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PEDIATRICS

Frequently Asked Questions

The following signs may suggest the need for immediate attention:

  • Fainting or loss of consciousness or if your child seems confused or disoriented
  • Unexplained seizure
  • Trouble breathing
  • A stiff neck and/or a rash with high fever
  • Loss of consciousness, confusion, headache or vomiting as the result of a head injury
  • A cut that is large or deep
  • Bleeding that won’t stop
  • A large burn, especially if it includes the chest, face, feet, groin or hands
  • Pain that is persistent and/or increases in intensity
  • Fever greater than 100.4 in a baby less than 6 weeks old

If your child is unconscious, a bone is sticking out or the situation seems critical, dial 9-1-1 immediately for an ambulance. When your child’s condition is life threatening or might cause permanent harm, it is safer for your child to be transported via ambulance. If you are calling 911 from a cell phone be prepared to tell them your location and address.

  • Injuries or accidents that may result in a trip to the emergency room:
    • Accidental poisoning including medicines, household cleaners, liquor (this includes beer and wine)
    • Choking, drooling, difficulty breathing
    • Electrical shocks
    • Falls
    • Guns, knives, and other weapons
    • Near drownings
  • 2-5 days old, 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years old and then yearly until they are 18 years old

  • Avoid contact with anyone who has a cold or smokes (secondhand smoke increases kid’s risk of getting sick)
  • Wash hands well and often, especially after nose-blowing and playing with other children
  • Sneeze and cough into shirtsleeves or tissues – not hands

Children can get up to 8 to 10 colds per year, you can help them feel more comfortable with:

  • Acetaminophen or ibuprofen as needed
  • A cool – mist humidifier in your child’s room
  • Thin the mucous with saline nose drops
  • Suction the nose with a bulb suction
  • Make sure they drink lots of liquids
  • Our recommendation is to start solid foods between 4 and 6 months of age. If your baby can sit independently on your lap or in a highchair, he/she is likely ready to start solids. It’s best not to feed your baby in a bouncy chair.
  • Most families start with rice cereal because it is iron rich. Mix the cereal with breast milk, formula, or water. We recommend starting with a midday meal. Once your baby has tolerated the cereal for 2-3 days, you may start to introduce single ingredient purees (fruits/vegetables). You will want to introduce a new puree every 2-3 days. At 6 to 7 months, your baby should be eating twice daily. At 7 months, your baby should be eating three times per day.
  • The meal does not replace a milk feed. It supplements the nursing and/or formula feeding that your baby already enjoys.
  • At your 6 month visit, you can discuss the introduction of table foods that will occur over the next 2-3 months. This will include lentils, beans, tofu, meats and other protein sources. We recommend not introducing dairy products like yogurt and cheese until 12 months of age. Cow’s milk and soy milk are not recommended as a beverage until one year of age.
While fever can be worrisome to parents, it is actually the body’s natural way of dealing with an infection.
First, it’s important to define what fever is. Unfortunately, in popular culture such as movies and television, the temperature 98.6 °F has been ingrained in a lot of minds as the “normal” temperature. As a result, it is common for parents to panic if their child has a temperature of 99 or 100. In actuality, the human body’s core temperature varies from individual to individual from 96.6 – 99.5 °F. In pediatrics, most experienced healthcare providers define fever as a temperature greater or equal to 100.4 °F (38 °C)

Now that fever is well defined, we can discuss what steps are needed if any to take when a child has a fever. This is largely determined by how old a child is. Generally speaking, the younger a child is the more attention fever deserves. Under 3 months of age, fever is considered to be an emergency. At this age, infants’ immune systems are still in the early stages of development. Hence it is important to have your child seen immediately if your newborn or young infant has a temperature greater or equal to 100.4 °F (38 °C) even if it means taking him or her to the emergency room. It is very important to have children in this age group assessed to rule out the possibility of serious infections that can affect their blood streams or central nervous systems.

In older children aged 3 months to about 5 years of age, the definition of fever is the same, but the need for assessing is a little less urgent. Generally, if children in this age group are alert, responsive, make eye contact, do not have severe headache or stiff neck, are not overly lethargic, and can drink small amounts of fluids without vomiting then they can be treated at home supportively with fever medications. Acetaminophen (the generic name for Tylenol) can be given to children of all ages. Ibuprofen (the generic name for Advil and Motrin) can be given to children older than 6 months.

Using both classes of fever medications by alternating one with the other has fallen out of favor in recent years due to increased risk of overdosing one medication or the other. Acetaminophen (Tylenol) should not be given more than 5 times in a 24 hour period as this can cause liver damage. If ibuprofen (Motrin or Advil) is over used it can cause abdominal pain or impact the kidneys. For these reasons, we generally recommend you stick with either acetaminophen or ibuprofen but not both. Also, these medications are based on your child’s weight, so follow the official dosing chart supplied by the drug manufacturer or check with your child’s healthcare provider for dosing. You can also use a cold compress or lukewarm bath to bring down the temperature. Never use ice cold water or put rubbing alcohol in bathwater for fever control as this could be dangerous.

