Frequently Asked Questions

Yes, we always welcome new patients to our practice! Please see the list of insurances that we accept under the "Office Info-Insurances" Menu Tab. If your child is new to the practice and needs a well visit, please note that we need all prior records sent to our office before making your appointment. This gives our doctors adequate time to prepare prior to your appointment. It also allows for us to give an appropriate amount of time for the appointment in case there are additional issues to discuss and make sure that the last well visit has been at least one year prior for insurance purposes. If the entire chart is unavailable in time, we ask that you please have your prior doctors office fax the vaccine records and last well summary to our office in the meantime. Thank you and welcome to Shine Pediatrics!

Yes, in fact we strongly encourage parents-to-be to visit our office for a complimentary meet and greet appointment. This is a great way to get acquainted with our office and our doctors. During this visit, we will answer any questions that you have about our practice or your new child. Visit our expectant parent's page for more information.

Please refer to our Insurance page to review a list of accepted insurance providers.

Yes, we promote breastfeeding. The American Academy of Pediatrics recommends breastfeeding babies for the first six to twelve months. Breastfeeding helps defend children against infections, prevents allergies, and protects against a number of chronic conditions. While experts believe that breast milk is the best nutritional choice for infants, breastfeeding may not be possible for all women.

Some women have specific medical considerations that impede breastfeeding; others choose to feed by formula because of discomfort, work schedule, or lifestyle choices. In these cases, an iron-fortified, milk-based infant formula is a good alternative. We will gladly discuss your diet and feeding concerns at your child's well care visit, or please call during office hours to speak with our experienced medical staff.

To make an appointment please schedule online. To ensure the best use of time, for both our physicians and patients, all of our office visits are by appointment only. We ask that you arrive on time for your scheduled appointment. Arrivals more than 10 minutes late to the scheduled appointment time will be rescheduled. If you must cancel an appointment, please notify us as soon as possible so we can offer that time to someone else.

Emergencies arise. We will advise you if there is going to be a delay in seeing you. If your schedule won't allow you to wait, we will be happy to reschedule your appointment. We do appreciate your patience and cooperation during our busy times and we will make every effort to keep your wait time to a minimum.

Please communicate any refill needs to your primary care provider via online patient portal messaging. Allow one business day for all routine prescription refills. For prescriptions that require prior authorization from your insurance company, please plan ahead to allow at least three to five days for refill approval.

ADHD medications are controlled substances that only allow a 30 day supply at a time. Please message your provider when a refill is needed via the patient portal. Controlled medication refills will only be sent Monday-Friday. 

We have a provider on call 24 hours a day, please call our office and your call will be appropriately routed to our after-hours service. This is for emergency purposes only. Refill of medications and referrals will not get handled after hours.

IN THE EVENT OF A LIFE THREATENING EMERGENCY, CALL 911.

Our routine health maintenance visit schedule follows the American Academy of Pediatrics vaccine guideline for children.

We recommend that your newborn be seen in our office 1-2 days after discharge from the hospital. Our staff understands the importance of this first visit and will make every effort to schedule this visit promptly.

Every effort is made to arrange your child's well care and follow up visits with the provider of your choice. When your child is ill, he or she may see any one of our nurse practitioners.

For non-urgent referrals:  when one of our providers refers you to a specialist, please schedule your appointment with the specialist, then call our office within five business days of your appointment. Your referral will be available within 72 hours. Most referrals are completed electronically and submitted directly to the specialist's office. Please check with our office staff to determine if your insurance plan processes referrals electronically.

For urgent referrals: when one of our providers determines that you need an urgent referral, your referral will be initiated immediately. Please remain in our office while your referral is processed, then proceed to your specialist.

Our office is open Monday through Friday. Limited appointment slots are also available on Saturday. As our daily schedule is subject to change, please refer to our website to confirm office hours. 

To help protect your child from many serious infectious diseases, we follow the immunization schedule recommended by the American Academy of Pediatrics. Please discuss your immunization questions and concerns with any of our pediatric providers.

