Other Services
ADHD/ADD Evaluations
Evaluate And Diagnosis Of Symptoms
Our trained professional staff will do the initial evaluation if you think your child is having problems with focusing and attention. We also continue to treat your child after the initial diagnosis has been made.
The ultimate goal in the treatment of ADHD/ADD is to make your child as successful as possible in all aspects of his/her life.
ADHD FAQs
What is ADHD?
Children with attention-deficit hyperactivity disorder or ADHD have differences in their brains than those who don’t have ADHD. Certain areas of their brain may mature more slowly. Additionally, children with ADHD have imbalances in neural networks and neurotransmitters, the chemicals that nerves use to communicate.
Knowing that ADHD has a neurological basis is important because it helps parents understand that their child isn’t disobedient or oppositional on purpose. Instead, children with ADHD need help to learn to control their behavior.
The brain differences are also important because they occur in specific areas responsible for skills such as self-regulation, organization, working memory, problem-solving, reasoning, and time perception. The brain areas affected determine your child’s ADHD symptoms.
What symptoms develop due to ADHD?
ADHD symptoms fall into three categories: inattentiveness, hyperactivity, and impulsivity. Some children may only struggle with inattention, while others have trouble with two or three categories.
Each child has a different range and severity of symptoms. However, their symptoms are severe enough to affect their performance at school, at home, and when socializing.
When children struggle with inattention, they:
- Can’t pay attention at school or while playing
- Have difficulty organizing tasks
- Avoid tasks requiring mental effort
- Lose important items
- Forget to do homework and chores
When children struggle with hyperactivity and impulsivity, they:
- Fidget, squirm, or get out of their seat during class
- Run or climb when it’s inappropriate
- Talk excessively and interrupt conversations
- Have a hard time waiting for their turn
- Act or speak without thinking
Children and adolescents with ADHD also have problems with working memory. Working memory allows them to hold several pieces of information in their head long enough to use them to plan, do calculations, or to coordinate one activity with another.
How do you diagnose and treat ADHD?
To evaluate and diagnose ADHD, our professional team use tools such as a checklist of symptoms, talking with parents and children about their challenges, and questionnaires completed by parents and teachers. Your child also has a thorough physical exam to be sure another problem is not the cause of their symptoms.
Once your child has an ADHD diagnosis, their pediatrician at our office may prescribe treatment and schedules regular follow-up appointments to monitor their progress.
In addition to a medication discussion, your pediatrician may also encourage you to seek executive functioning support and counseling through your child's school or an outside agency. This support can help your child develop the executive functioning skills needed to overcome many challenges with ADHD.
Your pediatrician may also encourage you to seek further evaluations like a neuropsychological evaluation or a psychiatric evaluation with colleagues in the Behavior Health field.
If you or your child’s teacher are concerned about your child’s inattentive, hyperactive, or impulsive behaviors, call our office to schedule an ADHD evaluation.
If we ask you to complete Vanderbilt forms you can find them here: Vanderbilt Forms
Asthma Care
Asthma & Allergy Management
Our practice provides a comprehensive asthma and allergy management program for our patients. Our pediatricians are trained in the diagnosis and management of childhood asthma and allergies. Diagnosis is usually made during a sick visit when a child is wheezing or exhibiting symptoms of allergies. Occasionally, we may diagnose your child with asthma or allergies during a preventive care visit based on patient or parent concerns or our exam findings.
Asthma Education
We teach about environmental controls and avoidance of triggers. We also watch your child using his/her inhaler to confirm it is being used correctly. Information about caring for the medication devices that your child uses is provided and reviewed at every visit. We will provide an Asthma Action Plan for your child for school and will provide a Food Allergy Action Plan if needed.
Maintence Visits
Children with asthma should be seen in our office every 3-12 months depending on their severity of illness and their asthma control. Regular visits are required in order for us to evaluate your child prior to medication refills.
