Last week, Dr. Alessia wrote a fantastic blog entry on why a child should have a pediatrician, and this week I’ll give you some tips on how to choose the RIGHT pediatrician for your family.  Notice I wrote “family” and not “child.”  This is because, in an ideal setting, a child, his/her parents, and the pediatrician should work as a team in making healthcare decisions.

Vrinda Kumar, M.D.

As Dr. Alessia pointed out in her last blog, all general pediatricians go through similar training: four years college, four years medical school and three years in a pediatric training residency.  We are all taught to practice evidence-based medicine (that means keeping up-to-date on the most recent research and scientific evidence, and using this information to better care for our patients).  We also follow recommendations from the American Academy of Pediatrics, who is a large group of people way smarter than me who look at all the scientific research happening in the world of pediatric medicine, and they summarize it in the form of recommendations for us so that we can keep our patients as healthy as possible! So, from an educational background perspective, we are not that different from one another.  However, we each come with different personalities and different viewpoints, and this is what makes each one of us unique.

Most pediatricians offer “meet and greet” appointments (most offices do not charge for this visit), where you can meet a physician face-to-face, spend 15 to 20 minutes talking, asking questions, and getting a feel for that physician’s personality.  I highly recommend doing this!  It’s a great way to see first hand if the pediatrician is the right fit for your family.

Here are four things you should keep in mind when choosing a pediatrician:

1. Seeing the pediatrician should be a joy, not a dread!  Making sure that you feel comfortable with your pediatrician is very important, especially in those first few months after your baby is born.  There are a lot of visits and a lot of questions (some can be a bit personal), and you want to make sure you can talk openly and with ease at each visit.  Feeling comfortable with your pediatrician really helps keep lines of communication open, and this is important in making healthcare decisions for your child.

2. You want to make sure you and your pediatrician are on the same page on immunizations and medications. Immunizations are a hot topic and many people have mixed feelings about giving their children immunizations. I encourage you to ask your pediatrician lots of questions so that we may answer them and help guide you in  making the right decision for you and your child.  Most of the visits during the first two years involve giving immunizations and immunizations are the center of pediatric preventative care, so it is something that will be discussed over and over again. Keep in mind that some pediatricians will not even accept patients who are not immunized.

3. Convenience is another factor to take into consideration. With the frequent visits to the pediatrician in the first 2 years of life, choosing a physician whose office is easily accessible is vital. Accessibility means being fairly close to home, and also it means convenient office hours that fit your schedule. Many offices will have weekend/evening hours, so if these hours work best for you, make sure your pediatrician’s office can accommodate that.

4. Even though infants do not seem to mind whether a male doctor or female doctor is examining them, older children might! Some boys feel more comfortable with a male physician, and on the same token, some girls may feel more comfortable with a female physician.  This becomes especially important when the child is reaching those pubertal/teenage years.  A regular checkup at that point starts to include some personal questions, many of which we ask with the parents out of the room.  If your child is more at ease with his/her physician, he/she is more likely to be more open and ask questions more freely.

I hope this takes some of the “eenie-meenie-miney-mo” out of choosing a pediatrician for your family.  Any pediatrician’s office should be more than happy to answer any questions you may have.  We all want to make sure that you have the best experience possible when you come see us, and we want to be able to provide the best care to your children!

Hello everyone! Yay for nicer weather – finally!

Nicole Keller, D.O.

This blog is going to be a two-parter – this week I’m going to offer you healthy eating tips and with my next blog I’ll follow-up with tips to stay fit and active.  Combine these two subjects and you’ll be well on your way to encouraging your kids (and yourself) to live a healthy lifestyle.

Eating well and staying fit is a family affair.  It is something the entire household should be a part of.  Here are my healthy eating tips for your family:

Re-vamp the way you grocery shop

• Make sure you make a healthy shopping list and stick to it.  Only allow yourself one to two “extras” that weren’t on the list to avoid buying unhealthy, but good looking, items.  If you don’t have the willpower to do that, try online grocery shopping.  Oh and don’t go shopping when you are hungry!  That’s when the cookie aisle is the most enticing.
• Skip certain aisles all together; the snack/chip/cookie aisle, the baking aisle, sometimes even the cereal aisle.  If you need something in these aisles look specifically for those items then turn that cart around and get out!  My husband and I love Oreos.  We rarely even go down the aisle that they are sold in so we aren’t even tempted.
• Look at labels.  I admit, they aren’t the easiest things to read, but, if you take a second to compare two items you might be surprised with what you learn.  Just because something is marked at “low fat” or “low sugar” doesn’t mean it is the healthiest option.  Look at calories (the lower per serving the better), fat (trans fats are bad!), fiber (more fiber makes you more full), and protein (lots of protein will keep you full longer) to get a well-rounded grocery item.
• Spend time in the fresh section.  Even though fruits and veggies can be expensive, if you spend some time, you can find items on sale that will feed your family well.
• Pick whole grains.  Make sure to do this for your bread items and whatever other options offer it.

