Children's Healthcare Medical Associates  
Frequently Asked Questions
Frequently Asked Questions

Toys NOT to Buy your Children:

Baby Alive: The concept of these adorable babies should be commended but they can be problematic for asthmatics. They've received reviews for attracting an abnormal amount of dust, ingested food getting stuck inside the body cavity and molding and the paint easily chipping off (within the 1st hour of play). Not to mention Baby Alive's frequent diaper leaks and occasionally waking during the night to talk is just a nuisance ... wow, she is alive.

Rainforest Playard: There have been over 1,350 reports of one or more of the side rails falling resulting in chipped teeth, a mild concussion, a broken nose, a broken wrist and numerous bumps and bruises. With those incidents, Fisher Price agreed to recall the playard recently on Jan 16. Fisher Price is offering a refund for the returned side panels to encourage buyers to stop using.

Sportsman Shotgun: Kids playing with waterguns is one thing but this realistic shot gun is another. Aside from kids playing with guns (even toy ones), this realistic shotgun could be dangerously mistaken for the real thing.

Smash Hands: Encourages kids to hit/smash things including people, pets and items which could result in serious bodily injury.

Fun Roller: Looks like so much fun, right? Wrong. Imagine this rolling into a tree or even worse -- into the street.

Lite Brite: An ol' school favorite gets an update but still feature those tiny plastic pegs. Although they spark a child's creativity and imagination, small parts can pose as a choking hazard.

Basketball Hoop: Tipping hazard and could run into pole on fast breaks unlike the wall mounted versions. Also, consider where this would likely be used if you don't have a driveway. If the street or parking lot sounds like a good idea, think again -- reports of small children being hit by cars backing out of parking spaces.

Baby Walker: Potential to roll down steps or into things that could fall over on the unsuspecting child. Also, if not properly locked in place, it could collapse with child inside.

Trampoline: Besides falling off and causing serious bodily injury, the safety net could pose as an entrapment issue.

Solitaire Peg Board: Choking hazard and sharp peg ends can lead to lacerations.

Aqua Roller: The Fun Roller's cousin but with the added element of water and mesh closures to handle up to 5 kids at a time, this becomes and instant kid trap.

As of January 1, 2008, all children 4 years of age and older who have not had naturally-acquired Chicken Pox should receive a booster vaccine to provide improved protection against this common childhood illness. All health insurers now pay for this vaccine.

Please call the office to schedule a "nurse's clinic" visit for your child(ren), or if you have questions about this new recommendation.

The American Academy of Pediatrics now strongly recommends a pre-teen Well-Child-Care visit for all 11 and 12 year olds. In addition to a complete patient history and physical exam, vision and hearing screeings, and urinalysis, the pre-teen visit will provide several newly recommended vaccines:

1) Menactra, a vaccine to prevent a life-threatening bacterial infection of the spinal fluid that currounds the brain and spinal cord.

2) TdaP (Tetanus, Diphtheria, and Pertussis [whooping cough]) -- the pre-middle-school Tetanus booster vaccine has been expanded to include a booster for Whooping Cough. Most adolescents and adults have lost their protection from their infant Whooping Cough vaccines by age 10 years.

3) Human Papilloma Virus Vaccine -- a new (in 2006) vaccine (exclusively for females ages 11 - 26 years) This vaccine provides excellent protection against the Sexually Transmitted Infection known as Venereal Warts, which are the underlying cause of 90% of all cervical cancers.

Please call our office if you have questions.


September is:

 * * * Children's Good Manners Month * * * (see below)

* * * National Childhood Injury Prevention Month * * *
* * * Family Meal Month * * *
* * * Baby Safety Month * * *] 
 * * * Backpack Safety Awareness Month * * *
* * * Attention Deficit Hyperactivity Disorder Month * * *
 * * * School Success Month * * *
 * * * Pediatric Cancer Awareness Month * * *
* * * National Skin Care Awareness Month * * *
 * * * Sports and Home Eye Health & Safety Month * * *
 * * * National Pediculosis (Lice) Prevention Month * * *

September 1 - 7 -- National Childhood Injury Prevention Week [] September 14 - 20 -- Substitute Teacher Appreciation Week September 19 - 25 -- National Baby Safety Week September 20 - 26 -- Child Passenger Safety Week; National Keep Kids Creative Week; Deaf Awareness Week; Adult Immunization Awareness Week September 8 -- International Literacy Day ( September 12 -- Video Games Day September 13 -- International Chocolate Day; National Grandparents' Day ( September 19 -- Wife Appreciation Day; America's Day for Kids September 24 -- Single Parent Family Day; Family Table Day - A Day to Eat with your Children September 26 -- R.E.A.D. in America Day; Family Health & Fitness Day USA; Kiwanis Kids Day 


AUGUST IS NATIONAL IMMUNIZATION AWARENESS MONTH The National Partnership for Immunization (NPI)--of which the American Academy of Pediatrics is a member--encourages greater acceptance and use of immunization for all ages through partnerships with public and private organizations. August 2008 has been designated as National Immunization Awareness Month (NIAM). Each year, this commemorative month strives to increase immunization awareness as parents and children prepare for the return to school, and the medical community prepares for the upcoming flu season. For more information on NPI and NIAM:


