january – april 2006 midlife moms center... · selecting the right pediatrician for your child is...

January – April 2006

Mommies in Motion Stay fi t with PPH’s new prenatal exercise class

Page 6

Baby Sign LanguageCommunicate early with your hearing infant or toddler0

Ask-the-PediatricianGet answers to your newborn care questionsPage 11

Sweet DreamsTips to help your baby sleepPage 12

Allergy AlertFoods to watch out for with childrenPage 13

Midlife MOMS

A HEALTH NEWS AND EDUCATION RESOURCE GUIDE FOR NEW AND EXPECTING PARENTS

Starting a Family after 40 Pages 4-5

2 JANUARY - APRIL 2006 www.pph.orgJANUARY - APRIL 2006 www.pph.org

Numbers to KnowKeep these important numbers handy for use in the event of an emergency.

Emergency Crisis Hotlines – 24-Hour Service

Fire, Police or Emergency 911

Poison Control 800.222.1222

California Missing Children Hotline 800.222.3463

California Youth Crisis Hotline 800.843.5200

Child Abuse Hotline 800.344.6000

Rape/Crisis Hotline 888.272.1767

Domestic Violence Hotline 888.385.4657

Missing, Abused & Exploited Children 888.818.4673

National Runaway Switchboard 800.621.4000

Vanished Children’s Alliance (VCA) 800.826.4743

Domestic Violence & Rape Crisis Hotline 760.757.3500

Youth Crisis Hotline 800.448.4663

Suicide and Crisis Counseling 800.479.3339

San Diego Police Department 619.531.2000

PowayPomerado Hospital 15615 Pomerado RoadPoway, CA 92064858.613.4000

Women’s Health Connection Gateway Medical Building15725 Pomerado Road Suite 100Poway, CA 92064858.613.4894

San MarcosThe HealthSource 120 Craven RoadSuite 103San Marcos, CA 92069

EscondidoPalomar Medical Center 555 East Valley ParkwayEscondido, CA 92025760.739.3000

Off-site classes are also available for groups, businesses and other organizations that would like instruction on a particular health topic. Call 858.675.5372 for more information.

Volume 2 – Issue 1January – April 2006

Editor-in-ChiefJanet Gennoe

Director of Marketing & The [email protected]

Content EditorsMary Coalson

Health Education [email protected]

Tammy ChungAssistant to The HealthSource

[email protected]

ContributorsGustavo Friederichsen

Chief Marketing & Communications Offi [email protected]

Tami WeigoldMarketing Manager

[email protected]

Kathy Lunardi, R.N.Community Nurse Educator

[email protected]

CeCe WilkensWilkens Communications

Jennifer Decker ArevaloPSY/MED Media

Design/ProductionChase Design

[email protected]

Trina HinchMarketing Project Manager

[email protected]

Mark SealRush Press

PhotographyJanet Gennoe

Director of Marketing & The HealthSource

Class Locations

3For a physician referral, or to register for a class, call The HealthSource at 800.628.2880.

SPECIAL FEATURES

4 - 5 Midlife Moms: Starting a Family After 40More and more women are waiting until their late 30’s and early 40’s to try to conceive. Discover the risks and rewards of a midlife pregnancy and your options surrounding fertility and adoption.

8 Getting “Baby-Friendly” at Pomerado HospitalLearn more about Pomerado Hospital’s unique initiative to promote, protect and support breastfeeding as the preferred source of nutrition for newborns and infants.

11 Ask-the-DoctorPediatrician Dr. Neil Goldfi nger answers some of new parents’ most frequently asked questions about newborn care.

12 Perplexed Over Pediatricians?Selecting the right pediatrician for your child is an important task. Explore tips for making an informed decision.

12 Sweet DreamsFollow these simple sleep tips to help your newborn (and you) rest easier.

13 Allergy AlertWhen the foods that are meant to nourish your infant instead result in illness, parents are rightfully concerned. Learn more about food allergies and how to prevent exposure.

EDUCATION

6 Childbirth Preparation ClassesThe birth of a baby will be one of the most important moments in your family’s life. Palomar Pomerado Health offers a wide variety of classes and services to help you and your partner prepare for pregnancy and delivery.

6 Mommies in MotionStay fi t with PPH’s new prenatal exercise class led by physical therapist Michelle Thompson.

8 - 9 Breastfeeding Classes and Lactation Services

9 Meet the InstructorCertifi ed childbirth educator and lactation consultant Kim Paden teaches expectant couples about the joys of having a baby.

