Other Services

  • Lactation Consultation

    BREASTFEEDING SUPPORT



    Breastfeeding provides essential nutrition for infants birth to one year and older. As with learning anything new, most breastfeeding mothers and babies (and dads too!) need some instruction and support during this learning period.



    THAT'S WHERE WE COME IN!



    We have a high number of breastfeeding families. We will do our best to help you meet your breastfeeding goals. Any breastmilk you feed your infant is a gift of health for your child that lasts their lifetime.



    We respect each family's feeding decisions. We do encourage moms to breastfeed exclusively or give only  breastmilk for the first four months then continue to breastfeed and give solid foods until your baby is a year old.



    We love babies and enjoy helping families learn how to breastfeed! We will help you as little or as much as you need. We provide in-office feeding evaluations for hands-on help as well as phone support for any questions you may have along your breastfeeding journey.



    SOME AREAS WE CAN PROVIDE GUIDANCE INCLUDE:

    • Positioning your baby at the breast
    • Latching
    • Caring for your breasts and nipples
    • Assessing milk transfer
    • Assuring adequate nutrition
    • Assembling and using a breast pump, including sizing for the right size flange
    • Storing milk
    • Returning to work/school while breastfeeding
    • Traveling and breastfeeding
    • Training a breastfeeding baby to a bottle
    • Teething while breastfeeding
    • Breastfeeding premature babies
    • Managing slow weight gain babies
    • Breastfeeding twins
    • Breastfeeding babies with special medical needs such as cleft palate, Down Syndrome, and heart conditions
    • Managing medications, medical tests or surgery while breastfeeding


    PLEASE CALL OUR OFFICE TO SCHEDULE AN APPOINTMENT WITH CHRISTINA COOK, CPNP/ LACTATION COUNSELOR AT OUR TOLEDO AND OREGON LOCATIONS.

  • Newborn Care

    NEWBORN CARE BEGINS FROM THE MOMENT YOUR BABY ARRIVES



    Our pediatricians understand the challenges of taking care of a newborn. They also provide the same gentle care they’d use for treating their family. If you’re pregnant, looking for a pediatrician, and you’d like to meet the team, or you need to schedule a newborn visit, call our office.



    NEWBORN CARE FAQS

    WHEN DOES MY NEWBORN HAVE THEIR FIRST CHECKUP?



    Your new baby has their first checkup within the first week after leaving the hospital. During this newborn care visit, our providers can follow up on any outstanding testing or concenrs from birth.



    Your newborn’s checkup is a comprehensive exam to be sure they’re growing and developing normally. During the checkup, the provider:



    • Checks your baby’s weight, length, and head circumference
    • Evaluates your baby’s feeding, bowel, and sleeping habits
    • Does a physical examination, including an eye exam
    • Performs a developmental evaluation


    These visits also give parents time to ask questions about their baby, whether they’re not sure about how to bathe the baby, they have trouble with feeding, they’re worried about the baby’s sleep schedule, or any other concerns.



    WHAT SCREENINGS DOES NEWBORN CARE INCLUDE?



    Some states routinely screens for genetic and rare medical conditions, including 32 core and 24 secondary conditions. The goal is to identify and treat diseases early enough to prevent serious complications such as growth problems, developmental delays, intellectual disabilities, blindness, deafness, and seizures.



    Within the first 24 hours after delivery, your newborn has a hearing screening, and blood is drawn from their heel to run the routine screening tests.



    WHAT ARE WELL-CHILD VISITS?



    Well-child visits are ongoing checkups for children that follow a specific schedule. After the initial newborn care visit, your newborn should see us at two weeks, one and two months.



    During each visit, their pediatrician will evaluate their growth, developmental milestones, and behaviors.



    Just like the initial newborn care visit, every well-child checkup is an opportunity to talk with the pediatrician about baby care and your baby’s health and safety.



    Your pediatrician also gives immunizations at the two-month visit to protect your baby from:



    • Polio
    • Hepatitis B
    • Rotavirus
    • Diphtheria
    • Haemophilus Influenzae
    • Pneumococcus


    Small doses of the same immunizations are repeated several times over the first 18 months to be sure your infant is fully immunized against contagious diseases.