Watch what your kids drink

• Drink more water.  Four to eight cups a day for school-aged kids is a great range to shoot for.  You can start giving your baby/toddler water after six months of age in a sippy cup or a cup with a straw.
• Milk is a healthy alternative to water for kids. From one to two years of age, kids should be on whole milk to get the necessary fat needed for brain development.  After two years of age, fat free milk is a healthy way to get them their dairy without the extra fat.
• Get rid of pop and juice. They should only be given on special occasions and in small quantities.  They are loaded with sugar and have little to no nutritional benefit (yes, even the ”all-natural fruit juices”).
• Cut out caffeine.  Caffeine is dehydrating and can make you crave more of that sugary drink it is coming from.  Plus, rarely do you need to give your kids more energy than they already have!

Get creative in the kitchen

• Eat at home and skip the restaurants.  Eating out is hard on your wallet and on your waistline.  Buying groceries and cooking at home will always be the cheaper and healthier option – and great for family bonding.
• Be sneaky with vegetables.  It is hard to get a picky toddler or school age child to eat all their veggies – this is a fact!  So try to “sneak” things in meals in a way your child might not even notice.  You can puree in cauliflower with mashed potatoes or mix it in with macaroni and cheese dishes.  Chop up carrots and acorn/butternut squash together – put a teaspoon of brown sugar on top to sweeten the dish and your kids will be gobbling it up before you know it.
• Be realistic with what you want your kids to eat.  Children’s taste buds are different than adults.  I remember as a kid I did not like brussel sprouts (I thought they tasted like feet!) but now I love them.  Offer your kids a variety of veggies and see what works – they might not have liked something in January but now in May they don’t mind it.  Don’t expect them to eat huge amounts either.  Sometimes just a couple spoonfuls are a victory.
• Make sure your kids know that they have to at least try their veggie (and other food items offered) before refusing them outright.  If they try a bite and don’t like them, then have a back up veggie ready (kids tend to like carrots, corn and green beans – try to have those around all the time).  Other than having a second veggie on hand, your child should eat what is offered to them at meal time and try not to become a short-order chef with whatever their demands at meal/snack time are.
• Snack healthy. For example, celery with light ranch dressing or a small bit of peanut butter can make for a wonderful healthy mid-day snack.  Chopped up apples are always a kid favorite and grapes are another filling fruit option.  Yogurt, string cheese or sliced cheeses are other good options too.
• Easy on the toppings.  Sometimes kids will like a veggie because it is loaded with butter, dressing or ketchup. It is fine to spice things up to get kids to like something initially, but, make sure you aren’t taking away all the nutritional value by overloading their veggies with toppings.
• Have a well-balanced plate at each meal.  Veggies and/or fruits should take up at least half your plate, grains/carbs (like potatoes, rice, bread) should take up about a fourth of your plate and your protein (usually a meat or fish item – or maybe beans for our vegetarians out there) should take up the remaining fourth of a plate.  Visit www.choosemyplate.gov for great online resources regarding healthy balanced food options.
• Make dessert healthy – but still fun.  Forget the chocolate cake and cookies, instead buy some mixed berries (frozen or fresh) and mix with light cool whip – tada!  You have a healthy sweet dessert light on calories and high in nutrients. Or, try low-fat yogurt with some honey or a fourth cup of granola – sweet, crunchy and healthy!  Remember, mom and dad, these desserts are for you too!
• Use free recipe websites/hand-outs.  I personally love allrecipes.com for ways to find how to creatively use a certain ingredient.

Watch your portions

• Visit http://www.webmd.com/diet/healthtool-portion-size-plate for easy to use portion guides to make sure you and your family are getting the right amount of food.
• Make sure to look at serving sizes.  Many times a food will boast “100 calories only” but you can only have a half a cup of that item to reach that caloric amount.  Make sure to glance at the serving size before you decide if that food is really as good as it is claiming.

