Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
This page offers informative and current information relevant to children 11-18 years of age.
The Elisa Project dedicated to the prevention and treatment of eating disorders: http://www.theelisaproject.org
Unintentional Strangulation Deaths From the “Choking Game” https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5706a1.htm
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- Anything beyond a local reaction to an insect sting
- Bleeding that cannot be stopped
- Breathing difficulties which are rapidly getting worse
- Fever and rash
- Serious accident or injury
For life threatening emergencies, call 911.
*CALL POISON CONTROL IMMEDIATELY at 800.222.1222. Save any containers or any material that is left in the container.
Remember, the best prevention is locking up your medicines and household cleansers and keeping them out of reach.
Abdominal (Stomach) Pain
Any pain in the abdomen is a cause for concern, though not necessarily alarming. Consult us if it appears significant or persistent.
Asthma is a disorder in which the airway bronchial tubes narrow from time to time, causing the child to have difficulty in breathing. It is characterized by wheezing on breathing out. Asthma may be triggered by emotional or environmental factors or infection. A child having an asthma attack requires immediate treatment to relieve his/her bronchial spasms and long-range care to find the cause. Begin his/her usual medication and encourage fluid intake. Call if no relief or if the condition worsens.
Runny or Congested Nose with or Without Cough
Nose drops are often helpful if used four times a day for about 3 days. We prefer saline for infants less than 3 months and Neosynephrine for older infants and toddlers. Use several drops of saline in each side of the nose followed by suctioning thoroughly with a bulb syringe. Children’s cough medicine or a non-prescription antihistamine may be helpful to older children. If fever lasts 24 hours the office should be notified or if difficulty in breathing is encountered, please contact us. Saline nose drops may be made by adding 1/4 tsp. of salt to 8oz. of water.
Medications: The instructions as well as names of medication should always be on each prescription. Antibiotics are not prescribed for routine colds or viral infections. If the child is ill enough for an antibiotic, he/she will need to be seen. Antibiotics should be used until the bottle is empty, unless you are otherwise advised. Antibiotics should never be used from a previous illness or from another person’s illness.
Over the counter cough medicines, such a Robitussin may be helpful. For high fever with severe cough, call the office.
Croup is a loud, deep, dry cough often coupled with breathing difficulties, characterized by a “crowing” sound on breathing in. You can help your child breathe easier by steaming your bathroom with hot water in the shower. Stay with your child for half an hour or so. Croup with fever (greater than 102) is more serious than croup without. We should examine your child if your are concerned about the severity of your child’s illness.
Diarrhea or Vomiting
When vomiting occurs stop giving solid food and milk. Small amounts of Pedialyte, Gatorade, 7-Up, Kool – Aid, tea and cola may help relax the stomach also. Soup broth given frequently is often helpful. For diarrhea, it is helpful to put your child on Pedialyte for 12-14 hours followed by a bland diet of bananas, jello, cereal and grated apple.
Earaches are common from infancy to six or seven years of age. Most but not all, follow a stuffy nose. If an infant rubs his ear or cries incessantly when he has a cold, especially at night, suspect an earache. Your pediatrician should examine your child to correctly treat the earache and protect your child’s hearing. Please call the appointment desk at 8:30 a.m. to schedule an appointment.
Fever is the body’s response to an infection or illness and not an illness itself. Therefore it does not always need to be treated. Generally a temperature greater than 102 degrees rectally should be treated with medicines, such as Tylenol every 4 hours.
If the temperature reaches 105 degrees in a child below the age of 4 years the child should be sponged (do not immerse) in tepid water in a shallow bathtub, to bring the fever down to 103 degrees or below. Your efforts to bring down the fever should be particularly aggressive in children with a history of seizures or if there is a family history of convulsions. Encourage the child with the fever to take fluids. Minimal amount of clothing and blankets should be used. Call if fever is not responsive to these measures.
Children commonly have nosebleeds. If bleeding continues after simple first-aid measures, such as constant pressure on the bleeding nostril for several (5-10) minutes and an ice bag, call the office.
Pinworms are a common infection among children and are not a social disgrace. Treatment for pinworms is generally prescribed for the whole family. If you note pinworms in your child, please call the office during office hours.
