Does my child need a safety seat while riding in an automobile?
Every child under 8 years of age must ride in a booster seat or other appropriate child safety seat.
For details, please click on the link attached above.
Associated URL: Kids In Safety Seats
Does your office accept children with special needs?
At Cambridge Pediatrics, we provide patient and family centered primary care and coordination of care for patients with complex medical problems. This allows children who see many subspecialists and therapists to have a true medical home.
In order to make your office visits run smoothly and to ensure that we take care of all of your current needs while you are here, we have the following office procedures in place for children with special needs.
Appointments Appointments are made with the appointment desk Monday through Friday at 301-645-1133 or you may request your appointment online. We recommend that you make your follow-up appointment immediately following your office visit or well in advance to be able to schedule the date and time that is most convenient for you. Please be sure to tell the receptionist that the appointment is for a child with special needs. If it is an online request, please specify this in the comment section in order to ensure that enough time is allowed for the appointment.
If you are unable to make your appointment, please call to cancel your appointment at least 24 hours in advance, so that we can make that appointment time available for another patient who may be in need of our services.
Your first appointment For your first appointment, please bring the following items to your visit:
- Current Insurance Card and Identification
- Recent Clinical Evaluations, Relevant Laboratory and Radiological Reports
- Growth Charts, Immunization Records, Medications and any other information that may be useful to the physician.
- Please print out and complete the Emergency Information Form for Children with Special Needs (see link below).
Day of Appointment Please arrive 10 minutes before your appointment to register at the reception desk.
Please take the time to update your address and phone number as we use this information to contact you with test results, for follow up information or questions after your visit. Feel free to bring your child's favorite toy/book to the visit as your appointment can be lengthy. First time visits for children with special needs are usually approximately 45 minutes long and follow up visits are routinely 30 minutes long. Due to the length of the visits,we require that patients arrive on time for their visits, in order to respect the appointment times of other scheduled patients.
PerscriptionsWe will assist families with refilling prescriptions for any patient seen in our office within the last 3 months. If a child has not been seen within the last 3 months, they must be seen in our office to update our medical records. Our goal is to provide you with enough refills to last until your next appointment. Please assess your prescription needs prior to your appointment and provide that list to the physician at the time of your visit. To obtain refills efficiently, we suggest you have your pharmacist fax the request to us at (301) 645-2369.
What do I do if I am not sure whether my child needs to be seen?
All children get sick at one time or another. Minor illnesses like colds and coughs are common. This is especially true for children who are in child care or school, where they may be exposed to more infections from other children. It is also common for children to have many minor injuries, as well as other medical problems that will need your pediatrician's attention. Answers to many of your questions can be found in our patient education section of the website which is currently under construction and will be expanding constantly.
If you are not sure your child needs to see the pediatrician, always call the office during normal business hours. The office staff can often tell you over the phone if your child needs to be seen and, if so, can set up an appointment. If an appointment is not needed but you still need medical advice, the staff will take a message for the pediatrician to return your call.
Routine calls include questions about medicines, minor illnesses, injuries, behavior, or parenting advice. You will usually not need urgent care for a simple cold or cough, mild diarrhea, constipation, temper tantrums, or sleep problems. For these cases you may just need proper medical advice.
However, if your child has any of the following, please call our office for a same day appointment:
- Vomiting and diarrhea that last for more than a few hours in a child of any age.
- Rash, especially if there is also a fever.
- Any cough or cold that does not get better in several days, or a cold that gets worse and is accompanied by a fever.
- Cuts that might need stitches.
- Limping or is not able to move an arm or leg.
- Ear pain with fever, is unable to sleep or eat, is vomiting, has diarrhea, or is acting ill.
- Drainage from an ear.
- Sore throat or problems swallowing.
- Sharp or persistent pains in the abdomen or stomach
- A rectal temperature of 100.4°F (38°C) or higher in a baby younger than 2 months of age.
- Fever and vomiting at the same time.
- Not eating for more than a day.
