Tips for Getting Children with Special Needs Vaccinated

By Troy Nelson, MD, pediatrician and medical director at DMG Children’s Rehabilitative Services

Whether it’s childhood immunizations or vaccinations for the flu or COVID-19, getting a vaccine is an anxiety-causing process for many children.  If your child has special needs or a complex medical condition, getting vaccinations can be more stressful for both you and your child.

Here’s some tips for supporting children with special needs getting vaccinated.

Before the appointment:

  • Ask for an appointment on a day and time that is not busy in your pediatrician’s office.
  • See if your child’s provider recommends pre-medicating with an over-the-counter pain reliever or using a topical numbing cream or spray.
  • Be honest with your child and explain to them what will be happening. For some children, it might be appropriate to prepare a couple days in advance; for others it might be the day of the appointment.
  • If possible, ask if your child can receive their vaccination in the car instead of going into the clinic.

Day of and during the appointment:

  • Try to remain calm before and during the appointment. Children pick up on nervous or anxious energy, especially from their family. If you are calm, your child is more likely to remain calm.
  • Bring your child’s favorite stuffed animal or doll with them for comfort.
  • If your child has a favorite provider, nurse, or medical assistant at your pediatrician’s office, ask for that person to be present to support your child.
  • Ask that your child be vaccinated in a quiet exam room, away from noise, the waiting area, and other people.
  • If appropriate, encourage your child to take some deep breaths.
  • If able, help your child relax by asking them to shake their arms and legs in a silly way.
  • Walk around with your child after the vaccination to distract them instead of sitting.
  • If multiple vaccinations are being administered, ask the provider to take a break in-between if it will help your child.
  • Reassure your child that they will be fine, and you and the provider will be there to support them.
  • Reward your child. If your child is having more than one vaccination in a single appointment, you may want to reward them after each vaccination with a sticker or other small item they like.

As pediatricians, our goal at DMG CRS’ primary care clinic is to make every child’s appointment positive and comforting.  Partnering with parents or guardians is key to this goal and making your child feel confident and safe with their medical providers.  We’re here to listen and support you in managing your child’s health and wellness.

 

This article was originally published by dmgaz.org on August 2, 2022

The Importance and Safety of Childhood Vaccinations

By Pamela Murphy, MD, pediatrician in the Spina Bifida Clinic at DMG Children’s Rehabilitative Services

childhood vaccinations

Contents:

As a pediatrician, I am asked frequently about childhood vaccinations. Are they safe? Do they cause one disease while trying to prevent another? As a parent or guardian, it’s our responsibility to provide safe care for our children and asking questions and getting the facts from credible sources are part of that responsibility.

U.S. public health officials and physicians have been combating misconceptions about vaccine safety for more than twenty years. Despite these efforts, childhood immunization rates have fallen in the past two decades resulting in resurgences of vaccine-preventable diseases such as whooping cough (pertussis) and measles. For example, in 2010, California saw more cases of whooping cough than any year since 1947, according to research published by the American Academy of Pediatrics.

August is Immunization Awareness Month. Let’s look at what childhood vaccinations are recommended when and address the most common misinformation about childhood vaccinations.

Recommended Childhood Vaccinations

The Centers for Disease Control and Prevention (CDC) has easy to review children’s vaccines schedules by age group on their website.  All the vaccinations listed below are available at DMG CRS’ primary care clinic.

Early Childhood: Birth to Age 6

  • Chickenpox/varicella
  • Hepatitis A
  • Hepatitis B
  • Diphtheria, tetanus, and pertussis (DTaP)
  • Haemophilus influenzae type b (Hib)
  • Influenza (flu): recommended annually from age six months and on
  • Measles, mumps, and rubella (MMR)
  • Pneumococcal conjugate disease (PCV13)
  • Polio (IPV)
  • Rotavirus (RV)

Children: Ages 7-18

In addition to any vaccines missed that were recommended during early childhood, the CDC recommends the following vaccines for kids ages 7-18:

  • Flu (annually)
  • Human papillomavirus (HPV)
  • Meningococcal conjugate (MenACWY)
  • Tdap (the DTaP booster)

If your child has certain health conditions that put them at increased risk for serious diseases, your pediatrician may also recommend the following vaccinations be administered:

  • Pneumococcal
  • Serogroup B meningococcal (MenB)

COVID-19 Vaccine

The CDC also recommends children ages six months and older receive the COVID-19 vaccination, and children ages five and older also get the booster. The COVID-19 vaccination is not available at DMG CRS. For more information on COVID-19 vaccinations for children, including locations providing these vaccinations, visit the Maricopa County Public Health website.

