they can continue to be active.
  • Medications. Includes inhaled medications in the form of MDIs also known as inhalers or “pumps” and nebulizers that are given by a machine. Rescue or quick relief medications like Albuterol help during an Asthma attack. They help open the airways or tubes that bring air to the lungs. Long-term controller medications like inhaled corticosteroids help improve the inflammation of the lungs. When these medications are used daily your child is less likely to have an Asthma attack.

Develop an Asthma Action Plan.

This plan is made with the help of your child’s doctor. It will help you and your child know what medications to use and when. It will also help you and your child know what to do in the case of an emergency. Share this plan with the school as well. It is important because your child spends a good amount of time there and the school will know exactly how to help your child.

By becoming knowledgeable about your child’s Asthma, avoiding triggers, and following a good Asthma Action Plan you are taking important steps in keeping your child healthy. Have your child see his/her doctor at least 2 times per year to ensure their Asthma is under control. Do not forget to make sure your child and family receive a yearly Flu vaccine. Your child should be able to enjoy everyday activities and participate in sports without any problems breathing if their Asthma is under control.

Adverse Childhood Experiences and Child’s Brain Development by Dr. Patricia Avila, Pediatrician

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Did you know that suffering a potentially traumatic event during childhood also known as ACE or Adverse Childhood Experience can have long lasting negative effects on a child’s health, brain development, and life potential? 

Adverse Childhood Experiences can include experiencing violence, abuse, neglect, witnessing violence in the home, loosing a family member, mental health issues in a parent, substance/alcohol abuse by a parent, or instability from divorce or having a parent become incarcerated. 

These events lead to what is called toxic stress. Research shows that this toxic stress negatively changes a child’s brain and body by affecting the child’s brain development, hormonal system and immune system. These changes can persist for years and can lead to long term behavioral, mental, physical health problems.

The toxic stress from ACEs on brain development can impact a child’s potential to: 

  • Develop normally – leading to delays in development.
  • Focus and learn – leading to learning disabilities, dropping out of school, lack of future job opportunities.
  • Make decisions – leading to increase risk taking behaviors such as involvement in drugs and unprotected sex, unwanted or teen pregnancy.
  • Develop mental illness – leading to increase depression, anxiety, and rates of suicide.
  • Form healthy, stable relationships – leading to continuing this cycle of toxic stress in their children and families.

Research also shows that toxic stress from Adverse Childhood Experiences negatively affects a child’s body and can lead to chronic health problems like: 

  1. Obesity.
  2. Cancer.
  3. Heart disease.
  4. Autoimmune problems.
  5. Asthma and chronic lung disease.
  6. Headaches.
  7. Early death from general poor health.

The more of these events a child has suffered, the higher the risk of developing these long-term problems.

The GOOD NEWS is that we can do something about this! Research also shows that we can PREVENT and UNDO the harm done and the future harm on a child’s brain and body. There are some simple things that parents/caregivers can do at home to help regulate a child’s stress response and change the negative impacts of the stress hormones to keep them healthy and on track with brain development.

These include providing our children with: 

1. Supportive and nurturing relationships.
a. Tell them and show them how loved, special, and important they are.
b. Spend quality time doing activities that they enjoy. Simple activities like making art, dancing, cooking, playing games, reading, and singing together are excellent choices.
c. Keep connections outside the home with friends and family members.
2. Regular physical activity. Recommendation for 1 hour of physical activity which does not have to be all at the same time. These can include sports, dance parties, hula hooping contests, hiking, playing tag, chasing the family dog, or anything you can think of to get your child physically active.
3. Healthy meals.
a. Avoid high sugar foods/drinks. Avoid high fat foods or foods/snacks high in carbohydrates.
b. Include fruits and vegetables with every meal. 5-9 servings of fruits/veggies per day are recommended. Fruits and veggies provide nutrients that no other foods can provide.
c. Include foods rich in healthy Omega 3 fatty acids such as fish, nuts, avocados, flax seeds.
4. Restful sleep.
a. Keep a routine with a regular bedtime.
b. Make sure the bedroom is quiet, calm and free of distractions.
c. Avoid all electronics including cell phone, tablet, computer, and TV 1-2 hours prior to bedtime.
5. Getting mental health care for yourself as parent/caregiver and for your child.
6. Practicing mindfulness.
a. This can include meditation, breathing exercises, and prayer.
b. Talk with your child about how they are feeling physically and emotionally.
c. Practice talking about, writing down, or drawing what you are grateful for each day with your child.

All of these will build connections in their brains to help them succeed in school, behave in ways you would expect and become happier, healthier, and more successful.
When parents and caregivers manage stress in positive ways as well, your brain also changes in ways to make you happier and healthier.