Helpful Resources:
Asthma in Children (Boston Children's)
How To's of Asthma Devices and Allergy Devices (Boston Children's YouTube Videos)
How to Use a Nebulizer with Facemask - video
How to Use a Nebulizer with Facemask - PDF Download
How to Use a Nebulizer with Mouthpiece - video
How to Use a Nebulizer with Mouthpiece - PDF Download
How to Use a Diskus Inhaler - video
How to Use a Diskus Inhaler - PDF Download
How to Use a Pulmicort Flexhaler - video
How to Use a Pulmicort Flexhaler - PDF Download
How to Use a Metered Dose Inhaler (MDI) with Spacer and Facemask - video
How to Use a Metered Dose Inhaler (MDI) with Spacer and Faskmask - PDF Download
How to Use a Metered Dose Inhaler (MDI) with Spacer and a Mouthpiece - video
How to Use a Metered Dose Inhaler (MDI) with Spacer and a Mouthpiece - PDF Download
How to Use an ASMANEX Twisthaler inhaler - video
How to Use an ASMANEX Twisthaler inhaler - PDF Download
How to Use a Qvar RediHaler - video
How to Use a Qvar RediHaler - PDF Download
Chronic Care Management
We are here to support you!
If your child has a disability or a chronic illness, your journey may feel like the road less traveled. You probably have interactions with many different professionals and specialists. You need information, assistance, understanding, and support.
We're here to help.
If your child has significant medical needs, we will partner with you to help you manage your child's condition. We look forward to getting to know you and your child, and will be your dedicated point of contact through this journey.
Fluoride Varnish
In An Effort To Provide The Best Possible Care For Our Patients
Beacon Pediatrics offers fluoride varnish to all eligible children starting at the 6 month old well child check and going every 3 months at regulalry scheduled physicals until the child establishes care with a dentist.
What is fluoride varnish?
Fluoride varnish (5% sodium fluoride) is used to prevent tooth decay. It lowers cavity causing oral bacterial levels and repairs and strengthens teeth. Fluoride varnish is a topical application and not considered systemic. It is endorsed by the American Dental Association, American Academy of Pediatrics and American Academy of Family Practice. The United States Preventive Services Task Force has proposed the application of fluoride varnish by medical providers.
Is fluoride varnish safe?
Yes! Fluoride varnish can be used on babies from the time that they have their first tooth (around six months of age). Fluoride varnish has been used to prevent cavities in children in Europe for more than 25 years. It is approved by the FDA and is supported by the American Dental Association.
What do I need to know about fluoride varnish?
In brief, it is safe and effective and can be quickly applied to the teeth. Infants and children can eat and drink shortly after application. The main purpose is to strengthen the enamel of the teeth and helps reduce the incidence of cavities by 30-35% and can even reverse early cavity formation.
Is there anyone that cannot get fluoride varnish?
Although rare, children with allergies to colophony (colophonuim) and pine nuts could have allergic reactions to fluoride varnish.
How is fluoride varnish put on my child’s teeth?
The varnish is painted on the teeth. It is quick and easy to apply and does not have a bad taste. There is no pain, but your child may cry just because babies and children don’t like having things put into their mouths by other people. Your child’s teeth may be a little bit yellow after the fluoride varnish is painted on, but this color will come off over the next few days.
How long does the fluoride varnish need to be applied?
The fluoride coating works best if painted on the teeth two to four times a year.
What is the cost?
Since this is recommendation from the US Preventive Services Task Force starting in May of 2015, most insurances will pay for the preventative care maintenance up to 4 times per year; however, some insurance companies are only paying for a once a year application. We would ask that you check with your insurance company if they do not cover these services. Please call our billing department if there are any outstanding questions.
What do I do after the varnish is put on my child’s teeth?
The physician will give you information about how to take care of your child’s teeth after the fluoride varnish is applied. Your child may not be allowed to eat or drink for a short time. Do not give him or her sticky or hard food until the next day. It is okay to get another varnish treatment after three months (with your dentist) or sooner if recommended. This treatment does not replace brushing your child’s teeth or taking a fluoride supplement.
Does fluoride varnish cause fluorosis?
No. Fluorosis is caused by long term over-exposure to fluoride. Fluorosis is caused by children who consume too much fluoride on an ongoing basis. For example, using excessive amounts of toothpaste or using fluoride tablets when their water supply is fluoridated. Per the Centers for Disease Control and Prevention, no published evidence indicates that professionally applied fluoride varnish is a risk factor for dental fluorosis, even among children younger than six years of age. Proper application technique reduces the possibility that a patient will swallow varnish during its application and limits the total amount of fluoride swallowed as the varnish wears off the teeth over several hours.
Adapted from the Fluoride Varnish Training Manual for Massachusetts Heath Care Professionals, 2017
Lactation Support
Breastfeeding Support
Breastfeeding provides essential nutrition for infants birth to one year and older. As with learning anything new, most breastfeeding mothers and babies (and dads too!) need some instruction and support during this learning period.
