This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Regular well child visits are an important element in maintaining your child's health.
At a well child visit, you can expect:
- Evaluation of growth and development
- Discussion of safety, nutrition, fitness, behavior, school, etc.
- A chance to ask questions
- A physical examination
- Age-appropriate screening tests (including hearing, vision, hemoglobin, lead testing, and urinalysis)
- Age-appropriate immunizations
Schedule of visits
- Hospital Newborn Exam
- 2-4 days after discharge
- 1-3 weeks of age if necessary
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 2 years
- Yearly visits ages 3-21 years
We encourage advance scheduling of well childcare visits.
For infants and toddlers please schedule your next check up at the end of your visit. Otherwise, we suggest you call 6-8 weeks ahead of the time you wish to be seen.
We will see sick children on the same day whenever possible with appointments. Please call after 8:00 am to schedule an appointment. Appointments cannot be scheduled before the office opens at 8:00 am.
- We do not encourage walk-in visits; we prefer a phone call prior to your visit. Every effort will be made to schedule a same-day appointment for your sick or injured child.
- Walk-in visits will be seen, but we will have to fit them into our schedule, so be prepared to wait.
If your child is already scheduled for a well child visit, but happens to be sick, we may still be able to do the well visit. If you have additional sick children (e.g., siblings), please call ahead so that we can accommodate them.
IF YOU THINK YOUR CHILD IS HAVING A LIFE THREATENING EMERGENCY, CALL 911
When our office is closed, the answering service will answer when you call our main number: (413) 589-9494
After hours calls are for PEDIATRIC EMERGENCIES only.
Please call with routine questions during regular office hours.
The service will reach the doctor on call. If the doctor does not return your call in 20 minutes, please call back. Please disable your Caller ID block; failure to do so may delay the doctor's response.
If possible, it is best to call before 8 PM. If your child needs medication, most pharmacies close at 9 PM. There are several pharmacies that are open 24 hrs.
Have the phone number of your pharmacy handy and remember to disable your caller ID block.
My child has a lump after her shots
After getting a vaccine, your child may have a small painless lump or a sore, red, swollen spot at the place where the injection was given. This lump may last up to 2 months. Warm compresses applied 3 times a day may be helpful.
Your child may also:
- have a slight fever
- have some decrease in activity
- have some decrease in appetite
- have some irritability
- limp for a couple of days (if the vaccine was given in the leg)
Remember, these reactions are normal and should only last for a couple of days!
My baby's tongue is white, does she have thrush?
A white tongue is called "milk tongue" and is often not thrush. Thrush is an infection in the mouth caused by a yeast-like organism called Candida albicans. This condition is most common in newborns.
If your baby develops white spots on the tongue and white spots that look like milk curd on the insides of the cheeks and lips, this may be thrush. These spots often bleed if you try to wipe them off. Thrush may be painful and cause feeding problems.
The same yeast infection can also cause a diaper rash. Some babies have the infection both in their mouth and on their bottom. Thrush also can spread to your breasts if your baby is breastfed.
Mild cases often clear up on their own however many babies need treatment with a prescription antifungal oral medication. These medications are applied orally with a dropper. A baby with a yeast infection in the diaper area can be treated with an antifungal cream following diaper changes. If your baby develops thrush and you are breastfeeding, you may want to use the same antifungal solution on your nipples to help prevent passing the infection back and forth between your breast and your baby's mouth. You can continue breastfeeding during treatment.
Disinfect daily any item that comes in contact with your baby's mouth. This includes nipples, pacifiers, teethers, breast shells, breast pads, bras, pump parts, artificial nipples. To sterilize bottle nipples or pacifiers - boil them for 20 minutes each day to kill the yeast that may be residing on them.
My baby's stool is green
The first bowel movements babies have are thick and dark green or black in color.
A breast fed baby's BMs will become yellowish, loose, and "seedy" in texture. A formula fed baby usually has yellowish to tan BMs that are the texture of peanut butter. When it comes to your baby's bowel movements (BMs), there is no "normal" number, color or schedule. The number, color, and texture of BMs vary greatly in the same baby and between babies of similar age. The color of the BMs depends on a variety of things, including what a breastfeeding mom is eating, the type of formula, and how often and how much your baby is fed.