Learn ways to manage your stress as a parent/caregiver:

  1. Know what is stressing you out. When you know what exactly it is, you can better deal with it.
  2. Ask yourself “can I do something about this?” If the answer is no, then let it go and focus on something else. If the answer is yes, break it down to small steps so that it is not overwhelming.
  3. Have faith. Think of other times you have overcome challenges. It has been proven that people who attend church, pray or practice other forms of spirituality have less stress.
  4. Relax. Use breathing exercises, meditation, listen to music, or take a nap.
  5. Form healthy habits for yourself by getting good sleep, exercising, and eating well.
  6. Take time for yourself like reading a book, picking up a hobby, or spending time with friends.
  7. Make connections with others. Have a support network that includes friends and family. Don’t be afraid to ask for help.
  8. You are never alone. Your child’s Pediatrician or Family Doctor can also be a great resource and support person for you. They can help give you ideas, resources, and help connect you with others who can help.

Additional resources:
Crisis Text Line Text HOME to 741-741 to connect with a Crisis Counselor. It is Free and is available 24/7.
National Domestic Violence Hotline 1-800-799-SAFE (7233) or text LOVEIS to 22522. Available 24/7.
Childhelp National Child Abuse Hotline 1-800-4-A-CHILD, 1-800-422-4453 or chat/text at www.childhelphotline.org. Available 24/7.

Amazing Brain Series of booklets to help parents/caregivers:
http://preventchildabuse.org/wp-content/uploads/2016/02/ABSapps.pdf
preventchildabuse.org/wp-content/uploads/2016/02/ABSwhateveryparent.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABStrauma.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABSteen.pdf

Other websites with great ideas for parents/caregivers:
https://childdevelopmentinfo.com/family-building/everyday-practices-to-make-your-child-feel-loved/#gs.4csgtk
https://childdevelopmentinfo.com/family-building/family-life-is-important-for-kids-mental-health-and-adjustment-to-life/#gs.4csmks

7 Tips to Improve Your Child’s Sleep Hygiene by Dr. Amit Jain, Pediatrician

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Do you wonder if your children are getting enough sleep? Are they going to bed early enough? It is well known that in today’s hustle and bustle of daily life, sleep tends to get compromised for everyone, children and adults alike. Sleep is essential to good health and has many benefits from allowing one’s brain to process and store in memory what was experienced and learned that day to rejuvenating so that they may be ready for the day ahead with full mental functionality. Without enough sleep, one may suffer consequences of sleep deprivation including difficulty concentrating, inattention, headaches, poor behaviors / irritability, obesity, and depression. With enough sleep, children may be able to better concentrate, have more energy, thus decreasing the risk for obesity, have better mental health, and even a healthier immune system.

As your children grow, their sleep needs will vary. The American Academy of Sleep Medicine has provided some helpful guidelines regarding how much sleep a child needs as they grow through various stages of their development.

This chart includes any naps a younger child may take during the day, as it is a total within a 24-hour period:

Is your child getting enough sleep? Our NOAH family wants to ensure your children are sleeping well, as it is an important component of their overall health. Below are some tips on improving your child’s sleep hygiene, so they may get a good night’s rest and stay healthy:

  • Keep a daily routine, including sleep and wake times, mealtimes, nap times, and play times. This can help the brain get into sleep mode when it is time for a nap or bedtime, as it helps with a smooth transition to sleeping. The disruption to this schedule should be kept to a minimum over the weekend and breaks as well.
  • Establish a good routine of daily physical activity, including getting fresh air and participating in age-appropriate sports.
  • Keep an eye on that screen time! The American Academy of Pediatrics (AAP) recommends no more than 2 hours of screen time per day. This includes computers, phones, TVs, tablets, etc.
  • Along the same lines, all screens should be turned off at a minimum of one to two hours before bedtime as the blue light emitted from screens can prevent the brain from being able to fall asleep, or prevent the brain from getting to deeper stages of sleep until later in the night.
  • Limit your child’s bed as a place to sleep, and only for sleep. Any playtime or homework should be done in a different environment, as a simple cue of getting into bed can help trigger the brain to start falling asleep.
  • Avoid any sugary beverages such as juices and sodas just before bedtime. This includes a bottle of milk, formula, or juice (only water if needed), as these beverages at bedtime can cause or increase the speed of baby bottle tooth decay.
  •  Regarding bedtime routine, the AAP recommends the 4 B’s of Bedtime: 
  1. Bathing: having this as a part of the normal sleep routine is a hygienic and soothing way to separate evening activities and dinnertime from bedtime and can help the brain get into bedtime mode if used as a part of a routine.
  2. Brushing: Getting in the habit of brushing their teeth before bedtime can not only help prevent cavities and tooth decay, but also can help the brain transition into bedtime mode.
  3. Books: This can stimulate excellent brain activity and it can also help cue the brain for bedtime if used as part of a daily routine.
  4. Bedtime: To reiterate, none of the above are more important than enforcing a reasonable bedtime and encouraging your child to sleep at the same time every night.