10 Infant- & Toddler-Care ClassesTake advantage of our special presentation infant- and toddler-care classes including baby-care basics, baby sign language and infant massage.

14 Sibling Education, Young Adult, CPR and First Aid Classes

Inside this Issue …

Stork Club Tours Call for dates, times and locations.

Tours of the Birth Centers at Palomar Medical Center and Pomerado Hospital are available by appointment only. If you are taking a weekend childbirth class at the Women’s Health Connection or Palomar Medical Center, there is no need to take this tour as well. Tours of the Birth Center at Palomar Medical Center are available in Spanish on the 2nd and last Wednesdays of each month from 7 to 8:30 p.m.

FEE: Free

Finding a Physician To select a Palomar Pomerado Health physician for your pre-pregnancy and pregnancy care, or to register for a PPH childbirth class, please call The HealthSource at 800.628.2880.

4 JANUARY - APRIL 2006 www.pph.org

Finding a PHYSICIAN

To select a Palomar Pomerado Health physician for your pre-pregnancy and

pregnancy care, or to register for a childbirth class, please

call The HealthSource at 800.628.2880.

– Starting a Family

JANUARY - APRIL 2006 www.pph.org

“These generational changes are pushing more and more women into their late 30’s and early 40’s before trying to conceive,” says Terry Scherl, R.N., director of Maternal and Infant Services at Pomerado Hospital.

According to the American Fertility Association, 20 percent of women in the United States now have their fi rst child after age 35. Most women at this age are healthy and have healthy pregnancies. Although some women have no trouble conceiving at this age, the probability of conception decreases three to fi ve percent per year after the age of 30 and even faster after 40.

Women are born with all of their eggs, but the quantity and quality of these eggs decrease with age or because of disease or environmental hazards. Endometriosis, uterine fi broids, thyroid gland problems and other medical problems are common culprits of infertility in women. Men may also have a problem with their reproductive functioning; in fact, about 30 percent of fertility problems are male related.

Once pregnant, women over the age of 35 have an increased risk of gestational high blood pressure or diabetes, having a miscarriage or stillbirth, carrying multiples and having a baby with a birth defect. (continued)

Many women today want to “have it all” — higher education, marriage, career, home — before they start a family.


No matter what their age, women should see their doctor before trying to get pregnant. Obstetricians usually recommend the following tests for older women during pregnancy to detect for possible birth defects:

• Ultrasound – high-frequency sound waves check fetal development

• Quad Marker Screen – a blood sample used to predict the likelihood of Down syndrome or brain and spinal problems

• Amniocentesis – amniotic fl uid from the sac surrounding the fetus is tested for birth defects

• Chorionic Villus Sampling (CVS) – genetic testing

“Results from these tests, as well as regular prenatal exams, provide valuable information for parents and the physician throughout pregnancy,” says Scherl.

Treating Infertility “When couples have diffi culty conceiving after trying for six months, it may be time to consult with a fertility specialist,” says Scherl. “Our PPH physicians can provide referral to a fertility specialist in the community.” According to The American Society of Reproductive Medicine, 85 to 90 percent of infertility cases are treated with drug therapy or surgery for structural problems like blocked fallopian tubes, endometriosis or fi broids. Assisted Reproductive Technology (ART) includes In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT) and Zygote Intrafallopian Transfer (ZIFT). “The use of assisted reproductive therapy has led to an increase in multiple births, premature births and the use of surrogates,” says Scherl. “At Pomerado, we have a support group for mothers of twins and triplets and are seeing more surrogate deliveries.”

AdoptionWhen conception does not or cannot occur, couples often consider adoption. Adoption choices include traditional closed adoptions when birth and adoptive families do not share identities, or open adoptions in which the birth and adoptive families meet and have ongoing communication about the child. Recently, foreign adoptions from countries such as China, Russia, Korea, Romania and Guatemala have risen dramatically as the waiting period is usually shorter than for domestic adoptions. To learn more about adoption, visit the National Adoption Information Clearinghouse at http://naic.acf.hhs.gov.