A pediatrician is a medical doctor who specializes in the care of children. Pediatricians have undergone special training in the health and illnesses of infants, teens and young adults, and the majority of pediatricians are certified by the American Board of Pediatrics after passing a comprehensive exam.

Pediatricians provide preventive health care for children in good health and medical care for children who are acutely or chronically ill. They also provide parents with support and advice with issues such as growth and development, safety and prevention, nutrition, and emotional wellness to foster a lifetime of good health.

As all children are different, we advise following several appropriate steps to advance your child's diet based on age and development. Please discuss these steps with our providers at your well care visit.

Messaging regarding lab results occurs securely through the patient portal, sent to you directly from your provider after review. You may receive a call from your provider with any lab results that require urgent attention.

Immunizations are a series of shots given to children at different ages to help ward off serious, and potentially fatal, childhood diseases. Making sure your child receives immunizations when scheduled is the best way to help protect your child from potentially fatal diseases. According to the American Academy of Pediatrics, vaccinations have reduced the number of infections from vaccine-preventable diseases by more than 90%. If you're apprehensive about vaccinations, please do not hesitate to contact our office.

Sick visits treat many types of injuries and illnesses that need same-day or next-day medical care. Children’s symptoms can change quickly, so don’t hesitate to get in touch with us if your child’s symptoms get worse. Portal messaging is the best way to contact your provider with any questions or concerns.

The following are some of the most common conditions treated during sick visits:

• Flu
• Upper respiratory infections
• Earaches
• Headaches
• Sore throat
• Congestion
• Coughs
• Abdominal pain
• Asthma
• Rashes or hive
• Allergic reactions
• Eye discharge or infection
• Vomiting and/or diarrhea

For any acute injuries requiring suturing or imaging, we do recommend that you proceed to your nearest urgent care or emergency room for treatment.

The goal of a sick child visit is to quickly diagnose the problem and start treatment that will help your child feel more comfortable. In addition to reviewing your child’s symptoms and medical history, a sick visit may include blood tests, a urine test, and a physical exam that includes checking your child’s heart, neck, throat, and ears.

If you’re ever in doubt about whether your child needs a sick visit, contact our office. We will ask a few questions to determine the severity of your child’s symptoms, and then help you decide if/when you need to come into the office.

You can schedule same-day sick visits any time the office is open, which includes every weekday and Saturday by appointment. The best way to schedule appointments is via our website.

While all the conditions often treated during a sick visit have the potential to need immediate care, some symptoms are red flags that your child needs quick medical attention.

Call us immediately for the following symptoms:

• Fever of 100.4ºF or higher in children younger than one-year-old
• Fever that lasts longer than three days
• Unusual symptoms lasting more than three days
• Persistent pain
• Widespread rash Fever of 102ºF or higher plus other symptoms in children over one-year-old

Other symptoms that may appear with a fever that signal a potentially serious problem include a rash, stiff neck, vomiting, and headache.

When your child is sick, contact the office as early in the day as possible so we can schedule a same-day visit if necessary.

If you have questions about your child’s symptoms or you need to schedule a sick visit, contact our office or book an appointment online.

The best way to communicate with your provider about any needs or concerns is via patient portal messaging.

Set a timer for 30 seconds and count the number of times your child’s chest rises. Double that number to get his respiratory rate.

If your baby or has any of the following symptoms, it could mean he’s having trouble breathing- please call us or 911 immediately:

• Bluish color around the mouth
• Pale or gray skin
• A grunting sound with each breath out
• Nose flaring
• Significant wheezing
• Upper chest sinks in with each breath

To take your child's pulse, you will need a watch with a minute hand or stopwatch app (easier) with the minutes and seconds displayed. Find a quiet place where your child can sit or lie comfortably.

If your child has just been active (running, jumping, crying, etc.), wait at least 5 minutes to allow the heart time to slow down and return to a normal beat.