Sweets are treats

• Cookies, cakes and candy should only be offered on special occasions.  Having them as an option for a daily dessert or snacks during the day can lead to bad habits.
• Don’t give in to a child who demands sweet treats.  Hunger strikes at meal times can be frustrating, but, giving in by letting your child have a sweet treat is no way to teach healthy habits.  They will soon only eat sweets and it will get harder and harder to get them to eat healthily.  Stick to your guns!

Now, try not to be overwhelmed – make small changes at first and keep at them.  If your child is overweight, they should be seen by their pediatrician several times during the year to monitor their weight closely.

If you would like more resources, check out http://www.rushcopley.com/services/healthy-weight/.  It is a great website designed to help you and your family find ways to eat healthy.

One last thing!  Now that farmer’s market season is here, make sure to check out your local vendors.  Here are a couple options:

Oswego, Plainfield, Naperville: www.kellersfarmstand.com
Aurora: http://theaurorafarmersmarket.com/

Please let me know if you have any questions or want more info – I’m happy to offer more suggestions or clarify my tips as needed. 

One quick thing before I get into this week’s post: In my last post, I mentioned when I wanted to be a doctor, but I never said why.  I was born with a “hole in my heart”; mine is a VSD. My “hole” was so big it would never close on its own. So, a month before I turned 11, I had open heart surgery to fix it. My surgeon did such an awesome job, it’s like the hole never existed. He is still practicing. Hopefully none of your children will need his services, but if so, he is the best!  Ok, on to this week’s post:

Why Choose a Pediatrician?

Pediatricians are doctors concerned with the physical, emotional, and social health of children from birth to young adulthood. Pediatricians provide health services ranging from preventive health care/checkups to the diagnosis and treatment of acute and chronic diseases. A pediatrician will: Do physical exams. Give your child recommended immunizations. Make sure your child is meeting developmental milestones in growth, behavior, and skills. Diagnose and treat your child’s illnesses, infections, injuries, and other health problems. Give you information about your child’s health, safety, nutrition, and fitness needs. Answer your questions about your child’s growth and development. Refer to and collaborate with specialists should your child need care beyond the pediatrician’s expertise.

Pediatricians understand the many factors that affect the growth and development of children. They understand that children are not simply small adults. Children change rapidly, so pediatricians take into account their stage of physical and mental development. They often present different symptoms from adults. They may need different prescriptions or treatments than adults. Pediatricians are specially trained to recognize the importance of these differences, especially with young children and newborns.

Because the welfare of children and adolescents is heavily dependent on the home and family, the pediatrician supports efforts to create a nurturing environment. Such support includes education about healthful living and guidance for both patients and parents. Pediatricians participate in the community to prevent or solve problems in child and adolescent healthcare, and they serve as advocates for children and adolescents.

Why Do You Need a Pediatrician?

Family physicians can also provide routine care for children. Choosing between a family doctor and a pediatrician can be a personal preference. Here are some reasons to consider choosing a pediatrician:

• Pediatricians have specialized training in the physical, emotional, and behavioral needs of children.
• Pediatricians only see children, so they often have a broader experience recognizing and treating childhood illnesses.
• If your child was born early or has a health condition that needs close monitoring, a pediatrician may offer more specialized care.

Pediatricians are therefore primarily concerned with the health, welfare, and development of children and adolescents from birth to age 21; they are uniquely qualified to provide care for children because of their specialized training and concern for their well-being. Pediatricians have graduated from medical school and completed a three-year residency program in pediatrics.

References:

www.abp.org

www.healthychildren.org

www.webmd.com

Vrinda Kumar, M.D.

It’s my first blog entry, and I’m so excited to be sharing some useful information about making traveling with kids a little easier and keeping them as healthy as possible during the trip.

First, a little about myself: I am first and foremost “Mommy” to my two-year-old daughter.  My husband and I live in Naperville, but I grew up in a small town in Kentucky, where my mom is still a practicing pediatrician after almost 35 years in the same office. In fact, she is a huge reason I went into pediatrics.  I saw the relationship she developed with her patients and their families, and she is now seeing the children of some of her earlier patients (how cool is that?!).  After training in St. Louis, I wanted to move to my favorite city in the world, Chicago! This is where I met my husband (also a physician, and a Chicago native), and we have now planted our roots here in the western suburbs.  I thought I knew what it took to raise a healthy child when I finished residency, but after having my daughter, I quickly found that I had SO much to learn.  It turns out that kids don’t read the textbooks!  As with my practicing style and as will be with all my future blog entries, I am coming to you with the perspective of, not only a pediatrician, but also a parent.  Parenting is a journey, with some highs and lows, moments you want to hold on to, and moments that can’t end fast enough. I hope that the small pieces of advice that you find on our blog make your parenting journey a little easier.