Childhood Vaccinations: Debunking the Myths

 According to PublicHealth.org, the following are the top three myths about childhood vaccinations.

 

Myth #1: Vaccines increase the risk of autism.

This hypothesis originated in 1997 from study by a British surgeon who concluded that the MMR vaccine was increasing autism in children in the United Kingdom. The article “has since been completely discredited due to serious procedural errors, undisclosed financial conflicts of interest, and ethical violations.” The physician author lost his medical license, and the paper was retracted.

Myth #2: Infant immune systems can’t handle so many vaccines.

The cells in the immune system are constantly being replenished, making it near impossible for a baby’s immune system to be overwhelmed by immunizations. In fact, babies are exposed to numerous bacteria and viruses every day; vaccines are minor in comparison.

Myth #3: Natural immunity is better than vaccine-acquired immunity.

While in some cases, catching a disease and getting sick (i.e., “natural immunity”) results in a stronger immunity to the disease than a vaccination, the risks outweigh the benefits. For example, if a child were to catch the measles, they would face a one in 500 chance of death from symptoms; in contrast, having a severe allergic reaction to the MMR vaccine is less than one-in-a-million according to the CDC.

 

As families travel more, especially internationally, the risk of contracting vaccine-preventable diseases increases. Even if the disease is not prevalent in the United States, it may be in other countries. COVID-19 gave us a strong example of how quickly a virus can spread from one continent to the next.

DMG Children’s Rehabilitative Services’ (DMG CRS) primary care clinic specializes in medical care of all children. We know that, especially if your child has a complex condition, getting vaccinations can be challenging and concerning. Your child may have increased anxiety resulting from their medical conditions making getting immunizations even more scary for them. You may have questions about how vaccinations fit into your child’s therapy plan. Our pediatric primary care providers are here to answer your questions and provide compassionate, experienced, and individualized care to support the health of your child and your family.

 

Article originally published by dmgaz.org on August 1, 2022 

Benefits of Breastfeeding for You and Your Baby

By Troy Nelson, MD, pediatrician and medical director, DMG Children’s Rehabilitative Services

Mother and her newborn baby

Contents:

The baby formula shortage in the United States has prompted the need to find solutions to decrease the risk of a shortage impacting the country again. According to a recent article by NPR, often overlooked in the race to fill the gap is the most natural alternative: mother’s milk.

The American Academy of Pediatrics (AAP) recommends “exclusive breastfeeding for about six months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for one year or longer as mutually desired by mother and infant.” Despite this recommendation, 2018 data published by the Centers for Disease Control and Prevention (CDC) revealed that only one in four babies born in the United States met this target; in Arizona, 50 to 60 percent of babies met this target.

So, why do mothers stop breastfeeding? According to the CDC, how long a mother breastfeeds is impacted by:

  • Issues with lactation and latching
  • Concerns about infant nutrition and weight
  • Mother’s concern about taking medications while breastfeeding
  • Unsupportive work policies and lack of parental leave
  • Cultural norms and lack of family support
  • Unsupportive hospital practices and policies

The Surgeon General’s Call to Action to Support Breastfeeding as well as medical experts in women’s health and pediatrics continue to push education about the benefits of breastfeeding. Let’s look at the benefits to you and your baby.

Benefits of Breastfeeding for Mom

According to HealthyChildren.org, an AAP website, breastfeeding provides emotional, mental and physical health benefits to a mother, including:

Release of good hormones: During breastfeeding, hormones such as prolactin and oxytocin are released which produce peaceful, nurturing, and relaxing sensations that promote bonding with your infant.

Quicker uterus recovery: Oxytocin, released during breastfeeding, helps return the uterus to its regular size more quickly and can reduce postpartum bleeding.