Sore Throat and Enlarged Nodes
When sore throat is encountered, and the child runs a fever for over 24 hours or seems unduly sick the first day, it may be necessary to see the child in the office and obtain a throat culture to determine the cause of the illness.
Strep infections in the throat should be fully treated with antibiotics. Lozenges may bring relief to the sore throat and allow the child to take fluids and rest more comfortably.
Infant Emergency Problems
Newborn infants respond differently and may have subtle symptoms of serious illness. The following signs or symptoms should be reported to our office immediately:
- Temperature of 101 degrees by rectum during the first 2 months.
- Repeated forceful vomiting (not just spitting up).
- Unusual crying – for example: grunting, or whining cry or hoarse cry.
- Refusal of food, several times in a row.
- Frequent watery green stools or bloody stools.
- Redness or pus around navel.
- Please also see section on Emergencies and After Hour Phone Calls.
Infant Non-Emergency Problems
The baby may have as many as one stool with each feeding or may go 48 hours with no bowel movement. This is normal for the individual baby, providing the stool is not too hard and the baby is relatively comfortable. Avoid the use of medication for bowel problems without consulting this office. Please try to make these inquiries during office hours. Breast-fed babies normally have watery stools.
Colic is crying presumably due to pain or cramping of the stomach and intestines, usually from excessive gas and is harmless but annoying. All babies cry a lot, but if your baby cries only once a day for 1-2 hours in the afternoon or evening, this may be normal for him or her. Babies with colic need to be burped well after each ounce of formula. Also, the bottles should be checked to see that they drip one drop at a time when inverted (otherwise the baby has to work too hard or gulp air when swallowing formula). Sometimes the baby can gain relief by being placed with his/her abdomen on a warm water bottle covered in a towel. If your baby seems to have frequent colic in spite of these precautions, call the office. Careful attention to our feeding instructions, especially relative to being relaxed and comfortable may alleviate or prevent colic.
Prevention through prompt diaper changes and thorough diaper washing and rinsing of cloth diapers is the best treatment.
A mild detergent and a fabric softener are recommended. Often the use of a diaper service is the most efficient and economical method of preventing problems with various detergents. If a rash does develop, leave off the diaper as much as possible and use a preparation such as Balmex to keep the skin dry.
This is often difficult to evaluate as to seriousness. Often symptoms can be relieved with the use of a bulb syringe. If there is difficulty in feeding and breathing or a fever is present, call the office.
Most of the newborns have swollen eyelids the first week. This will gradually disappear by 7-10 days. If swelling and excessive mucus drainage or redness persists, call for advice.
If white spots on the tongue or inside of the cheeks persist, call the office during office hours.
Newborn Feeding – Formula / Solid Foods
If your baby is bottle fed, we suggest Similac with Iron or Enfamil Lipil formula. It is available in several forms. The composition of each is the same when used as directed. Vitamins and iron are provided in the formula. The usual full term baby does not need extra vitamins. The formula is well tolerated at room temperature.
We prefer powder or concentrated liquid since ready-to-feed formula does not supply flouride. The concentrated liquid comes in 13oz. cans to mix in equal parts tap water and formula (1:1).
If the formula is prepared one bottle at a time and used immediately, sterilization is not necessary, provided the bottles and nipples have been washed throughly and sterilized in the dishwasher. A 24 hour supply can be prepared this way provided the bottles are kept adequately refrigerated.
Drinking water may be used directly from the tap without sterilizing.
Store bottles of formula in the refrigerator; remove when ready for use and place in a bottle warm or pan of hot (not boiling) water for a few minutes. Formula may be set out of the refrigerator before feeding and given at room temperature. Test the temperature of the formula by shaking a few drops onto the inside of your wrist. It should feel warm but not hot.
Testing nipples regularly will save time when you’re ready to feed your baby.
Nipple holes should be the right size to help the baby suck easily. When the nipple holes are the right size, warm milk should drip as rapidly as possible without forming a stream.
If the nipple holes are too small, the baby may tire of sucking before he/she gets all the formula needed. If the holes are too large, the baby gets too much formula too fast, and may not get enough sucking satisfaction.
