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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​It is rare for children to become seriously ill with no warning. Based on your child’s symptoms, you should contact your child’s pediatrician for advice. Timely treatment of symptoms can prevent an illness from getting worse or turning into an emergency.

Some children have frequent recurrent ab­dominal pain. Overeating can cause stom­ach discomfort. So can gas, constipation, food intolerance, intestinal infections and food poisoning, urinary tract infections, ap­pendicitis, and many other serious medical conditions, the majority of which are quite rare.

Almost all children have times when their attention or behavior veers out of control. However, for some children, these types of behaviors are more than an occasional problem. Children with attention-deficit/hyperactivity disorder (ADHD) have behavior problems that are so frequent and severe that they interfere with their ability to function adequately on a daily basis.

ADHD is a chronic condition of the brain that makes it difficult for children to control their behavior.

The condition affects behavior in specific ways. For example, children with ADHD often have trouble getting along with siblings and other children at school, at home, and in other settings. Those who have trouble paying attention usually have trouble learning. An impulsive nature may put them in actual physical danger. Because children with ADHD have difficulty controlling this behavior, they may be labeled “bad kids” or “space cadets.”

Effective treatment is available. If your child has ADHD, your pedia­trician can offer a long-term treatment plan to help your child lead a happy and healthy life. As a parent, you have a very important role in this treatment.

Left untreated, ADHD in some children will continue to cause ­serious, lifelong ­problems, such as poor grades in school, run-ins with the law, failed relationships, and the inability to keep a job.

ADHD includes 3 groups of behavior symptoms: inattention, hyperactivity, and impulsivity.

Symptoms of ADHD
Behavior symptom: How a child with this symptom may behave:
Inattention
  • Often has a hard time paying attention, daydreams
  • Often does not seem to listen
  • Is easily distracted from work or play
  • Often does not seem to care about details, makes careless mistakes
  • Frequently does not follow through on instructions or finish tasks
  • Is disorganized
  • Frequently loses a lot of important things
  • Often forgets things
  • Frequently avoids doing things that require ongoing mental effort
Hyperactivity
  • Is in constant motion, as if “driven by a motor”
  • Cannot stay seated
  • Frequently squirms and fidgets
  • Talks too much
  • Often runs, jumps, and climbs when this is not permitted
  • Cannot play quietly
Impulsivity
  • Frequently acts and speaks without thinking
  • May run into the street without looking for traffic first
  • Frequently has trouble taking turns
  • Cannot wait for things
  • Often calls out answers before the question is complete
  • Frequently interrupts others

Not all children with ADHD have all the symptoms.

Children with ADHD may have one or more of the symptom groups listed in the table above. The symptoms are usually classified by the following types of ADHD:

  • Inattentive only (formerly known as attention-deficit disorder [ADD])—Children with this form of ADHD are not overly active. Because they do not disrupt the classroom or other activities, their symptoms may not be noticed. Among girls with ADHD, this form is more common.
  • Hyperactive/impulsive—Children with this type of ADHD show both hyperactive and impulsive behavior, but they can pay attention. They are the least common group and are frequently younger.
  • Combined inattentive/hyperactive/impulsive—Children with this type of ADHD show a number of symptoms in all 3 dimensions. It is the type that most people think of when they think of ADHD.

If your child has shown symptoms of ADHD on a regular basis for more than 6 months, please make an appointment to discuss this with your pediatrician.

In most cases, ADHD treatment should include: 

  • A long-term management plan with
    • Target outcomes for behavior
    • Follow-up activities
    • Monitoring
  • Education about ADHD
  • Teamwork among doctors, parents, teachers, caregivers, other health care professionals, and the child
  • Medication
  • Parent training in behavior management
  • Individual and family counseling

Treatment for ADHD uses the same principles that are used to treat other chronic conditions like asthma or diabetes. Long-term planning is needed because these conditions are not cured. Families must manage them on an ongoing basis. In the case of ADHD, schools and other caregivers must also be involved in managing the condition.