Potential reduced risk of disease: Some studies have found that breastfeeding may reduce the risk of developing breast and ovarian cancers, cardiovascular disease, rheumatoid arthritis, and type 2 diabetes.

Natural contraception: Exclusive breastfeeding delays the return of the mother’s menstrual period, which can help extend the time between pregnancies.

Less expense: Formula can cost four to ten dollars a day or $1460-$3650 annually.

Ease of preparation:  Human milk directly from the mother is the right temperature, so no taking time to warm bottles of formula.

Ease of travel:  Whether you are going out to run an errand or for the day, no need to bring a bag of temperature-controlled formula.

Environmentally friendly: You get the satisfaction of knowing you are not contributing baby formula cans and packaging to landfills.

Benefits of Breastfeeding for Your Baby

Breast milk provides a baby with ideal nutrition and supports growth and development. According to the CDC, the benefits of breast milk for your baby include:

The best source of nutrition for most babies, because as the baby grows, the mother’s milk will change to meet the baby’s needs.

Shared antibodies from the mother with her baby

Supports proper brain development through docosahexaenoic acid (DHA), a polyunsaturated fatty acid found in breast milk

Helps protect babies against some short- and long-term illnesses and diseases and decreases the risk of:

  • Allergies
  • Asthma
  • Ear infections
  • Obesity
  • Sudden infant death syndrome (SIDS)
  • Stomach viruses or illnesses
  • Type 1 diabetes

If you have questions about breastfeeding or want more information, please contact your women’s health provider or pediatrician. We’re here to help you make the right decision for you and your baby and provide the support and resources needed for you to care for your newborn.

This post was originally published on June 8th, 2022 at DMGAZ.org

Mental Health and Your Child

By Megan Aros-O’Malley, PhD, pediatric psychologist at DMG Children’s Rehabilitative Services

mental-health-child

May is Mental Health Awareness Month. Unfortunately, children in the United States are currently facing a mental health crisis. Data from the Centers for Disease Control and Prevention (CDC) indicate that one in five children has a mental or behavioral health condition such as anxiety, depression, attention-deficit/hyperactivity disorder, autism spectrum disorder, or disruptive behavior disorder. However, only about 20 percent of these children received care from a mental health provider.

Parents are often the first to recognize that their child is struggling emotionally and/or behaviorally. A few signs that a mental health difficulty could be arising include (but are not limited to):

  • Persistent worries or anxiety
  • Persistent behavioral acting out, aggression, or disobedience
  • Hyperactivity or constant movement beyond regular playing
  • Difficulty paying attention
  • Marked decline in school performance
  • Inability to cope with setbacks and problems
  • Severe mood swings
  • Threatening to kill or harm oneself and/or self-injury
  • Strange thoughts, beliefs, or unusual behaviors

Untreated mental health conditions can have many short- and long-term impacts on children’s development, social and behavioral functioning, and home and school life.

Fortunately, help exists. DMG Children’s Rehabilitative Services (DMG CRS) Behavioral Health clinic has pediatric psychologists and counselors available to meet the mental health needs of children of all ages. DMG CRS behavioral health providers collaborate with families to develop a comprehensive treatment plan that can include services such as consultation, psychotherapy, and/or psychological testing. Furthermore, with more than 25 pediatric medical specialties on-site, DMG CRS behavioral health providers are skilled at partnering with other pediatric specialists to provide whole-child care that incorporates physical and mental health domains.

This post was originally published on May 5th, 2022 at DMGAZ.org

 

What Immunizations Does Your Family Need?

by Misty Cox, FNP-C, WHNP-BC, Family Nurse Practitioner

Arizona family

Contents:

Do you know anyone who has recently had Haemophilus influenzae type b (Hib)? Do you know what Hib is?  Probably not in both cases.  Affecting mostly children under five years-old, Hib is a disease that can seriously damage a child’s immune system and cause brain damage, hearing loss, or even death.  According for the Centers for Disease Control and Prevention (CDC), before the four dose vaccine was available, approximately 20,000 children were affected by Hibs annually.