  • Referral Information

    Children may experience a range of medical conditions that could benefit from the expertise of a pediatric specialist in a particular field. We emphasize the coordination of all healthcare providers involved in a child's treatment. Our role involves working with specialists to ensure the best care for your child, including providing guidance on when specialty care is recommended.



    In order to facilitate a productive relationship between the patient, primary care provider, and specialist, it is essential for us to conduct an initial assessment at our office before making a referral. This step enables us to furnish the specialist with comprehensive and current information regarding the child's health condition, as well as details about their recent physical examination. Additionally, this allows us the opportunity to discuss if a referral is absolutely necessary. Patients consistently derive advantages from the constructive collaboration between primary care providers and specialists.

  • Asthma Care

    ASTHMA & ALLERGY MANAGEMENT



    Our practice provides a comprehensive asthma and allergy management program for our patients. Our providers are trained in the diagnosis and management of childhood asthma and allergies. Diagnosis is usually made during a sick visit when a child is wheezing or exhibiting symptoms of allergies. Occasionally, we may diagnose your child with asthma or allergies during a preventive care visit based on patient or parent concerns or our exam findings.



    SPIROMETRY (PULMONARY FUNCTION TESTING OR PFT'S)



    Pulmonary function testing is done at least annually and may be done when monitoring medication changes. The test results are interpreted by our providers to help guide your child’s treatment. This is a non-invasive test than can be performed in all patients age 5 or older with asthma to assess lung function and response to medication and to assess overall asthma control. 



    ASTHMA EDUCATION



    We teach about environmental controls and avoidance of triggers. We also watch your child using his/her inhaler to confirm it is being used correctly. Information about caring for the medication devices that your child uses is provided and reviewed at every visit. We will provide an Asthma Action Plan for your child for school.



    MAINTENCE VISITS



    Children with asthma should be seen in our office every 3-12 months depending on their severity of illness and their asthma control. Regular visits are required in order for us to evaluate your child prior to medication refills.



    HELPFUL RESOURCES:

  • ADHD/ADD Evaluations

    EVALUATE AND DIAGNOSIS OF SYMPTOMS



    Our trained professional staff will do the initial evaluation if you think your child is having problems with focusing and attention.  We also continue to treat your child after the initial diagnosis has been made.  



    The ultimate goal in the treatment of ADHD/ADD is to make your child as successful as possible in all aspects of his/her life.



    ADHD FAQS



    WHAT IS ADHD?

    Children with attention-deficit hyperactivity disorder or ADHD have differences in their brains than those who don’t have ADHD. Certain areas of their brain may mature more slowly. Additionally, children with ADHD have imbalances in neural networks and neurotransmitters, the chemicals that nerves use to communicate.



    Knowing that ADHD has a neurological basis is important because it helps parents understand that their child isn’t disobedient or oppositional on purpose. Instead, children with ADHD need help to learn to control their behavior.



    The brain differences are also important because they occur in specific areas responsible for skills such as self-regulation, organization, working memory, problem-solving, reasoning, and time perception. The brain areas affected determine your child’s ADHD symptoms.



    WHAT SYMPTOMS DEVELOP DUE TO ADHD?



    ADHD symptoms fall into three categories: inattentiveness, hyperactivity, and impulsivity. Some children may only struggle with inattention, while others have trouble with two or three categories.



    Each child has a different range and severity of symptoms. However, their symptoms are severe enough to affect their performance at school, at home, and when socializing.



    When children struggle with inattention, they:

     

    • Can’t pay attention at school or while playing
    • Have difficulty organizing tasks
    • Avoid tasks requiring mental effort
    • Lose important items
    • Forget to do homework and chores


    When children struggle with hyperactivity and impulsivity, they:

     

    • Fidget, squirm, or get out of their seat during class
    • Run or climb when it’s inappropriate
    • Talk excessively and interrupt conversations
    • Have a hard time waiting for their turn
    • Act or speak without thinking


    Children and adolescents with ADHD also have problems with working memory. Working memory allows them to hold several pieces of information in their head long enough to use them to plan, do calculations, or to coordinate one activity with another.



