Welcome to Community Medical Providers
We are honored you have selected Community Medical Providers for your family healthcare. We are honored that nearly 1000 valley residents choose our healthcare providers each day! In fact, nearly 1 out of every ten Central California residents selects CMP.
This section is for you – to help you understand your healthcare a little better. If there is ever anything we can do to make your care better, please don’t hesitate to let us know.
Please take a moment to read our most commonly asked questions. We're always available to answer your questions and encourage you to contact our office if you have a question that is not answered below.
Q: Is your office accepting new patients?
Yes, we always welcome New Patients. Contact our office for additional information or to request an appointment.
Q: What is the best way to schedule an appointment with your office?
You can schedule an appointment by calling our office during regular business hours.
Q: Can I meet my pediatrician before my baby is born?
Yes, in fact we strongly encourage parents-to-be to visit our office for a prenatal 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.
Q: How often should my child see the pediatrician?
Your child should not only see the pediatrician for an illness; it is also important to schedule well-child-care exams regularly, beginning in infancy. Also called well-care visits or checkups, these routine examinations provide the best opportunity for the doctor to observe the progress of your child's physical and mental growth and development; to counsel and teach parents; to detect problems through screening tests; to provide immunizations, and to get to know one another. Well-care visits are strongly recommended as part of preventive pediatric care.
Well-child visits are also a good time for parents to raise questions and concerns about a child's development, behavior, nutrition, safety and overall well-being.
The American Academy of Pediatrics recommends this schedule for routine well-care visits:
- 3 to 5 days
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 24 months
- 30 months
- 3 years
- 4 years
- And once every year thereafter for an annual health supervision visit that includes a physical exam as well as a developmental, behavioral, and learning assessment.
Q: How do I know when I should bring my child in?
We have provided a number of resources that give generalized indications of when to seek medical help for certain conditions. Please visit our Parent Resources page for more information. You can also use the American Academy of Pediatrics Symptom Checker. However, if you are concerned your child may be sick please do not hesitate to call the office. The best way to determine what is bothering your child is to make an appointment with their Pediatrician. Since children cannot accurately communicate what hurts or explain what their symptoms are, we feel it is important to exam them. If you think it is a minor issue, we are happy to take a message and discuss it with the doctor. Our staff will call you back with the doctor’s recommendation.
Q: Where can I get help about breastfeeding?
Please visit our dedicated page on Breastfeeding for more detailed information and where to seek help.
Q: Why does my child need to receive vaccinations?
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 or visit our Immunizations page.
Q: What is a Pediatrician?
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.
- The head is often molded with soft swellings at the top and back of the head from the pressure of going through the birth canal. This will resolve quickly.
- The soft spot (or fontanel) on the head can be small or quite wide. It is not dangerous to touch it. You may feel it pulsating - this is normal. It may also feel full when the baby cries.
- “Stork Bites” are the reddish-purple spots and lines in the back of the neck, mid-forehead and upper eyelids. These will disappear with time.
- A red linear spot on the white part of the eye next to the iris is a small hemorrhage that results from the birth. It goes away with time. It is not harmful.
- Eye drainage in one or both eyes can occur after 1 or 2 weeks of life. This usually means the tear duct (lacrimal duct) is plugged at the corner of the eye next to the nose. Wipe the eyes with a water soaked cotton ball and clean them regularly. See or call the doctor’s office if it gets worse (especially heavy yellow/green drainage).
- Blue hands and feet are normal for the first month of life and are especially present for the first few days. The area around the mouth may look a little bluish, especially when sucking.
- Bluish pigmentation on the back and buttocks are normal. These bluish areas are often mistaken as bruises.
- Fine, tiny white spots on the nose and face are normal.
- Red dots on the baby’s body, which look like mosquito bites, develop on the second, third or fourth day of life. They are normal and indicate good maturity in the baby.
- Heat rash is common with babies. It comes and goes. It is a fine, red rash heaviest on trunk and face.
- Jaundice (yellowness) occurs in some babies on the 2nd to 5th day of life. It may last 1 to 4 weeks. It is usually physiological (natural) and goes away on it’s own. It rarely causes a problem for the baby. Having one or more bowel movements a day, some indirect sunshine, and plenty of milk helps relieve the Jaundice. If the Jaundice worsens (when you see that the whites of the eyes are yellow or the yellowness has crept down from the face to the chest, arms and legs), give us a call. We may order a blood test (heel stick) or wish to see your baby.
- Most babies lose 6 to 10 ounces of weight during the first few days of life. It is the extra body water that is lost. They typically regain their birth weight by the second week. Bottle fed babies regain it more rapidly than breast fed babies.
- The upper lip can develop a sucking blister in the middle. This is normal.
