Forms

Well Visit Handouts

At each well visit we will provide you with a handout of important information that is specific to your child’s age and development. You will receive a hard copy with their growth documented in the office but you can also download them here in PDF format.

Post-Partum Support

Moms Supporting Moms is a community-based resource, and is a “…peer-led, judgment-free support group for women struggling with issues related to pregnancy, delivery and early motherhood.” As it says very appropriately on their website:

“The adjustment to new parenthood sometimes can be difficult. Irritability, anxiety and even sadness over changes in lifestyle can be expected as parents settle into a new routine of caring for an infant.”

If you or someone you care about is having difficulty adjusting to the changes surrounding motherhood, please reach out during your visit to our office to a provider or nurse, or call for guidance.

They can be reached at 919.454.6946 and can found on the web at Moms Supporting Moms.

Flu Season

With the flu season just around the corner, we have a few things to keep in mind.

First, and most importantly, we recommend that all children 6 months and older receive the flu vaccine. This is the best and most effective way to prevent your children from getting the flu. If you haven’t already, please call one of our offices to schedule a nurse visit to receive the flu vaccine. Bear with us as our supplies of the flu vaccine are changing daily.

Tamiflu

At this time of year, we receive lots of letters from urgent care clinics in the area stating that a child has been diagnosed with the flu and been given Tamiflu, usually appropriately, but sometimes inappropriately. Tamiflu is ONLY indicated in children 2 weeks and older who have been symptomatic for LESS THAN 48 hours. When given in the first 48 hours of the illness, Tamiflu has been shown to reduce symptoms by only 1-2 days. Therefore, do not expect your child to improve immediately after being given Tamiflu.   

After 48 hours, there is no evidence that Tamiflu has been shown to be effective and should’t be given unless your child is critically ill from the flu (meaning your child is in the ICU in the hospital). There are only a few, rare, reasons to give Tamiflu to children who have been exposed to influenza. We can explain those situations to you if this case should arise. 

Just like antibiotics, inappropriate use of Tamiflu can lead to increase in resistance, decreasing the effectiveness of Tamiflu. If you have more questions refer to the CDC web site or call our office.

Safety

Ear Piercing

Several of our providers now provide professional ear piercing for our patients.  We prefer to see children from two to six months, and over 8 years of age. Please call our office if you would like to schedule your child’s first ear piercing with us.

General Childcare

Please maintain regular face-to-face contact with us! No website or reference guide can replace personal professional care for your child.

Adolescent Care

As your child moves from elementary school to middle school, their body and interests change, and our parenting changes along with them. As pediatricians, the way we care for your child changes as well. We assess for risky behavior, counsel on safety and discuss a large number of developmentally appropriate topics.

Adolescent Vaccines

As your child moves to middle school, there will be a number of vaccines that we will discuss and recommend:

• Tdap
  Now required by North Carolina before middle school entry, this protects children against tetanus as well as pertussis, or “whooping cough”
• Varicella
  A second dose of this chicken pox vaccine is recommended before adolescence
• HPV/Gardisil
  Protecting against a family of viruses that causes genital warts has also been shown to greatly reduce a young womans chance of getting cervical cancer. It is a three-dose series
• Menactra
  This meningitis vaccine is becoming a required vaccine for college entry. It lasts for at least 10 years, so we are currently giving it in middle school.
• Hepatitis A
  This viral infection leads to vomiting and diarrhea, along with the liver infection. It can be obtained from food contaminated from an infected person or from certain other high-risk behaviors. It is a two-dose series.

Adolescent Safety

It’s never too early to talk to your child about being an adolescent and becoming a young adult. The hardest part is starting the conversation. KidsHealth.org offers some great resources for you and your children to navigate their growth together.

Please take time to check out The Center for Young Women’s Health for valuable information on hundreds of teenage issues your young woman may be facing.

There has been recent concern about a new “game” adolescents play called the choking game. Like any risky behavior, parents need to educate themselves about the signs of such behavior.

Contraception

If you are interested in discussing contraception for your child, we have many providers that are available and willing to discuss the various means of contraception.  We can prescribe oral contraceptive pills and depo injections.  As of September 2015, we have a provider in each office that is qualified to insert the Nexplanon implant.  If you have questions about any of these methods of contraception, please call our office to schedule an appointment.

Transitioning to Adult Care

Perhaps one of the most important things we can teach our children is to prepare them to be an adult.  That includes treating them like an adult in the doctors office.  This means that we will often have conversations with the teenagers in the room by themselves to help them become accustomed to talking with a doctor.  As your children get closer to 21, then we will start preparing the transition to adult medicine, increasing the child’s responsibility in their own care.  The website Got transition, has lots of resources for parents and teens to prepare them for this transition.

Breastfeeding / Lactation Consult

• Please arrive 15 minutes prior to appointment time.
• Please bring a list of questions or concerns you have
• Please bring all items that you use regularly when nursing or pumping. This may include pillows, pumps, shields.
• If you have a support person available to attend, please invite them to join us if you feel comfortable.

Vaccinations

Our Vaccine Policy

We believe in the effectiveness of vaccines to prevent serious illness and to save lives.

We believe in the safety of our vaccines.

We believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

We believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.

We believe that thimerosal, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.

We believe that vaccinating children and young adults may be the single most important health-promoting intervention we perform as health care providers, and that you perform as parents/caregivers.  The recommended vaccines and their schedule are the results of years and years of scientific study and research, with data gathered on millions of children by thousands of our brightest scientists and physicians.

These things being said, we recognize that there has always been and will likely always be controversy surrounding vaccination.

The vaccine campaign is a victim of its own success.  It’s precisely because vaccines are so effective at preventing illness that we even discuss whether or not they should be given.  Because of the safety and effectiveness of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox.

Over the past several years, some people have chosen not to vaccinate their children with the MMR vaccine after publication in Europe of an unfounded suspicion that the vaccine caused autism.  This claim was later discredited and retracted.  Unfortunately, decreased vaccination rates have resulted in a rise in the number of measles cases across Europe.

Please understand that delaying or “breaking up” vaccines to give one or two at a time over several visits goes against expert recommendations and can put your child at risk for serious illness or even death.  Doing these things also goes against our medical advice.

As medical professionals entrusted with the lives of children we believe strongly that vaccinating children on schedule with currently available vaccines is the right thing to do.  With rising rates of pertussis being seen in this country we have made the decision here at Cary, Fuquay, and Apex Pediatrics to require our patients to meet certain vaccine standards to be part of the practice.  This is to protect the health of your child, our patients, and our community.

Finally, if you should refuse to vaccinate your child despite all our efforts and recommendations, we will ask you to find another health care provider who shares your views.

We write this statement not to scare you, nor to coerce you, but to make you aware of the facts, and to emphasize the importance of vaccinating your child.

Please feel free to discuss any questions or concerns you have about vaccines with any one of our providers.  Please also recognize that we will do everything we can to convince you that vaccinating your child according to the recommended schedule is the right thing to do.  It is our job to advocate for children and their health is our priority.

Vaccination Facts from the Centers for Disease Control

Bear in mind that diseases we vaccinate are not gone.  The number of cases of measles last year was more than any single year since the 1990’s; most of the cases in children who have not been vaccinated either because of age or by choice.

See the Downloads list below for fact sheets about each vaccine.