The air we breathe is filled with pollen, pol­lutants, and dust – especially in Texas. Most children and adults are unaffected by these intruders.

Many people mistakenly use the word allergy to refer to a disease or almost any unpleasant or adverse reaction. We often hear someone say, “I have allergies,” “He’s allergic to hard work,” or “She’s allergic to anything that’s green.” In reality, allergies are reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema.

Your immune system is made up of a number of different cells that come from organs throughout the body—principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose).

Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens.

Symptoms Associated With Allergies

Eyes, Ears, Nose, Mouth

  • Red, teary, or itchy eyes
  • Puffiness around the eyes
  • Sneezing
  • Runny nose
  • Itchy nose, nose rubbing
  • Postnasal drip
  • Nasal swelling and congestion
  • Itchy ear canals
  • Itching of the mouth and throat

Lungs

  • Hacking dry cough or cough that produces clear mucus
  • Wheezing (noisy breathing)
  • Feeling of tightness in the chest
  • Low exercise tolerance
  • Rapid breathing; shortness of breath

Skin

  • Eczema (patches of itchy, red skin rash)
  • Hives (welts)

Intestines

  • Cramps and intestinal discomfort
  • Diarrhea
  • Nausea or vomiting

Miscellaneous

  • Headache
  • Feelings of restlessness, irritability
  • Excessive fatigue

When to Suspect an Allergy

Allergies can result in various types of conditions. Some are easy to identify by the pattern of symptoms that invariably follows exposure to a particular substance; others are more subtle and may masquerade as other conditions. Here are some common clues that should lead you to suspect your child may have an allergy.

  • Patches of bumps or itchy, red skin that won’t go away
  • Development of hives—intensely itchy skin eruptions that usually last for a few hours and move from one part of the body to another
  • Repeated or chronic cold-like symptoms, such as a runny nose, nasal stuffiness, sneezing, and throat clearing, that last more than a week or two, or develop at about the same time every year
  • Nose rubbing, sniffling, snorting, sneezing, or drippy nose
  • Itchy, runny eyes
  • Itching or tingling sensations in the mouth and throat
  • Coughing, wheezing, difficulty breathing, and other respiratory symptoms
  • Unexplained bouts of diarrhea, abdominal cramps, and other intestinal symptoms.

If your child has been experiencing any of these symptoms or if you have any questions, you can always ask one of our pediatricians. Simply call us to schedule an appointment to discuss allergies with your pediatrician.

Asthma is a chronic disease of the tubes that carry air to the lungs. These airways become narrow and their linings become swollen, irritated, and inflamed. In patients with asthma, the airways are always irritated and inflamed, even though symptoms are not always present. The degree and severity of airway inflammation varies over time.

Children with asthma can have symptoms start or worsen when they are exposed to many indoor substances such as

  • Dust and dust mites
  • Cockroaches
  • Animals such as cats and dogs
  • Molds
  • Secondhand cigarette smoke

Children with asthma may also be sensitive to colds and other viral infections, cold air, and particles or chemicals in the air. Ongoing exposures to these substances will not only worsen asthma symptoms, but also continue to aggravate airway inflammation.

Inflammation of the airways causes them to be oversensitive and “twitchy,” often called “hyperreactive.” When the airways are hyperreactive, they can go into spasms, causing blockage and symptoms of wheezing, chest tightness, and shortness of breath.

Any child who has asthma symptoms more than twice per week should be treated. One of the most important treatments of asthma is to control the underlying inflammation of the airways. This can be done with medications or by avoiding environmental factors that cause or aggravate airway inflammation.

Knowing the causes and triggers for asthma can allow families to reduce or avoid these triggers and reduce ongoing airway inflammation and hyperreactivity. This can reduce the severity and frequency of asthma symptoms and, hopefully, the need for as much asthma medication.

If your child has shown symptoms, please call us to make an appointment to discuss this with your pediatrician.