To feel a pulse, you press two fingers — your index ("pointer") and middle fingers — onto a major artery in the body. Press gently. Never press with your thumb, as it has a pulse all its own and can throw off a reading. When you've located the pulse, you will feel a throbbing sensation.

There are several areas on the body to read a pulse, but in kids these are generally the easiest places:

• On the neck (carotid artery pulse). The carotid artery runs along either side of the throat (windpipe). Run your fingers about halfway down the neck and press gently to the left or right side of the windpipe (carefully avoiding the Adam's apple in teen boys). Press gently. You should feel the pulse. If not, try again or on the other side.
• On the wrist (radial pulse). This is the spot where most adults have their pulse taken. It can work well in kids, too. To find the right spot, place a finger at the base of your child's thumb and slide it straight down to the wrist. On the wrist, press gently to feel for the pulse. This works best if your child's hand is lying flat or bent slightly backward.
• In the armpit (axillary pulse). Press your fingertips into the armpit, feeling around for the arm bone. When you feel the arm bone beneath your fingers, you should also feel the pulse. This method works well for infants. · In the crease of the elbow (brachial pulse). This location works best for infants. Place your infant on his or her back with one arm flat along the baby's side (elbow crease facing up). In the crease of the elbow, gently place your fingers on the inside of the arm (the pinky side). Feel around for a pulse. Once you've located the pulse (feeling a "throbbing" or "beating" sensation on your fingers), begin counting the beats within a 30-second timeframe. After 30 seconds, stop. Take the number of beats (for example, 45 beats in a 30-second period) and double it. So:
• 45 x 2 = 90 beats per minute. The heart rate for your child would be 90, which is within the normal range for most kids. (This is just an example; your child's heart rate may be different.)

If you don't feel comfortable taking a pulse this way, or have difficulty, there is another option. Many smartphone apps and Apple watches can give pulse readings simply by pressing a finger over the camera lens or watch. For a good reading, your child needs to be very still, so this method works best in older kids who are more cooperative.

When Does Your Child Have a Fever?

• Rectal, Forehead or Ear temperature: 100.4° F (38.0° C) or higher
• Oral (mouth) temperature: 100° F (37.8° C) or higher
• Under the arm (armpit) temperature: 99° F (37.2° C) or higher
• Caution: Ear temperatures are not accurate before 6 months of age

Where to Take the Temperature

• Rectal temps are the most accurate. Forehead temps are the next most accurate. Oral and ear temps are also accurate if done properly. Temps done in the armpit are the least accurate. Armpit temps are useful for screening at any age.
• Age under 3 months old (90 days old). An armpit temp is the safest and is good for screening. If the armpit temp is above 99° F (37.2° C), re-check it. Use a rectal reading. Reason: If young babies have a fever, they need to see a doctor now. New research shows that forehead temps may also be accurate under 3 months of age.
• Age 3 months to 4 years old. Rectal or forehead temps are accurate. An ear thermometer can be used after 6 months old. An armpit temp is good for screening if it is taken right.
• Age 4 years and older. Safe to take the temp orally (by mouth). Ear and forehead thermometers are also good.
• Digital (electronic) thermometers are easily found in stores. They do not cost very much. They can be used for rectal, armpit and oral temps. Most of them give an accurate temp in 10 seconds or less. The AAP suggests you replace any glass thermometer in the house with one of these products.

Rectal Temperature: How to Take

• Age: Birth to 4 years old
• Have your child lie stomach down on your lap. Another way is on the back with the legs pulled up to the chest.
• Put some petroleum jelly on the end of the thermometer and the anus.
• Slide the thermometer gently into the anus no more than 1 inch. If your child is less than 6 months old, put it in no more than ½ inch. That means until you can no longer see the silver tip.
• Be gentle. There should not be any resistance. If there is, stop.
• Hold your child still. Leave a digital thermometer in until it beeps (about 10 seconds).
• Your child has a fever if the rectal temp is above 100.4° F (38° C).