Hib is just one of many diseases we rarely encounter any longer thanks to vaccines.  More than 16 diseases can be prevented or decreased in severity if vaccines are proactively administered.  The most current example is COVID-19 and associated variants, including delta.

August is Immunization Awareness Month, so let’s review vaccines recommended throughout our lifetimes.

Please consult your primary care provider (PCP) for more information on recommended vaccines, timing, number of doses and when to receive based on medical history, risks, and other factors.

Childhood Vaccinations

The CDC has easy to review children’s vaccines schedules by age group on their website.

Early Childhood: Birth to Age 6

  • Chickenpox/varicella
  • Hepatitis A
  • Hepatitis B
  • Diphtheria, tetanus, and whooping cough/pertussis (DTaP)
  • Hib
  • Influenza (flu): recommended annually from age six months and on
  • Measles, mumps, and rubella (MMR)
  • Pneumococcal conjugate disease (PCV13)
  • Polio (IPV)
  • Rotavirus (RV)

Children: Ages 7-18

In addition to any vaccines missed that were recommended during early childhood, the CDC recommends the following vaccines for kids ages 7-18:

  • Flu (annually)
  • Human papillomavirus (HPV)
  • Meningococcal conjugate (MenACWY)
  • Tdap (the DTaP booster)

If your child has certain health conditions that put them at an increased risk for serious diseases, your PCP may also recommend the following vaccinations be administered:

  • Pneumococcal
  • Serogroup B meningococcal (MenB)

 

Adult Vaccinations

The CDC also provides information to adults to help adults understand what vaccinations are recommended based on age, lifestyle, medical conditions, and more.

Young Adults: Ages 19-26

  • Flu: recommended annually
  • HPV, if not previously received
  • Tdap, if not previously received

Adults: Age 50+

  • Flu: recommended annually
  • PCV13: recommended for all adults with a condition that weakens the immune system, cerebrospinal fluid leak, or cochlear implant
  • Pneumococcal polysaccharide vaccine (PPSV23): protects against serious pneumococcal disease, including meningitis and bloodstream infections and is recommended for all adults age 65 and older

If you have one of the following medical conditions, talk with your PCP about additional vaccinations that may be recommended to decrease your risk of serious illness and complications.

  • Asplenia
  • Asthma
  • Diabetes Type 1 and/or Type 2
  • Heart disease, stroke, or other cardiovascular disease
  • HIV
  • Kidney/renal disease
  • Liver disease
  • Lung disease
  • Weakened immune system

Adults: Special Groups

If you fall into one of the following categories, additional vaccinations may be recommended.  Consult the CDC website for more information or speak with your PCP.

COVID-19 Vaccination

The COVID-19 vaccine is highly recommended to fight against the coronavirus and variants, like delta.  This vaccine is now available for everyone age 12 and older.  For the most current information on the COVID-19 vaccine, please visit the CDC website.

If you have questions about what vaccinations you and your family need, DMG primary care providers (PCP) are here for you. To find a DMG PCP at a location near you, click here. We’re here to support the health of you, your family, and the entire community.

Article originally published on August 10, 2021 by District Medical Group

How Telehealth Can Help You and Your Child

By Troy Nelson, MD, pediatrician and medical director, DMG Children’s Rehabilitative Services

telehealth family

Contents:

A March 2021 survey found that 61 percent of respondents had used telehealth vs. less than 20 percent in March 2020.  The COVID-19 pandemic created a need for a safe way to visit with a medical provider to get non-emergent medical care, and telehealth was the answer.  At District Medical Group (DMG), including DMG Children’s Rehabilitative Services (DMG CRS), we offer telehealth appointments and have encouraged patients to use this technology to continue care for themselves and their families.

While many of our DMG CRS patients have complex conditions, telehealth can still be used to support ongoing treatment and ensure our young patients remain healthy and on course with prescribed treatment plans during the COVID-19 pandemic and beyond.

Here’s some ways telehealth is being used at DMG CRS to support the health of our pediatric patients and support their families:

Intake Appointments for New Patients

While we love to meet new patients and their families in-person, their health and safety is our number one priority.  Fortunately, through a telehealth meeting, we can gather all needed information about our new patient, understand the family’s health and wellness goals for their child, and begin development of a multi-specialty treatment plan. We can also get to know your child and you through these telephone visits.

