Why choose a Pediatrician?

Kids are not just little adults. Kids’ bodies and minds continue to grow and develop, and as a result, work differently.  We, pediatricians, should keep in mind these differences when taking care of kids. Have you ever thought about a newborn coming to this unknown world and studying it day by day? Have you ever imagined the enormous work that has been done by every child from the first day of life to the first day of school? Do you know that baby’s birth weight quadruples by 2 years of age and that most children will double their birth height by 3-4 years of age? (Do the math, quadruple your weight, double your height, and see the number.)

Children and adults have significantly different patterns of illness, injury, and stress responses. For example, the brain and the immune system develop extensively during early childhood; environmental exposures may harm these immature systems as well as behavioral, cognitive, and emotional development.

Just another example: by the time a baby is born she will have l00 billion brain cells, but these cells aren't yet connected in circuits the way they will be as the brain matures. In the first few years of life the brain rapidly forms connections between brain cells, and ultimately a single cell can connect with as many as 15,000 other cells. This period is called “Windows of opportunity”. It is a sensitive period in a child’s life and we should not miss it.

A further major difference between pediatrics and adult medicine is that children are minors and cannot make decisions for themselves. The issues of privacy, guardianship, and legal responsibility must be addressed at each visit. Pediatricians often have to communicate with the whole family, rather than just the child. However, adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances.

As a matter of fact, pediatricians take care of all the children's needs from medical to emotional problems, providing support when you are looking for it and helping you overcome diseases when they happen. Growing healthy together is our goal.

Well Child Office Visits

Well-child visits are designated and scheduled to help children grow into healthy adults. Keeping the well child well is one of the major goals of pediatrics.  A well-child visit includes monitoring of growth and development, early detection of illness through screening and laboratory tests, immunizations, parental guidance and counseling, and, of course, getting to know one another. It is your opportunity to ask questions and address any concerns that you may have.
Lydig Pediatrics follows the well child check schedule recommended by the American Academy of Pediatrics and Bright Futures Guidelines.

3-5 days visit
1 month visit
2 month visit
4 month visit
6 month visit
9 month visit
12 month visit
18 month visit
24 month visit
30 month visit
3 year visit
continue with annual physical unless recommended otherwise (for children with chronic illnesses)

What to expect at your Well-Child Office Visits:

Newborn (usually while in the hospital, otherwise 1st office visit as early as possible for home or birth center delivery): initial history, measurements (length, weight, head circumference), hearing test, developmental surveillance, psychosocial/behavioral assessment, physical examination, heart defect screening, risk assessment for elevated blood pressure and vision problem, blood test for bilirubin, newborn blood screen, immunization (Hepatitis B 1st dose), ANTICIPATORY GUIDANCE for parents.

3-5 Days Visit: initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, newborn blood screening follow up, risk assessment for hearing, vision, and blood pressure problem, immunization (Hepatitis B 1st dose, if was not given at birth), anticipatory guidance.

2 Week Visit: may be recommended for weight check up

1 Month Visit: initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, newborn blood screening follow up, risk assessment for hearing, vision, and blood pressure problem, as well as assessment of risk factors for tuberculosis, anticipatory guidance.

2 Month Visit: initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, newborn blood screening follow up, risk assessment for hearing, vision, and blood pressure problem, immunization (Hepatitis B 2nd dose, DTaP #1, Rotavirus #1, Hib #1, Pneumococcal #1, Polio #1 ), anticipatory guidance.

4 Month Visit: initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, ANEMIA, and blood pressure problem, immunization (DTaP #2, Rotavirus #2, Hib #2, Pneumococcal #2, Polio #2 ), anticipatory guidance.

6 Month Visit: initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem, lead exposure, tuberculosis, oral health,  immunization (Hepatitis B 3nd dose, DTaP #3, Rotavirus #3, Hib #3, Pneumococcal #3, Polio #3, 1st Flu vaccine during flu season ), anticipatory guidance.

9 Month Visit:  initial/interval history, measurements (length, weight, head circumference),  DEVELOPMENTAL SCREENING, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem, lead exposure, oral health,  immunization (catch-up, 2nd Flu vaccine during flu season, if not given before), anticipatory guidance.

