Author: Anderson Hills Pediatrics

As your child’s medical provider, we want to make sure your children are reaching their developmental and emotional milestones. 2020 has been a year unlike any other for us and our children alike. Navigating a new normal can take its toll on a child’s social skills, their ability to cope with challenges, and even their quality of life.

Saturday, October 10th was World Mental Health Day. This day is meant to raise awareness and reduce the stigma of mental health conditions, something that we treat commonly at our practice. Did you know…

• 17% of children (ages 6-17) experience a mental health disorder each year
• Over 9% of children between the ages of 2-17 are diagnosed with ADHD
• More than 7% of children between the ages of3-17 have been diagnosed with a behavioral disorder
• Over 7% of children between the ages of 3-17 have been diagnosed with an anxiety disorder
• More than 3% of children between the ages of 3-17 have been diagnosed with depression

Many of these disorders are noticed by significant and serious changes in the way children behave, learn, manage emotions, etc. In cases where the symptoms are persistent and severe, children have difficulties at school, home and in play. Without treatment, these children can have long-term impacts in life.

We recognized that we were seeing an increased number of children with behavioral health, anxiety, depression and more in our practice. We wanted to make sure we could provide your child the best possible care, and sometimes that requires treatment beyond what a physician provides. Due to this, we have partnered with Cincinnati Children’s Hospital Medical Center to bring you the best possible counseling care. Caitlin Geiser, LPCC-S started with our practice in September and has been providing counseling for patients at both of our locations as well as telemedicine. 

Tips for dealing with mental health at home: 

• As the parent or guardian, you know your child best. If you have a child that is dealing with any behavioral or mental health concerns or you yourself are concerned with their behaviors, give us a call! Our care team is available by phone 24 hours per day, and would be happy to help you navigate what is needed for your child’s care. You may reach us at (513) 232-8100.
• Encourage your child to discuss their emotions. It is important for children and adults to have a safe space to discuss being worried, angry or sad. Taking care of mental health is just as important as physical health.
• Model healthy coping skills for your children.  Parents often do things to manage stress, worry, and anger which they find helpful, but they do them “behind closed doors” so to speak.  Tell your kids what you are feeling and how you are going to handle it.  For example, “I just had a really frustrating day at work and I need to calm down.  I’m going to take some deep breathes and relax for a little bit.”  Or ask your child to help you think of some ideas to help you calm down.  Involving your kids in the process of identifying healthy coping skills is a great tool you can implement daily!

“There is hope, even when your brain tells you there isn’t.” ― John Green

Resources:

https://www.cdc.gov/childrensmentalhealth/data.html

https://www.cdc.gov/childrensmentalhealth/basics.html

Children respond to stress in different ways. They can be more clingy, angry, agitated, or do things they normally don’t. Below are a few tips to help you and your child deal with stress that may be associated with back-to-school changes, the pandemic, or everyday life.

• Respond to your child’s reactions in a supportive way. Give them extra time and attention. Listen to their concerns, speak kindly, and reassure them.
• If your child is feeling anxious about returning to school, involve them in a plan to prepare for potential problems or concerns. For example, if they are worried about what will happen if they are at risk from one of their classmates getting COVID-19, talk about all of the ways the school is working to keep everyone safe. Also get their input on ideas to keep their environment feeling as normal as possible.
• If possible, create opportunities for the child to play and relax.
• Keep to regular routines and schedules as much as possible. You can also create new ones in new environments. Include school/learning and time for safely playing and relaxing. We encourage you to continue to make sure your efforts to maintain these routines are done in a safe, socially distanced way!

Behavioral health concerns (such as anxiety, depression, behavior problems, adjustment concerns) often arise in childhood and can impact a child/teen’s functioning. We have found that for some patients these concerns have been amplified due to the pandemic this year. To help with these common concerns, we have a behavioral health specialist, Caitlin Geiser, LPCC-S, on our team. If you are in need of additional support for your child, Caitlin will focus on your child’s psycho-social functioning and help teach you and your child strategies to reduce symptoms.

If you have any questions about therapy services or would like to schedule an appointment, please call us at 513-232-8100. Our goal at Anderson Hills Pediatrics is to provide the best possible care to your child so he or she can achieve the best possible health and quality of life.

Source: World Health Organization

Amy Fry, RN, IBCLC and Hilda Lyons, BSN, RN, CBS

Breastfeeding comes easily for some mothers, but for others it does not. If you choose to breastfeed or provide breast milk for your baby, our lactation team is here to help!