Consultations with Specialty Providers

Like intake appointments, when a new pediatric specialist is being engaged to support your child’s health, a consultation between you and the DMG CRS medical specialist can usually be completed through a telehealth appointment.  As all clinics within DMG CRS use the same electronic medical records (EMR) system, the new DMG CRS medical specialist can easily view your child’s medical history and discuss next steps with you.

As well, if you have a regular follow-up scheduled with a DMG CRS specialty physician who has been treating your child, it may be able to be completed through a telehealth appointment. Through a telehealth appointment, your child’s DMG CRS physician and you can determine if an in-person visit is needed based on how your child is doing on his/her treatment plan.

Behavioral Health Visits

Because a physical examination is not needed, behavioral health visits are among the easiest to facilitate through telehealth.  COVID-19 has been stressful for people of all ages, including children. That’s why maintaining scheduled visits for your child with his/her DMG CRS behavioral health specialist is important.

Primary Care for Minor Illnesses or Injuries

If your child has a minor scrape or bruise that is concerning you or woke up with a cough, mild fever, or other non-emergent symptoms, contact the primary care clinic at DMG CRS to see if a telehealth visit is appropriate.  In some cases, minor symptoms can be easily diagnosed and treatment prescribed without an in-person examination.

Reengaging with Your Child’s Providers

If you missed regular medical appointments for your child during the COVID-19 pandemic, a telehealth appointment is a good way to reengage your child’s medical provider(s).  Through a telehealth visit, you can provide medical updates so the DMG CRS physician can determine your child’s present health status and make appropriate referrals.

The health, wellbeing and safety of your family is our number one priority.  At DMG CRS, we’re here for you providing options to ensure your child’s treatment plan stays on-track and support you in helping your child live a happy and healthy life.

This post was originally published on April 27th, 2021 at DMGAZ.org

 

Early Intervention for Infants and Toddlers with Developmental Disabilities

By Troy Nelson, MD, pediatrician and medical director, DMG Children’s Rehabilitative Services

child with development disabilities

Contents:

March is Developmental Disabilities Month.  According to the Centers for Disease Control and Prevention (CDC), the United States has experienced an increase in children with developmental disabilities.  Developmental disabilities would include:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Autism spectrum disorder (ASD)
  • Cerebral palsy
  • Moderate-to-profound hearing loss
  • Learning disability
  • Intellectual disability (ID)
  • Recurrent seizures in the past 12 months
  • Stuttering or stammering in the past 12 months
  • Visual impairment
  • Any other developmental delay

The same CDC study also revealed that some groups of children were more likely to have a developmental disability than others, such as:

  • Boys compared to girls
  • Non-Hispanic white and non-Hispanic black children compared to Hispanic children or non-Hispanic children of other races
  • Children living in rural areas compared to children living in urban areas
  • Children with public health insurance compared to uninsured children and children with private insurance

The CDC found that 17 percent of children 3–17 years-old had a developmental disability, and this percentage increased over the two time periods compared (2009–2011 and 2015–2017).  Specifically, diagnoses increased for ADHD, ASD and ID.

One of the potential reasons for the documented increase is improved awareness, screening, diagnosis, and service accessibility. Healthcare providers and parents/guardians are having more conversations about symptoms (called “developmental delays”) of developmental disabilities early, allowing for improved diagnosis and early intervention.

What is a “Developmental Delay?”

Parents or guardians are in the best position to detect a developmental delay in an infant or toddler.  Developmental delays fall into five categories:

  • Adaptive development: The ability level of a child related to age-appropriate life skills, such as self-care (feeding, dressing, etc.)
  • Cognitive development: How children think, explore and figure things out, including knowledge and understanding and problem solving
  • Communication development: The skills to understand and express thoughts, feelings, and information
  • Physical development: Motor skills defined as children’s abilities to use and control their bodies, including vision and hearing
  • Social or emotional development: how children start to understand who they are, what they are feeling and what to expect when interacting with others

If you sense a developmental delay in your child, surface your concerns to your child’s primary care provider (PCP) immediately.  Your child’s PCP will assess your child through a developmental screening and engage the right specialists and support, as needed, to optimize early intervention.