Schedule of Annual Wellness Checks

  • The first week visit (3 to 5 days old)
  • 1 month old
  • 2 months old
  • 4 months old
  • 6 months old
  • 9 months old
  • 12 months old
  • 15 months old
  • 18 months old
  • 2 years old (24 months)
  • 2 ½ years old (30 months)
  • Annually 3-21 years old

The Benefits of Well-Child Visits:

  • Prevention. Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.
  • Tracking growth and development. See how much your child has grown in the time since your last visit, and talk with your doctor about your child’s development. You can discuss your child’s milestones, social behaviors and learning.
  • Raising concerns. Make a list of topics you want to talk about with your child’s pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.
  • Team approach. Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

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We believe that breastfeeding is the optimal source of nutrition through the first year of life. We recommend exclusively breastfeeding for about the first six months of a baby’s life, and then gradually adding solid foods while continuing breastfeeding until at least the baby’s first birthday. Thereafter, breastfeeding can be continued for as long as both mother and baby desire it.

Breastfeeding should begin as soon as possible after birth, usually within the first hour. Newborns should be nursed whenever they show signs of hunger—approximately eight to twelve times every twenty-four hours. The amount of time for each feeding and the frequency of feeding vary widely for each mother-baby pair. It is important to recognize signs that the baby is getting milk, particularly after the first few days of life. These signs include four to eight wet diapers and three to four loose, seedy stools per day.

All of our pediatricians can provide guidance on routine breastfeeding questions and troubleshooting. We also have International Board Certified Lactation Consultant (IB-CLC) Pediatricians on staff at our care centers that can provide a complimentary latch consult to each newborn at no cost.

Sports Injuries

A safe and speedy return to activity following a sports injury or an illness depends on early recognition and treatment. Knowing when to see your doctor is an important step in this process. With major injuries or illnesses, there is little doubt about the need to seek medical attention. However, it is much more difficult to know when to seek help if there is no obvious trauma or if the symptoms don’t get in the way of playing. Many overuse injuries, such as tendonitis or stress fractures, happen over time and often have subtle symptoms. The result can be a delay in diagnosis and treatment, and delays can lead to a more serious or disabling injury.Athletes should see a doctor for:

  • Symptoms that do not go away after rest and home treatment
  • Any condition that affects training or performance that has not been given a diagnosis or has not been treated
  • Any condition that may be a risk to other teammates or competitors

Types of conditions

There are 3 types of conditions in which an athlete may need to see a doctor:

  1. Acute injuries
  2. Overuse injuries
  3. Medical illnesses or conditions

Also, any athlete with a chronic injury or medical condition should see a doctor and be approved to participate in sports. Even if a pre-sport physical is not required, it is a good idea for all athletes to have an annual medical checkup before the sports season begins. This is especially true if there is any history of medical problems, injury, or regular use of medicines, or if there are questions about training.The following are examples of these 3 conditions, their typical symptoms, and when to check with the doctor.

 