You can treat your child’s symptoms of fever as described above if they appear uncomfortable. However, if they are acting or playing normally during the fever you really do not have to give any medication. Fever is part of the body’s natural defenses against infection. When the body detects an infection, it raises its core temperature to better deal with the infection.

Children six years of age or older are treated similarly to those in the 3 month – 5 years of age group, except that their doses of fever medication will be higher because they weigh more than the previous group. Usually older children are better able to verbalize what may be bothering them. This helps in their assessment and can give parents and healthcare providers a better sense of how urgently they need to be seen.

Severe headache, frequent vomiting, stiff neck, extreme fatigue, difficulty breathing, or confusion are red flags to have your child seen promptly in the emergency room. If your child does not have these signs but is just feeling a bit under the weather, you may be able to treat supportively at home. However, if fever persists for more than 24 hours, we recommend that you bring your child into the office for a sick visit to assess his or her symptoms.

A. Fatiregun, MD

Postpartum Pathways

Human Papilloma Virus (HPV) is the most common sexually transmitted disease in the United States. The virus is spread by vaginal, anal, or oral sex and infects almost 80 million people – both men and women – yearly.  Most of those infected are in their late teens or early twenties.

When certain cells in the cervix, vagina, anus, or back of the throat are infected with HPV, normal cell growth can be affected and cancerous or warty lesions can develop. Each year in the United States nearly 20,000 women and over 12,000 men are affected by cancers caused by HPV. It has also been estimated that about 1% of those who are sexually active can develop genital warts during his or her lifetime. Even more disturbing is the fact that nearly 12,000 women in the United States are diagnosed with cervical cancer yearly and 4,000 women die from this disease annually even with screening and treatment.

In medicine often the most effective means of keeping patients free from disease is prevention, and the best way to prevent HPV and its complications of cancer and genital warts is the HPV vaccine. To date this is the only vaccine released for use in the United States that can directly impact forms of cancer. The Center for Disease Control and the American Academy of Pediatrics recommend that the vaccine be given as early as 11 or 12 as part of the adolescent vaccination schedule. The vaccine garners the best results when it is given before patients are sexually active. If it is started before age 15, it is given as a two shot series 6 months apart. If the vaccine is started after a patient’s 15th birthday, then a three shot series is given over a 6 month period. The vaccine works best when given earlier, but it still affords protection up until age 26 for those who have not been vaccinated.

The HPV vaccine was first used in the United States in 2006. Since its debut, it has been incredibly effective in preventing infection from HPV. It has also demonstrated an excellent safety record. Over 60 million doses of the HPV vaccine have been administered in the United States. Reported side effects include muscle soreness at the site of inoculation, dizziness, fever, and nausea for 1 or 2 days after the vaccine is given. In addition, adolescents who receive the vaccine have been shown to experience fainting. These spells are not unique to the HPV vaccine. Some patients who have blood drawn or receive other vaccines also have similar episodes, but the frequency in young patients who receive the HPV is a bit higher than that of the general population. For this reason it is prudent to have adolescents who receive the HPV vaccine monitored for 15 minutes while seated to avoid injuries that can be caused by falls.

Ultimately, the HPV vaccine is the best weapon in our arsenal against the rampant problem of HPV and its complications in our society. Over the years its impact on cervical cancer has been well documented. However, the HPV vaccine can also greatly reduce the incidence of vulvar cancer, penile, and throat cancer in both sexes. With side effects similar to that of a tetanus shot, improved use of the HPV vaccine in the health of our adolescents and young adults would no doubt go a long way toward controlling the spread of HPV and improving the lives of millions in the United States.

Agboola O. Fatiregun, MD

The American Academy of Pediatrics recommends no juice for children younger than 6 months of age, up to 4-6 ounces daily for children ages 1-6 years and 8-12 ounces for children 7 and older

  • Does MacArthur Medical Center accept Medicaid?
    • MacArthur Medical Center accepts most forms of Medicaid. Our patients come from Irving, Las Colinas, Grand Prairie, Dallas, Hurst, Euless, Bedford, Colleyville, Grapevine, Southlake, Keller, Richland Hills, North Richland Hills, Wataga, Saginaw,  Arlington, Coppell, Mesquite and other areas as well.

Does Macarthur Medical Center accept the Healthy Texas Women Program?

We proudly accept the Healthy Texas Program

 Can I have insurance and medicaid at the same time?

Yes. Your private insurance insurance plan is your primary and your Medicaid plan becomes your secondary insurance. Medicaid will cover charges not covered by your insurance including deductibles and copays.

Who will I see for my visits?

Macarthur Pediatrics is staffed with highly-trained, experienced  Pediatricians and Nurse Practitioners.

Do your doctors speak Spanish?​

Many of our doctors speak Spanish fluently. We also have providers Hindi and Gujarati.

