September 2021

This Month's Newsletter The Pediatric Center newsletters will now hit your inbox the first to second week of the month. It's hard to believe we are now in September and the school year has begun. We hope you enjoy these last few days of summer and try to ease in to a busy schedule. Now is a good time to make any well-visit appointments before the calendar books up. In this month's newsletter, we announce this year's flu clinic dates and times. We will once again be utilizing the app we used last year for a seamless and safe experience. In a recent blog article, we offer guidance on giving your baby their first bath. We also share a NYTimes article that discusses the benefits of mask-wearing. Further, we provide information on insurance coverage and referrals based on your type of plan. Finally, we bring your attention to the RSV virus and what to look for in your child. We continue to include information on our office procedures, services we offer and complimentary new mom and baby classes.   The Pediatric Center is here for all of your urgent medical needs, even when the office is closed. There is always someone available from our practice. All you have to do is call: 908-508-0400.   Our goal is to further develop our relationship with our patients and create an open forum. We welcome your comments and ideas. If you would like to see something included in this newsletter, please email us at pedcenter.com@gmail.com with ideas only, please no medical requests.   As always, we welcome you to share your experience with our practitioners with an online review.    Sincerely, The Pediatric Center Staff

Baby's First Bath

There are a lot of firsts with newborns – first feeding, first outing, first haircut. If this is your first baby, some of these can feel a little scary, including giving your baby their first bath. Your baby’s first bath is a wonderful experience with many benefits including strengthening your bond with your baby, providing a learning experience and soothing them if they are sleepy or fussy. There are also some important bathing tips to follow to ensure safety, ease and comfort. You want to consider the products you use, the temperature of the water and the best way to clean your baby. We provide all of this information and more - Simply follow these steps....

Are Masks Actually Beneficial?

A recent article in the New York Times suggests that "wearing a mask can help your child learn." The author of the article, Dr. Judith Danovitch, an associate professor of psychological and brain sciences at the University of Louisville and a Learning Sciences Exchange fellow at New America, studies the cognitive and social development of children. There is growing concern among parents that wearing a mask in school and in social situations can impair a child's ability to learn and socialize. Dr. Danovitch believes these concerns are unwarranted. "Children in cultures where caregivers and educators wear head coverings that obscure their mouths and noses develop skills just as children in other cultures do. Even congenitally blind children — who cannot see faces at all — still learn to speak, read and get along with other people," says Danovitch. Although she understands the reasoning behind the concerns, she contests that masks in school could actually improve social and cognitive skills and help strengthen abilities like self-control and attention. She recognizes that masks are uncomfortable and bothersome however wants to acknowlegee an optimistic side of the new normal. . Danovitch points out, "...looking at eyes is at least as important as looking at mouths to understand whom you are looking at and what they are trying to convey. In fact, children with a stronger capacity to discern people’s thoughts and emotions based on their eyes alone exhibit greater social-emotional intelligence. Children also rely on other cues, such as prosody, gesture and context, to figure out what new words mean and what other people are thinking.." Wearing a mask can also contribute to self-control and self-regulation. It can also give a sense of caring for a community by participating in an act for the greater good. Danovitch summarizes, "Ultimately, how children feel about wearing masks at school, and how much they psychologically benefit from wearing them, is going to depend on how the parents, teachers and caregivers around them present the issue. Masks are hopefully not here to stay, but while they are still necessary, we should make the most of them." Note: This is an opinion article. Source: NYTimes.com

Could It Be RSV?