To enlarge holes that are too small, push a red hot needle gently through from the outside. An easy way to prepare the needle is to put the blunt end in a cork and heat in the flame of a match or lighter.
If the nipple holes are too big, the nipple is worn out and should be thrown away.
Any new foods should be offered initially once a day in small amounts of one or two teaspoonfuls. Offer the same food daily until the baby becomes accustomed to it. Don’t introduce new foods more often than every week or two. New foods are usually best accepted if fairly thin or diluted. The food is frequently pushed out of the mouth by the baby becasue he or she does not yet know how to swallow efficiently. Use a spoon small enough to fit easily in your baby’s mouth.
Foods will be introduced as directed by pediatrician.
- Rice Cereal – Rice cereal is excellent to offer the baby who has a large appetite early in life and is not satisfied with breast milk or formula. It will add significant amounts of iron to the infant’s diet. Other cereal may be introduced after rice, in any order.
- Vegetables – Begin vegetables before fruits because the sweet taste of fruits make the change to vegetables difficult.
- Fruits – Especially bananas and applesauce.
- Orange Juice and Eggs – Not before 9 months of age.
If a more structured schedule is desired, consult the office.
General Tips on Feeding
Feeding is one of the baby’s first pleasant experiences. The baby’s first love for its mother arises primarily from the feeding situation. At feeding time the baby receives nourishment from his food and nourishment from his mother’s love. The food, correctly taken, helps him/her to grow healthy and strong. The mother’s love, generously given, helps him/her to feel secure. Help your baby get both kinds of nourishment.
Both of you should be comfortable. Choose a chair that is comfortable for you. This will help you to be calm and relaxed as you feed your baby. Your baby should be warm and dry so that he or she is comfortable also.
Hold your baby in your lap, with their head slightly raised and resting in the bend of your elbow. Whether breast feeding or bottle-feeding, hold your baby comfortably close.
Feeding schedules are usually most satisfactory if the hours are set roughly and the baby is allowed to eat when he/she becomes hungry. For example, anytime between 3-5 hours after the last bottle feeding or 2-3 hours after the last breast feeding. New babies usually need to be fed about every 3 hours but may often go 4-5 hours between feedings.
We would suggest that you attempt to arrange a feeding just prior to your usual bedtime, so that you may have an uninterrupted period of much needed rest. This will fulfill the baby’s demand for food during the daytime and early evening and encourage sleeping through the night as soon as possible. Should the baby occasionally awaken and cry less than 21/2 hours after feeding, he/she is not necessarily hungry. As in breast feeding, comfort and relaxation is important for both mother and child. The infant should be burped at least once during and after feeding. Bottles should never be propped for any reason during feedings and the baby should never be placed on its back after feedings. The bottle should always be held so that the nipple is filled with formula. The baby should never be allowed to take a bottle in bed while flat on his/her back.
The mother who is breastfeeding should continue her prenatal vitamins along with a well balanced diet and increased volume of fluids, some of which should probably be milk. Also, we recommend avoiding cigarettes, alcohol and laxatives. If you are using any medications, check with us regarding its excretion into breast milk. If you develop an infection, let us know so we may advise you on what to do.
Successful nursing of an infant depends a great deal on the mother’s state of mind. You should be relaxed, calm and as happy as possible. You should get ample rest. For the first few days the breast secretions are a deep yellow color called “colostrum”. To help avoid the problem of cracked and sore nipples, gradually increase the time the baby is kept at the breast. Remember that nature provides that the amount of milk available will be small the first few days.
Most mothers find it best to nurse at both breasts with each feeding, starting on the opposite side each time and not nursing over 30 minutes. Take the breast from the baby’s mouth several times during the feeding to allow the baby to catch its breath. The nipples should be washed once or twice daily with soap and water. We recommend the use of a nursing bra. If nipples are cracked and sore, various preparatory creams such as Lanisol are available for nipple care.
Care of the Cord
The cord falls off at variable lengths of time, usually 1 to 2 weeks. When the cord separates, there is often a small amount of bleeding which is of no consequence. The navel should dry up within a week after the cord falls off.