How are Amy and Hilda here for you? Through a focus of CARES, or our Anderson Hills Pediatrics core values.

COLLABORATION: They work together with your family to provide the best plan of care for your child. Each baby and feeding situation is unique, so our team focuses on finding the solution that is right for the family.

ACCESS: Our lactation specialists want to make sure they are easy for you to reach! You can reach out to them through our patient portal, office visits, or by phone at 513-232-8100 option 4.

RESPECT: We respect your family’s feelings, wishes, rights, and traditions. These go into consideration when we are determining the best care plan for the mother and child.

EXPERIENCE: Our lactation specialists and clinical team have years of experience in helping mothers and babies with lactation needs. We work together to ensure your family has a positive experience.

SERVICE: We want to make sure your family is equipped with information to help with feeding. We are here to provide families with the information to help mothers nurture and nourish their baby.

August is Breastfeeding Month. We are proud to be able to offer this service to you and your family. For additional resources, we also encourage you to check out a library of advice from Healthy Children/ the American Academy of Pediatrics.

Healthy Children

In Person or Online School?

With the number of Covid-19 cases increasing in Southwest Ohio and Northern Kentucky and school districts coming out with their proposals for the 2020/2021 school year, many parents are reaching out to us for recommendations.

This is definitely not a one size fits all situation. The American Academy of Pediatrics (AAP), the CDC, Washington, Columbus, local health departments, have all offered their recommendations/opinions. They are addressing what is best for the majority of children. We agree with the AAP that “schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits.”

However, you the parents are not making decisions for the average child, you are making decisions for your child. Here are some things to consider, some questions you should ask yourself and your child, if she/he is old enough:

1)      Clearly your first consideration is your child. Is your child healthy or does he/she suffer from a chronic medical condition that may be exacerbated by a serious respiratory infection? How did your child fare during in-home schooling this spring? Does your child need in person instruction in the classroom or does he/she do better learning at their own pace on their own time? Can your child navigate the virtual assignment board, find the necessary virtual materials, and submit them correctly? Is your child self-motivated to keep on track? It is very likely that in person instruction will be interrupted as the number of Covid cases increases. Can your student adapt to the possibility of going from in school to all virtual, to maybe a hybrid model? Or is consistency better for your student which could be achieved by an all online year. Does your child thrive in the social interactions with her or his peers or are those added stressors? Do you rely on nutritional support for your child in the school setting? Does your child have special needs, needs like OT/PT/speech/behavioral or mental health support? Are you concerned that your child has a learning disability that needs to be evaluated at school? Does your child have adequate opportunities at home for physical activity?

2)      Then think of your own situation. Being a parent is a full-time job. Being a teacher is a full-time job. Are you equipped to support your child’s learning on a daily basis for multiple hours per day? Do you have a job outside the home? Are you a single parent? Are you healthy or do you have a chronic medical condition that requires you or those around you to quarantine? What about other members of your household? How would the possibly changing situation of in-school learning going to fully online to possibly a hybrid model affect your household? Do you need more consistency due to job or other constraints? School strategies may need to be revised and adapted depending on the level of viral transmission in the school and throughout the community. How will you be able to adapt to those changes?

3)      What about extended family circumstances? Do you need to care for a sick grandparent or other individuals that are at higher risk from Covid-19? Do you have extended family available to you to help with your child’s learning? Are family members available to help when your child gets ill?

4)      What is your school’s proposal? We know that social distancing decreases the risk of infection. The primary mode of transmission is through respiratory droplets by persons in close proximity to each other. Is your school able to socially distance children? How often will your child be in crowded hallways or are the students staying in the same classrooms and only teachers are moving between rooms? We also know that face masks mitigate the spread of the virus, when social distancing is not feasible. Is you school implementing a face mask requirement? Will your child be able to tolerate such a requirement? Where is your child eating lunch? What about physical education?  Spread through respiratory droplets will be more of a concern at those times. What about busing or drop-off and pick-up procedures?

It is important to understand the mounting evidence regarding COVID-19 in children and adolescents, including the role they may play in transmission of the infection. SARS-CoV-2 appears to behave differently in children and adolescents than other common respiratory viruses. Although children and adolescents play a major role in worsening outbreaks due to influenza, information to date (and this may change) suggests that may not be the case with SARS-CoV-2. Although many questions remain, so far the evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from Covid-19 infection. In addition, children may be less likely to become infected and to spread the virus. There are multiple, granted small, studies that indicate that the primary spread is from adult to adult and adult to child rather than the other way around.