12 Month Visit:  initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem, tuberculosis, oral health, BLOOD TESTS for anemia and lead level, immunization (varies, usually MMR, Varicella, Hep A 1st dose, 4th dose of Hib and PCV can be given, as well), anticipatory guidance. 

15 Month Visit: initial/interval history, measurements (length, weight, head circumference), developmental surveillance, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem, anemia, immunization (varies, 4th dose of DTaP, Hib and PCV can be given), anticipatory guidance.

18 Month Visit: initial/interval history, measurements (length, weight, head circumference), DEVELOPMENTAL SCREENING, AUTISM SCREENING, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem,  anemia and lead exposure, oral health,  immunization (varies, 4th dose of DTaP can be given, catch-up), anticipatory guidance.

24 Month Visit: initial/interval history, measurements (length, weight, BMI, head circumference), developmental surveillance, AUTISM SCREENING, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem, anemia, lead exposure, tuberculosis, dyslipidemia screening, oral health, immunization (catch-up, seasonal Flu), anticipatory guidance.

30 Month Visit: initial/interval history, measurements (height, weight, BMI), DEVELOPMENTAL SCREENING, psychosocial/behavioral assessment, physical examination, risk assessment for hearing, vision, blood pressure problem, anemia screening, oral health, immunization (catch-up, seasonal Flu), anticipatory guidance.

3 Year Visit: initial/interval history, measurements (height, weight, BMI, blood pressure), vision (if the patient is uncooperative, re-screen within 6 months), developmental surveillance, psychosocial/behavioral assessment, physical examination, risk assessment for hearing problem, anemia, lead exposure, tuberculosis, oral health, immunization (catch-up, seasonal Flu), anticipatory guidance.

4 Year Visit: initial/interval history, measurements (height, weight, BMI, blood pressure), vision and hearing tests, developmental surveillance, psychosocial/behavioral assessment, physical examination, anemia, lead, tuberculosis, and dyslipidemia screening, immunization (DTaP, Polio, MMR, Varicella), anticipatory guidance.

Middle Childhood: 5-10 year visits:
Continue with Annual Physical unless recommended otherwise (for children with chronic illnesses)
What to expect at your visits:
Initial/interval history, measurements (height, weight, BMI, blood pressure), vision and hearing tests, developmental surveillance, psychosocial/behavioral assessment, physical examination, anemia, lead (until 6 year of age), tuberculosis, and dyslipidemia (every other year) screening, lipid profile at 10 year of age, oral health (visit the dentist every 6 months), immunization (catch-up, HPV (Papillomavirus) series may be started at age 9 years), anticipatory guidance.

Adolescent Appointment: 11-21 year visits:
We enjoy guiding adolescents through the physical and emotional changes that make the transition to young adulthood such an exciting, but often turbulent time.
What to expect at your visits:
Initial/interval history, measurements (height, weight, BMI, blood pressure), vision test and hearing problem screening, developmental surveillance, psychosocial/behavioral assessment, Alcohol and Drug Use Assessment, Depression Screening, physical examination, anemia, tuberculosis, and dyslipidemia screening, lipid profile at 20 year of age, STI/HIV Screening (a screen for STI/HIV between 16 and 18 years), screening for cervical dysplasia at age 21, oral health (visit the dentist every 6 months), immunization (Tdap, Meningococcal vaccine at 11 year of age with a booster dose of MCV4 given at age 16 years, HPV, if not given before), anticipatory guidance.

Immunization Guidelines

Lydig Pediatrics follows the immunization guidelines recommended by the American Academy of Pediatrics. We firmly believe it is in the very best interest of all children to receive these immunizations on the recommended schedule. We are open to discuss in detail  questions about vaccination and share our knowledge with parents who have a doubt and do not wish to vaccinate their children  on the recommended schedule. 
We participate in the New York State Immunization Registry program (NYSISS), which ensures that each patient's immunization history is part of the State's database.

When Do Children and Teens Need Vaccinations?