What Can I do to make my visit easier?

As a new patient to our practice, we know the paperwork and forms can be overwhelming. The most important thing you can bring with you to your first appointment is your immunization record.

Why is breastfeeding good for my baby?

Breastfeeding has been shown to stimulate gastrointestinal tract growth motility and help decrease risks of diarrhea, respiratory tract illness, ear infections, and urinary tract infections.

Breastfeeding also provides some lasting effects as infants who are breastfed are less likely to be obese later in life, develop certain cancers, or suffer from diabetes mellitus.

Why is breastfeeding good for me?

Breastfeeding produces a hormone called oxytocin which can accelerate recovery from childbirth.

Breastfeeding also produces prolactin, which combined with prolactin, can have a positive impact on stress and maternal-infant bonding. It can also help enhance weight loss as it burns up to 500 calories a day!

Breastfeeding may also decrease lifetime risk of breast, ovarian, and endometrial cancers.

Breastfeeding may also save you money as it is estimated that the average family will spend about $1000 on formula.

How long should I breastfeed?

The World Health Organization recommends exclusive breastfeeding for 6 months then continued breastfeeding combined with solid foods for 2 years or as long as mother and baby desire. There can be many barriers to this including cultural norms, embarrassment, lactation problems, as well as employment and child care.

How often will I need to breastfeed?

The frequency can be variable and depends on things like maternal milk supply, efficiency of milk transfer, etc but can be as often as every hour. In the first 1-2 weeks after delivery, the average is about 8-12 times a day. In the first week after delivery, moms should wake sleeping infants if they haven’t nursed in the last 4 hours.

Look for nursing cues the signal hunger like movements of hands towards the mouth, and sucking on fingers and fists, Later signs include agitation, flailing of extremities, and loud and persistent crying.

Your pediatrician will keep a close eye on weight gain/loss to ensure adequate intake. They will also provide you with instructions on how to monitor urine output and stool to make sure infant is doing well.

Can everyone breastfeed?

People on certain medications or with certain infections (HIV, Active tuberculosis, or active herpes on the nipple) should not breastfeed. Talk to your doctor about your medications and medical problems to make sure it’s appropriate for you and your child.

Can what you eat and drink affect your breast milk?

A poor diet can hinder breast milk productions while a healthy diet will pass important vitamin and minerals to your baby. It is best to eat a well balanced diet to get these nutrients can you can continue your prenatal vitamin into the post partum period. Women who are vegans should make sure to get enough B12 in their diets

Alcohol does get into breast milk as well. The amount considered to be “safe” is controversial but heavy drinking can be harmful to your infant. If you choose to drink occasionally drink alcohol during lactation, it is reasonable to limit it to 2 ounces of liquor or about 8oz of wine. It would be best to nurse two or more hours after alcohol intake to minimize the amount of alcohol in breast milk.

Some medications are also present in breast milk so review your current medications as well as any new medications to make sure they won’t affect your production or your infant.

It hurts too much to breastfeed! Help!

Breastfeeding shouldn’t be painful. Pain can be due to things like engorged breasts, sore nipples, and mastitis.

Engorgement is when the breast becomes uncomfortably full with milk. Ensure you’re breastfeeding a minimum of eight times every 24 hours. Check that your baby has a good breastfeeding latch. You can massage your breasts gently while feeding to help the milk drain effectively. You can express a little milk, either by hand or with a breast pump before breastfeeding to help soften your nipple so it’s easier for your baby to latch on to. If your baby is unable to breastfeed, you can replace the feeds with expressions. Pump your breasts until they feel much softer – a minimum of eight times every 24 hours. If you’re concerned you’re suffering from breast engorgement, try these things but make sure you notify your provider if you notice skin redness or any fever because it is possible to develop mastitis which is an infection within the breast.

Sore nipples can be due to an improper latch where your baby is biting directly on the nipple rather than having the nipple far back in his or her mouth. First, check baby’s body position. Be sure that he opens his mouth very wide, like a yawn, before you offer your breast, checking to see that his tongue is cupped and forward in his mouth. His lower lip should not be tucked in—it should be fanned outward on the breast. If you gently pull down the corner of the baby’s mouth while he is nursing, you should see the underside of his tongue, which should extend over his lower gum line, cupping the breast. You can also apply lanolin ointment to the areola to prevent cracks and pain.

Painful nipples can also be due to bacterial and yeast infections! If you’re noticing breastfeeding is becoming more painful rather than improving, talk to your provider so that they can do an exam. Some women may need topical medicine to help prevent worsening of skin conditions.

What are other resources?

https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/default.aspx

https://www.llli.org

https://www.ilca.org/main/home

https://www.womenshealth.gov/breastfeeding

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Meet the Providers

DR. NEHAL SHAH

DR. NEHAL SHAH

Pediatrics
DR. AGBOOLA O. FATIREGUN

DR. AGBOOLA O. FATIREGUN

Pediatrics