    HOW DO YOU DIAGNOSE AND TREAT ADHD?

    To evaluate and diagnose ADHD, our professional team use tools such as a checklist of symptoms, talking with parents and children about their challenges, direct assessments of attention and questionnaires completed by parents and teachers. This is why it is also crucial that your child is up to date on their wellness exam to be sure another medical problem is not the cause of their symptoms.



    Once your child has an ADHD diagnosis, our providers can prescribe medication treatment and schedule regular follow-up appointments to monitor their progress.



    Our providers may recommend conventional and/or holistic treatments, depending on each child’s needs. For example, your child may improve with a combination of medication, dietary changes, and behavioral support.



    If you or your child’s teacher are concerned about your child’s inattentive, hyperactive, or impulsive behaviors, call our office to schedule an ADHD consultation with our providers.  They can then refer you to our on- site school psychologists.

  • Sports Physicals

    SPORTS PHYSICALS ARE DIFFERENT FROM THE TYPICAL WELL-CHILD CHECKUP BECAUSE THEIR GOAL IS TO BE SURE YOUR CHILD CAN SAFELY ENJOY SPORTS WITHOUT RISKING HARM TO THEIR BODY.



    • Ensure your child is prepared for vigorous physical activity
    • Gather information on your child’s health and development
    • Watch for potential warning signs of serious illness
    • Meet the requirements of your child’s school, camp, or sports team
    • Identify possible risk factors with a certain sport
    • Receive advice on avoiding injuries


    Regular physicals are an important part of preventative pediatric care. Getting your child a sports physical if it has been longer than 6 months since their regular physical gives the doctor the opportunity to examine your child, evaluate their health and fitness, and determine whether or not they are prepared for sports or school activities.



    Sports physicals DO NOT replace annual physicals.  Yearly comprehensive wellness exams should be a part of your child’s ongoing healthcare because they also provide an important opportunity to discuss your child’s development and any concerns you may have.  These are also required yearly by your insurance company.





    SPORTS PHYSICALS FAQS



    WHAT IS A SPORTS PHYSICAL?

    Every teen (12 years +) in Ohio/  Michigan who wants to play in a sport or engage in other school activities like cheerleading must have a sports physical or a preparticipation physical examination. They also need a sports physical to clear them to return to their activities if they suffer an injury or become ill during the season.



    The purpose of a sports physical is to be sure your child can safely participate in sports. Suddenly starting high-intensity workouts and engaging in competitive sports can quickly aggravate a pre-existing problem or lead to a preventable injury when an exam discovers potential problems.





    WHY IS A CHILD’S MEDICAL HISTORY IMPORTANT?

    Children and parents use a medical history form to provide information about:



    • Chronic illnesses such as asthma, diabetes, or epilepsy
    • Hospitalizations or surgeries
    • Past injuries such as concussions, sprains, or fractures
    • Problems with dizziness, chest pain, or breathing during exercise
    • Medications and supplements
    • Allergies
    • Family history of serious illnesses
    • A yearly complete medical history helps your provider determine if your child has a condition that sports activities might aggravate.


    HOW IS A SPORTS PHYSICAL EXAM DIFFERENT FROM AN ANNUAL CHECKUP?

    The physical exam for sports participation has a different focus than a wellness exam. During a sports physical, our providers evaluate your child’s musculoskeletal health- assessing bones, muscles, and joints for flexibility, strength, and signs of overuse injuries or stress.



    Their provider carefully examines concerns that could reappear during sports activities, such as previous fractures, sprains, concussions, skin infections, a past history of pain or dizziness, and chronic health conditions.



    An existing condition doesn’t always prevent a child from playing sports, but it may mean that they need help to accommodate their activity.



    If your child has asthma, for example, they may need a different inhaler or need to learn to use their inhaler shortly before they start their warmups to prevent an exercise-induced asthma attack.



    If your child needs any type of physical, call our office to schedule an appointment.