To help ensure a healthy pregnancy, obstetricians recommend that moms-to-be:

• Eat healthy foods

• Gain the proper amount of weight

• Take prenatal multivitamins that contain folic acid and Vitamin B

• Exercise regularly

• Limit caffeine

• Avoid alcohol, tobacco and other drugs

• Avoid medications or herbal supplements unless approved by your doctor

• Attend prenatal classes and read publications on pregnancy and childbirth

Infertility Resources If you are struggling to become or stay pregnant, there is help. Following are some online resources that may prove helpful in your journey to conceive.

The National Infertility Associationwww.resolve.org

The American Fertility Associationwww.theafa.org

The American Society for Reproductive Medicinewww.asrm.org

The March of Dimeswww.marchofdimes.com

National Birth Defects Prevention Networkwww.nbdpn.org

The National Women’s Health Information Centerwww.4woman.gov

– Starting a Family

STEPSto a

Healthy Pregnancy


Childbirth PreparationPreparation for Childbirth

Four-Week Series6:30 – 9 p.m.

Women’s Health Connection (Poway)Choose one of the following four-week series:

Mondays, January 9 – 30Mondays, February 27 – March 20Mondays, April 10 – May 1Tuesdays, January 10 – 31Tuesdays, February 28 – March 21Tuesdays, April 11 – May 2Thursdays, January 5 – 26

Palomar Medical Center (Escondido)Choose one of the following four-week series:

Tuesdays, January 17 – February 7Tuesdays, March 7 – 28Tuesdays, April 4 – 25Wednesdays, January 11 – February 1Wednesdays, March 1 – 22Wednesdays, April 5 – 26Thursdays, March 2 – 23

Prepare for a safe and satisfying birth experience with this four-week childbirth preparation series held at the Women’s Health Connection in Poway and Palomar Medical Center in Escondido. Small classes ensure personalized instruction focusing on the signs and stages of labor, hospital procedures, medication options and Cesarean birth. A general overview of labor-coping techniques is provided, and newborn characteristics, infant feeding and postpartum adjustments are discussed. A tour of the birth center is not included in this class but is available by appointment free of charge.

FEE: $70 / mom or couple (includes childbirth manual)

Preparation for Childbirth “In a Weekend”9 a.m. – 3:30 p.m. (Saturdays)10 a.m. – 3:30 p.m. (Sundays)

Women’s Health Connection (Poway)Choose one of the following four classes:

January 7 – 8February 4 – 5March 4 – 5April 1 – 2

Palomar Medical Center (Escondido)Choose one of the following four classes:

January 14 – 15February 11 – 12March 11 – 12April 8 – 9

Our weekend class includes the same information covered in our four-week series, but takes only two days to complete. A tour of the birth center is included. We recommend early registration for this popular class.

FEE: $70 / mom or couple (includes childbirth manual)

Cesarean Birth LectureCall for dates, times and locations

Expectant parents who anticipate a Cesarean birth and choose not to enroll in a childbirth class may attend a one-hour lecture about Cesarean birth that is part of our regular childbirth series. Information covered includes indications for a Cesarean birth, pre-operative procedures, medications, the birthing process, and post-operative and recovery procedures.

FEE: $10 / mom or couple

Childbirth Preparation Preparation for Childbirth “In a Weekend”

Classesthe

Prenatal Exercise Class Four-Week Series6 – 7 p.m.

The HealthSource, San MarcosMondays February 20 – March 13

Women’s Health ConnectionThursdaysApril 6 – 27

Take steps now to stay in shape, feel your best and maximize your total well-being during pregnancy. Palomar Pomerado Health is proud to present “Mommies in Motion,” a unique fi tness class designed specifi cally for expectant mothers. Led by physical therapist Michelle Thompson of PPH’s Rehabilitation Services, this four-week series promotes physical fi tness and good health through education and exercise.

Educational topics include posture and body mechanics, essential pregnancy exercises, pelvic fl oor muscle awareness, labor expectations and relaxation techniques, while hands-on exercise instruction focuses on warm-up and stretching, cardio-respiratory endurance, strength training, cool-down and relaxation.

This class is suitable for women of any stage of pregnancy or fi tness level. A signed physician consent form is required, and participants should bring an exercise mat or large towel to each class. Space is limited so register today.

FEE: $40 / participant

“Mommies in Motion”


BreastfeedingSuccessful Breastfeeding

6:30 – 9 p.m.