Emergency calls require the pediatrician's prompt attention. But it is best to know what to do before a problem occurs. During a scheduled checkup, ask the pediatrician what to do and where to go should your child ever need emergency medical care. Learn basic first aid, including CPR (cardiopulmonary resuscitation). Keep emergency and poison center phone numbers posted by your telephone.
An infant or child needs emergency medical treatment immediately if he has any of the following:
- Bleeding that does not stop after applying pressure for 5 minutes.
- Suspected poisoning.
- Seizures (Rhythmic jerking and loss of consciousness).
- Increasing trouble with breathing.
- Skin or lips that look blue, purple, or gray.
- Neck stiffness or rash with fever.
- Head injury with loss of consciousness, confusion, vomiting, or poor skin color.
- Blood in the urine.
- Bloody diarrhea or diarrhea that will not go away.
- Sudden lack of energy or is not able to move.
- Unconsciousness or lack of response.
- Acting strangely or becoming more withdrawn and less alert.
- Increasing or severe persistent pain.
- A cut or burn that is large, deep, or involves the head, chest, or abdomen.
- A burn that is large or involves the hands, groin, or face.
Call 911 (or your emergency number) for any severely ill or injured child.
What is the recommended vaccine schedule?
Our current Immunization Schedule:
2 weeks: PKU
1 mth: No Shots
2 mth: Pediarix #1 (DTaP, IPV, Hep B), Hib #1, PCV #1 (Prevnar), RotaTeq #1
4 mth: Pediarix #2 (DTaP, IPV, Hep B), Hib #2, PCV #2 (Prevnar), RotaTeq #2
6 mth: Pediarix #3 (DTaP, IPV, Hep B), Hib #3, PCV #3 (Prevnar), RotaTeq #3
9 mth: No Shots
12 mth: MMR #1 (or Proquad), Varicella #1 (or Proquad), Hep. A #1, PCV #4 (Prevnar), 15 mth DTaP #4, Hib #4
18 mth: Hep. A #2
2 yr: No Shots
3 yr: No Shots
4 yr: MMR #2, DTaP #5,IPV #4
11-12 yrs: TDaP, Meningococcal
What items do I need to keep on hand in my medicine cabinet?
The items we suggest that you have on hand are:
- Non-Aspirin (acetaminophen) pain reliever such as Infant or Children's Tylenol, Infant or Children's Motrin, or Infant or Children's Advil with childproof caps. For the correct dosage, click on your preferred choice of medication.
- Rectal and oral thermometer.
- Nasal syringe and saline nasal drops
- Diaper rash ointment if you have a small child (Balmex, A&D Ointment, etc.)
- Band Aids, gauze wrap, and tape
- Hydrogen peroxide
- Cool mist vaporizer
- Antibiotic Ointment ( Neosporin or Bacitracin)
- Bactine spray
- Mylicon drops if you have an infant
- Petroleum jelly (For easier rectal thermometer insertion)
- Infant nail clippers or child's emery board
- Rubbing alcohol and cotton balls (For cleaning newborn's navel)
- Calamine lotion
- Hydrocortisone 0.5%
How do I care for a newborn baby?
Baby's First Weeks—Newborn Care
That's the question asked by every new parent. Even when it's not their first baby' parents may need a "refresher course" when a new baby comes along. The newborn period is a special time when your baby adjusts to life outside the womb. Newborns sleep a lot and have to eat frequently. They may cry frequently and need a lot of attention. A newborn infant can place a lot of demands on the parents, especially a mother who is recovering from labor and delivery. This section answers some "Frequently Asked Questions" for the parents of newborns.
What are the basics of newborn care?
Bring baby home. You must take care of some important safety steps before taking your newborn home:
- Car seat. You must have an approved car seat to drive your baby home from the hospital. Infants under 1 year old must ride in a rear-facing car sear, properly installed in the back seat.
- Home safety/childproofing. Make sure your home has working smoke detectors (check batteries). Ask your doctor for advice on childproofing your home.
- No smoking! Avoid smoking around your baby and discourage others from smoking inside your home.
- Breast versus bottle. Breast milk is the recommended diet for your newborn. Mothers will receive breast-feeding instruction after delivery. If you choose not to breast-feed or there are medical reasons why you can't, infant formula is an acceptable alternative to breast-feeding.