RSV, or respiratory syncytial virus, is a rather common virus that causes respiratory illness of the nose, throat, and lungs. Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold however some children can get very sick from RSV. Masks and physical distancing for Covid-19 led to fewer cases of RSV in 2020. We are now starting to see a rise in cases for this season in 2021. Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days. A cold can include an upper respiratory tract infection with the following symptoms: Fever (temperature of 100.4 or higher) Cough (dry or wet sounding) Congestion Sneezing Runny nose Fussiness Poor feeding For bronchiolitis, or lower respiratory tract infection, symptoms may include cold symptoms, plus: Fast breathing Flaring of the nostrils Head bobbing with breathing Rhythmic grunting during breathing Belly breathing, tugging between their ribs, and/or tugging at the lower neck Wheezing Know what to look for Chest wall retractions occur when a baby must use muscles between the ribs or in the neck to breathe. It is a sign that baby is having to work harder than normal to breathe. Watch your child's rib cage as he or she inhales. If you see it "caving in" and forming and upside-down "V" shape under the neck, then he or she is working too hard. Infants with a higher risk for severe RSV infection include: Young chronological age (≤12 weeks) at the start of RSV season Premature or low birth weight infants (especially those born before 29 weeks gestation) Chronic lung disease of prematurity Babies with certain types of heart defects Those with weak immune systems due to illness or treatments Additional risk factors for severe RSV infections include low birth weight, having siblings, maternal smoking during pregnancy, exposure to secondhand smoke in the home, history of atopy (allergies/eczema), not breastfeeding, and being around children in a childcare setting or living in crowded living conditions. When to call the doctor RSV symptoms are typically at their worst on days 3 through 5 of illness. Fortunately, almost all children recover from an RSV infection on their own. Call your pediatrician right away if your child has any: ·Symptoms of bronchiolitis (listed above) Symptoms of dehydration (fewer than 1 wet diaper every 8 hours) Pauses or difficulty breathing Gray or blue color to tongue, lips, or skin Significantly decreased activity and alertness  Some children with RSV may be at Symptoms that worsen or do not start to improve after 7 days A fever (with a rectal temperature of 100.4°F or higher) and he or she is younger than 3 months of age (12 weeks) A fever that rises above 104°F repeatedly for a child of any age Poor sleep or fussiness, chest pain, ear tugging, or ear drainage (there is an increased risk of developing a bacterial infection, such as an ear infection How to diagnose RSV Pediatricians diagnose children with a cold or bronchiolitis by asking about their symptoms and by doing a physical exam. Your pediatrician may do a nasal swab test to determine if your child has RSV or another virus. A chest x-ray and/or oxygen saturation test may also be done to check for lung congestion. Because most children recover without difficulty and because there is no treatment for RSV, these tests usually are not necessary. RSV is contagious and spreads just like a common-cold virus―from one person to another. Symptoms can appear 2 to 8 days after contact with RSV. According to the Centers for Disease Control and Prevention (CDC), people infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks―even if they are not showing symptoms. RSV enters the body through the nose or eyes or, usually from: Direct person-to-person contact with saliva, mucus, or nasal discharge Unclean hands (RSV can survive 30 minutes or more on unwashed hands) Unclean objects or surfaces (RSV can survive up to 6 hours on surfaces, toys, keyboards, door knobs, etc) Children and adults can get RSV multiple times–even during a single season. Often, however, repeat infections are less severe than the first one. Treatment There is no cure for RSV and medications, like steroids and antibiotics, do not help with RSV. To help your child feel more comfortable, do the same as you would for any bad cold. Use nasal saline with gentle suctioning to allow easier breathing and feeding, a cool-mist humidifier to help break up mucus and allow easier breathing, and ensure they drink lots of fluids and have frequent feedings to keep them hydrated. Try to section baby's nose before attempting to breast or bottle-feed. Supplementation with water or formula is unnecessary for breastfed babies. If difficult for the baby to feed at the breast, expressing breastmilk into a cup or bottle may be an option. Acetaminophen or ibuprofen (if older than 6 months) can help with low-grade fevers. Always avoid aspirin and cough and cold medications. How to protect your child from RSV Try to prevent germs by washing your hands with soap and water – scrubbing for at least 20 seconds all year long. You also want to ensure you child is up to date on immunizations and get the whole family annual flu shots. Getting vaccinated with Tdap―to protect against whopping cough is especially important for adults who are around infant—new parents, grandparents, babysitters, nannies, etc. Your child should also be immunized against COVID-19 if they are eligible. Limit your baby's exposure to crowds, other children, and anyone with colds. Keep them home from school or childcare when they are sick and teach them to cover their coughs and sneezes. Disinfect objects and surfaces in your home regularly and avoid exposing your child to smoke from tobacco or other substances. Feeding your baby breastmilk will give them unique antibodies to prevent and fight infections. Rest assured that most children recover well from RSV. Please be sure to contact your pediatrician if you suspect your child is sick.  Source: HealthyChildren.org