Armpit Temperature: How to Take

• Age: Any age for screening
• Put the tip of the thermometer in an armpit. Make sure the armpit is dry.
• Close the armpit by holding the elbow against the chest. Do this until it beeps (about 10 seconds). The tip of the thermometer must stay covered by skin.
• Your child has a fever if the armpit temp is above 99.0° F (37.2° C). If you have any doubt, take your child's temp by rectum or forehead.

Oral Temperature: How to Take

• Age: 4 years and older
• If your child had a cold or hot drink, wait 30 minutes.
• Put the thermometer under one side of the tongue towards the back. It's important to put the tip in the right place.
• Have your child hold the thermometer with his lips and fingers. Don't use the teeth to keep in place. Keep the lips sealed until it beeps (about 10 seconds).
• Your child has a fever if the temp is above 100° F (37.8° C).

Digital Pacifier Temperature: How to Take

• Age: Birth to 1 year. Only good for screening. Requires the baby to suck on it, which is not always possible. 
• Have your child suck on the pacifier until it beeps (about 10 seconds).
• Your child has a fever if the pacifier temp is above 100° F (37.8° C).

Ear Temperature: How to Take

• Age: 6 months and older (not accurate before 6 months)
• This thermometer reads the heat waves coming off the eardrum.
• A correct temp depends on pulling the ear backward. Pull back and up if over 1 year old.
• Then aim the tip of the ear probe between the opposite eye and ear.
• Parents like this thermometer because it takes less than 2 seconds. It also does not need the child to cooperate. It does not cause any discomfort.
• Caution. Being outdoors on a cold day will cause a low reading. Your child needs to be inside for 15 minutes before taking the temp. Earwax, ear infections and ear tubes do not keep from getting correct readings.

Forehead (Temporal Artery) Temperature: How to Take

• Age: Any age
• This thermometer reads the heat waves coming off the temporal artery. This blood vessel runs across the forehead just below the skin. 
• Place the sensor head at the center of the forehead.
• Slowly slide the thermometer across the forehead toward the top of the ear. Keep it in contact with the skin. 
• Stop when you reach the hairline. 
• Read your child's temp on the display screen.
• Note: some newer forehead thermometers don't need to slide across the forehead. Follow the box directions on how to take the temp.
• Used in more doctor's offices than any other thermometer.
• Parents like this thermometer because it takes less than 2 seconds. It also does not need the child to cooperate. It does not cause any discomfort.
• Caution: Forehead temperatures must be digital. Forehead strips are not accurate.

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/measuring_children.html

To measure height accurately at home:

1. Remove the child or teen’s shoes, bulky clothing, and hair ornaments, and unbraid hair that interferes with the measurement.
2. Take the height measurement on flooring that is not carpeted and against a flat surface such as a wall with no molding.
3. Have the child or teen stand with feet flat, together, and against the wall. Make sure legs are straight, arms are at sides, and shoulders are level.
4. Make sure the child or teen is looking straight ahead and that the line of sight is parallel with the floor.
5. Take the measurement while the child or teen stands with head, shoulders, buttocks, and heels touching the flat surface (wall). (See illustration.) Depending on the overall body shape of the child or teen, all points may not touch the wall.
6. Use a flat headpiece to form a right angle with the wall and lower the headpiece until it firmly touches the crown of the head.
7. Make sure the measurer’s eyes are at the same level as the headpiece.
8. Lightly mark where the bottom of the headpiece meets the wall. Then, use a metal tape to measure from the base on the floor to the marked measurement on the wall to get the height measurement.
9. Accurately record the height to the nearest 1/8th inch or 0.1 centimeter.

1. Use a digital scale. Avoid using bathroom scales that are spring-loaded. Place the scale on firm flooring (such as tile or wood) rather than carpet.
2. Have the child or teen remove shoes and heavy clothing, such as sweaters.
3. Have the child or teen stand with both feet in the center of the scale.
4. Record the weight to the nearest decimal fraction (for example, 55.5 pounds or 25.1 kilograms).