Navigating the NICU

No expectant mom wants to imagine bonding with her newborn in a neonatal intensive care unit (NICU) instead of a home nursery.  Diana Bullman was faced with that reality when her daughter Juliet was born prematurely at 30 weeks gestation.  In this CHOC Radio segment, she and Dana Sperling, a CHOC social worker, offer tips to parents who suddenly find themselves and their little one in the NICU.  Some of the advice includes:

  • Rallying friends and family for support, from making meals to babysitting siblings
  • Openly communicating to your spouse and acknowledging difficult moments
  • Educating yourself on the NICU, from understanding the different monitors to knowing shift changes

Hear more from Diana and Dana in this podcast.

CHOC Radio theme music by Pat Jacobs.

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Choosing the Right Pediatrician for your Child


During open enrollment, parents may evaluate their family’s healthcare plan, which can mean searching for new doctors and specialists for their children. Choosing your child’s primary care doctor is important. We spoke to Dr. Dan Mackey, a CHOC Children’s pediatrician, who offered tips to help parents make the right decision for their child.

Importance of a Pediatrician

It’s important for children to see a pediatrician, rather than a family practitioner who may treat older members of the family. A pediatrician is specially trained to care for infants, children and teens.   A pediatrician has graduated from medical school and completed a three-year residency program in pediatrics.  A board-certified pediatrician has passed rigorous exams administered by the American Board of Pediatrics.

Kids are not “little adults.” Different ages can present different illnesses and behavioral problems, which pediatricians are trained to recognize, diagnose and treat. Teens need pediatric care, too. Their bodies are still young and growing, their brains are still developing, and they are not yet ready for adult care, says Mackey.

A pediatrician’s office is generally designed with kids in mind, with waiting areas and exam rooms geared toward making children feel comfortable and engaged. Pediatricians’ office schedules are usually created to accommodate same-day and sick appointments.

In addition to choosing a pediatrician who is in-network with the family’s insurance plan, parents want to make sure the pediatrician is aligned with good pediatric subspecialists and their local children’s hospital.  Other factors to consider include:

  • Bedside manner
  • Interaction with office staff
  • Office hours and ease of scheduling an appointment
  • Medical records: paper or electronic
  • Method of communication with doctor: many offices offer phone, email and an online patient portal

Part of the Family

Having an open dialogue with your child’s pediatrician is important.  Parents shouldn’t shy away from asking questions.

“Being available for questions is important to families,” says Mackey. “A lot of teaching and education goes on over the years as the child grows up. It starts with educating the parent about nursing and nutrition, and continues with discussions about child safety, including issues like discipline and behavior.”

In addition to being a trusted resource on parenting, your child’s pediatrician is someone with whom you will spend a lot of time as your children grow up.

“Hopefully the relationship the family has with the pediatrician becomes a very long and pleasant one that lasts many years,” says Mackey. “Eventually, the pediatrician almost becomes part of the family, and a trusted member to turn to for help and advice. The best part of the job is getting to watch the child grow up.”

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    Ensuring Safe Sleep for Babies

    October is Sudden Infant Death Syndrome (SIDS) Awareness Month, but parents should remember two things year-round to keep babies safe during sleep: babies should sleep alone and on their backs, a CHOC Children’s community educator tells CHOC Radio.

    In podcast No. 36, Amy Frias outlines tips for parents to ensure their child stays safe while sleeping:

    • How to create a safe sleeping environment
    • What to do if the baby rolls onto their tummy

    Printable tip sheets with information to keep children safe while sleeping are also available on CHOC’s website.

    CHOC Radio theme music by Pat Jacobs.

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    Support CHOC, Purchase CHOC Kids’ Cards

    Get a head start on your holiday shopping with CHOC Kids’ Cards — now on sale! CHOC Kids' Cards

    These special greeting cards were created by current and former patients at CHOC Children’s. This year, 12 new fun designs have been added to the collection, ranging from holiday beach scenes to traditional Christmas images. Every day cards are also available.

    Make these cards your own by adding a custom message or company logo. Each box of greeting cards comes with gold seals and white envelopes.

    All proceeds from the sale of these cards support CHOC.

    Learn more, shop now.

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    Frequently Asked Questions: Scheduling an Appointment at CHOC

    CHOC Children’s has more than 500 pediatric specialists in more than 30 specialty areas. As we strive to make the appointment-setting process as easy as possible for parents and referring physicians, we offer the following frequently asked questions.

    Q: How can I be sure my child’s treatment at CHOC is covered by my insurance?

    A: Choose a health insurance plan that has CHOC Children’s in its network when you review health care coverage options for your family. If you have any questions about your coverage, don’t hesitate to contact your insurance provider.

    Q: How do parents make appointments for their children at CHOC?

    A: To make an appointment at CHOC, talk to your child’s primary care doctor (pediatrician) about obtaining a referral. He or she will provide us with your child’s pertinent health records, as well as obtain authorization from your insurance company. Once all documentation has been received, we will call you to schedule your child’s appointment. If you have any questions, please call the Patient Access Center at 888-770-2462 and select “Specialty Care.”