- The umbilical cord dries and falls off in 1 to 2 weeks. Keep it clean and dry until it falls off. Use the “cut away” newborn diapers or keep the diaper folded down below the cord to allow it to dry. It may ooze blood intermittently during the healing process. It may become foul smelling after one or two weeks if not cleaned appropriately.
- White mucous or even blood from the vagina during the first week or two is normal.
Feeding, Stooling, and Voiding
Some mothers are afraid that their baby is not getting enough milk while on the breast. This happens especially in the first several days after birth. If your baby is feeding 8 to 12 times a day and having 4 to 5 wet diapers with two or more stools per day, is alert and bright eyed, then he or she is getting enough milk. It is important that the baby latches on correctly in order to breast feed effectively. There are several different options that you can try to accomplish proper latching. For assistance, please call The Beast Feeding Resource Center at Fresno Community Hospital (559) 459-6288, the Lactation Clinic at Saint Agnes Hospital (559) 450-5210 or LaLeche League at (559) 265-3301. Avoid supplementing with formula from bottle as much as possible. It can delay baby’s progress in learning to nurse from the breast.
- Some babies feed only five minutes and then fall asleep. It is important that the baby nurses actively at the breast (listen for the baby’s swallowing). To keep the baby awake, rub the head, tickle the feet, burp frequently, or even undress the baby. Don’t let your baby go longer than four hours without feeding, even if it means awaking him or her. It’s also okay if baby wishes to feed as often as every 1 – 2 hours.
- Most babies do some spitting up. The baby is probably keeping down most of the milk, but to reduce spitting up, you may do the following; burp more often during the feeding, give more frequent feedings (but make them a little smaller), hold the baby upright for 20 - 30 minutes after a feeding, or perhaps change the formula type (if bottle fed). Call us or see us if the baby is vomiting too much, or has projectile vomiting (shooting it out 2 to 3 feet) and not gaining weight.
- Your baby will go through growth spurts at 2 to 3 weeks, 6 weeks, and 6 months and may have a sudden increase in feeding demand. Allow him or her to nurse on demand and avoid supplementing with formula if at all possible.
- From day one, hiccups occur often, usually with each feeding. They are normal. Don’t try to stop them.
- By day 2 to 4, the baby may only have 2 to 3 wet diapers a day. This will increase as the breast milk increases in quantity. Baby should have 6 wet diapers by day 6. Remember, disposable diapers have greater absorbency and you may not be able to tell if wet or not – test the weight or feel the diaper. Try pouring 2 to 3 tablespoons of water or more into a fresh diaper to educate yourself how heavy it feels.
- Frequent loose stools are normal for babies. The breast-fed baby will have yellow, seedy, runny stools after each feeding. Bottle fed babies will have two or more loose-to-soft yellow stools a day. The stools with be black on the first day of life, then turn green for a couple of days, and finally, yellow. As the baby gets older, he or she may even have only one stool every 1 to 5 days. If eating and feeling well, this is okay.
- Constipation can occur later. This means hard (sometimes “pebbly”) stools, which are difficult to pass. You may try 1 to 2 tsp. of sugar in a bottle with 2 to 3 ounces of breast milk or water. Try it once or twice a day as needed. After two weeks of age, one ounce of diluted prune juice can be given once or twice a day. You may occasionally use a pediatric glycerin suppository. Some babies may have a large soft stool with a lot of crying and straining. Try the above measure and see if it helps.
- A pink or orange spot on the diaper comes from normal urine crystals.
- All babies get diaper rash. It comes from the stools and urine irritating their skin. Occasionally, a yeast infection may be the cause of a fiery red diaper rash with raised lesions or little bumps. Most diaper rashes can be treated by cleansing the skin with water, avoiding diaper wipes, and applying a layer of Desitin, A&D Ointment, Balmex, Triple Paste (which can be purchased in our Pharmacy), or Vaseline to protect the skin from the next soiling or voiding. A yeast infection can be treated with an over-the-counter anti-fungal cream such as Lotrimin or Miconazole. If the baby has white patches in the mouth along with the diaper rash, a prescription oral medication will be needed.
- Babies may be sleepy the first few days of life and may be difficult to awaken for feedings. For the first week, awaken the baby to feed it if four hours have passed. Some babies sleep during the day, but are awake at night. That’s okay. Try waking him or her up every 2 to 3 hours during the day to feed.
- The “startle” reflex is normal. The baby will shoot out its hands and arms in response to a noise or sudden touch. The chin quivers and the fingers tremble momentarily. Swaddling the baby makes him or her feel more secure.
- All babies sneeze occasionally. They may also sound stuffy during the first few weeks. It doesn’t mean they have a cold (in the first week of life).
- Funny noises, squeaks, and grunts can be heard from a normal baby. They also breathe irregularly. They can pause in their breathing up to 5 to 10 seconds occasionally. You can be assured that baby is fine if the color remains normal and pink.