Care of the Circumcision
If a Plastibell has been used, a plastic rim will be attached at the time you take the baby home. This falls off at 5 to 6 days after circumcision. If another method is used, there will be a slight redness for several days. Squeeze soapy water followed by clear water over the penis to clean it.
Do not bathe the baby until the cord is healed and in the case of circumcised boys, the cicumcision is healed. Simply sponge bathe your infant on top of a counter using warm water and a cloth with a mild soap such as Ivory or Johnson’s Baby Soap. Wash the face gently. The scalp should be washed every 2-3 days to prevent cradle cap. Do not be afraid to wash over the soft spot. Baby’s breast enlargement is common for the first few weeks; however, do not rub or squeeze the enlarged breasts.
With baby boys who are not circumcised, after the first two week pull the foreskin back as part of the bath.
With baby girls, wash and dry from the front to the back toward the rectum. During the first few weeks a slightly blood tinged vaginal discharge may be present.
After the bath, you may wish to use lotion to keep the skin soft (Johnson’s, for example). Powder is generally not helpful and should be kept away from the baby’s mouth and nose where it might be inhaled.
Q-tips can be used to cleanse the folds of the genitalia in girls and dry the folds of the ears. Do NOT push Q-tips into the ear canal. Nails should be trimmed straight across with cuticle scissors.
Keep the house at a comfortable 70 to 75 degrees for the first few weeks. Then the night temperature may be lowered. If at all possible, the baby should have a separate room and certainly should have a separate bed. Keep the baby’s sheets drawn tight and do not use a pillow.
Do not overdress your baby, particularly in the summer. The baby needs to be dressed in the same thickness clothing that you wear.
Auto and Bicycle Safety
Prevent the number one cause of death in children. Get a car seat and use it always. Children must remain facing rearward, in the back seat, until they are at least two years old. All children should remain in car seats until they weigh approximately 80 lbs. Everyone should wear seatbelts. Please be aware that you are also required to obey all safety seat laws for states through which you are driving. Visit www.seatcheck.org for more information.
Children and parents should wear bicycle helmets.
Smoking and Your Baby
Smoking has been demonstrated conclusively to be detrimental to all those exposed and may be especially difficult for infants and young children to tolerate. These children suffer many more upper respiratory infections and may be prone to ear infections. All smoking should be done outside the home and babysitters should be interviewed regarding smoking habits.
North Dallas Pediatric Associates follows the immunization guidelines recommended by the American Academy of Pediatrics www.healthychildren.org. For descriptions of these vaccines and the diseases they protect against, please visit www.immunizationinfo.org or www.cdc.gov/vaccines/. Learn more about vaccinating your child by visiting http://www.whattoexpect.com/child-vaccinations/index.aspx. The following immunizations and tests are required in order to remain a patient in our practice.
*Combination Vaccine, which includes DTaP, IPV and Hepatitis B
**TB Skin Test is optional for 12 mos. and older, depending on risk factors
***Combination Vaccine, which includes DTaP and IPV
|Birth||Hepatitis B #1|
|2 mos||*Pediarix #1, HIB, Prevnar and Rotarix|
|4 mos||*Pediarix #2, HIB, Prevnar and Rotarix|
|6 mos||*Pediarix #3, HIB and Prevnar|
|9 mos||Test for Anemia|
|12 mos||*TB Skin Test, MMR, Prevnar, Varicella and Hepatitis A #1, HIB|
|18 mos||DTaP #4, Hepatitis A #2, HIB (if not given at 12 mos.)|
|2 yrs||If not given at 18 mos. Hepatitis A #2|
|4-6 yrs||***Kinrix, MMR and Varicella #2|
|11-12 yrs||Menactra, Tdap, Varicella #2 (if not given at 4-6yrs.) and HPV|
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Well Child Office Visits
Keeping the well child well is one of the major goals of pediatrics. During a well-child visit, we are primarily concerned with observing growth and development, early detection of illness through screening and laboratory tests, immunizations, counseling and teaching parents, and getting to know one another. We recommend routine office visits as follows:
- 3-5 days
- 2 weeks
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 24 months (2 years)
- 30 months
- 3 years
After the 3 year well-child visit, children are seen Once A Year For Well Care. The yearly visit also gives you a chance to ask questions about your child’s physical development and behavior. It is your opportunity to ask questions and address any concerns that you may have. It helps to write questions down. Don’t be afraid to ask questions about your child’s progress even though these questions may seem trivial. MAKE SURE YOUR QUESTIONS ARE ANSWERED AND YOU UNDERSTAND WHAT YOU HAVE BEEN TOLD. YOU HAVE THE RIGHT TO BE FULLY INFORMED ABOUT OUR FINDINGS AND OPINIONS.