Women’s Health ConnectionChoose one of the following four classes:

WednesdaysJanuary 4, February 1, March 1 or April 5

Palomar Medical CenterChoose one of the following two classes:

MondaysFebruary 13 or April 10

Breastfeeding is “nature’s way” to feed a baby, but it doesn’t always come naturally. Enhance your opportunity for a positive breastfeeding experience with this informative class led by a certifi ed lactation consultant. Classes are offered at the Women’s Health Connection in Poway and Palomar Medical Center in Escondido. Topics include the benefi ts of breastfeeding, breast anatomy and physiology, getting off to a good start, common diffi culties and solutions, and returning to work.


Breastfeeding Support GroupThe Women’s Health ConnectionTuesdays, 1 – 2:30 p.m.

The HealthSource, San MarcosThursdays, 1 – 2:30 p.m.

Meet with a certifi ed lactation consultant and other new moms to share information and learn new ideas during these weekly group sessions. Call the Women’s Health Connection at 858.613.4894 for more information.

FEE: Free

Ask new parents and chances are they’ll say that Pomerado Hospital is already a baby-friendly hospital. Now, the hospital is working toward achieving the offi cial designation as part of a global initiative sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).

“Being a baby-friendly hospital means we promote, protect and support breastfeeding,” says Terry Scherl, R.N., director of Maternal and Infant Services at Pomerado Hospital. “Breastfeeding has many lifelong health benefi ts for both the mother and infant.”

The Baby-Friendly Hospital Initiative (BFHI) was created to recognize hospitals and birthing centers that offer an optimal level of care for lactation while also helping parents to make informed choices about how they feed and care for their babies. The goal is to provide breastfeeding mothers the information, confi dence and skills needed to successfully initiate and continue breastfeeding. Pomerado Hospital was encouraged by The Tri-Regional Health Advisory Council to seek this offi cial designation as a way to promote breastfeeding and its advantages.

“The Tri-Regional Health Advisory Council is working to reduce the rate of childhood obesity,” says Scherl. “While researching the causes of childhood obesity, they found a benefi cial relationship between breastfeeding and a lower rate of obesity in children.”

To gain offi cial designation, Pomerado must meet 10 guidelines and successfully complete an on-site survey that evaluates policies. The process may take two years to complete.

Currently, Palomar Pomerado Health (PPH) promotes breastfeeding with bilingual lactation consultants, support groups and classes offered at the Women’s Health Connection in Poway and Palomar Medical Center in Escondido. Lactation counseling is also offered through the Welcome Home Baby! program, a unique collaboration organized by PPH and made available to fi rst-time parents living in North County. In addition, breastfeeding supplies are available for purchase or rent at the Women’s Health Connection Boutique.

To register for a breastfeeding class, call The HealthSource at 800.628.2880. For more information about renting or purchasing a breast pump, contact the Women’s Health Connection Boutique at 858.613.4894.

Getting “Baby-Friendly” at Pomerado Hospital Ask new parents and chances are they’ll say that Pomerado “The Tri-Regional Health Advisory Council is working to reduce


Lactation SERVICESSERVICES

While Kim Paden may be the newest childbirth educator and lactation consultant to join The HealthSource team, to her students she’s like an old friend.

“Kim was a great teacher who developed an easy rapport with us,” said a participant in Paden’s childbirth class. “She made it fun and simple to learn.”

Paden, who teaches Childbirth Preparation, Breastfeeding, Baby-Care Basics and Becoming a Big Brother/Big Sister, has been working in perinatal education for more than 13 years. It was during an assignment to the labor/delivery floor in nursing school that she made her career decision ... and she’s never looked back.

“I love teaching new parents how to bring their babies into the world under the best possible circumstances,” says Paden. “When they feel prepared and knowledgeable,

they’re going to be more confident and comfortable during delivery. I have a real passion for my breastfeeding classes as well ... it’s a wonderful feeling to make a difference in the lives of a new family.”

In addition to her roles as a childbirth instructor and lactation consultant, Paden also has experience as a labor and post partum Doula. And, her exposure to other cultures has provided new insights as well. Paden lived in Lithuania for eight years during which time she helped to develop a childbirth education program.

Paden and her husband live in Rancho Penasquitos with their four children.

To register for a childbirth or breastfeeding class, call The HealthSource at 800.628.2880.