- Avoid giving your baby supplemental bottles, at least until breast-feeding and milk production are well established. Breast-fed babies need additional vitamin D, found in multivitamin supplements. Additional iron and fluoride may be recommended as well.
- How often? Healthy infants want to feed frequently during the first week—every 2 to 4 hours. Breast-fed infants may need to be fed more often than bottle-fed infants. Breast-feeding stimulates the breast to make more milk. It's normal for the baby to lose weight during the first week. Your baby should be gaining weight by the end of the second week. In general, until your baby has gained enough weight, he or she should be breast-feeding at least eight times per 24 hours.
- How much? If you're breast-feeding it may be difficult to tell how much milk your baby is getting. Generally, if your newborn is satisfied after nursing, sleeps between feedings, and gains weight, he or she is getting enough milk, after the first few days, diapers should be wet every 4 hours or so.
- How much? How often? Generally, newborns sleep most of the day for the first few months.
- They generally sleep for 1 to 4 hours at a time, followed by 1 to 2 hours of awake time. Most babies settle into a nightly routine by 2 to 3 months.
- Most babies do not sleep 5 to 6 hours through the night until they are at least 3 months old. Until that time, your baby will probably wake up at least once during the night to be fed. (2 a.m. feeding).
- "Back to sleep."
- Place babies on their backs to sleep! This is the most important thing you can do to reduce your infant's risk of sudden infant death syndrome.
- Your baby should sleep in a crib with a firm mattress. The matters should be covered by a fitted sheet. Do not use a top sheet, pillow, or blanket. Dress your baby in sleepwear appropriate for the temperature.
- Bathing. Babies don't need to bathe every day—once every few days is fine. Give only sponge baths for the first couple of weeks, until cord stump falls off. (Your doctor will give you instructions on caring for the umbilical cord.)
- When you stat giving your baby tub baths, use a basin or special "baby tub" with no more than 2 inches of water. Use only mild soap, if any.
- Support your baby's head during the bath
- Never leave your baby alone in the bath, even for a few seconds!
- Crying. Some newborns cry a lot. Although crying sometimes means your baby needs feeding or a diaper change, at other times it's difficult to tell why he or she is crying. Hold and comfort your baby, gently rocking, singing, or talking to him or her. Call our office if you find it difficult to comfort your baby.
- Illness: If your baby seems sick or warm, take his or her temperature. The best way to take a newborn's temperature is to use a rectal thermometer. If the temperature is 100.4 F (38 C) or higher, call our office.
- Urine and stools. After the first few days. Diapers should be wet every 3 to 4 hours or so. Your baby will probably pass the first dark green "meconium" stool within the first 48 hours after birth, usually in the hospital. After that, your baby's stools (bowel movements) will be green or yellow and soft. This varies; in breast-fed babies, stool may be looser (more liquid).
- If your baby goes more than 6 hours without wetting the diaper, this may be a sign of dehydration, which can develop very quickly in babies. If stools are very watery and frequent (diarrhea), this may be a sign of illness, especially if your baby has a fever. (However, it's normal for babies to pass stool every time they feed.)
- Emotions/postpartum depression. It is normal for new mothers to feel tired and "stressed out." As much as possible, keep in touch with your sources (family, friends). Some mothers may develop postpartum depression in weeks and months following the birth of a new baby. If you feel down or unhappy or are having trouble handling the demands of caring for a new baby, call your doctor's office.
- Taking baby out. Your baby must be in an approved car seat every time he or she goes in the car. It is fine to take your baby out for walks in stroller. Dress you baby appropriately for the weather; there is no need to "over-dress" your baby on warm days. On sunny days, keep the baby's skin covered, since babies get sunburned easily.
A parent (or other responsible caregiver) needs to be present at all times. It's fine to leave your baby in another room, as long as you can hear him or her if he or she cries.
- Skin rashes. There are several types of skin rashes that are common and harmless in newborns. Just to be sure, ask the doctor if your doctor newborn develops a rash. A baby's skin is sensitive and is sometimes bothersome for parents in that it may be dry and have a variety of rashes, including "pimples." Most of these are harmless and will most likely go away on their own, but you should always ask about them. Oils and Vaseline on the skin tend to worsen these rashes. Certain perfumes soaps and laundry detergents on clothing may also cause or worsen rashes.
