Baby doctor visits must go on during pandemic

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PORTSMOUTH – In the first two -years of life, a baby sees the pediatrician 11 times, for well-baby visits and scheduled immunizations.

Baby visits are important for the child’s health and should continue even as people navigate the COVID-19 pandemic say Seacoast-region medical professionals, who have taken great pains to make sure the littlest ones, and their parents will be safe.

Dr. Nettie Colella, a pediatrician with Greater Seacoast Community Health sees patients at both Families First in Portsmouth and Lilac City Pediatrics in Rochester. There are also pediatricians seeing children at Goodwin Community Health in Somersworth, the third arm of GSCH.

Colella said pediatricians are worried about the widespread interruption of immunization schedules, possibly happening because parents are afraid to bring kids in because of the risk of infection from the coronavirus.

There are potential outbreaks without immunizations,” said Colella. “Whooping cough, meningitis and measles, can be far more dangerous to children than COVID-19. In 2019, we saw an outbreak pf measles. There were 1,200 cases in the US, with 120 hospitalization and 60 cases with serious complications. In a country where we were declared measles free in 2000, this was a frightening situation.”

Colella said there are procedures in place to keep children needing care safe.

“For example, I am not seeing as many patients in my office as I would have during normal operations,” said Colella. “I use telehealth, but I need to see my most vulnerable populations and that strongly includes infants and young children.

“I worry about losing contact with the children as we might be the only adult beside a parent they are seeing right now. They are not in school and we need to be a second set of eyes on them. They are in social isolation. I have a daughter who is a senior in high school, She has lost athletics. She is not going to have a prom, a graduation. She is already worried about college. I want to be someone my patients can talk to about how they are feeling.”

Colella said GSCH has behavioral health and social workers on staff to help with any mental health or family issues they identify. She said it is important to assure a patient is not neglecting their mental health because of the isolation and is taking their prescribed medication.

Colella said video visits can be used to help manage diabetes, to care for children with ADHD and help with sleep issues. She said that some follow ups for chronic conditions is possible through telehealth.

“But for those first two years, seeing them in person is so important,” said Colella. “During well baby visits, we inspect their growth and development. We talk with the parents about nutrition and sleep patterns. We can talk anticipatory, what to expect as the baby grows. We get the opportunity to check in on the entire family, for issues like postpartum depression. It really does take a village to raise a baby right.”

Most important is keeping the child on a well-organized schedule of childhood immunizations.

“Immunization are given to children at set intervals,” said Colella. “Keeping to the schedule provides the best protection for the child.”

Children are given primary immunizations in the first 30-45 days of their life. They need the measles and chicken pox shot between the age of four and five, and a booster for it at age 11, when they will also get the primary meningitis immunization and HPV vaccine.

“It’s so important to emphasize the importance of getting our patients in,” said Colella. “I am so impressed with how quickly GSCH responded to the COVID-19 needs. We have a really good operations team for all our locations and plans were put into place to make all of our services safe for staff and patients.”

Patients and staff are screened, for temperature, cough, and any signs of respiratory ailment before entering any of the three locations.

“We have a tent set up outside for screening and if you come without a mask, we will give you one,” said Colella. “Patients are sent in one at a time and go directly to a patient room. People should come if they normally would. Do not decide that because Johnny has a cut, you can take care of it. In a week, if it is infected, the care is more difficult. We can look at it, even over the phone and advise you.”

GSCH changed the hours of operations for the clinics, and staggered visits for clinicians and patients, so there are not a lot of people in any office at any time. Colella said they are using telehealth whenever possible. Masks are being used by everyone in the buildings. Colella said they have a high-risk respiratory clinic set up at specific times, and low-risk patients are not scheduled at that time.

“I prefer video visits when I do telehealth,” said Colella. “I find it helpful to be able to see my kids and their parents. I can work with a family where the son is having trouble sleeping. We can talk about nutrition and we can do good quality follow up to previous visits. We can make sure they are keeping up with needed medications. Some people do not have the capability to do live feeds and we can do telephone visits if we need to. Being able to do that frees up protected spaces in the offices to see patients.

“The other important thing I think should be mentioned is that patients without a primary care doctor should not avoid seeking healthcare due to pandemic. GSCH (Families First, Goodwin Community Health and Lilac City Pediatrics) are all accepting new patients and new patient appointments can be via telehealth. It is so important to address all medical and behavioral needs at this time.”

Colella said that recommendations on booking in office appointments are changing rapidly as the state starts to liberalize stay at home orders and patients should call the office, where appointment will be scheduled as appropriate based on the child’s age and medical needs.

To make an appointment, call Families First at 603-422-8208, Lilac City Pediatrics at 603-335-4522, or Goodwin Community Health at 603-749-2346.

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