Dosing Guide for Common “over-the-counter” Medications

If your child takes an overdose or unknown dose of any medication, call NYC Poison Control Center 212-POISONS (764-7667) or 1-800-222-1222

ACETAMINOPHEN
(Most Common Brand Name: Tylenol)
Dosage: Every four (4) hours.
Please be aware that there are two liquid dosage strengths of acetaminophen. The
concentrated Infants’ drops have 80 mg per 0.8 ml (dropperful) and the Children’s syrup or suspension has 160 mg per 5 ml (teaspoon). Make sure you know which strength you are using so that you can look up the dose properly.
When to use:
Acetaminophen should be used to reduce fever and relieve pain. Acetaminophen has no anti- inflammatory actions. 
Side effects: Acetaminophen taken at proper doses is very safe. Only if an overdose of the medication occurs is there a likelihood of any side effect. Beware - large overdoses of acetaminophen can be deadly. This medicine should be kept out of reach of your children.
 
*Never treat fever in an infant less than three months of age without first speaking with the physician.

***Note: For Infants’ Drops, use dropper supplied with medication ***

IBUPROFEN
(Most Common Brand Names: Motrin and Advil)
DO NOT GIVE TO INFANTS LESS THAN 6 MONTHS OLD.
Dosage: The dosage is every 6 to 8 hours.
Please be aware that there are two liquid strengths of ibuprofen (concentrated infant drops and children’s suspension) and several strengths of tablets (chewable tablets, junior strength tablets, and adult tablets). Because of this, dosing errors are possible if you choose the wrong dosage strength. Therefore, we advise you make sure you properly look up the dose.
When to use: Ibuprofen should be used to control high fevers which are unresponsive to acetaminophen (Tylenol). It can also be used to control pain and reduce inflammation.
Side Effects: May cause stomach upset, other side effects are rare.

 Acetaminophen and Ibuprofen both work to relieve moderate aches and pains as well as lower almost any fever.  Both come in chewable tablets and liquids, however only Tylenol comes in a suppository form.  Although acetaminophen and ibuprofen accomplish the same goals, they are different chemicals so you can alternate between them or even use them together.   
Acetaminophen and Ibuprofen should not be given to relieve congestion or runny noses, unless it is marketed as a 'Cold Remedy'.  In these cases the medicine is supplemented with some decongestants.  We do not recommend these medications for children younger than 6 year of age!

CHILDREN’S BENADRYL ALLERGY LIQUID
(Generic Name: Diphenhydramine)
(Antihistamine)
DO NOT GIVE TO INFANTS LESS THAN 6 MONTHS OLD.
Dosage: Every four (4) hours.
Please be aware that there is a Children’s Benadryl Liquid in pre-filled spoons. 
When to use: Benadryl is an antihistamine medication which is particularly good at relieving symptoms due to upper respiratory allergies such as runny nose, sneezing, itchy, watery eyes, itching of the nose and throat, and may help coughs due to post-nasal drainage. It is also useful to treat itching due to any cause, especially with rashes due to allergy or viruses (example: Chicken Pox). Use Benadryl to treat insect bites and stings.
Side Effects: Benadryl may cause drowsiness or, less commonly, agitation or insomnia. Other side
effects are rare. Several years ago it was thought that antihistamines such as Benadryl should not be given to children with asthma. This has now been disproved. Actually, it may control nasal allergies of children with asthma.

COUGH SUPPRESSANT
(Most Common Brand Name: Delsym Cough Suppressant 12 hour)
DO NOT GIVE TO CHILDREN LESS THAN 2 YEARS OLD.
Most cough preparations contain ingredients, such as antihistamines and decongestants, in addition to a cough suppressant which aren’t always needed. Also, if you are already giving your child other allergy medications, you may be overdosing them by using a combination cold and cough syrup. Delsym contains only a cough suppressant and is safe to give with other over-the-counter or prescription allergy medications your child may be taking.
Dosage: Every 12 hours.
When to use: Use for non-productive cough which is interfering with your child’s ability to sleep.
Side Effects: The active ingredient in medications used to suppress a cough is dextromethorphan. It is quite safe. Rarely, it has been known to cause slight drowsiness, nausea, and dizziness.