    Q: How quickly can my child be seen by a specialist?

    A: We strive to see all patients in a timely matter and do our best to provide immediate appointments when possible. Some of our services are in high demand by children in our community. For that reason, there may be a delay in the availability of the referred specialist. Urgent conditions require medical review to ensure priority scheduling. Your pediatrician will contact our specialist to determine the best treatment plan for your child.

    Q: Where will my child’s appointment be scheduled?

    A: CHOC specialty services are available at several health centers across Southern California, however, not every specialist sees patients at every location. We will provide you information about your location at the time of scheduling.

    Q: Once I get an appointment, what do I need to bring to my first visit?

    A: Your child’s doctor will provide us your child’s medical records ahead of time. Please bring additional information that you would like us to know, such as medications your child may need that day, a list of questions you may have and any new patient forms that may have been mailed to you. You will also be asked to pay any required co-pays at the time of your visit.

    Q: My child’s pediatrician referred me to a specific specialist. Is this the physician who my child will see?

    A: Specialists work in group practice at CHOC, so your child may be treated by another doctor who works in tandem with the specialist identified by his or her primary care doctor. All of our specialists are specially trained and qualified to provide care for your child.

    Q: Why was my referral not accepted?

    A: Not all medical conditions require specialty care. Our specialists review each referral case, and may determine that a child would be more appropriately treated by his or her primary care physician.

    If you have any additional questions about scheduling an appointment at CHOC, please call the Patient Access Center at 888-770-2462.

    Halloween Safety: Remind kids that medicine is not candy

    Halloween SafetyHalloween is approaching and with it, the customary bags of candy. Children anticipate sweet treats this time of year, which may cause them to mistake medication, not properly stored, for candy. CHOC Children’s pharmacists warn parents to be particularly vigilant this time of year, helping ensure treats don’t turn into “tricks” for little ghosts and goblins.

    Adults should follow these simple medication safety tips:

    • Use the word “medicine,” not “candy,” when talking about medications
    • Store medicine out of the reach of children
    • Do not leave handbags, containing medicine or other potential hazards, on the floor where children can find them
    • Properly close medicine caps on tamper-resistant bottles
    • Read the label before taking or giving medicine
    • Take medicine out of the sight of children, who learn by copying adults
    • Properly dispose of medication. Even expired medications can have harmful effects when taken inappropriately

    More than 50 percent of poison exposures involve medications.

    In any case of possible ingested poison, call the Poison Control Center at (800) 222-1222 and be ready to provide responses to the following:

    • Who took the medicine?
    • What did they take?
    • How much did they take?
    • How long has it been?
    • How are they behaving?

    Call 911 if the person has difficulty breathing or is unresponsive.

    For more information, visit the California Poison Control System website.

    Preparing your child for surgery

    Surgery is scary for kids and parents, alike, but not talking about an upcoming surgical procedure can create more fear and anxiety in children. In episode number 29, Child Life Specialist Brianne Ortiz offers tips for preparing children, from toddlers to teens, for surgery.

    The amount of information, in addition to how and when it’s presented, depends on the emotional and cognitive age of the child. Brianne recommends parents speak to children, ages 3 to 5, approximately three to five days before the scheduled surgery. These younger-aged children often think they’ve done something wrong, so it’s important to reassure them that’s not the case and to present information in concrete terms they understand. She reminds parents that toddlers don’t have a concept of time. Instead of saying a procedure will last an hour, for example, explain that it will be over in about the same time as their favorite TV show.

    Adolescents most often worry about waking up during surgery and about pain. Brianne educates teens on the role of the anesthesiologist and the hospital’s pain scale. She encourages teens to engage with their care team and not be afraid to speak up.

    Listen to the episode for more helpful tips, including resources offered by CHOC.

    CHOC Radio theme music by Pat Jacobs.

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    Will Your Newborn Need Surgery? Plan Now

    The news comes as a shock, usually during the first prenatal ultrasound between the 16th and 20th week of pregnancy. Treatment planning, however, cannot begin too soon when a developing baby is diagnosed with a complex birth defect.


    Some babies are born with complex conditions requiring surgery during the first few hours following birth. From the moment prenatal testing reveals an abnormality, CHOC Children’s is ready to help with the prenatal care and birth planning necessary to ensure the best-possible outcome.

    CHOC has a trained and experienced team that includes perinatologists, neonatologists, pediatric surgeons and NICU nurses to guide families through the months before delivery. And families are essential to the planning process.

    “The well-being of the child is surprisingly dependent on the well-being of the family, both psychologically and emotionally,” said Dr. David Gibbs, division chief, pediatric surgery, CHOC Children’s Specialists. “Preparation helps the family cope better, and the family that is coping better is able to provide better care for their child.”

    According to Dr. Gibbs, recent advances in the care and outlook for babies born with abnormalities have come from closer prenatal coordination with perinatologists and families, combined with highly specialized neonatal intensive care. The CHOC NICU is rated by the American Academy of Pediatrics as a Level 4 NICU, the highest designation available and given only to facilities that also provide onsite surgical repair of serious congenital or acquired malformations.