GRANDPARENTS' DAY Sunday, September 7th, is Grandparents' Day. Please join our staff in wishing a healthy and wonderful day to all Grandparents (and Great-Grandparents, too) of our practice. We hope they still have lots of time and energy to keep up with those active grandchildren. ( -


International Literacy Day is celebrated each year on September 8th. International Literacy Day was first observed on September 8, 1967. The aim of International Literacy Day is to focus attention on the need to promote worldwide literacy. It is estimated that 860 million of the world?s adults do not know how to read or write (nearly two-thirds of this number are women), and that more than 100 million children lack access to education. On International Literacy Day, individuals, organizations, and countries throughout the world renew their efforts to promote literacy and demonstrate their commitment to providing education for all. The United Nations Educational, Scientific, and Cultural Organization (UNESCO) is the founder of International Literacy Day, and is responsible for appointing a jury to award international literacy prizes. Four literacy prizes are awarded annually on International Literacy Day. They are: The International Reading Association Literacy Award, the Noma Literacy Prize, and two King Sejong Literacy Prizes. The International Reading Association has sponsored the International Reading Association Literacy Award since 1979. The award is presented at the UNESCO celebration of International Literacy Day. As part of a network of literacy organizations, the International Reading Association cosponsors an annual celebration of International Literacy Day, which typically includes featured speakers, representatives from a wide range of governmental and nongovernmental institutions, members of the press, and invited guests. State and provincial councils and national affiliates of the International Reading Association often sponsor International Literacy Day activities and celebrations. Because International Literacy Day coincides with the beginning of a new school year in many countries, classroom teachers use this day to recognize the importance of literacy in the lives of both children and adults. (


 Kindergarten Readiness Checklist This checklist is designed to help you prepare your child for school. Before you begin, remember: * You are your child's first and most important teacher. * Every day your child is learning as you talk, play, and work together. * Readiness is a combination of age, individual growth, and experience. * Your child will develop at his or her own rate; however, your involvement will promote readiness. * Your child will learn by doing. * Play is an essential part of learning. * Your child learns best when he or she is involved in activities that are interesting and fun. The checklist is designed to help you look at your child's physical, social, emotional, and cognitive development. This checklist includes tips to help guide you as you work and play with your child, and items that are important to your child's success in kindergarten. It is designed for four- and five-year-olds. The criteria for many items on the checklist should not be applied to children three years old or younger. Part 1: Concept Development Does your child: recognize and/or name colors? match or sort items by color and shape? participate in art and music activities? understand concepts such as: in, out, under, on, off, front, and back? know her/his body parts (head, shoulder, knees, etc.)? draw a picture of her/himself including head, body, arms, and legs? demonstrate curiosity, persistence, and exploratory behavior? Here are some tips for helping young children construct their own understanding of concepts as they interact and work with materials, people, events, and ideas: Provide age appropriate toys that require thinking. This includes puzzles, blocks, or sorting toys. Save scraps, bits, boxes, and other things from around the house to use for creative experiences. Count objects around the house, such as plates and forks for the table, and crackers for snacks. Play games with your child using words such as: "Put the ball on the chair" and "Get the pot from under the sink." Play Simon Says. For example: Simon says, "Put your hands under your feet." Simon says, "Put your hands over your head." Part 2: Number Concept Development Does your child: arrange items in groups according to size, shape, or color? group items that are the same? arrange toys or objects in size order, big to small or small to big? use words like bigger, smaller, or heaviest to show comparison? compare the size of groups of toys or items? correctly count four to ten objects? show an understanding of the passing of time? The development of number concepts?classifying, ordering, counting, and time and space relationships?is directly related to children's ability to perform mathematical tasks throughout their school years and the rest of their lives. It is important to help young children feel confident in dealing with number tasks. Here are some tips for parents: Let your child set the table ("How many forks do we need?" "How many chairs?" Provide opportunities to put away groceries. Provide opportunities to compare objects. Set up a routine or sequence for personal care. Provide objects or toys for play. [AOL Parenting 2007]


 Back to School Tips MAKING THE FIRST DAY EASIER Remind your child that she is not the only student who is a bit uneasy about the first day of school. Teachers know that students are anxious and will make an extra effort to make sure everyone feels as comfortable as possible. Point out the positive aspects of starting school: It will be fun. She'll see old friends and meet new ones. Refresh her memory about previous years, when she may have returned home after the first day with high spirits because she had a good time. Find another child in the neighborhood with whom your youngster can walk to school or ride with on the bus. If you feel it is appropriate, drive your child (or walk with her) to school and pick her up on the first day.

 BACKPACK SAFETY Choose a backpack with wide, padded shoulder straps and a padded back. Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of the student's body weight. Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may also increase curvature of the spine. Consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs, and they may be difficult to roll in snow.