Please call in advance to schedule well care.
Sick Child Office Visits
We have open appointments for sick children each day and will not turn away a patient of ours who we feel should be seen that day Our nurses will triage when our schedule is full so that no one whose illness requires them to be seen that day is turned away. Please tell the appointment secretary the nature of your problem so that appropriate time may be allotted. During a sick child visit we limit our counseling to the problem at hand.
ADHD / ADD appointment information –
The physicians at North Dallas Pediatric Associates requires that your child be seen in the office every three months; once a year for a physical exam and three times a year for an ADHD/ADD follow-up evaluation.
In addition to the examination by the doctor, ADHD/ADD evaluations depend in part on feedback from the parent and the child’s teachers.
The documents shown below are used during these evaluations.
Effective June 1, 2015, all ADD/ADHD medication refill requests will require 5 business days to process (do not count Saturday and Sunday).
If you insist on a prescription being processed in less than that amount of time, you are subject to a $25.00 service charge, payable at the time of pick-up in the Plano office.
If you lose a prescription, let it expire, or do not receive it in the mail, you must pick up a new prescription in the Plano office and pay the $25.00 fee as well.
You can avoid these situations by doing the following:
- Book your appointment before you leave the office. Anyone in the office can do this for you. If you do not have an appointment scheduled, your refill request will be denied.
- Request your refill online (not by phone). If you require a reply, we will not call you. You will receive a reply via email. Make sure to check your junk mail if you have not made us a “safe” contact.
- If you choose to call for a refill and do not have your next appointment scheduled, you will receive a letter which will delay the process even more.
We are trying to make this process as smooth as possible.
Thank you in advance for your cooperation.
North Dallas Pediatrics
Online Kids Games, Preschool Crafts and Family Activities. www.nickjr.com.
Play, explore, and read on PBS KIDS Island www.pbskids.org.
Top 100 Children’s Books http://libraries.state.ma.us/pages/top100
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As parents you always have questions and concerns, especially if this is your first child. This section is intended to answer some of the more common and frequently asked questions.
Newborn Feeding / Breastfeeding
Newborn Feeding – Formula / Solid Foods
Childhood Non-Emergency Problems
Tweens and Teens
Health Topics – HealthyChildren.org
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Click the links below for information on current issues.
A website about healthy weight for kids, teen and their parents http://www.weigh2rock.com/
Top 100 Children’s Book http://libraries.state.ma.us/pages/top100
Sports Injury, Treatment and Prevention http://www.childrens.com/Specialties/sports-medicine/
Health Topics http://www.HealthyChildren.org
Be Yourself, Live Smoke Free http://www.nosmokingroom.org/
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As part of your Well Care, and under the guidelines of Bright Futures and the American Academy of Pediatrics, your doctors has asked that you complete the Nutrition Questionnaire. You can find the appropriate age form for your child below.
Optimal nutrition is important for sustenance, good health, and well-being throughout life. As the relationships among diet, health, and disease prevention have become clearer, nutrition and the promotion of healthy eating behaivors have received increased attention. The nutrition status of infants, children, and adolescents affects their growth and development and resistance to diseases. Lifelong eating behaviors and physical activity patterns are often established in early childhood. Therefore, it is important for children and adolescents to build the foundation for good health by choosing a healthy lifestyle, including practicing healthy eating behaviors and participating in regular physical activity.
Dr. Allan deVilleneuve, Dr. Carolyn Evans, & Connie Ray RN, CPNP