Know Your Insurance & What it Covers

Did you once have a PPO or POS insurance but have now transitioned to HMO? If that is the case, your process for referrals may have changed. Your type of health insurance will dictate if you can go straight to a specialist or if you require a referring from another doctor. If you have a health maintenance organization (HMO) or point of service (POS) plan, you'll probably need to first go to your primary care physician (PCP) first. If they agree that you need to see a specialist, they'll refer you to one, and indicate in your medical records that this has been done. Some health plans require the referral to be in writing directly from the doctor, while others will accept a phone call from your primary care physician. The best thing you can do is be proactive and ensure your insurer has received a referral before making an appointment with your specialist. How HMO Plans Work Health maintenance organizations require you to select a primary care physician. HMOs usually require members to only use providers in the plan’s network. The primary care physician is then responsible for managing all your health care going forward. The primary care physician becomes responsible for making recommendations as far as courses of treatment, specialist visits, medications, and more. The primary care physician also provides referrals for any other necessary services or specialist visits within the network, allowing you to see another doctor within the health plan’s network. If you do not have a referral, the HMO will most like not cover any of the charges Note – some modern HMOs have relaxed these rules and now allow members to visit specialists within the plan's network without having a referral from their primary care physician. It’s important to check the specific requirements of your plan. HMOs have become much more common in the individual health insurance market over the last few years as insurers work to control costs. How POS Plans Work Point of service plans also require referrals from a PCP to see a specialist. Unlike an HMO, a POS will generally cover some of the cost of out-of-network care, if you have a referral from your primary care physician Plans that do not require referrals Referrals are not necessary for a preferred provider organization (PPO) or an exclusive provider organization (EPO). A PPO is a health plan that has contracts with a wide network of "preferred" providers and you can choose care out-of-network. Unlike an HMO, a PPO or EPO does not require you to choose a primary care physician and you do not need referrals to see other providers in the network. Because of this flexibility, PPO plans tend to be more expensive than HMO plans with otherwise comparable benefits. Prior Authorization In addition to a referral from your primary physician, a prior authorization from your insurance may be required. Your primary may automatically obtain prior authorization as part of the referral process, however you should double check with your insurer and the specialist prior to your appointment. In-Network Payment Regardless of whether you have an HMO, EPO, POS, or a PPO, for in-network services you'll be responsible for co-payments, deductible and any coinsurance. Out-of-Network With an HMO or EPO, you are typically not covered for any out-of-network services unless it's an emergency. If you have a PPO or POS, there is typically coverage for out-of-network care, but the provider can balance bill you for the portion that your insurer doesn't cover ​since the provider hasn't signed a contract with your insurer (with a POS, you'll need a referral from your PCP in order to have any insurance coverage for the out-of-network treatment).8 If you choose to go outside of the network for your care, you will usually need to pay the provider initially, and then get reimbursed by the PPO. Most PPO plans have higher annual deductibles and out-of-pocket maximums for out-of-network care, and some PPO plans have no limit on the out-of-pocket costs you'll incur if you go outside the network. Source: VeryWellHealth.org

Covid-19 Office Procedures

Our strict CDC guidelines continue, Our office is completely sanitized and treated before each appointment. We continue the following protocols: Phone screening prior to a visit No patients in the waiting rooms Scheduled appointments only Patient clearance prior to entering the office Car visits, when needed Virtual telemedicine, if requested

Please continue to limit your visit to one parent only for all patients over 2 years of age, wear a face mask while in the office and maintain social distancing. Please do not make an appointment or come to the office if you have any symptoms of COVID-19. No admittance to the office if you have traveled outside of the state of New Jersey until 10 days past the date of return, 7 days of a negative PCR test upon return, or if you have proof of vaccination. We look forward to seeing you!