Benefits of Early Intervention

“Early intervention” describes services and support that help babies and toddlers (from birth to three years of age, in most cases) with developmental delays or disabilities. Early intervention may include speech therapy, physical therapy, behavioral health support and other types of medical services based on the needs of the child and family.

According to the CDC, intervention is likely to be more effective when it is provided earlier in life because:

  • Connections in a baby’s brain are most adaptable in the first three years of life.
  • Services can change a child’s developmental path and improve outcomes for children and their families.
  • Families are better able to meet their child’s needs at an early age and throughout their lives.

As the largest multi-specialty interdisciplinary clinic (MSIC) in Maricopa County, DMG CRS provides all needed medical and support services in one place so your child’s treatment plan is managed through a single medical record.  If you have questions about your child’s development at any age, please contact us to schedule an appointment with a pediatrician or the appropriate pediatric specialist.

This post was originally published on December 9th, 2020 at DMGAZ.org

 

Dental Services Expanded with the Addition of Two Dentists

dmg crs dentristy

DMG Children’s Rehabilitative Services (DMG CRS) has expanded dental health services, including more space and two new dentists.  With these changes, we are also now serving patients of all ages- from small children to adults.  We’re excited to now be a one-stop shop for dental services for the whole family.

Our experienced and dedicated team offers preventive and assessment services for pediatrics and adults, including:

  • Cleanings
  • Exams
  • Fluoride varnish
  • Sealants
  • X-rays

Meet Our New Dentists

Sara Karlin, DSD is a Board Certified pediatric dentist who is relocating from the East Coast to sunny Arizona.  Completing her dental education at University of Maryland, Dr. Karlin completed her specialty training in pediatric dentistry at New York University and Bellevue Hospital Center.

Treating patients at the Rose F. Kennedy Center during residency provided Dr. Karlin the opportunity to skillfully treat patients with special needs. This experience and her compassionate approach to care with greatly benefit our young DMG CRS patients with unique medical conditions and needs.

When Dr. Karlin is not treating patients, she enjoys spending time outdoors, playing tennis and singing.  While she lived in Manhattan, she relished the opportunity to attend Broadway shows with friends and family.

 

Leila Zadeh, DMD serves patients of all ages- from kids to adults- and is committed to staying up-to-date with the latest advancements in dental procedures, techniques, and materials. In fact, when she is not treating patients, she regularly reviews and completes continuing medical education (CME) courses to ensure she is providing patients the most current, high quality care.

Inducted into the National Dental Honor Society of Omicron Kappa Upsilon, Dr. Zadeh received her Doctor of Dental Medicine (DMD) from AT Still University’s Arizona School of Dentistry and Oral Health (ATSU-ASDOH), where she graduated with honors. She completed an additional post-doctoral program in Advanced Education in General Dentistry (AEGD) through New York University Langone Dental Medicine at ATSU-ASDOH.  During this AEGD program, Dr. Zadeh provided needed dental care to underserved populations in Arizona serving patients of all ages.

Dr. Zadeh is active in the dental health community and is a Board member of the Arizona Academy of General Dentistry, Central Arizona Dental Society, Phi Beta Kappa National Honor Society, and Omega Kappa Upsilon National Dental Honor Society. She is also a member of the American Dental Association and Academy of General Dentistry.

COVID-19 and Kids’ Mental Health

By Melissa Meyer, DNP, PMHNP-BC, child psychiatry specialist at DMG Children’s Rehabilitative Services
family in the kitchen together2020 has been a year like no other, especially for children.  Kids have had to completely change their routines, including:

  • Attending school from home (“virtual learning”)
  • Limiting and/or eliminating in-person social activities
  • Limit extracurricular activities, such as team sports, clubs, etc.

All the above activities are critical to providing balance to a child’s life, and without these options, children, like many adults, may be feeling isolated.  And to top it off, we don’t know when things will change and return to “normal.”  As a result, children may feel increased stress, fear, anger, hopelessness, anxiety and may experience depression.