In summary, for most students and families, in school education will be best for academic learning, social emotional development, intervention services, and physical activity. With appropriate physical distancing when possible, face masks when distancing is not feasible, hand-washing, cleaning and disinfection of surfaces, and using outdoor spaces whenever possible, the threat of Covid-19 in our children can be mitigated. Most children will learn best when physically present in the classroom.

However, as a parent you know your child best. If you have specific questions about your child’s situation, please call us. As your child’s primary care provider we are happy to discuss your specific situation with you.

Petra Hackenberg-Bauer, MD, FAAP

Our goal at Anderson Hills Pediatrics is to provide the best possible care to your child so he or she can achieve the best possible health and quality of life. Behavioral health concerns (such as anxiety, depression, behavior problems, adjustment concerns) often arise in childhood and can impact a child/teen’s functioning. To help with these common concerns, a behavioral health specialist, Caitlin Geiser, LPCC-S has joined our team. Caitlin will focus on your child’s psychosocial functioning and help teach you and your child strategies to reduce symptoms.

The behavioral health specialist will submit a separate bill to your insurance company for the service. Depending on your specific coverage, you will either be charged a second copay or be billed for any balance not paid by your insurance (deductible and/or co-insurance).  If you have Ohio Medicaid, the services will be covered.

Because specific benefits differ among insurance plans, please call your insurance company and ask for coverage information for the billing codes (CPT codes) listed below.

CPT code             Mental Health Services   

90791                    Psychiatric Diagnostic Evaluation

90832                    Psychotherapy 30 minutes, with patient and/or family member

90834                    Psychotherapy 45 minutes, with patient and/or family member

90846                    Family Psychotherapy (without patient present)

90847                    Family Psychotherapy (with patient present)

The coverage level that applies to the therapy services may be different than the coverage level that applies to the medical doctor’s charge.

If you have any questions about therapy services after talking to your insurance company or would like to schedule an appointment, please call 513-232-8100. Please note that your child’s primary pediatrician may need to see your child for a visit prior to scheduling an appointment with Caitlin.

Hand sanitizers containing 60% alcohol are an important weapon against the fight of Covid-19. However, not all alcohols are created equal. The Food and Drug Administration (FDA) recommends that methanol should not be used in hand sanitizers due to its toxic effects.

Reports of poisoning due to methanol have been issued following repeated use and absorption through the skin or ingestion by mouth. Symptoms may include nausea, vomiting, headache, blurred vision or blindness, seizures, coma, and death. Young children who accidentally swallow these products or older children and adults who intentionally swallow them are at highest risk.

It is important to check the labels on your hand sanitizers for the active ingredients and if methanol is listed, please dispose of the products in hazardous waste containers. According to the FDA they should not be flushed or poured down a drain. For a complete list of manufacturers and product names containing methanol follow this link on the FDA website

Washing hands with soap and water is the preferred method of keeping your and your children’s hands clean. However, if soap and water are not available, please supervise children ages 5 and younger while using hand sanitizer and store these products out of your children’s reach.

Please stay safe and healthy!

Petra Hackenberg-Bauer, MD

Pediatrician

Anderson Hills Pediatrics, Inc.

513-232-8100

The return of sports and outdoor summer play unfortunately may come with the return of injuries such as sprains and muscle strains.  Many new injuries will respond to R-I-C-E treatment.

REST the injured extremity, avoiding activity that causes pain.

ICE the injury for 20 minutes every 3-4 hours for the first 2-3 days.

COMPRESSION with an ACE wrap to help immobilize the injury and reduce swelling.  The wrap should be snug but not overly tight. Start the wrap beyond the injured area and continue to wrap back to and above the injury.  The wrap can also be used to hold an ice pack in place.

ELEVATE the injured area above the level of your heart as much as possible until the swelling improves.

Seek medical care if the pain and swelling are severe or if not improving with initial supportive care.

Currently at Anderson Hills Pediatrics we are giving away ice packs to patients coming in for Sports Physicals with their well care.  We hope that your child stays healthy and won’t need to use the ice pack but if they do find themselves injured, we are here to help!

What to know before you go….