Meet the Instructor

Kim Paden Certifi ed Childbirth Educator

and Lactation Consultant

Palomar Pomerado Health’s certified lactation consultants provide telephone, inpatient and outpatient consults for new mothers who choose to breastfeed their babies. Breast pumps are also available for sale or rental through the PPH Women’s Health Connection Boutique, along with a wide variety of breastfeeding supplies and literature. Following is a directory of lactation services available through Palomar Pomerado Health.

Palomar Medical Center 760.739.2434555 E. Valley Parkway, Escondido, CA 92025Breastfeeding classes; inpatient and outpatient lactation consults; telephone advice warmline; other related services.

Pomerado Hospital 858.613.4605 15615 Pomerado Road, Poway, CA 92064Breastfeeding classes; inpatient and outpatient lactation consults; telephone advice warmline; other related services.

Women’s Health Connection Boutique 858.613.489415725 Pomerado Road, Suite 100, Poway, CA 92064Medela® breast pumps for rental or purchase; pump kit accessories; nursing bras; breast-care products; breastfeeding classes; support group meetings.

To register for a breastfeeding class, call The HealthSource at 800.628.2880.


Infant and Toddler CareBaby-Care Basics

12:30 – 3 p.m.

Women’s Health ConnectionChoose one of the following four classes:

Saturdays January 21, February 18, March 18 or April 15

Since babies don’t come with instructions, this class will provide you with the guidance needed to experience a more confident beginning. Topics include basic physical care skills, growth and development, normal daily activities/habits, safe-proofing your home, nutritional needs and management of illnesses.


Infant MassageWomen’s Health ConnectionWednesdays, 6:30 – 7:30 p.m. March 15 and 22

Touch is the primal language of newborns. That’s why infant massage has become an increasingly popular method of bonding and relaxation between a baby and parent. Designed for babies’ ages 1 to 6 months, infant massage incorporates touch, massage, and reflexology in a loving, fun, one-on-one interaction – providing nourishment for a newborn’s healthy development.

Palomar Pomerado Health will host a special infant massage class during two one-hour sessions at the Women’s Health Connection in March. Led by Certified Infant Massage Instructor Wendy Morris, this unique class will explore the many advantages of infant massage and provide hands-on instruction using a variety of easy-to-learn massage techniques. Please bring your baby to both one-hour sessions. Babies recently immunized should not participate. Register today, as space is limited for this class.

FEE: $35 / couple and baby

Have you been blessed with multiple bundles of joy? The Mothers of Twins and Triplets Club meets monthly and provides

a forum for friendship and support for families, or expecting

families, with twins or triplets. Speakers and special programs

help parents deal with the pressure of raising multiple-birth

children. For more information, call 858.451.8612.

Women’s Health Connection 6:30 – 9 p.m. Wednesday, February 8 or Wednesday, April 26

Made popular by the hit movie “Meet the Fockers,” baby sign language is the latest trend in early communication for hearing babies and toddlers.

Starting as early as 7 months, before verbal skills are developed, your baby can begin to learn to express his or her wants or needs through the art of signing. Studies have shown that signing babies may learn to speak earlier, develop larger vocabularies, have stronger parent/child bonds, show more interest in books, engage in more sophisticated play, have less frustration, crying and tantrums, and have increased IQ scores.

Palomar Pomerado Health will present special sessions on Baby Sign Language at the Women’s Health Connection in Poway. Monta Briant, a Sign2Me Certified Instructor, will teach 50 to 60 signs during the class and provide couples with a copy of her book, “Baby Sign Language Basics.” Please note that this class is for parents and caregivers only. Space is limited so register today!

FEE: $40 / couple

Mothers of Twins Triplets CLUB

This hearing baby is using baby sign language to

communicate that she would like to “eat.”

Baby Sign Language


Neil Goldfi nger, M.D., is a board-certifi ed pediatrician with Centre for Health Care, a multi-specialty group with offi ces in Rancho Bernardo and Ramona. Through his affi liation with Pomerado Hospital, he sees many newborns and offers the following answers to popular questions asked by new parents.

HealthSource: What do I do when my baby cries?

N.G.: Crying and fussing are normal. Soon you will be able to tell if your baby needs consoling, feeding, tending to or maybe just to be left alone for a short time. Swaddling, going for a car or stroller ride, playing soft music or white noise, or providing a warm bath are helpful soothing techniques when all other needs have been met.

