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CHILD AND ADOLESCENT CARE

Child and Adolescent Care

NEWBORN CARE, WELL CHILD & ADOLESCENT CARE

HELP WITH BREAST FEEDING

IMMUNIZATIONS INCLUDING ANNUAL FLU VACCINES

SCHOOL, SPORTS & CAMP EXAMINATIONS

VISION AND HEARING TEST

ROUTINE TESTS & SCREENINGS

DIAGNOSTIC & TREATMENT SERVICES FOR ACUTE & CHRONIC ILLNESS

Appointments:
Sick Visits: We believe that every child should be seen as soon as possible and will offer you an appointment the same day with either provider. If an appointment cannot be made for the same day, we shall certainly discuss treatment options to make your child comfortable till seen.

Physical Examinations: All physical appointments are made as per the schedule and we shall try and schedule the appointment with the provider of choice. A schedule of the physicals and vaccinations advised by the American Academy of Pediatrics is available.

To establish a rapport with both providers, we request that you schedule visits with both at different visits. When both providers are in the office, they discuss the care of each child and Dr. Limaye will come in at the end of the visit to answer any questions you may have. Both providers update each other at the end of the day.

Calls During Office Hours:
Every call is answered as fast as possible. If the call is deemed urgent, the staff will get the provider out of the room. If it is a routine call, you can expect an answer either at lunch time or before the end of the day.

Physical Schedule:
https://brightfutures.aap.org/materials-and-tools/tool-and-resource-kit/Pages/default.aspx

The schedule followed in the office is based on the guidelines by the American Academy of pediatrics.

WELL CHILD CARE SCHEDULE
Age	Physical Examination	Health assessments	Immunization
At Birth	PE (In hospital)	Newborn screen #1, Hearing Screen	Hep B#1, Parental TdaP
1-2 weeks	Ht, Wt, HC
1 mth	Ht, Wt, HC
2 mths	Ht, Wt, HC		DTaP/IPV/HepB #1, Hib#1, PCV13#1, Rotavirus#1,
4 mths	Ht, Wt, HC		DTaP/IPV/HepB #2, Hib#2, PCV13#2, Rotavirus#2
6 mths	Ht, Wt, HC,	To check for Fluoride in water	DTaP/IPV/HepB #3, Hib# 3, PCV13# 3, Hep B #3,
9 mths	Ht, Wt, HC,
12 mths	Ht, Wt, HC,	Hb, Lead levels, (PPD- If at risk), Dental care	MMR#1, Varivax#1, Hep A#1,
15 mths	Ht, Wt, HC,		Hib# 4, PCV13#4.
18 mths	Ht, Wt, HC,	Assessment for autism	DTaP#4, HepA#2,
2 years	Ht, Wt, HC,	Hb, Lead levels, (chol, PPD- If at risk)
3 years	Ht, Wt, BP, Hearing, Vision	(Hb, Lead, lipid profile, PPD-as indicated)
4 -5 yrs	Ht, Wt, BP, Hearing, Vision	Hb. (Lead, lipid profile, PPD-as indicated)	DTaP#5, IPV#4, MMR#2, Varivax#2,
6-10 yrs	Ht, Wt, BP, Hearing, Vision	Lipid profile, (PPD-If at risk).	HPV # 1, # 2 and/ #3 (after 9 years of age)
>11 yrs	Ht, Wt, BP, Hearing, Vision	Adolescent / depression screen. Hb in 5-6th and 10th grade. (Lipid profile, PPD-If at risk)	Meningococcal #1, #2, TdaP, HPV # 1, # 2 and /#3, Meningococcal B #1, 2 at 16 years of age.

NEW PARENTS

Becoming a parent is one of life’s greatest, most rewarding but often most challenging experiences. Be prepared so you can focus on the important things and enjoy this period.
You will have a million questions regarding the care of your baby. Babies do not come with instruction sheets! So we have put together a small handbook, which will answer some of your questions. Newborn Care Handbook
We welcome expectant parents to meet us, see the office and ask us all the questions before the baby arrives. We would like to guide you through your hospital stay and the initial newborn care.
At the Hospital:
You will be asked to pick a primary care provider before you leave with the baby. This way the hospital can fax the discharge notes and also talk to the provider if needed.
After the baby is born, you can hold the baby for some time and then the baby is taken to be warmed, Vit K given, and erythromycin eye drops administered. The baby is then taken to the nursery for bathing, and measurements of the weight, height, and head circumference.
The baby will be with you in the room for the most part of your stay. This ‘rooming in’ will give you some experience to take care of the baby with help available to answer all your questions.
During the hospital stay, the routine care will involve:
One of the hospitalists will come and check the baby within 24 hours of birth and daily till discharge
The baby will be weighed and vitals done per schedule.
Hepatitis B vaccine given with your consent.
The Oto-acoustic emission test (OAE) for hearing will be done.
The test for metabolic disorders (PKU test) and for cystic fibrosis will be done.
Jaundice levels checked periodically as needed.
Breast Feeding:
We strongly advise you to breastfeed your baby. There are many advantages in doing that. Please ask the lactation consultant to help you position the baby, latch on, and nurse the baby in the best way possible.
Our providers are dedicated to helping new mothers succeed in breastfeeding their newborn. Preparation for it starts even before the baby is born.
Please click the link for the breastfeeding brochure. Breast Feeding Brochure
You can obtain the breast pump early. Once your routine is set and breastfeeding well established and comfortable you can start using it.
Circumcision:
If you wish to have circumcision done, please inform the nurse on day 1. This way either the pediatrician or the obstetrician can perform the procedure early and the baby observed for the rest of the stay.
Discharge:
We like to see the baby within 24-48 hours of discharge from the hospital. This will enable us to answer all your questions, and make sure the transition is going smoothly for you. Please call us to make the appointment before leaving the hospital.
We like to avoid having the newborn staying in the waiting room with other children, so we shall make the maximum effort to move the new baby into a room quickly.

Insurance:
For state insurance, every child needs to have his/her own insurance from day 1.
For private insurance, the baby is covered under the mother’s insurance for the first 30 days. Please make sure you enroll your baby quickly to avoid a lapse in insurance coverage.

Visits:
After the initial newborn visit, we shall follow the baby till he/she regains birth weight. The visits after that are as per schedule. A schedule of the physicals and vaccinations advised by the AAP is available.

At Home:
It will be a joyful but occasionally stressful transition after you take your baby home. Make sure that you have some help at home. Do not hesitate to accept any help given by friends or family. Rest as often as you can. Your day will revolve around the baby.
Going Back to Work:
If the mother chooses to go back to work, make preparations early so the transition is smooth.
Try to return to work, mid week if possible. It will ease your return to work and will be less daunting than facing an entire week of work.
Childcare:
Plan the care and do a trial run for a week before going back to work. This will give you peace of mind and reassure you about your baby’s care.