- All babies cry! All babies have different temperaments. Some cry readily and some are very calm. Some babies are “easy”, but some take a lot of time to calm down once the crying has begun. Read Dr. T. Berry Brazelton’s Book, Infants and Mothers for a nice description of temperaments in babies. Calming the unpredictable, demanding “difficult” baby can be stressful, time consuming and extremely challenging for a new parent. Dr. Brazelton’s most recent book, Touchpoints, discusses crying and development stages in greater detail.
- Guests and visitors are appropriate if they help you, but inappropriate if they are distracting you and taking up your time when you need to be resting and breast-feeding your infant. Let your visitors know what you need from them, and they will usually be willing and glad to help. Let others do the cooking, cleaning, and laundry. At least for the first week, discourage a lot of visitors. Put pertinent birth information on the answering machine and let it do the rest! Mom needs her rest and plenty of time to get acquainted with her baby and to learn how to breast-feed.
- Yes, babies are different! Relax & enjoy them!
What is Upsetting or Disagreeable to Baby?
- Loud noises which trigger the startle reflex and crying
- Baby may be hungry
- Wet or soiled diaper that needs changing
- Awake and no one to socialize with. Please realize your baby may like the social holding and your talking very much and often. Go ahead and do it, you cannot do it too much!
- Too cold or too warm
- Pain from gas, cramps, tape on skin or burning diaper rash
- Stuffy or congested nose, making it hard to breathe
- Visiting the church nursery or other public places where other children and adults pass on that first cold virus with a friendly kiss or hand caress. Give your baby a month before encountering these virus carriers. Blame this restriction on the Pediatrician. We don’t mind; we want your baby well!
When can I take my baby out?
- It’s California! Do it! The weather is fine, especially in the afternoon. Just dress baby appropriately. There is nothing wrong with the outside air, except on high pollution days.
- If the temperature is comfortable for you, it is okay for your baby, indoors and out
- Avoid crowds of people, and ask that people not touch your baby the first month (you don’t know what they have had their hands on!). Explain that your Pediatrician ordered it then they won’t be insulted, but use your best judgment.
Why Babies Cry
- Gas, soiled diaper, hot, cold, too quiet, too much noise, stomach cramps, or can’t pass BM. Some babies are simply not getting enough “socialization”. Hold him or her, sing or talk to her. Babies cannot be “spoiled”. There is no such thing. However, some need “neurological discharge” time, which means they’ve had input all day long – being held, cuddled, and stimulated a lot, and now they need a bit of time to cry and unload. It’s okay. Let your baby have a good cry. Most babies go through this. Let us see your baby if the crying is unusual or too much.
Solutions to Crying
- Take care of the above problems.
- An active baby who feeds eagerly, has no fever, and is alert when awake, is almost always a WELL baby. So, relax! You probably don’t need to call the doctor.
- Reduce household noise if the baby startles easily or has a difficult temperament.
- Purchase a cotton “sling” or infant carrier to hold and support baby close to you.
- Sing or talk softly, play soft gentle music, use a ticking clock in the crib, or rock the baby
- Massage the legs and body gently
- Heating pad or warm water bottle to warm sheets in crib - do NOT place heat directly onto the baby’s body.
- Burp frequently, baby may have too much gas. Check hole in the nipple, it may be too big causing baby to drink too fast, gulping too much air with the formula.
- Did baby fall? Did brother or sister pinch or hit baby? Check for injuries.
- A good pair of tennis shoes is sometimes the only thing that works – lots of holding and walking. If your baby responds to this, do it. If you’re too tired, ask spouse, grandma or others to take over.
- If on Similac or Enfamil, try switching to Isomil or Prosobee. Some babies are intolerant of both cow milk and soy formula, and therefore, may respond well to Nutramigen or Alimentum. They are twice the cost, but may be worth a try. Call our office for an appointment (437-7338) to discuss changing the formula.
- You have fed, changed, bathed, soothed the baby and now you are tense. The baby is still crying. He/she is tired. Rocking may perhaps only continue the stimulation. So, lay the baby down in the crib and let him or her unload with a good cry. In 15 to 20 minutes, the crying may perhaps melt into sleep. We call this “neurological discharge” time. Read about it in Touchpoints by T. Berry Brazelton, MD.
- If nothing is working, visit us at the office.
When to call or see the Doctor
- Fever over 100-101 degrees, especially if baby is acting ill or feeding poorly
- Excessive vomiting or diarrhea
- Relentless crying in baby who feeds poorly or not very active
- Labored breathing
- Progressive coughing
- Turning blue
- Sores in the mouth
- Poor feeding
- Jaundice (yellowness) of the eyes, or yellow skin progressing from the face to the chest, arms and legs.
Did you know...
Influenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions are at high risk for serious flu complications.
The best way to prevent the flu is by getting vaccinated each year. Please visit the CDC for more information and call us today to schedule your appointment: (559) 437-7311.