If all else fails, it’s okay to let your baby cry for a while and tire out. If he or she seems inconsolable, take a temperature to check for illness. Most importantly, do your best to remain relaxed as your baby may sense your anxiety if you become stressed.

HealthSource: How much should my baby be sleeping?

N.G.: Newborns generally sleep 20-22 hours each day and are initially unable to tell day from night. Therefore, you need to let your infant know that daytime is for playing and nights are for sleeping by shortening feeding time at night, keeping lights low and changing diapers quickly. You may want to wake your baby if he or she is taking daytime naps for longer than three hours. Fortunately, most infants will sleep through the night by three months of age.

HealthSource: My baby has different colored bowel movements – is that okay?

N.G.: Occasional variations in color and consistency of stools are normal. Within 24 hours, a baby will usually have his or her fi rst stool. It is a thick, dark green or black substance called meconium and may take several days to clear up – changing to a yellow-green color. If your infant’s bottom becomes irritated, small streaks of blood may appear in the stool. However, if there are large amounts of blood, mucus or water in the stool, take your baby to your doctor for further evaluation.

Normally, newborns pass a stool within two or three hours of feeding, day or night. By three to six weeks, he or she will pass three or four stools per day, although I know of some babies who may only have one bowel movement per week.

The stools of breast-fed babies look like slightly runny mustard with seeds in it and pass in an explosive fashion. If a baby is bottle fed, his stools will be fi rmer. It is normal for babies to strain, fuss or cry with bowel movements.

HealthSource: How do I know if my baby has diarrhea?

N.G.: If your baby is having more than one bowel movement per feeding and it is full of liquid, then he or she probably has diarrhea. If a fever is also present, call your doctor immediately.

HealthSource: How do I know if my baby is getting enough to eat?

N.G.: Check your baby’s diapers for clues. Diapers are so absorbent now that you must check carefully to see if it is wet. In the fi rst few days, he or she may have only two or three wet diapers a day. By the time your baby is a week old, it is normal to have six or eight wet diapers a day.

Weight gain, of course, remains the most reliable sign that an infant is getting enough to eat. Most babies lose up to seven percent of their body weight in the fi rst few days after birth, but should regain their birth weight by 14 days. Normal weight gain is one-half to one pound every two weeks.

HealthSource: Should I change what I eat while I am breastfeeding?

N.G.: In general, it is not necessary to make any dietary changes while nursing unless your baby has problems. Sometimes certain foods, especially in large quantities, may upset a baby’s tummy. Some nursing mothers say “gassy” foods, such as cabbage, onions, garlic, broccoli, turnips and strawberries, as well as cow’s milk or other dairy products, may cause their infant to have an upset stomach. Caffeine can also cause problems, such as irritability, for breast-fed babies.

It usually takes many hours from the time you’ve eaten the problem food until you see a reaction, and most reactions do not last more than 24 hours.

“I have also been asked if sneezing in babies means they are getting sick and if frequent hiccups are okay,” says Dr. Goldfi nger. “Both are perfectly normal. And, it is also normal for new parents to have lots of questions, so I usually recommend the following books to them: Caring for Your Baby and Young Child by Steven Shelov, M.D., and New Mother’s Guide to Breast Feeding by Joan Younger Meek, M.D.”

Ask the Doctor: Caring for Your Newborn

Neil Goldfi nger, M.D.,pediatrician with Centre for Health Care, a multi-specialty group with offi ces in Rancho Bernardo and Ramona. Through his affi liation with Pomerado Hospital, he sees many newborns and offers the following answers to popular questions asked by new parents.

HealthSource: What do I do when my baby cries?


Follow these tips for making an informed decision.

In addition to picking out nursery furniture, a layette and a name, you also need to decide on a pediatrician for your child. Start by seeking referrals from friends or your obstetrician and checking providers listed in your health plan directory.

Once you have a list of potential doctors, schedule a get-acquainted interview. It’s a good opportunity to learn about the physician’s personality, patient care philosophy and accessibility. When you call, ask if the doctor is accepting new patients and double check that the offi ce accepts your health insurance.

The American Academy of Pediatrics recommends that you ask:

• What hospitals are you affi liated with?

• What are your offi ce hours? Do you have Saturday or evening appointments?

• What is your position on child rearing matters such as breastfeeding, circumcision, antibiotics and nutrition (introduction of solid foods)?

• How often will you want to see my baby?