- Diaper Rash . Prevention is the best medicine when it comes to the diaper area. The area should be kept as dry as possible and gently washed with water with each change. Diaper wipes often contains perfumes and other irritant which may worsen rashes. A&D ointment, Destin, Balmex, etc. may help certain diaper rashes but if the rash persists or appears to bother your baby, we should see him because some rashes need special attention.
- Doctor's office visits. The doctor will want to see your infant for several "well-baby" visits. The first visit will probably be 2 or 3 days after your baby goes home, with another visit at 1 or 2 weeks. (The doctor may recommend a different office visit schedule.)
- At these visits, the doctor will check to make sure your baby is doing all right, give recommended immunizations (vaccinations), and answer all questions about infant care. Between office visits, it's a good idea to write down any questions you want to ask the doctor.
When should I call your office?
Call our office if you have questions or concerns about caring for your baby. Between well-baby visits, call our office immediately if any of the following occur.
- Vomiting (not just simple spitting-up).
- Dehydration (caused by vomiting or diarrhea)
If you're not sure your baby is getting enough breast milk or formula.
- Baby going hours without wetting diaper. (with highly absorbent disposable diapers, this may be hard to judge. It may help to place a cotton ball on the penis or vagina.
- Reduced wetness inside mouth.
- Irritability or extreme tiredness.
- In very severe cases, sunken eyes or "soft spot" (fontanelle).
- Your baby is running a fever—temperature 100.4°F or higher, measured by a rectal thermometer. Even without a fever, call if your baby is irritable or refusing to eat.
- Umbilical cord problems, especially redness of the skin around the cord, active bleeding, fluid coming from the cord stump, or very foul odor.
- Excessive crying.
- Depression in mother—feeling overwhelmed.
- Jaundice: yellow or orange color of the baby's skin.
What is the recommended well visit schedule?
The American Academy of Pediatrics recommends regular health care visits at the following times:
- Before your baby is born (for first-time parents).
- Before your newborn is discharged from the hospital, and again within 48 to 72 hours for babies discharged before 2 full days of life.
- During the first year of life—visits at about 2 to 4 weeks of age, and also at 2, 4, 6, 9, and 12 months of age.
- During the second year of life—visits at 15, 18, and 24 months of age.
- In early childhood—yearly visits from 2 through 5 years of age
- During the early school years—visits at 6, 8, and 10 years of age.
- In adolescence and early adulthood—yearly visits from 11 through 21 years of age.
What precautionary measures do I need to make regarding my child's safety?
Childproofing your home
Babies and toddlers are naturally curious. They love to explore their world, especially as they become able to crawl and climb. It's important to be aware of the possible hazards in your home and to remove or eliminate as many of these dangers as you can. Childproofing means going through each room, removing dangerous objects, and taking the simple steps needed to reduce the risk of injury.
How Can I childproof my home?
- Prevent poisoning. All medicines, household cleaners, chemicals, laundry products, and other poisonous substances should be placed out of reach. Place these items up high, preferably where children can't even see them. Use safety latches or locks for further protection.
- Buy medicines in child-resistant packages. Avoid putting medicines or poisons into other containers that are not child-resistant or could be confused for something to eat or drink. Use safety latches or locks for further protection.
- Put safety latches or locks on cabinets and drawers. Simple, inexpensive devises can keep babies and toddlers from opening cabinets and drawers. Safety latches are designed to be easily opened by adults but not by babies and tots. Put latches on cabinets in the bathroom, kitchen, basement, garage—any room your child can get into.
- Prevent fire and burns. Make sure smoke detectors are installed in your home. Check batteries regularly
- Keep hot objects out of reach, for examples, pots and pans on the stovetop. Don't leave the stove burners on. Don't use cooking utensils, curling irons, or other appliances with long electrical cords; children can pull these items down.
- Use approved flame-retardant children's sleepwear.