Depending on how old your child is, he or she may deal and/or reveal these emotions in different ways.  Adolescents and young adults may try to hide their struggles because of fear, shame, or a sense of responsibility to avoid burdening others. Younger children may not know how to talk about these feelings but may show changes in their behavior or development.

Here’s some tips for supporting your child through these uncertain times and helping them deal with these confusing emotions.

  1. Check in with your child often. Ask him or her how he or she is feeling and be (age appropriately) open in sharing how the changes brought on by the pandemic are impacting you.  The goal is for your child to know that his or her feelings are not “strange,” and people of all ages are having these emotions.  At the same time, you want to share empathy and confidence with your child.
  2. Watch and listen for signs that your child is struggling.
    1. Younger children: Bedwetting; fussiness, tantrums or hitting; difficulty sleeping; taking steps backward in development; stomach issues such as nausea or loose stool; and/or separation anxiety
    2. Adolescents: Challenges sleeping; changes in mood or increased moodiness; decreased appetite and/or weight loss; less interest in activities previously enjoyed, including texting and video chatting; issues remembering things; less interest and/or apathy for academics and schoolwork; use of alcohol or drugs or new risky behavior; talk or interest in suicide; and/or lack of personal hygiene
  3. Stay in touch with your child’s primary care provider (PCP) or pediatrician through telephone, patient portals, and/or in-person or telehealth visits. He/she can do basic depression evaluations and help you determine if additional support is needed, be it counseling/therapy, medication, or other tools or activities to help your child.

DMG Children’s Rehabilitative Services has behavioral health providers to support children of all ages.  As a parent, you’re not alone; healthcare providers are here to support the health of your child and your entire family.

Originally published by District Medical Group

Healthy Weight, Child Diabetes and Your Child

By Troy Nelson, MD, Medical Director at DMG Children’s Rehabilitative Services

children playing outdoors

Contents:

Did you know November was American Diabetes Month?  According to the American Diabetes Association, more than 34 million people in the United States have diabetes, and more than seven million of those people are undiagnosed. About 210,000 Americans under age 20 are estimated to have diagnosed diabetes.

Type 1 Diabetes: Diagnosed at Younger Ages

According to the Centers for Disease Control and Prevention (CDC), type 1 diabetes accounts for approximately 5-10% of diabetes cases in the United States.  Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults.

Type 2 Diabetes: Increasing Pediatric Cases

Type 2 diabetes is the most common type and is generally diagnosed in middle age or older.  However, the incidence is on the rise in children because more children are becoming obese.  Being overweight or obese increases the risk of developing type 2 diabetes, regardless of age.

Symptoms of Type 2 Diabetes in Children

Your child may develop type 2 diabetes so gradually that there are no noticeable symptoms. Sometimes, the disorder is diagnosed during a routine check-up, which is why regular well-child exams are important.

Symptoms of type 2 diabetes in your child may include:

• Blurry vision
• Darkened areas of skin, especially around the neck and armpits
• Fatigue
• Frequent urination
• Increased thirst

Type 2 Diabetes Risk Factors in Children

• Age and sex: Many children develop type 2 diabetes in their early teens. Adolescent girls are more likely to develop type 2 diabetes than are adolescent boys.
• Family history
• Inactivity
• Overweight, especially in the abdomen
• Pre-term birth (before 39-42 weeks)
• Race or ethnicity: Black, Hispanic, American Indian, and Asian American people are more likely to develop type 2 diabetes

Preventing and Managing Pediatric Type 2 Diabetes

You can help decrease the risk of your child getting type 2 diabetes as well as help manage it if your child has been diagnosed.

• Get an annual well-child exam with your child’s pediatrician or family medicine provider.
• Eat healthy foods as a family; encourage your child to participate in meal planning and preparation.
• Ensure your child gets plenty of physical activity; identify activities you can do as a family, like hiking or walking the dog.
• Help your child maintain a healthy weight.

DMG Children’s Rehabilitative Services includes pediatric and young adult providers,  endocrinologists and nutritionists to support your child and your family.  We are committed to educating you and your child and developing treatment plans to optimize your child’s health and long-term wellness.

 

This post was originally published on December 9th, 2020 at DMGAZ.org