• Do you have separate “sick” and “well-child” waiting rooms?

• Is around-the-clock emergency care available?

• Do other doctors share call coverage? Who are they?

• Do you reply to phone or e-mail questions about my baby? What is the usual time for response?

• Who answers questions over the phone during offi ce hours? How are calls handled after offi ce hours?

• Do you use a nurse practitioner (NP) or physician assistant (PA)?

• What is your approximate fee for a well-baby check up?

• Is payment due at time-of-service?

After the interview, you will have observed the offi ce staff and their customer service. You will also know if the pediatric practice is a good fi t for you and your child.

For assistance with a physician referral, call The HealthSource at 800.628.2880.

SWEET DREAMS: Tips to help your baby sleep

Chances are the sleep-deprived mother or father in the grocery line has a newborn who hasn’t settled into a sleep pattern. Erratic sleep schedules are common during the fi rst weeks or months of life as infants learn to distinguish night from day.

The National Sleep Foundation recommends these sleep tips for newborns and infants:

• Put your baby in the crib when he or she is drowsy, not asleep.

• Encourage nighttime sleep:

Create a quiet, calm period before bedtime through music, bathing or singing.

Limit the length of feeding time during the night.

• Develop consistent daytime and bedtime schedules and routines early.

• Place the baby to sleep on his or her back with the face and head clear of blankets and other soft items.

• Establish a regular “sleep friendly” environment:

Dim lights.

Limit activity and noise.

Provide a warm, safe bed and clothes.

Set room temperature at a comfortable level.

• Encourage baby to fall asleep independently and to become a “self-soother.”

Neil Goldfi nger, M.D., a board-certifi ed pediatrician with Centre for Health Care, suggests that new parents also consider giving their infants a pacifi er, as recent evidence shows that it may decrease the risk of Sudden Infant Death Syndrome (SIDS). He also suggests that parents sleep when the baby sleeps.

Source: www.sleepfoundation.org

PERPLEXED Over PEDIATRICIANS?

Follow these tips for making an informed decision.

13For a physician referral, or to register for a class, call The HealthSource at 800.628.2880.For a physician referral, or to register for a class, call

Simple, Healthy SNACK IDEAS

for KIDS

When the foods that are meant to nourish your infant instead result in illness, parents are rightfully concerned. Learning about food allergies and how to prevent exposure can help your infant thrive. Start your education with these facts:

• Eight percent of children under the age of six have allergic reactions to food and less than fi ve percent have confi rmed food allergies.

• While almost any food can cause an allergic reaction, the most common culprits are eggs, cow’s milk, peanuts and other nuts, soy, wheat and seafood.

• The best food for a newborn is mother’s milk. Sometimes, hypersensitive babies may have an allergic reaction to the foods their breastfeeding mothers eat. Eliminating suspicious foods from the mother’s diet may provide relief.

• As solid foods are introduced, start with those that do not cause allergic reactions in adults such as carrots, pears, potatoes and rice. Avoid wheat, corn, eggs, citrus and nut butters.

• Not all reactions to food are due to allergy. For example, sensitivity to milk may be due to a defi ciency of the enzyme that breaks down lactose sugar in milk (lactose intolerance).

Diagnosing food allergies usually starts with eliminating the suspicious food from your child’s diet for several weeks. Then, the foods can be reintroduced one at a time while allergic responses are evaluated. Your pediatrician may also recommend blood and skin tests.

Once the food culprits are identifi ed, ask your pediatrician to suggest alternative foods to assure that your infant’s nutritional needs are met.

• Can egg substitutes be used in place of whole eggs?

• What alternatives are there for cow’s milk, which is nutritionally important for developing young bodies?

Parents of infants and children with food allergies must be proactive in protecting their child from unintentional exposure. This includes reading food labels and alerting family members, childcare providers, schools and parents of playmates to avoid offering forbidden foods. Being diligent can help your infant avoid unnecessary illness due to food allergies.

Resources:

American College of Allergy, Asthma & Immunologywww.acaai.org

American Academy of Pediatricswww.aap.org

PERPLEXED Over PEDIATRICIANS?