Iron supplements may cause the BM to appear dark green.
You should not worry about the color of the BM unless it is black, red (bloody), or white.
My baby's not stooling as often
When starting solids BMs will firm up, but will also change texture based on what the baby is eating. Rice cereal may cause BMs to be more formed. There is no need to be concerned about constipation as long as the BMs are soft.
My child had a cold and a fever and now has a rash
Viral infections commonly result in skin lesions and rashes. Some viruses result in rashes with specific characteristics (e.g., chickenpox), but others are not easy to identify. Viral infections commonly cause rashes, especially in children, and eruptions usually resolve after the immune system clears the virus. After the rash is gone, some skin peeling may occur.
My child has a nose bleed
Nosebleeds (known as epistaxis) are a very common during childhood. The nose easily bleeds as a result of trauma to the nose, dry nasal passages and from the normal picking, vigorous nose blowing and rubbing of the nose. Children, with allergic rhinitis (nasal allergies), tend to have more nosebleeds due to chronic nasal congestion and inflammation.
A nosebleed usually starts suddenly from one nostril. Fortunately, most nosebleeds stop on their own within a few minutes.
Have your child lean forward and spit out any blood. Do not have your child lay flat on his/her back as this can result in increase bleeding and swallowing of blood. Tightly pinch the soft parts of the nose against the center wall for 5-10 minutes, do not release pressure. Have your child breathe through his/her mouth during this time. If after 5-10 minutes the bleeding has not stopped, repeat the process. Do not insert anything into the nose.
Apply a small amount of Vaseline to the nasal passages at bedtime or spray each nostril with nasal saline twice a day. Use a humidifier in your child's room while they are sleeping. Treat nasal allergies.
CALL OUR OFFICE:
- If the bleeding does not stop after 20 minutes of direct pressure
- If your child appears pale or sweaty or your child is not responding to you
- If your child continues to have frequent nosebleeds despite the use of Vaseline and humidification
- Your child's nasal allergies are not controlled by over the counter antihistamines
- If you have other questions or concerns
My baby has pink eye, the eye is tearing and has drainage
Most likely your baby has a blocked tear duct. A blocked tear duct (nasolacrimal duct obstruction or dacryostenosis) is a common condition in babies. It occurs when the normal drainage system for tears (the lacrimal system) fails to open or becomes blocked (obstructed), stopping the flow of tears from the eyes into the nose. Blocked tear ducts are very common in newborns. Up to 70% of all newborns are believed to have blocked tear ducts. They cause noticeable symptoms in 6% to 20% of these babies.
What are the symptoms of a blocked tear duct?
Babies who have blocked tear ducts usually have symptoms the first few days to the first few weeks after birth. Symptoms often affect only one eye, but may affect both eyes, and usually include:
- Excessive tears, ranging from the eye appearing wet to tears running down the cheek (epiphora).
- Buildup of yellowish-white mucus drainage at the inner corner of the eye and on the lashes.
- Swelling and redness of the eyelids and irritation of the surrounding skin.
The symptoms of a blocked tear duct may get worse after an upper respiratory infection (such as a cold or sinus infection). Also, symptoms may be more noticeable after the baby has been exposed to wind and cold, because these may cause increased production of tears.
How is a blocked tear duct treated?
Usually no treatment is needed for a blocked tear duct in a baby. It usually clears up on its own by the time the baby is 1 year old. Keeping the baby's eyes clean to prevent infection until the duct opens may be all that you need to do.
The primary treatment is gentle cleansing of the lids with a warm wet washcloth. Use a clean portion of the washcloth with each pass. This should be accompanied by a regimen of firm nasolacrimal duct massage, usually 2 or 3 times a day. With a clean finger, simply rub the area between the inside corner of the eye and the bridge of the nose.
If signs of infection develop, the baby may need an antibiotic eye drop medication. If the duct remains blocked after the baby is 6 months, an evaluation by a pediatric ophthalmologist may be suggested.
CALL OUR OFFICE:
- The eyelids are red or swollen
- The white part of the eye becomes red
- The inner lower corner of the eyelid develops a red lump
- Lots of yellow-green discharge is present