TRAVELLING TO AND FROM SCHOOL Review the basic rules with your youngster: School Bus Wait for the bus to stop before approaching it from the curb. Do not move around on the bus. Check to see that no other traffic is coming before crossing. Make sure to always remain in clear view of the bus driver. Car All passengers should wear a seat belt and/or an age- and size-appropriate car safety seat or booster seat. Your child should ride in a car safety seat with a harness as long as possible and then ride in a belt-positioning booster seat. Your child is ready for a booster seat when she has reached the top weight or height allowed for her seat, her shoulders are above the top harness slots, or her ears have reached the top of the seat. Your child should ride in a belt-positioning booster seat until the vehicle's seat belt fits properly (usually when the child reaches about 4' 9" in height and is between 8 to 12 years of age). This means the shoulder belt lies across the middle of the chest and shoulder, not the neck or throat; the lap belt is low and snug across the thighs, not the stomach; and the child is tall enough to sit against the vehicle seat back with her legs bent at the knees and feet hanging down. All children under 13 years of age should ride in the rear seat of vehicles. Remember that many crashes occur while novice teen drivers are going to and from school. You may want to limit the number of teen passengers to prevent driver distraction. Do not allow your teen to drive while eating, drinking, or talking on a cell phone.

BIKE Always wear a bicycle helmet, no matter how short or long the ride. Ride on the right, in the same direction as auto traffic. Use appropriate hand signals. Respect traffic lights and stop signs. Wear bright color clothing to increase visibility. Know the "rules of the road, which can be found at

WALKING TO SCHOOL Make sure your child's walk to a school is a safe route with well-trained adult crossing guards at every intersection. Be realistic about your child's pedestrian skills. Because small children are impulsive and less cautious around traffic, carefully consider whether or not your child is ready to walk to school without adult supervision. Bright colored clothing will make your child more visible to drivers.

 EATING DURING THE SCHOOL DAY Most schools regularly send schedules of cafeteria menus home. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat. Try to get your child's school to stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice in the vending machines. Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child's risk of obesity by 60 percent. Restrict your child's soft drink consumption.

BULLYING Bullying is when one child picks on another child repeatedly. Usually children being bullied are either weaker or smaller, shy, and generally feel helpless. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood, or over the Internet. When Your Child Is Bullied Help your child learn how to respond by teaching your child how to: Look the bully in the eye. Stand tall and stay calm in a difficult situation. Walk away. Teach your child how to say in a firm voice. "I don't like what you are doing." "Please do NOT talk to me like that." "Why would you say that?" Teach your child when and how to ask for help. Encourage your child to make friends with other children. Support activities that interest your child. Alert school officials to the problems and work with them on solutions. Make sure an adult who knows about the bullying can watch out for your child's safety and well-being when you cannot be there. When Your Child Is the Bully Be sure your child knows that bullying is never OK. Set firm and consistent limits on your child's aggressive behavior. Be a positive role mode. Show children they can get what they want without teasing, threatening or hurting someone. Use effective, non-physical discipline, such as loss of privileges. Develop practical solutions with the school principal, teachers, counselors, and parents of the children your child has bullied. When Your Child Is a Bystander Tell your child not to cheer on or even quietly watch bullying. Encourage your child to tell a trusted adult about the bullying. Help your child support other children who may be bullied. Encourage your child to include these children in activities. Encourage your child to join with others in telling bullies to stop.

BEFORE & AFTER SCHOOL CARE During middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning and watch over them after school until you return home from work. Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age. If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone. If you choose a commercial after-school program, inquire about the training of the staff. There should be a high staff-to-child ratio, and the rooms and the playground should be safe.

DEVELOPING GOOD HOMEWORK HABITS Create an environment that is conducive to doing homework. Youngsters need a permanent work space in their bedroom or another part of the home that offers privacy. Set aside ample time for homework. Establish a household rule that the TV set stays off during homework time. Be available to answer questions and offer assistance, but never do a child's homework for her. To help alleviate eye fatigue, neck fatigue and brain fatigue while studying, it's recommended that youngsters close the books for 10 minutes every hour and go do something else. If your child is struggling with a particular subject, and you aren't able to help her yourself, a tutor can be a good solution. Talk it over with your child's teacher first.

FREE ENTRANCE TO AUTUMN FUN AT BALBOA PARK MUSEUMS Autumn offers a great opportunity to visit Balboa Park's spectacular array of museums FOR FREE !! Every Tuesday, a selection of these fine museums open their doors to visitors without the usual fees for admissions, thanks to sponsorship by the Balboa Park Museums association. Each Tuesday during the month, the "free day" is available at different sites: 1st Tuesday - Natural History Museum, Reuben H. Fleet Science Center, San Diego Model Railroad Museum 2nd Tuesday - Museum of San Diego History; Museum of Photographic Arts 3rd Tuesday - San Diego Museum of Art, Museum of Man, Japanese Friendship Garden, Mingei International Museum 4th Tuesday - San Diego Aerospace Museum, San Diego Automotive Museum, House of Pacific Relations International Cottages, San Diego Hall of Champions, Hall Of Nations For specific information about exhibits, hours, and exclusions, please contact the Balboa Park Visitors Center (619-239-0512 or


PRACTICE NEWS Please welcome our new staff: