Pediatric Services

From your baby's long-awaited arrival until those first days of school, you'll be visiting the doctor regularly to make sure that your child is healthy and developing well. These check-ups are essential to ensure appropriate physical and mental development, and to provide vaccinations to prevent serious bacterial and viral illnesses. We are happy to discuss vaccines with you during your visit, and answer any questions you may have.

It is also our pleasure to discuss any questions or concerns you may have about your baby at these visits (or any time you call or come in!). It can be tough to remember everything you want to discuss with the doctor and everything the doctor tells you. These sheets give you a sense of what to expect at each visit and help you keep track of the guidance your doctor provides. Feel free to print them out and bring them with you!

• Your Child's First Checkup: The Hospital
  We recommend your child's first office visit be 1 to 2 days after discharge from the hospital
• Your Child's Checkup: 2 to 4 Weeks
• Your Child's Checkup: 2 Months
• Your Child's Checkup: 4 Months
• Your Child's Checkup: 6 Months
• Your Child's Checkup: 9 Months
• Your Child's Checkup: 12 Months (1 Year)
• Your Child's Checkup: 15 Months
• Your Child's Checkup: 18 Months (1½ Years)
• Your Child's Checkup: 2 Years
• Your Child's Checkup: 3 Years
• Your Child's Checkup: 4 Years
• Your Child's Checkup: 5 Years

Playing sports is a great way to have fun and stay fit. And anyone who has played sports knows that you have to pay some extra attention to your health. If you play team sports, you may have had a sports physical. A sports physical is a visit to the doctor to make sure you're in good enough shape to play the sport you want to play.

There are two main parts to a sports physical: your medical history and the physical exam.

Your medical history includes questions about illnesses and injuries you have had, such as asthma or a broken leg. It is important to know about medical problems that run in your family or any medicines you take on a daily basis. For example, has anyone in your family had heart trouble? Another important question is whether you've ever passed out, felt dizzy, or felt pain in your chest while running or playing. You should fill out the form with your mom or dad so the answers are the same. Your doctor may ask additional questions during the exam.

During the physical exam, the doctor may:

• Measure your height, weight, temperature, blood pressure, and pulse
• Check eyesight and hearing.
• Test urine.
• Examine your body from head to toe.
• Offer appropriate vaccinations and routine blood examination.

This is also your chance to discuss any other questions you have about your health and playing sports.

Have you had a flu shot? Most kids have and there's good reason. Like all vaccines, this one can protect you from a pretty awful illness – the flu.

This type of vaccine contains live flu virus, though, and shouldn't be given to kids who have certain health problems – or even kids who live with people who could get very sick from the flu.

In a healthy person, the flu causes a fever, body aches, and other cold-like symptoms. A person who has the flu will sleep a lot and feel sick, but will get better in a week.

The problem with the flu, also called influenza (say: in-floo-EN-zuh), is that it makes some people really sick. They are less able to get well on their own so they may need to go to the hospital. That's why a flu shot or nasal mist vaccine is recommended for just about everyone.

We screen for appropriate development during each well child visit, but are also available to evaluate children for developmental issues any time a parent is concerned. We can help guide parents on appropriate interventions, such as speech, occupational, or physical therapy when needed. We may recommend blood testing, imaging, or neurological testing to evaluate for causes of any abnormalities we find. We may also refer to specialists such as neurologists or developmental pediatricians when appropriate.

As you might expect, we are available for urgent and non-urgent illness assessment and management. Same-day appointments are available, and patients can often be worked in for more urgent issues upon discussion with our clinical staff. We have supplies available in office for acute illness management.

There are some issues that may best be addressed by arranging for a consultation between your child's pediatrician and yourself. Some issues may be too sensitive or complex to address in a conventional appointment that includes your child at least at the outset. If you have concerns that you believe may be best discussed in such a consultation, please let our staff know and we will work with you to make these arrangements.

Although we live in the information age and getting information is as easy as a few taps on a smartphone, not all of that information is trustworthy or based upon a foundation of good evidence. We are committed to providing our parents and patients with information that is well-researched and reliable. Just ask us. We'll provide you with the knowledge you need and the resources to get more if you need it.

Attention Deficit Disorder, with or without hyperactivity, is a common behavioral disorder that affects an estimated 8% to 10% of school-age children. Boys are about three times more likely than girls to be diagnosed with it, though it is not yet understood why.

Kids with ADHD can act impulsively, be hyperactive, and have trouble focusing. They may understand what's expected of them but have trouble following through because they find it difficult to sit still, pay attention, or attend to details.

Of course, all kids (especially younger ones) act this way at times, particularly when they are anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and occur in different settings. They impair a child's ability to function socially, academically, and at home.

The good news is that with proper treatment, kids with ADHD can learn to successfully live with and manage their symptoms. We can help guide you on diagnosis and treatment options across a broad range of behavioral and medical interventions.

Routine medical exams for kids' vision include:

• Newborns should be checked for general eye health by a pediatrician or family physician in the hospital nursery.
• High-risk newborns (including premature infants), those with a family history of eye problems, and those with obvious eye irregularities may be referred to a pediatric ophthalmologist.
• In the first year of life, all infants should be routinely screened for eye health during checkups with their pediatrician.
• At age 4, kids begin yearly eye health screenings and visual acuity tests (or tests that measure sharpness of vision) with their pediatrician.
• Kids who wear prescription glasses or contacts should have annual checkups by an eye doctor to screen for vision changes.

Most children who are born with a hearing loss can be diagnosed through a hearing screening. But in some cases, the hearing loss is caused by things like infections, trauma, and damaging noise levels, and the problem doesn't emerge until later in childhood. So it's important to have kids' hearing evaluated regularly as they grow.

Your newborn should have a hearing screening before being discharged from the hospital. Every state and territory in the United States has now established an Early Hearing Detection and Intervention (EHDI) program to identify before 3 months of age every child born with a permanent hearing loss, and to provide intervention services before 6 months of age. If your baby doesn't have this screening, or was born at home or a birthing center, it's important to have a hearing screening within the first 3 weeks of life.

If your baby does not pass the hearing screening, it doesn't necessarily mean there's a hearing loss. Because debris or fluid in the ear can interfere with the test, it's often redone to confirm a diagnosis. If your newborn doesn't pass the initial hearing screening, it's important to get a retest within 3 months so treatment can begin right away. Treatment for hearing loss can be the most effective if it's started by the time a child is 6 months old.

Kids who seem to have normal hearing should continue to have their hearing evaluated at their annual physical.

If your child seems to have trouble hearing, if speech development seems abnormal, or if your child's speech is difficult to understand, talk with your doctor.

One of the best ways to find a good pediatrician is to do your own personal shopping. We here at Cook Children's appreciate the opportunity to meet future parents of newborns in prenatal consultations so that we can answer your questions and provide important information. It also gives you the chance to make sure you feel comfortable with your baby's doctor and get things set up before you have your baby. Just one less thing to worry about in the busy days following your baby's birth.

To view Cook Children's guide on choosing a pediatrician for your child, click here.

If there is one thing that is most important to pediatricians, it is the concept of prevention. It is really at the heart of just about everything we do. Whether it is counseling about how to keep your child well and safe, or providing life-saving immunizations to prevent serious infectious diseases, we would much rather prevent a disease than have to treat one. Your children are our future and we take keeping them well very seriously!

Our doctors can see and treat minor injuries including lacerations and simple fractures. We can close minor lacerations. We order and interpret x-rays as needed, and direct care for simple orthopedic (bone) injuries. We will help arrange referrals and follow-up for more complicated injuries and issues.

Children, like adults, sometimes have chronic conditions that require ongoing treatment. Sometimes that treatment is provided by the pediatrician and sometimes that treatment is provided by our colleagues in the pediatric specialties. Our state of the art electronic medical record allows us to see who is caring for our patients and what care is being provided. That helps us make sure that of all the care is coordinated and that your child is getting the right treatment at all times.

Dr. Olvera uses the Blomdahl® medical ear piercing system, which is only available to physicians.

Why should I choose medical ear piercing?

In our office, your child will receive professional care from a pediatrician who has been trained in sterile technique and wound management.

The Blomdahl medical ear piercing system uses single-use cassettes, which minimize the chance of infection at the piercing site, and medical-grade plastic or titanium piercing studs, which eliminates the risk of nickel allergy. Using this system also eliminates the possibility of patient-to-patient cross-contamination because only the single-use part of the equipment ever comes in contact with the skin at the piercing site.

What are the age restrictions for ear piecing at your office?

We recommend ear piercing occur between 3 to 9 months for infants and when school-aged children are 6 years old or older. Waiting until children are 3 months old ensures that they have had their first set of vaccines and allows the ear to grow big enough to allow for accurate placement of the earring. We do not recommend ear piercing for children between 9 months and 6 years of age because the child must either be small enough to allow us to completely control her movements during the procedure or cooperative enough to sit still during the procedure and be capable of actively participating in aftercare. All eligible patients must be up-to-date on all vaccines.

Can my child have an ear piercing done during a well-child or sick visit? How much does it cost?

Ear piercings are only done during visits solely dedicated to the medical ear piercing procedure. We do ear piecing by appointment only. This allows enough time to perform the procedure, explain and answer questions about the aftercare. We charge $50.00, or $75.00 with an extra pair of earrings. Because this is a cosmetic procedure, it will not be filed to your insurance.

Where do you pierce?

We only pierce earlobes and only do one piercing per lobe per visit. We do not pierce ear cartilage (the upper part of the ear), noses or belly buttons.

For our adolescent girls and young women, we manage routine gynecological care including menstrual problems, STD testing, and referrals when needed.