If your child has trouble falling asleep or getting enough sleep, please reach out to your NOAH provider for further recommendations. We are happy to help promote this important concept in good health.

For additional information, visit the American Academy of Pediatrics website healthychildren.org.
(https://www.healthychildren.org/English/healthy-living/sleep/Pages/Healthy-Sleep-Habits-How-Many-Hours-Does-Your-Child-Need.aspx)

Healthy Smile Tips by Dr. Lou Sarrosa, Dental Director

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During the month of February, thousands of dedicated professionals, healthcare providers, and educators come together to support National Children’s Dental Health Month. The goal is to promote the benefits of good oral health to children, their caregivers and members of the community. At NOAH we believe in educating our little community members on the importance of having a healthy smile. We do this by partnering with local school districts, hosting free dental health screenings and providing oral health education to all attendees. We also attend various events in the community where we offer the same services while encouraging families in need of a dentist to come see us at one of our dental offices. At NOAH, we take oral health education a step further by providing these free community screening events all year long. With your help, and just a few simple tips from our dental pro’s, you and your child can have a healthy smile that is bright and cheerful.

HEALTHY SMILE TIPS

  • Brush your teeth twice a day with a fluoride toothpaste.
  • Clean between your teeth daily.
  • Eat a healthy diet that limits sugary beverages and snacks.
  • See your dentist regularly for prevention and treatment of oral disease.

Halloween Safety Tips by Amit Jain, MD, FAAP, MBA

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It’s that time of year again! Halloween is right around the corner. With it comes lots of fun, elaborate costumes, tricks, and treats! Have your children thought of the costume they’d like to wear this year? We here at NOAH want to make sure they stay safe while out trick or treating this year. With assistance from the American Academy of Pediatrics, have provided some great safety tips below to keep them safe while they’re out.

Fun / elaborate costumes can be an exciting part of Halloween. One of the most effective but most easily forgotten ways to help make your child’s Halloween a safe one is with costume safety.

Here are some great safety tips:

  • As most of the trick or treating happens after dusk, make sure costumes are bright and colorful and / or have some reflective surfaces that can be easily seen by drivers and others. You can even consider adding some reflective tape or striping to the costumes and trick-or-treat bags with such tape. It can even help for a cool effect the children would love.
  • Make sure the costumes are short enough to prevent tripping, and are clearly labeled as flame-resistant.
  • Along with this, make sure your children have shoes that fit well and are comfortable for walking long distances.
  • Masks can obscure a child’s vision, especially to the sides (peripheral vision) as the mask moves around their face. Consider non-toxic makeup and decorative hats as fun and safe alternatives to masks.
  • Any swords or other sticks / canes that are a part of the costume should not be sharp or too long that they could hurt your child if they trip and stumble over these objects.
  • Make sure all children and their escorts have flashlights with a fresh set of batteries.
  • Before leaving for trick or treating, make sure your children know how to call 9-1-1 or their local police department in case they get lost or separated or in an emergency. Have a safety plan in place for the chance that a child gets separated from the group, which should include having the child stay where they are in a safe location if they do get separated from the group. The non-emergency number for the Phoenix Police Department is: 602-262-6151.
  • Also, make sure they have a good meal prior to going trick or treating, and bring a water bottle for each child and the children’s escorts to stay hydrated while out.
  • A parent or responsible adult should be with and watching children at all times while out. Instruct children to always stay in a group and close to the parent / responsible adult. Also instruct them to remain on well-lit streets, always use the sidewalks (or as close to the edge of the road as safe if no sidewalk is available, facing traffic), and use designated crosswalks to cross the street.  Don’t assume you have the right of way – it is much more difficult to see the road and pedestrians at night! While out trick-or-treating, only go to homes with a porch light that is on. Remember to never enter homes or cars for a treat.
  • If your older children are going alone, plan and review a route that is acceptable to you beforehand – and ensure they will stay on that route. Plan and agree upon a time that they should arrive home by. Remember curfews – Phoenix juvenile curfew hours are 10 p.m. for children 15 and younger and midnight for 16- and 17-year-old children. If possible, give them a cell phone for emergency contact use.
  • Finally, after the fun night of trick-or-treating, sort and check all treats before the child eats any of them (including ones they eat while still out trick-or-treating). Throw away any spoiled, unwrapped, or suspicious looking treats. Ration out treats for the weeks and months following Halloween. They should not eat any of these treats immediately before bedtime. Along with this, remind your children that the rules don’t change from a normal day – remember to have your children brush their teeth before bedtime to get all of that stuck-on candy out of their teeth.
  • Also, don’t forget to have regular check-ups with our wonderful Pediatric Dentists here at NOAH!

Please check the American Academy of Pediatrics website for some more awesome safety tips here:

https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Halloween-Safety-Tips.aspx

Have a fun, safe, and Happy Halloween from your friends at NOAH!

Car Seat Safety by Dr. Amit Jain, Pediatrician

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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

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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

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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

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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

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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