That's where we come in!
- We have a high number of breastfeeding families. We will do our best to help you meet your breastfeeding goals. Any breast milk you feed your infant is a gift of health for your child that lasts their lifetime.
- We respect each family's feeding decisions. We do encourage moms to breastfeed or pump and feed breast milk for the first four months, then continue to breastfeed and give solid foods until your baby is a year old. For parents not offering human milk, infant formula is a safe and nutritious solution. Commercially available infant formulas are strictly regulated by the Food and Drug Administration. They mimic the nutritional components of human milk and come in a variety of baby-friendly options. Regardless of which type of feeding plan works best, every parent’s decision represents careful thought that deserves the unquestionable support that we pledge to give to all of our families.
Lactation Support Services:
South Shore Health Warm Line
- Phone: 781-624-8602 (lactation specialist will call back within 24 hours)
New England Mothers First
- Phone: 508-921-4157 (home visits for lactation)
- Website: www.newenglandmothersfirst.com
Yvonne Maalouf, IBCLC
Lactation Consultants of the South Shore
- Conact: Lynn Ricardo, RN, IBCLC, LLC
- Phone: 508-944-5129
General Breast Feeding Advice
Things to Remember:
As much skin to skin time as you can do. It is really great for both you and the baby!
Look for those early feeding cues:
- Eyes moving under the eyelids
- Mouthing (making kissy faces)
- Rooting (turning the head and opening the mouth)
- Ringing the hand to the mouth
- Late feeding cue is crying
Babies nurse a lot, especially in the beginning! When the baby shows any of these signs of being hungry try to breastfeed. Breastfeeding should be on demand - this won't be forever!
Breast-Fed babies should usually feed about 10-15 minutes at each breast during each feeding, and should be offered both breasts at every feeding. Breast-fed babies should nurse as often as every 2-3 hours, and at least 8-10 times in a 24hr period, and not go without nursing longer than one 4-5 hour stretch per day. This means you should be nursing around the clock- to ensure your breasts are getting enough stimulus to keep up an adequate supply, and give your baby enough to eat. Breast milk is rapidly digested and meals need to be frequent.
You will know your baby is getting enough to eat if he is having 4-6 palm-sized (adult palm size) stools per day.
The only vitamin your baby will need in addition to your breast milk is Vitamin D. Adequate amounts can be found in one dropper per day of D-Visol, Tri-visol or Poly-Visol or 1 drop per day of "D-Drops". Breast feeding mothers should continue to take their prenatal vitamins.
Get Into Position:
- Baby's nose is opposite your nipple
- Baby's body is at the same height as your nipple - you and your baby should be tummy to tummy
- Baby's head can extend back, allowing the widest possible mouth opening -- this means place your hand at the base of your baby's head so you can support the baby's upper back and the bottom of the baby's head
Get A Good Latch:
- Touch the babies nose with your nipple (using the arm that supports the baby)
- Move the baby's back until the mouth opens WIDE
- Move the baby forward so that the tongue and lower lip seal first and then the upper lip
- The baby's mouth will appear off-center when compared to the areola (the darker skin around the nipple)
Signs Your Baby Is Full:
Your baby is:
- Relaxed
- Hands are open (not clenched in a little fist)
- Arms are floppy
- Brow is smooth
- Toes are curled
- A baby doesn't always burp after breast feeding - unlike a bottle there isn't any air in breast milk coming out of a breast so unless your baby gulps a lot, s/he may not burp so don't stress if you can't get a burp out all the time.
Pumping:
- If you are going back to work remember you only need enough pumped breast milk to cover the first day at work. You will pump while you are away and be able to give that to the baby the next day
- POWER PUMPING: if you are worried about your supply at all, you can power pump -- ideally you pump until the milk stops flowing or slows down, then stop the pump for 2 minutes, pump for 5 minutes, stop for 2 and pump for 5 - it doesn't matter if milk is coming out or not this is about stimulating your body to make more milk
- Your body naturally makes the most milk in the morning, so this is a good time to pump for storage, feed you baby and then pump right afterwards, over time your body will increase how much milk it is making and you will be able to store it.
- Some accessories that are completely optional but I found helpful - car adapter, and nipples that go on the top of the bottles that you pump into (so you can pump and just use that container to give a bottle - cuts down on what you have to carry!)