DELSYM COUGH SUPPRESSANT 12 HOUR
(Dextromethorphan)

Our Dosing Guide gives dosages for common over-the-counter medications used in children. These medications are dosed according to weight. To calculate your child’s dose, look up his or her weight in the Dosing Guide and read across to the proper dose for each medicine listed. If you do not know your child’s weight and if your child is too young to stand on bathroom scales, a simple way to determine his or her weight is to first weigh both you and your child as you hold him. Then weigh yourself alone. Subtracting these two numbers will give you a fairly accurate weight for your child. The doses listed in the Dosing Chart are standard doses which are safe for your child.  

Commonly used abbreviations:
mg=milligram
tsp=teaspoon
ml=milliliter
cc=cubic centimeter
dppr=dropperful
1 cc=1 ml
1 tsp=5 cc

Resources

NYC Poison Control Center 212-POISONS (764-7667) or 1-800-222-1222
http://www.nyc.gov/html/doh/html/environmental/poison-control.shtml or
http://www.aapcc.org/centers/?states_served=NY&local_center_submit=Search#search
The poison control center is staffed 24 hours a day, 365 days a year by registered pharmacists and nurses certified in poison information. Access to the Language Line provides translation services in more than 150 languages, and services are available for the hearing impaired utilizing telecommunications devices for the deaf at (TDD) 212-689-9014. The New York City Poison Control Center also produces educational materials including brochures, telephone stickers, and videos which are available free of charge.

* Are your children uninsured? New York State has a health insurance plan for kids, called Child Health Plus. Click the link to learn about  the plan: https://www.health.ny.gov/health_care/child_health_plus/ or https://nystateofhealth.ny.gov/ or http://www.insurekidsnow.gov/

* This are useful website for parents. You can read about normal development, research any illnesses, and stay up to date on the latest recommendations here:
www.healthychildren.org
http://kidshealth.org/
http://www.medicalhomeinfo.org/for_families/
www.babycenter.com/
http://familydoctor.org/familydoctor/en.html

*  If your child has special medical needs you will find this useful. If you have gotten a call about
a positive newborn screening test, click on the "newborn disorders" tab to learn more. www.medicalhomeportal.org
http://www.resourcesnyc.org/about/about-rcsn

* If you are planning any international travel check the CDC's website for up-to-date information
and advisories. http://www.nc.cdc.gov/travel

* Terrific information to help your family obtain and maintain healthy weights. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/eat-right/index.htm

* Please visit the Consumer Product Safety Commission website for valuable information about products that have been recalled.
www.cpsc.gov/en/Recalls

* Useful and up-to-date information about food allergies:
www.foodallergy.org

* Interested in preventing underage drinking?
www.parentsempowered.org

* If you have been asked to try a dairy-free diet this will be a helpful site. www.thefussybabysite.com/coping/non-dairy-diet-and-breastfeeding

* This website has information about helping kids with reflux, celiac disease, and other gastrointestinal problems. www.gastrokids.org

Telehealth Visits

Patients at Lydig Pediatrics can now access virtual care visits (also called telemedicine or telehealth) from our pediatricians using your smartphone, computer, or tablet. We are using a secure telemedicine solution that is adhered to HIPAA, PIPEDA, and GDPR data privacy requirements. Please call us to schedule the telehealth visit. To join a video call with the doctor, please go to the following link https://doxy.me/lydigpediatrics, and enter your child's name in the popup box. It is recommended to connect 15 minutes before the time of appointment to manage your microphone, camera, and other peripheral devices.  

Registering with the Practice

We appreciate your trust in us and look forward to working with you in maintaining your child's health and developing good health care habits. Before your first visit, please notify your health insurance company of your new primary care provider if required. To reduce waiting time during your first visit and increase record accuracy, please complete and sign the NEW PATIENT REGISTRATION FORM. Shortly after completing the forms, we will get back to you and schedule your first visit. If you would like to register the second patient, please use ADD PATIENT TO EXISTING FAMILY FORM.