- Cover electrical outlets. Simple devices are available to prevent children from putting their fingers or small objects into electrical outlets.
- Keep toys and other small objects out of reach. For babies and toddlers under the age of three, remove all objects small enough to be swallowed (for example, small toys, coins, watch batteries).
- Install safety gates. Install safety gates to keep child from entering unsafe areas, especially staircases.
- Avoid walkers. They don't improve walking skills but do increase risk of injuries by letting toddlers get into places they shouldn't (for example, near staircases and hot stoves).
- Prevent bath hazards. Many serious injuries to babies and toddlers occur at bath time. Prevent burns by making sure the bath water is not too hot. If possible, set the temperature of your water heater to 120°F (49°C). Another option is to install antiscald devices on your sink and bath. Always test water temperature before placing your baby in the bath. Never leave you baby or toddler alone in the bath, even for a minute! Drowning can occur in the time it takes to answer a phone call. Cordless phones are good option for homes with infants or young children.
- Swimming pools are another drowning hazard. Just like a bath, don't leave your child alone in or near a pool. For home pools, lock doors to make sure your child can't enter the pool area alone.
- Secure windows and doors. Simple devices are available to keep windows from opening wide enough to allow children to fall out. Other types of window guards or safety nets may be installed as well. Young children may be strangled by the cords on window blinds. Cut the cord or install special safety devices. Lock doors or install doorknob covers to keep your child from getting into unsafe areas
- Recheck your home every few months to make sure it is safe. This especially important as you child reaches new milestones, for example, crawling or climbing.
Other Safety Tips
- Keep your child safe in the car. Use a car seat or booster seat appropriate for your child's age. Talk to your doctor if you have any question about child passenger safety.
- Never leave you child alone in the car. On warm days, the inside of a car can become dangerously hot within minutes.
- When your child is old enough to understand, teach him/her about safety precautions.
- As your child grows, emphasize important safety messages about playing with matches, watching out for cars, and so forth.
When should I start toilet training?
To toilet train sucessfully, your child needs to be ready. This means knowing when it's time to go, being able to hold it for at least a little while, and being able to let you know when he or she needs to go. For most children, toilet training starts anywhere between 2 and 4 years old. The decision to start toilet training depends on your individual circumstances. Choose a time when things are there are no stressful events in the home.
No single approach to toilet training is right for every child. It is important to establish a routine and to be patient! Choose a potty chair for your child. A potty chair is more comfortable for children. Having the child watch parents or siblings go to the bathroom can be helpful. Be sure to praise your child's efforts! Don't be negative or angry if your child occasionally has an accident, they are a normal part of toilet training. Schedule potty trips before and after naps, every couple of hours and after meals. Keep the mood positive. If your child shows signs that he or she needs to go the bathroom, take him or her to the potty chair. Boys usually learn to urinate sitting down at first. Teach your child how to wipe with toilet tissue. Girls should wipe front to back to avoid spreading stool to the vagina. Teach your child to always wash their hands after using the potty.
When your child seems to be getting the idea, switch to training pants. Give your child some time to get used to the idea of moving from a potty seat to the big toilet. Toilet training can take weeks or even months. Remember to be patient, even in the most difficult cases, toilet training does happen eventually.
You should call our office if:
- Your previously toilet trained child starts having accidents again.
- You have any questions.
- Your child has difficult or uncomfortable bowel movements.
Why does my child need well visit exams and how often?
Regular visits to the pediatrician are a key part of preventive health care. At each visit, the pediatrician will fully examine your child. This checkup will give the pediatrician a chance to:
- Make sure your child is eating well, growing well, and is healthy.
- Update immunizations.
- Track your child's growth and development.
- Find physical problems before they become serious.
- Help inform you on how to keep your child healthy and safe.
- Answer all of your questions.
Infants and children need frequent checkups during the first 24 months of life. After 2 years of age most children do not need regular visits as often. We recommend a well visit once annually after 2 years of age, however the pediatrician will schedule visits based on your child's own needs.
Make sure you write down any questions you have before each office visit, so that you do not forget to ask them. Keep up-to-date records on your child's growth and immunizations. Bring this information with you to each visit.