Summer is in full swing, which generally means it is time for vacations. As the cases of COVID-19 grow around the country, we want to help you in making the most informed decision prior to loading up the car or booking your next trip. The Centers for Disease Control and Prevention (CDC) has created guidance for considerations for travel. Before you go, a few considerations are:

• Are you heading to a “hot spot?” Traveling to areas with increased COVID-19 can increase your risk of infection. There also may be increased travel restrictions due to the viral spread. It is encouraged that you check state or local health departments for more information before you travel.
• Will you be able to socially distance while traveling? Being less than 6 feet from others can increase your chance of infecting others or becoming infected.
• Are you at an increased risk of infection? If you or those you or those you are planning to travel with are at an increased risk of illness, it is recommended that travel be limited.
• Will you need to quarantine after traveling? Some states, work-sites, and schools may require a 14-day quarantine after traveling.
• Are you sick or have you been in contact with someone that has COVID-19? Travel is not recommended for anyone that is sick or if you have been around someone with COVID-19 in the past 14 days.
• How will you travel? Traveling by airplane, bus, train or even stopping at rest stops can lead to virus exposure. Choosing a way to travel that allows you to avoid close contact with others is the most ideal.

Should you choose to travel during this time, we recommend that you continue to follow the CDC recommendations for COVID-19:

• Wear your mask or face covering.
• Clean your hands often and when soiled by washing with soap and water for 20 seconds or using hand sanitizer.
• Avoid touching your eyes, nose, or mouth.
• Avoid close contact with others by staying 6 feet apart as much as possible.
• Cover coughs and sneezes.
• Limit your exposure to others as often as possible.

To ensure you and your child’s safety, we are continuing to offer telehealth visits, curbside appointments, and are separating ill and healthy appointments. Our team also continues to take extra precautions with cleaning and wearing personal protective equipment (PPE) such as masks, gowns, etc.  Going forward, we will also require that all patients over the age of two wear a mask for face covering while inside our offices.

All patients coming in for appointments will continue to be screened for travel, symptoms, and possible exposure to COVID-19 prior to the visit. However, we do ask that all patients that have traveled within 14 days prior to any check-up appointment contact our office to determine if an alternative appointment type or rescheduling is necessary.

Please do not hesitate to reach out if we can answer any of your questions or concerns. We also continue to update our website.  Facebook page and Instagram account with new information frequently.

Thank you for trusting us for your care needs!

Content source: Centers for Disease Control and Prevention (CDC):

https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html

We are excited to be offering a few virtual education classes to you in the month of July. These physician led classes are FREE, and a great way to acclimate to some of the new normal of COVID-19.

Caring for a Newborn During COVID-19

Dr. Grubert will be presenting a class to all soon to be or new parents on what expectations you should have after delivering your newborn during the COVID-19 pandemic. She will address information to keep your newborn safe, discuss visitor guidelines, and more.

Date: Tuesday, July 14, 2020

Time: 7:00PM

Acclimating Back to Daycare During the Pandemic

Dr. Brady will be hosting a class focused on what your pediatrician wants you to know about sending your child back to daycare during the pandemic. She will outline tips and ways to keep your child and family healthy as your childcare routines are adjusted.

Date: Wednesday, July 22, 2020

Time: 7:00PM

These classes are available for any parent that is looking to know more about caring for their child/children at this time. You may register online for one or both of these classes by clicking here

Summertime, and the livin’ is easy – but in the time of COVID 19, it’s not as easy as it used to be.  One thing that has not changed is the need to wear sunscreen.

Children 6 months and older should wear sunscreen whenever they are going outside, even on cloudy days.  The American Academy of Pediatrics recommends sunscreen that is SPF (sun protection factor) 30 or higher containing zinc oxide or titanium oxide.  You should use a broad spectrum sunscreen on your child that is one with UVA and UVB protection.  Apply the sunscreen at least 15 to 30 minutes prior to going outside.  Be generous in your application, covering all sun exposed areas including the face, nose, ears, and neck.  Don’t forget to apply sunscreen to the feet, hands, and the backs of the knees.  You should reapply sunscreen every 2 hours and after swimming or sweating.

You may also wish to buy clothing labeled with an ultraviolet protective factor (UPF).  The AAP also recommends sunglasses with 99% UV protection.

Infants under 6 months should be kept out of the sun.  Babies should be kept in the shade, under a tree, or an umbrella.  They should be dressed in long sleeved, light weight clothing.  If there is no way to avoid the sun, you may apply sunscreen, SPF 30 or higher, to small areas of sun exposed skin.

So, as you head out for summer family fun, don’t forget your mask, hand sanitizer, water bottle and SUNSCREEN.  Have a great time!

Dr. Meri Schrader