Acute Injuries
 Examples Symptoms When to Check With Your Doctor
Sprains, strains, fractures, dislocations, growth plate separation, torn cartilage, bruises, cuts, scrapes, pinched nerves, herniated disks Pain (other symptoms that restrict sports activity and affect daily activity), swelling, bruising, deformity, spasm, restricted or locking joint, instability, numbness, tingling, shooting pains
  • Joint swelling, locking, or instability
  • Visible deformity or mass in arms, legs, or joints
  • Inability to fully move a joint, arm, or leg
  • Inability to stand or walk
  • Back or neck pain-especially if there is also numbness, weakness, or pain that runs down the arm or leg
  • Pain that does not go away
  • Pain that disrupts daily actitvity or sleep
Overuse Injuries
Examples Symptoms When to Check With Your Doctor
Tendonitis; shin splints; stress fractures; growth plate problems like Osgood-Schlatter, Sever’s disease, or Little League elbow; bursitis; fasciitis; compartment syndrome; nerve entrapment; spondylolysis Pain (or other symptoms that get worse with activity but go away with rest); tightness, popping, or grinding in joints; mild or localized swelling; weaknessAt first, symptoms are noticeable after vigorous activity. As the condition gets worse, symptoms occur with any activity and, eventually, the symptoms restrict activity.
  • Localized pain that gets worse over time or increases with continued activity
  • Pain, swelling, stiffness, and/or weakness that gets in the way of training or sports activity
  • Pain or other symptoms that do not go away even with treatments such as rest, ice, or use of pain medicines
  • Pain that gets in the way with daily activity or disrupts sleep
Medical Illness/conditions
 Examples Symptoms When to Check With Your Doctor
Concussion Headache, disorientation, loss of consciousness*, blurry vision, nausea, memory loss, dizziness, lethargy, agitation, vomiting, fatigue, moodiness*It is possible to have a concussion without loss of consciousness.
  • Check with a doctorbefore return to play with any concussion or if any of these symptoms develop after a head injury.
Fever Other symptoms depend on cause of fever.
  • Any fever 101°F or greater for 4 hours or longer. Playing with a fever may increase the risk of heat illness.
Skin infection (impetigo, herpes, ringworm, measles) Rashes that are raised, open, draining or with a discharge; have small blisters; or are cracked and bleeding
  • These types of rashes should be checked and treated before returning to sports, particularly for athletes in contact or collision sports.
Abdominal (stomach) pain Pain, nausea, vomiting, diarrhea, constipation, appetite loss, decreased fluid intake
  • If symptoms persist, they should be checked. Liver and spleen can be enlarged with mono or other flu-like illnesses. This is most important for athletes in contact or collision sports.
  • These symptoms increase the risk of dehydration, which can negatively affect performance and increase the risk of heat-related illness.
Cardiac (heart) disease (myocarditis, pericarditis, endocarditis, cardiac contusion, dysrhythmia) Chest pain, shortness of breath, palpitations, feeling light-headed or passing out with exercise
  • See a doctor if any of these symptoms develop.
Respiratory (breathing) disease (asthma, bronchitis, pneumonia), laryngeal contusion/fracture, pneumothorax (collapsed lung), choking Shortness of breath, cough, wheezing, chest pain, stridor (noisy breathing), absent breath sounds
  • See a doctor if any of these symptoms develop.
Heat injury (heat exhaustion, heat stroke) Exhaustion, muscle cramps, nausea, vomiting, headache; consider heat stroke if body temperature increases
  • For heat exhaustion—check with a doctor before returning to play.
  • For heat stroke—call 911.

 

Concussions

A concussion is any injury to the brain that disrupts normal brain function typically on a temporary basis. Concussions are usually caused by a blow or jolt to the head but may occur from a hit to the body that produces a reflex force to the head.

The following is information from the American Academy of Pediatrics about concussions, including guidance on treatment and prevention.

When do concussions occur?

Concussions can happen in any sport but more often occur in collision sports, such as football, rugby, or ice hockey. They also are common in contact sports that don’t require helmets, such as soccer, basketball, wrestling, cheerleading, and lacrosse. Many concussions also occur outside organized sports. For example, a child riding a bike or skateboard can fall down and hit their head on the street or an obstacle.

Symptoms

The symptoms of a concussion range from subtle to obvious and usually happen right after the injury but some may take hours to a few days to develop. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Symptoms of a concussion include the following:

  • Headache
  • Nausea or vomiting
  • Dizziness or balance problems
  • Double or blurry vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling dazed or stunned
  • Feeling mentally “foggy”
  • Trouble concentrating
  • Trouble remembering
  • Confused or forgetful about recent events
  • Slow to answer questions
  • Changes in mood—irritable, sad, emotional, nervous
  • Drowsiness
  • Sleeping more or less than usual
  • Trouble falling asleep
  • What to do if you suspect a concussion

Concussions should be taken seriously and all athletes with suspected concussions should not return to full sports practice or participation until cleared by a doctor. A doctor can confirm the diagnosis of concussion and decide when it is OK for the athlete to return to play. Athletes who continue to play after their injury are at increased risk for worse symptoms, a more prolonged recovery and more serious injury to the brain if additional head injuries occur while recovering.