Traveling can be a daunting task with kids, especially with infants and toddlers.  I remember before having my own child and traveling with her, I would look at parents at the airport with a baby dangling from one arm, a diaper bag hanging off the other arm with the contents falling out, struggling to fold a stroller, and getting their other 45 bags on the belt and cringing at the thought of having to do that one day. Good news, it’s not that bad!  Here are some helpful hints and tidbits that will hopefully make it go a little smoother:

• Just take the basics! You are going to have your hands full just taking care of your child, so try to keep everything else you are going to be lugging around as light as possible.
• Make sure you carry sanitizing hand gel and wipes. Water and soap is not always readily available. Thorough and frequent hand-washing is the best way to prevent the spread of illness!
• If flying, keep the vents above your head CLOSED. The vents recirculate air (and germs) throughout the flight, so it’s safer to keep them closed.
• Keep liquids (including breastmilk/formula/milk) easily accessible as you go through airport security. It will save time and effort for everyone involved. TSA is required to test liquids with a fancy machine, but no worries…no one will be touching the actual liquid your baby is going to be drinking.
• Keep extra diapers and an extra set of clothes in your carry-on bags. Your child will without doubt choose the most inopportune time to soil that cute outfit you picked out for traveling day.
• Keep a diaper changing pad handy. Even though most bathrooms have diaper changing stations, there are often no liners available for it, which means there are plenty of bacteria on the surface. That diaper changing pad will provide a nice barrier between your baby and those germs.
• Try to plan your trip at a time when your child is most likely to be sleeping (i.e. naptime). The less aware they are that that they are stuck on your lap for the next few hours, the better.
• If you are flying, take something that your child can suck on during takeoff and landing (pacifier/bottle/straw cup). This will help equalize the pressure in the ears that tends to build up in the ears during periods of altitude change, often causing discomfort and pain.
• Take plenty of things to keep your child busy! This incudes books, toys, coloring books/crayons, DVD’s, etc. It’s boring for a kid  (and for an adult!) to sit in one place for an extended period of time. It also helps to take something that your child turns to for comfort (stuffed animal, blankie, etc.) to help them stay calm throughout the trip.
• If you want to be REALLY considerate and you know you have a potential screamer on your hands, you can even consider handing out earplugs to your neighbors…just in case of a meltdown. They will appreciate the effort.
• If you are going to be riding in a car at any point during your trip, do not forget the car seat. Most car seats and strollers can either be gate checked (pick it up at the gate at the end of the flight) or checked in (picked up at baggage claim).
• Bring a lightweight stroller that has easy open/close. Your hands will be too full with the little one to be fiddling around with the stroller. It’s also great to have a stroller that reclines for naptime.
• If your child can tolerate being in a baby carrier, such as an ErgoBaby or Baby Bjorn, it’s a great way to keep your child close to you and to keep your hands free. Airport security with let you go through security with your baby in the baby carrier. That way, you’ll have two hands to fold your stroller and put all those bags/shoes/belts/liquids in the security bins.

As a sidenote, if you are going to be toting breastmilk, it’s best to keep it in a cooler with ice-pack. If you are flying, the water in the ice-pack must be frozen solid in order to successfully pass through TSA. If it is melted at all, they may not allow it. If you are pumping, carry extra batteries for your pump in case you cannot find a free electrical outlet nearby.

If you are traveling abroad, you can always call your local health department to see if there are any additional vaccinations or medications your child may need prior to/during travel.

I hope this helps to make your next trip a little easier.  Here’s wishing you happy, healthy, and safe travels this summer!  Send us a postcard! 🙂

Nicole Keller, D.O.

Welcome to my first blog post!  I’m so excited that the Rush-Copley
pediatricians are able to offer you another resource to help you find reliable information on common child healthcare topics. We can’t wait to hear from you to see what topics you want discussed and what questions we can answer for you.