Storage:
- "rule of 4's" -- can store breast mill at room temperature for 4 hours, fridge for 4 days, regular freezer (attached to fridge) for 4-6 months ("deep" freezer okay for 6-12 months)
- Bags work great, (The First Years brand are less expensive and work well)
- Fill the bag to the 4 oz line, push all the air out, write the expiration date on the top (4 months from today)
- Freeze! (freezing the packages on a cookie sheet will make them nice and flat, there is a milk storage bag dispenser, "The First Years Milk Storage Dispenser", it keeps the breast milk organized so you don't lose any bags in your freezer and you are using the oldest frozen milk so it doesn't expire - another optional accessory that I found helpful). **REMINDER-- DO NOT REFREEZE THAWED MILK**
Using Frozen Milk:
- Just put bag in a bowl full of hot tap water DO NOT MICROWAVE
- You just need it to have the chill off
- Make sure to test it and swirl it to make sure it isn't too hot and there aren't any hot spots
- Do not re-freeze thawed milk!!!! This can expose your child to potentially harmful bacteria.
- Remember your breast milk is constantly changing, you body is making higher calorie milk to support the growth of you baby, so sometimes when you are using older breast milk it is lower calorie and the baby may want a little more than they normally need
Information About Medications and Breastfeeding
You have to be careful when taking any medication (over the counter, herbal or prescription) and nursing. When in doubt check it out! There is actually a hotline you can call to ask!
- Infant Risk Center: 806-352-2519 (provides up-to-date evidence based information on the use of medications during pregnancy and breastfeeding)
For moms that would like to donate breast milk or to request donor breast milk, please see the Mother's Milk Bank Northeast at milkbankne.org
Call your child's healthcare provider if:
Your baby develops a fever (rectal temperature equal to or greater than 100.4 F). Please call us at ANY time of the day if your child has a fever as it will need prompt evaluation and treatment. (This is true for all babies 0-8 weeks of age; for babies older than 8 weeks of age, evaluation can usually wait until regular office hours, as long as the baby is alert and responsive).
Your child is very irritable and you cannot calm him after 1/2- 1 hour.
(Above breastfeeding tips are from Molly Mazanac, NP-- Pediatric Nurse Practioner and mom of many!!)
Newborn Care
Newborn Care Begins From The Moment Your Baby Arrives
Newborn Care FAQs
When does my newborn have their first checkup?
Your new baby has their first checkup within a few days after leaving the hospital. During this newborn care visit, their pediatrician reviews the birth history, performs a weight check, discusses routine newborn care, and answers all of your questions... bring a list!! Also, please be sure to bring all documentation from your delivery and hospital stay.
Your newborn’s checkup is a comprehensive exam to be sure they’re growing and developing normally. During the checkup, the pediatrician:
- Checks your baby’s weight, length, and head circumference
- Evaluates your baby’s feeding, bowel, and sleeping habits
- Does a physical examination, including an eye exam
- Performs a developmental evaluation
These visits also give parents time to ask questions about their baby, whether they’re not sure about how to bathe the baby, they have trouble with feeding, they’re worried about the baby’s sleep schedule, or any other concerns.
What screenings does newborn care include?
In Massachusetts, your newborn nursery team screens for genetic and rare medical conditions, including 32 core and 24 secondary conditions. The goal is to identify and treat diseases early enough to prevent serious complications such as growth problems, developmental delays, intellectual disabilities, blindness, deafness, and seizures.
Within the first 24 hours after delivery, your newborn has a hearing screening, and blood is drawn from their heel to run the routine screening tests.
What are well-child visits?
Well-child visits are ongoing checkups for children that follow a specific schedule. After the intital newborn appointment (2-3 days after delivery), your newborn should see the pediatrician at 2 weeks, 1 month and 2 months.
During each visit, their pediatrician will evaluate their growth, developmental milestones, and behaviors. If your baby needs routine blood draws, they can also be done in the office.
Just like the initial newborn care visit, every well-child checkup is an opportunity to talk with the pediatrician about baby care and your baby’s health and safety.
Your pediatrician also gives immunizations at the two-month visit to protect your baby from:
- Polio
- Hepatitis B
- Rotavirus
- Diphtheria
- Haemophilus Influenzae
- Pneumococcus
Small doses of the same immunizations are repeated several times over the first 18 months to be sure your infant is fully immunized against contagious diseases.