If your child has shown symptoms or if you have questions, please do not hesistate to call us.

While COVID-19 causes mild illness in some people, others get very sick and need hospital care. These articles can help you learn more about COVID-19 and how you can protect your family and others.

Signs and Symptoms of Fever

A fever is usually a sign that the body is fighting an illness or infection. Fevers are generally harmless. In fact, they can be considered a good sign that your child’s immune system is working and the body is trying to heal itself. While it is important to look for the cause of a fever, the main purpose for treating it is to help your child feel better if he is uncomfortable or has pain.

What is a Fever
Normal body temperature varies with age, general health, activity level, and time of day. Infants tend to have higher temperatures than older children. Everyone’s temperature is highest between late afternoon and early evening, and lowest between midnight and early morning. Even how much clothing a person wears can affect body temperature.

A fever is a body temperature that is higher than normal. While the average normal body temperature is 98.6°F (37°C), a normal temperature range is between 97.5°F (36.4°C) and 99.5°F (37.5°C). Most pediatricians consider a temperature above 100.4°F (38°C) as a sign of a fever.

Signs and Symptoms of a Fever
If your child has a fever, she may feel warm, appear flushed, or sweat more than usual. She may also be more thirsty than usual.

Some children feel fine when they have a fever. However, most will have symptoms of the illness that is causing the fever. Your child may have an earache, a sore throat, a rash, or a stomach ache. These signs can provide important clues as to the cause of the fever.

When to call us:

The most important things you can do when your child has a fever are to improve your child’s comfort by making sure they drink enough fluids to stay hydrated and monitor for signs and symptoms of a serious illness. It is a good sign if your child plays and interacts with you after receiving medicine for discomfort.

Call us right away if your child has a fever and:

  • Looks very ill, is unusually drowsy, or is very fussy
  • Has been in a very hot place, such as an overheated car
  • Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea
  • Has immune system problems, such as sickle cell disease or cancer, or is taking steroids
  • Has had a seizure
  • Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher
  • Fever rises above 104°F (40°C) repeatedly for a child of any age

Also call us if:

  • Your child still “acts sick” once his fever is brought down.
  • Your child seems to be getting worse.
  • The fever persists for more than 24 hours in a child younger than 2 years.
  • The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.

A number of heart conditions can affect children. Some are structural abnormalities they are born with. Others deal with the electrical system that controls the heartbeat. Concern about a heart problem often causes patients and parents a lot of anxiety. Many times, the symptoms described by children are not because of a problem with the heart. The following articles will give you information about common heart problems encountered in childhood. If you have a concern about your child’s heart, please discuss it with your pediatrician.

At Georgetown Pediatrics, we believe in the effectiveness of vaccines to prevent serious illness, to promote health and wellness, and to save lives.  We also believe in the safety of vaccines.

We believe that children and young adults should receive all of the recommended vaccines according to the schedule published by the Center for Disease Control and Prevention and the American Academy of Pediatrics.

We believe, based on all available data, scientific literature, current studies, and evidence-based medicine, that vaccines do not cause autism or other developmental disabilities.  We also believe that thimerosal, a preservative that has been in vaccines for decades, and that remains in a only a few vaccines today, does not cause autism or other developmental disabilities.

We believe that vaccinating children and young adults is the single most important health-promoting intervention we perform as health care providers, and that you perform as parents/caregivers.

We know, and want you to know, that the recommended vaccines and their schedule are the results of years and years of scientific study and research, with data gathered on millions of children, by thousands of our brightest scientists and physician.

We understand that there has always been, and will likely always be, controversy surrounding vaccination. But that controversy does not change the facts, or the science, or the evidence about vaccines.

The vaccine campaign is a victim of its own success. It’s precisely because vaccines are so effective at preventing illness that we even discuss whether or not they should be given.  Because of the safety and effectiveness of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox. And that, of course, is a wonderful thing.