  • Behavioral Health

    DOES YOUR CHILD NEED A BEHAVIORAL EVALUATION?



    WHAT WE DO



    In collaboration with The Pediatric Center, Inc providers and our school psychologists, we evaluate and treat children for behavior concerns and school problems including:



    • Inattention and hyperactivity/ impulsivity
    • Anxiety
    • Depression
    • Atypical behaviors or socialization concerns


    If you have concerns about your child's behavioral development, please call our office and schedule a consultation with one of our providers. We will discuss your concerns and gather information that will be used to determine how we can best help your child. If a Behavioral Evaluation is needed, we will schedule a visit for you with one of our school psychologists and provide you with assessment tools that you can complete prior to the your visit.



    ASSESSMENT TOOLS TO COMPLETE FOR CHILDREN AGES 5-12:

    • Vanderbilt Assessment - Parent Initial
    • Vanderbilt Assessment - Teacher Initial
    • Screen for Child Anxiety Related Disorders (SCARED) - Parent
    • Screen for Child Anxiety Related Disorders (SCARED) – Child
    • Center for Epidemiological Studies Depression Scale for Children (CES-DC)

    ASSESSMENT TOOLS TO BE COMPLETE FOR CHILDREN AGES 13-18:

    • Vanderbilt Assessment - Parent Initial
    • Vanderbilt Assessment - Teacher Initial
    • Screen for Child Anxiety Related Disorders (SCARED) - Parent
    • Screen for Child Anxiety Related Disorders (SCARED) – Child
    • Center for Epidemiological Studies Depression Scale for Children (CES-DC)
    • Patient Health Questionnaire 9 (PHQ9)
    • CRAFFT screening tool


    Assessment tools used on a case by case basis include: 



    • Child Obsessional Compulsive Inventory- Parent and Child (CHOCI)


    IMPORTANT! ALL ASSESSMENTS MUST BE COMPLETED BEFORE THE DAY OF YOUR CHILD’S APPOINTMENT.

    WHAT TO EXPECT AT A BEHAVIORAL EVALUATION



    On the day of your child's behavioral evaluation, please arrive 10 minutes prior to your scheduled appointment time. If your appointment is scheduled after regular business hours, please ring the doorbell and have a seat. We will be out to get you shortly!  The first appointment (or initial consultation) is for parents/ caregivers and the child.  Please bring completed forms from school, your home assessment, any teacher input/ notes you may have and current grades if applicable.



    The second appointment is for the CHILD ONLY for testing- the parents will wait in the waiting room while testing is completed.



    The third appointment is for PARENTS ONLY.  If able, please refrain from bringing siblings to avoid extra distractions.  At this appointment, you will discuss results of testing and what possible next steps could include. We can also discuss how to improve school performance.



    If the decision is made to consider medication management, an appointment can be made with one of our providers to discuss options.



    ONGOING MEDICATION MANAGEMENT

    After your child's initial evaluation, if medication is started, your child must be seen within 28 days in order to continue the medication. If your child is doing well with his/her medication, subsequent appointments will be scheduled every 3 months. If a  medication or dosage change is needed, your child must be seen within 1 month to assess your child's progress and to determine if the medication can be refilled.  Failure to follow this protocol, can adversely affect your child's prescribed regimen and will result in no refills of medications.

  • Chronic Care Management

    WE ARE HERE TO SUPPORT YOU!



    If your child has a disability or a chronic illness, your journey may feel like you are on the road less traveled. You probably have interactions with many different professionals and specialists. You need information, assistance, understanding, and support.



    WE'RE HERE TO HELP.



    If your child has significant medical needs, we will partner with you to help you manage your child's condition. We look forward to getting to know you and your child, and will be your dedicated point of contact through this journey.

  • Refilling Your Medications

    Routine medication refills can be made through your pharmacy. Antibiotics will not be refilled. If your child is behind on their well care or routine checks for their condition, the medication will not be refilled until care is up to date.  For ADHD medication, all requests must be made through the "Med Line".   This number is (419) 473-6670- and follow the prompts.  Please allow 24-48 hours for these refill reqests.
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