Ear Piercing

A to Z Resource Guide

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

A to Z Resource Guide

General Childcare

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

Reliable Web Sites

Recommended Reading

  • The Mother’s Almanac, Kelly and Parsons
  • Baby and Child Care, Spock
  • Your Child’s Health, Barton Schmitt
  • AAP Guide to Your Child’s Symptoms, Schiff and Shelov

Adolescent Care

A to Z Resource Guide

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/Gardasil
    Protecting against a family of viruses that causes genital warts has also been shown to greatly reduce a young woman’s chance of getting cervical cancer. It is a two dose series if given before age 14. If a patient gets their first dose at 15 or older, they will get three doses.
  • Menactra
    This meningitis vaccine is becoming a required vaccine for college entry. Patients get their first dose in 7th grade and a booster before their senior year in high 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.

Reliable Web Sites

Recommended Reading

  • Caring for Your Teenager, Greydanus (AAP Publication)

Breastfeeding / Lactation Consult

A to Z Resource Guide

Breastfeeding / Lactation Consult

Andrea Vance is an International Board Certified Lactation Consultant (IBCLC) with a deep passion for supporting families throughout their feeding journey. A North Carolina native, she holds a Bachelor of Science degree in Maternal Child Health and Human Lactation, a foundation that shaped her expertise and inspired her path to becoming an IBCLC.

Married and a mom of three, she loves capturing memories with her camera, exploring the outdoors with her family, and traveling around the world to experience new places and cultures. Andrea understands both professionally and personally how pivotal this chapter of parenthood can be. Through her role with Cary/Fuquay/Apex Pediatrics, she provides evidence based lactation care tailored to the unique needs of each family. Her approach blends clinical knowledge with heartfelt support, making space for both the “science” and the “soul” of early parenthood.

With a strong background in maternal and infant nutrition, infant kinesiology and bodywork, and a specialization in perinatal disorders (PPD), Andrea is dedicated to helping families navigate feeding and parenthood with confidence, comfort, and understanding.

Feeding your baby is more than a task — it’s a bond, a journey, and a chapter worth nurturing. You’re not alone, and Andrea is here to walk beside you every step of the way!

When you schedule an appointment:

  • 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.

Recommended Reading

  • Nursing Your Baby, Pryor
  • New Mother’s Guide to Breastfeeding, AAP, Meek (ed.)
  • A Simple Guide to Breastfeeding, Ewy
  • The Womanly Art of Breastfeeding, La Leche League
  • The Nursing Mother’s Companion, Kathleen Huggins, RN
  • Breastfeeding Mother's Guide to Making More Milk, West & Marasco
  • Mother Multiples, Gromada
  • Adventures in Tandem Nursing , Flower
  • Mothering Your Nursing Toddler, Bumgarner
  • Breastfeeding Your Premature Baby, Gotsch

Vaccinations

A to Z Resource Guide

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 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 that based on all available literature, evidence, and current studies, that vaccines do 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 of robust scientific study and research.

Vaccines are a victim of their own success because they are so effective at preventing illness. Because of the safety and effectiveness of vaccines, many of the younger generations have never seen a child with polio, tetanus, bacterial meningitis, or even chickenpox. Vaccine use is supported and continues to be recommended by the American Academy of Pediatrics (AAP) and numerous infectious disease experts globally.

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. It is our job to advocate for children and their health is our priority.

At Cary, Fuquay-Varina, and Apex Pediatric Centers, our goal is to partner with parents for the long-term health of children and advocate for their protection. As such, we are committed to the use of vaccines and believe strongly that they prevent serious diseases without resulting in significant risks. Thus, we require patients in our practice to be vaccinated according to established standardized immunization policies (see below). If you should refuse to vaccinate your child despite our efforts and recommendations, we will ask you to find another health care provider who shares your views.

If you have more questions, please see our “Vaccine Facts & Perspectives” download below.

TYPICAL VACCINE ADMINISTRATION SCHEDULE:

Birth – 2-Weeks: (1 shot) Hep B

Birth – 8 months: (1 shot) RSV

 2-month series (3 shots):  DTap/IPV/HiB, Pneumococcal, Hep B, and oral Rotavirus

4-month series (2 shots):  DTap/IPV/HiB, Pneumococcal, and oral Rotavirus

6-month series (3 shots):  DTap/IPV/HiB, Pneumococcal, Hep B, and oral Rotavirus

1 year series (4 shots):  MMR, Varicella, Hep A, and Pneumococcal

15-month series (2 shots): DTaP, HiB

18 month (1 shot): Hep A

4-5 years old (2-4 shots depending on combination used): MMR, Varicella, DTaP, IPV

9 – 12 years old: HPV (2 doses needed)

11-12 years old (2 shots):  Tdap, MCV4

16-17 years old:  MCV4, Meningitis B (2 doses needed)

To meet our practice standards, the following are REQUIRED:

1 year standard: Each infant should have 3 doses each of DTaP, IPV, HiB, & Pneumococcal by 1 year of age.

2-year standard:  Each toddler should have the 1-year standard + 1 dose each of MMR, Varicella + boosters of DTaP, HiB, & Pneumococcal (total of 4 each) by 2 years of age

6-year standard:  Each child should have the 2-year standard + boosters of MMR, Varicella, DTaP & IPV.

12-year standard:  Each child should have the 6-year standard, + Tdap booster & MCV4.

17-year standard: Each child should have the 12-year standard + MCV4 booster

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.

Downloads

Reliable Web Sites

Recommended Reading

  • Vaccinating Your Child, Humiston and Good
  • What Every Parent Should Know About Vaccines, Offitt & Bell

Contraception

A to Z Resource Guide

Contraception

At Cary, Fuquay and Apex Pediatrics, we are proud to be following the latest recommendations from the AAP for the most effective adolescent contraception. We offer traditional guidance for birth control, including but not limited to abstinence, condoms, oral contraceptives and Depo Provera.

Nexplanon

Our providers are trained in the insertion of Nexplanon, which is a small, soft, and flexible birth control implant that is just 4 centimeters in length.  It is inserted directly and discretely under the skin on the inside of the arm.  The procedure is quick with minor discomfort and Nexplanon provides up to 3 years of continuous pregnancy prevention.  No daily pills, sticky patches or injections.

Once it is inserted, Nexplanon is over 99% effective.  If you or your teen are interested in Nexplanon or any other form of contraception, ask to schedule a consult with one of our trained providers in ANY of our locations.  We can tell you all about it!

Appointments