We write this statement not to scare you, nor to coerce you, but to make you aware of the facts, and to emphasize the importance of vaccinating your child. We recognize that the choice may be emotional for some parents so we will do everything we can to support you, and to help you understand that vaccinating according to the schedule is the right thing to do.

Please understand, however, that delaying or “breaking up” the vaccines to give one or two at a time over two or more visits goes against expert recommendations, and can put your child at risk for serious illness or even death. Doing this goes against both our medical advice and our core principles at Georgetown Pediatrics.

As medical professionals, we know that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults.

We’re always happy to answer any questions, or to discuss any concerns, you may have about vaccines.

Age Immunizations & Screening Tests
Newborns Hepatitis B
2 weeks State Newborn Screening, Hepatitis B
2 months DTaP, IPV, Hepatitis B, HIB, Prevnar, RotaTeq
4 months DTaP, IPV, HIB, Prevnar, RotaTeq
6 months DTaP, IPV, Hepatitis B, HIB, Prevnar, RotaTeq
9 months check up
12 months MMR, Varicella, Hepatitis A, Hemoglobin, Lead/Tuberculosis screening
1 year-5 years Spot Vision Screening
15 months DTaP, HIB, Prevnar
18 months Hepatitis A
24 months check up
30 months check up
4 years Hearing/Vision, DTaP, IPV, MMR, Varicella
11 years Tdap, Menactra, Gardisil
16 years Menactra
17-18 years Menactra

Learning disabilities can be difficult to define. How these disorders are classified isn’t as important as recognizing that each one can seriously interfere with a youngster’s ability to learn. All learning impairments share one thing in common: deviations in processing in one or more locations of the brain.

If you child or adolescent is obese or overweight, he has a higher incidence of having a number of serious medical problems, including

  • High blood pressure (hypertension)
  • Abnormal lipid levels
  • Metabolic syndrome (A condition of insulin resistance associated with high blood pressure, high triglyceride levels, obesity, and in some cases, liver disease and menstrual irregularities in girls)
  • Type 2 diabetes (once called adult-onset or non–insulin-dependent diabetes)
  • Asthma
  • Sleep apnea (repeated disruption of normal breathing during sleep)
  • Skin infections (eg, fungi trapped in folds of skin)
  • Pain in the knee, thigh, and hip (often associated with a condition called slipped capital femoral epiphysis)
  • Back pain
  • Liver disease
  • Gallstones
  • Inflammation of the pancreas (pancreatitis)
  • Menstrual abnormalities (eg, irregular or missed periods, known as polycystic ovarian syndrome)
  • Severe headaches with visual disturbances

Schedule an appointment with your pediatrician if you’re concerned with your child’s weight. 

 

Additional Resources:

There are many different types of seizures. Some are very short, lasting only a few seconds, while others can last longer. The term epilepsy is used to describe seizures that occur repeatedly over time without an illness or brain injury. The collection of articles below covers the diagnosis and treatment of seizures as well as information on the support children and families may need when managing seizures.

The form is due, what do you do? We’ve all been there. Paperwork piles up, and sports physicals sneak up on us just before our children’s sport and activity begins.

To make life easier (and what parent wouldn’t like that), the American Academy of Pediatrics (AAP) recommends asking to have a sports physical when scheduling your child’s next routine well-child visit.

Why see the pediatrician for a sports physical:

Seeing your pediatrician for routine well-child visits and sports physicals helps keep your child’s medical records and health history up to date. Pediatricians are also trained to identify and treat both medical and bone/joint problems that are commonly seen in children and adolescents who play sports. And they can ensure your child is caught up on immunizations and discuss any concerns in a confidential setting. If your child is not as active as they should be, they counsel on the benefits of physical activity.

The American Academy of Pediatrics (AAP) recommends making appointments at least 6-8 weeks before starting a season to give time for any additional evaluation or new treatments. The AAP is against mass physicals (such as in a school gymnasium) and using urgent care settings. These places often lack privacy and a healthcare provider who knows your child and has access to past medical records.

Source: American Academy of Pediatrics