In-House Covid-19 Testing & Guidelines The Pediatric Center continues to offer Covid-19 testing for all patients and their families. Do you need a test to travel, return to school or any other reason? The Pediatric Center offers testing with an instant 20- minute Rapid test and PCR test results within 48 hours. Please visit our Covid-19 Testing page to learn more about the types of tests, what to do if you are exposed to Covid-19 and isolation and quarantine guidelines.

Virtual New Mom Support Group The Pediatric Center offers a weekly Virtual New Mom Support Group every Friday at 10 am. The classes are facilitated by our own Dr. Mckegney via Zoom. Simply register here. The support group is open and free to the public.

Virtual Prenatal Class

On-Site Lactation Support Center The Pediatric Center's Lactation Support Center and lactation suite are available to you to support breastfeeding your child.     We offer complimentary lactation consultations and are now offering virtual visits.   To schedule your lactation consultation, attend our free prenatal class or make an appointment please call us at 908-508-0400.

Patient Portal The Pediatric Center's patient portal provides personal access to your family's medical records.    You can access information such as immunization records, visit summaries, request appointments, view dates for upcoming appointments and pay your bill.   Sign up is quick from our website. Click here.

Do You Need A Pediatric Specialist? The Pediatric Center works with a wide network of doctors we can refer to a pediatric specialist if you need one.    As part of our practice, we specialize in developmental & behavioral health and focus on positive parenting practices. We can offer guidance on depression, eating disorders, developmental concerns and many other issues. You are not alone.    Please call to make an appointment to meet with one of our physicians: 908-508-0400.

The Pediatric Center Online Bill Pay Online Bill Payment The Pediatric Center offers the ease and convenience of online bill payment from our Bill Payment & Insurance page on our website.    Payments Over The Phone If you prefer, you can still make a payment over the phone by calling The Pediatric Center's billing department, Office: 908-508-0400 / Billing Department: 786-249-1234

ImPACT Concussion Testing The Pediatric Center offers on-site ImPact concussion testing.   ImPACT, an FDA cleared tool for baseline and post-injury testing, measures visual and verbal memory, reaction time, and processing speed to help determine if a patient (ages 12-59) can safely return to activity.

Vaccine Education Center Our website offers a Vaccine Education Center with immunization schedules for your child.   Reminder - we offer all students going to college the Meningococcal B vaccine. This vaccine is covered by insurance. It is recommended it be administered to all students starting college as part of their pre-college physical. We also offer the Gardasil vaccine.

Find More Topics On Our Blog

The Pediatric Center's blog is an invaluable resource for pediatric and parenting topics. The blog is right on our website. It includes topics such as "12 Super Foods for Lactation Aid", "Best Winter Skincare Tips" and so much more.

We Love Your Feedback! Your feedback is very important to us! We would love to hear about your positive experience with our doctors and nurse practitioners. You can  write and post a review right on our website or on our Facebook page.  Thank you for your kind words!

Free Virtual Prenatal Class Join our free, virtual prenatal class on the 3rd Thursday of every month with our own Dr. McKegney! Learn more.

For Parents Resources for breastfeeding, immunization schedules, what to do if your child is sick, online references & much more! Click here.

New Mom Support Group Are you a new mom and want to connect with other moms while learning about your newborn? Join our weekly support group. Register here.

Follow Us On Facebook! Keep up to date with pertinent news information and important announcements on Facebook including time sensitive topics and office closings, etc.   Simply like us by clicking on the button to the right!   Announcements will also be posted on the home page of our website under "What's New".

The Pediatric Center 556 Central Avenue, New Providence, NJ 07974 908-508-0400 www.PedCenter.com