    That immediate access to the full NICU medical team, resources and support is critical for babies born with gastroschisis, a condition that requires surgery within the first hour following birth, and omphalocele, which must be corrected within the first few days. For the smallest and sickest, CHOC’s Small Baby Unit offers additional support to help babies grow and recover more quickly with fewer infections and setbacks.

    For babies born with congenital diaphragmatic hernia, the CHOC Surgical NICU provides the optimal environment in which to stabilize and gain strength before surgery. One special room inside the CHOC NICU converts into a state-of-the-art operating room, allowing pediatric surgeons to perform delicate procedures within the unit.

    And babies born with congenital cystic adenomatoid malformation (CCAM) may actually get to go home for continued evaluation months before surgery.

    Deciding Where You’ll Deliver

    Dr. Gibbs added that an important element of prenatal planning is deciding in advance where your baby will be born. Moms who know their baby will need surgery may choose to deliver at a hospital that is near a pediatric facility like CHOC. When the baby is born, the CHOC Transport Team is ready 24 hours a day to transport the baby to CHOC from hospitals throughout the region. Specially trained and equipped, this team uses ground and air transportation to travel to and from hospitals throughout Orange, Los Angeles, Riverside, San Bernardino and San Diego counties — and even beyond.

    “We expect most children will do well and have normal lives,” Dr. Gibbs said. “But the first step is meeting with the perinatologist, pediatric surgeon and NICU team. Starting that relationship as soon as possible will make the process of coping with what may seem to be an overwhelming process a lot easier.”

    CHOC’s surgeons provide cardiothoracic surgery, gastrointestinal (GI) surgery, general surgery, neurosurgery, urological surgery, otolaryngological (ENT) surgery, plastic surgery, ophthalmologic surgery and orthopaedic surgery.

    Learn more about surgical services at CHOC.

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    Weight-Related Bullying – Tips Parents Should Know

    Bullying continues to be an unsettling epidemic that’s most apparent in our children’s schools. There are many forms of this negative behavior, but weight is one of the top reasons why some kids get “teased,” a CHOC Children’s pediatric psychologist says.

    “This behavior could lead to eating disorders, such as anorexia or binge eating,” Mery Taylor, PhD explains. “Victims of weight bullying may also develop other mental or health issues, such as anxiety, depression or social isolation.”

    Although bullying can occur with kids of any weight, overweight children tend to be at higher risk for bullying. This can lead to a number of consequences, including a negative body image, she says.

    In recognition of National Bullying Prevention Month, we spoke to Dr. Taylor about ways parents can tackle this issue with their kids.

    Dr. Taylor suggests this three-step approach when dealing with weight-related bullying:

    1)      Assure your child that he is loved. Your child may be feeling unaccepted, unwanted and alone. Remind your child how much you love him and how special he is. Point out the people around him who love him and who value all the positive things about him. Focus on the positives in your child’s life.

    2)      Listen. Sometimes parents want to immediately problem solve. Before any actions are taken, try to connect to your child’s emotions first. Ask your child to tell you in his own words what the issue is. Find out if this is an isolated case, or if it’s a pattern.

    3)      Ask your child: How do you want to handle this? Although you may already have a plan of action in mind, ask your child what he feels comfortable with. This will help you execute your plan. If the bullying is a repeated pattern, you have even more ground to stand on and can take appropriate action. Contact the school and find out possible disciplinary action. If the problem persists, insist on having a meeting with the principal. Let the principal discuss the matter with the other family. It is rarely a good idea to confront the parents of the offending child.

    Dr. Taylor also suggests looking out for changes in your child’s usual behavior, such as getting into fights, changes in sleep or appetite, acting withdrawn, angry or irritable. Sometimes the signs can be subtle, so it’s important to keep an open, honest dialogue with your child and regularly ask him about things going on at school.

    Follows are additional tips to encourage a healthy body image:

    • Promote healthy eating and exercise habits and model this behavior. Depending on the case, this could be an opportunity to talk to your child about a healthier lifestyle.
    • Do not criticize your own body or others’ bodies.
    • Help your child boost his self-esteem by focusing on his talents and positive attributes.
    • Encourage your child to do the things he loves most. This could boost his confidence and help him redirect his focus.
    • Get educated on resources available for families and schools on body image and bullying.

    Learn more about mental health services at CHOC.

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    Tips for coping with hospitalization with Chloe Krikac

    From pet therapy to Seacrest Studios, CHOC Children’s offers a host of amenities to help children cope with their hospitalization. The child life department plays a key role in normalizing the hospital environment by making things like medical equipment and procedures feel less strange.

    In this CHOC Radio segment, Child Life Specialist Chloe Krikac shares a little about the support provided to patients and families, in addition to offering tips to parents. Bringing comfort items, such as a favorite pillowcase or stuffed animal, and family photos is one suggestion Chloe offers parents and caregivers to help children feel more “at home” in the hospital. Although developmental age and health condition impact what information is provided to a child, the approach is the same: making sure patients understand why they are in the hospital and how the doctors and nurses are going to help them get better.

    For more tips, listen to episode number 31 of CHOC Radio.

    CHOC Radio theme music by Pat Jacobs.

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