• Mini bagels • Crackers with cheese • Popcorn or pretzels • Rice Cakes • Yogurt • Cheese crackers such as Goldfi sh • Raw vegetables, such as celery, carrots, caulifl ower or

broccoli with a low fat dip• Fresh fruit in season cut into slices or halves, such as

apples, oranges, bananas, grapes or strawberries • Non-sugared cereals or snack mixes made with popcorn

and whole grain cereal • Dried fruits such as raisins or apricots


Young Adult ClassesBabysitting Basics*

Women’s Health ConnectionFriday, February 24, 6 – 9 p.m. Saturday, April 22, 10 a.m. – 1 p.m.

The HealthSource, San MarcosFriday, February 3, 6 – 9 p.m. Friday, March 10, 6 – 9 p.m.

This three-hour babysitting course is designed for boys and girls ages 10 to 14. Topics covered include babysitter responsibilities, caring for children, overview of first aid, infant/child growth and development, calling 911, fire safety and poison prevention and action, and tips for a professional babysitter. Those completing the course receive a certificate to present to prospective employers.

FEE: $15 / boy or girl (includes course materials)

Becoming a Young Woman*7 – 8:30 p.m.

Women’s Health ConnectionChoose one of the following two classes:

Fridays, January 20 or March 3

The HealthSource, San MarcosFriday, April 7

This informative class helps young women 10 to 12 years old explore the emotional and physical changes of puberty. Emphasis is placed on how each girl experiences changes in her own special way. Additional topics include challenges with competition and development, communicating with parents, menstruation, purchasing personal female items, cramps and other common menstrual discomforts, and emotional changes and hormones. Mothers are encouraged to attend and share this unique time with their daughters. Please note there is no discussion on sex.

FEE: $10 / daughter and mother

*The “Babysitting Basics” and “Becoming A Young Woman” classes are available for off-site instruction upon request. Please call 858.675.5376 for more information.

Sibling EducationBecoming a Big Brother/Big Sister

10 – 11:30 a.m.

Women’s Health ConnectionChoose one of the following two classes:

Saturday, January 21 or Saturday, March 18

Palomar Medical CenterChoose one of the following two classes:

Saturday, February 25 or Saturday, April 29

This 90-minute class offered at the Women’s Health Connection in Poway and Palomar Medical Center in Escondido will help big brothers and sisters prepare for the new baby’s arrival. Activities include safe ways to interact with the new baby, special art projects, diapering and feeding their “own” baby (please bring a doll or stuffed animal), and a tour of the birth center. This class is designed for children ages 3 to 5.

FEE: $15 / family

CPR & First Aid ClassesAmerican Heart Association Life Support and HeartSaver First Aid CoursesCPR for Family and Friends

This course teaches basic life saving techniques including how to relieve an obstructed airway. It is suggested for the lay rescuer such as new parents, babysitters, caregivers or anyone who is preparing to help others in distress but does not need certification.


HeartSaver First AidThis four-hour class includes instruction on the general principles of first aid, as well as medical, injury and environmental emergencies. Topics covered include choking, chest pain, fainting, seizures, low blood sugar, bleeding, burns, shock, bites, stings, poisoning and more. This course complies with OSHA regulations and is open to anyone.


The American Heart Association strongly promotes knowledge and proficiency in BLS, ACLS, and PALS and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the American Heart Association, and any fees charged for such a course do not represent income to the Association.

For information on additional CPR and First Aid Classes offered at Palomar Pomerado Health, please see page 12 of this issue of The HealthSource.


www.pph.org 15615 Pomerado Road 858.613.4000• •

Agency: JohnsonGray

Client: Palomar Pomerado Hospital

Job:6530 PPH ED.Skater.m1.0

Description: 6530PPH ED.Skater.m1.0

Color: 4/c 5c x 11

Publications: Health Source

Live: 8.0x10.5 Full Page

Trim: 8.5x11

Date:Date:4/19 Time:11:29am Lori

You do allyou can to

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You do allyou can to

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But accidents can still happen.

But accidents can still happen.

It seems like children always find a way to hurt themselves. Which is why we makesure we’re always ready. Our Emergency Department has a superior team of physicians, very short wait times and advanced technologies that rival some of the best in the county. Also, with a patient satisfaction score in the 99th percentile among hospitals surveyed nationwide, you can feel comforted knowing we’ll treat your family like they’re our own. We know you can handle thebumps and bruises that occur in everyday life. However, if something more seriousever comes up, our Emergency Department is just around the corner and ready to help.

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january – april 2006 midlife moms center... · selecting the right pediatrician for your child is...

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