Before I get started with my topic, let me tell you a little about me.  I was born and raised in the northwest suburbs.  I’ve been a Chicagoland girl all my life.  Although I grew up in the ‘burbs and spent years living in the city, I’m a bit of a country girl at heart.  I love to ride horses and have 3 of my own in my backyard today.  I actually live on a working farm with my husband (who is a farmer).  I love the open space, fresh veggies (sweet corn and squash are my favorites), and a relaxed way of life.  When I’m not busy being a pediatrician, I love to sit on my front porch and relax with my pets (dogs and cats), go for a ride around the farm, or go running along our mile long driveway.  Even so, my horseback riding and running will be taking a back seat this summer as I am expecting my first child due in early September. Don’t worry though – I’ve had 11 nieces and nephews to help train me…along with all I’ve learned from being a pediatrician.

Enough about me – let’s talk about babies; specifically, your baby’s first appointments with the pediatrician.  I’m fresh off giving a “Bringing Home Baby” talk to new parents at Rush-Copley and I’d like to share that information with you now, blog style!  I love newborns so this topic is especially fun for me.

First of all, congratulations to you all!  Whether it is your first or your fourth child, it is a big deal!  Once you have given birth, your pediatrician will come to see your baby at the hospital in the first 24 hours of life.  We make sure baby is feeding well and has a normal physical exam.  There will be a lot of routine testing done in the hospital, but once that is all done, you’ll be sent home and it will be time to make baby’s first doctor’s appointment.

Your baby’s first appointment with the pediatrician should be two to three days after hospital discharge.  At this appointment we make sure baby has transitioned well to the home.  We’ll get the baby’s weight, height and head circumference and make sure they are all at acceptable limits.  We expect all babies to lose weight the first weeks of life, but, want to make sure they aren’t losing too much.  We’ll also ask you about feeding (how often, how much), voiding (we talk a lot about dirty diapers) and sleep.  Once we determine how things are going, we’ll talk about normal newborn topics: common rashes, normal noises (they hiccup…a lot!), fevers, offering tummy time, starting vitamins and more.  We’ll also give you some advice on what to expect from your baby and what to expect in the next couple weeks of life.  Last, but certainly not least, we want to make sure YOU are doing well.  Bringing home a newborn is no small feat and it is important to make sure mom and dad are handling things and have extra support if needed.

The next appointment is usually when your baby is two weeks old.  At this visit we want to make sure baby is back at his/her birth weight.  We’ll also reevaluate feeding, voiding, sleeping, etc.  We’ll answer your questions and see how the first two weeks have gone – time to pat yourself on the back at this visit…you made it through two of the hardest weeks with your new bundle of joy!  After the two week visit we’ll have you come in for another visit at one-month old.  This visit just makes sure baby is continuing to grow and develop as expected.  It gives us another chance to answer your questions as well.

After the one month visit, we wait until your baby is two months old for their next visit.  We’ll assess growth and development again, but, this is a “big” visit for another reason: this visit is where the first set of vaccines is given.  Vaccines are an important part of preventative health maintenance and should be given ideally on the schedule provided to us by the CDC. If you have questions about vaccines, please ask your pediatrician – possibly even before the two month visit – so you can work together to make sure the best decisions are made regarding your baby’s health and their vaccines.

Each appointment differs a little depending on your pediatrician but the above descriptions will give you at least an idea what to expect in the first couple months of life.  We still see your baby often after that (4 months, 6 months, 9 months, 1 year, etc) but these first visits really establish your relationship with your baby’s doc.  Please know you can always call our offices at any time if you have questions in between appointments.  You’ll either speak to a nurse, leave a message for your pediatrician, or talk to your pediatrician personally to make sure your questions get answered.  Newborns throw a lot of curve balls and we are ready to “catch them” whenever you aren’t sure what to do.

Here are some resources I particularly like for newborn care and questions:

Baby 411, 6^th edition (Authors: Dr. Ari Brown and Denise Fields). Windsor Peak Press, 2014.

 Healthy Sleep Habits, Happy Child, 3^rd edition (Author: Dr. Marc Weissbluth). Random House Publishing, 1999.

 The Happiest Baby on the Block (Author: Dr. Harvey Karp). Bantam Books, 2003.

The Happiest Baby: Guide to Great Sleep (Author: Dr. Harvey Karp). William Morrow Paperbacks, 2013.

What to Expect The First Year, 2^nd edition (Authors: Sandee Hathaway, Arlene Eisenberg, Heidi Murkoff). Workman Publishing, 2003.

AAP website for parents: www.healthychildren.org

 Pediatric practice blog: www.kidsdocblog.rushcopley.com

 Thanks for reading! Happy Spring everyone!