Welcome to Rub Pediatrics, M.D., P.A., a dynamic Pediatric practice with services to help your infant, child and/or adolescent grow and develop in the years to come.We are delighted to inform you that we have offices located at North Shore Medical Center in Miami and at Aventura Hospital in Aventura, Florida to better meet your needs. As you might already know, Rub Pediatrics, M.D., P.A., consists of physicians, ancillary practitioners, and a complimentary staff that will help and assist you with your child’s health needs.

The first healthy newborn visit is between 2 days and 4 weeks of age, usually at 7 days of life, unless the baby had medical issues or problems at the time of birth in the hospital or birthing center at which time an appointment would be appropriate anywhere between 2-14 days. Return office visit for newborns are in 4 weeks, unless medical issues arise. Premature or infants with medical needs will be seen on a weekly basis or more frequently as needed.

In order for us to be most efficient during your visit, please:1. Check your insurance coverage to see whether your

children are covered under your plan and what services they are entitled to.

2. Find out your responsibility with your insurance company regarding your co-payment and/or deductible are concerned.

3. Find out whether your insurance company will cover well-child care, sickness, hospitalization, and immunizations.

4. Call for an appointment whenever possible. A same day visit, such as for emergencies will be accommodated on a first come first serve basis. Well-child care is only by appointment.

5. Have your insurance card available upon arriving to the office. Register your child’s name at the front desk, and specify if your insurance, address or phone number have changed. If you have a different name other than your children, please indicate so;

6. Pay the required co-payments and deductibles at the beginning of the office visit (upon registration); If your insurance does not cover the services, please pay for the service before the office visit; The calendar year for most insurances start in January.

7. You MUST enroll your newborn to your policy. Your newborn is not automatically added. For group coverage, contact your human resources office. For individual coverage, contact the insurance company directly. Then, contact the insurance company one week later to confirm your new baby was in fact enrolled on your policy. We advise you to add your baby within the first week after birth. Don’t wait.

8. Each insurance company has different rules and regulations. Please familiarize yourselves with your insurance policies. For HMO’s, if referrals to another physician need to be made, please be patient. Most insurance companies require that we contact them, and obtain permission (at times, up to two weeks). It is your responsibility to pick up the referral form(s) and make necessary appointments and arrangements. You must get the phone number of the specialist from our Referral department, call for an appointment and then call our referral department back to make the appropriate referral. We will help you to make the referral when needed, but you must help your child get the appropriate referral when indicated.

9. If you have a problem reaching a specialist physician, please contact your insurance company in order for them to clarify the problem and help you with your referral.

10. If you cannot pay for the visit, please notify us prior to your visit so that arrangements can be made.

11. Payments can be made by way of cash, VISA, MasterCard, Discover, AMEX or Debit Card. Personal checks will not be accepted.

12. If your child was in the emergency room or hospitalized, you must make a follow-up visit at one of our offices within 2 weeks in order for us to monitor your child’s recovery. If your child is ill, please contact us immediately. We have a 24 hour service call back, so no question is too small or too big, when in doubt call. If issues with your child occur in the morning, call us then, do not help us by waiting until 5 pm or later to call, because you did not want to bother us, you do not bother us.

13. If you have any questions regarding your child’s care, do not hesitate to contact us. Either a doctor, ARNP, RN or PA will respond to your call. If you do not hear from us, within an hour, please feel free to call back.

GETTING TO KNOW YOUR BABYCongratulations on your newborn baby. Your baby is an individual, from the day he or she is born. As the parents, the people most closely involved, you will come to know your baby the best. Trust yourself. Don’t take too seriously all the advice of well-meaning friends and relatives.All babies sneeze, yawn, belch, have hiccups, pass gas, cough, cry, and get fussy. These are normal behaviors. Sneezing is

the only way that babies can clean their noses. Hiccups are just little muscle spasms, and they can often be stopped by giving the baby a few swallows of lukewarm water. Crying is a baby’s way of saying, “I am wet,” “I want to be held,” “I am too hot,” “I am too cold,” “I’m bored,” “I am hungry.”” You will gradually learn to know what your baby means when he or she cries.Because your baby has not had time to build up resistance to infection, try to limit visitors during the first few weeks at home. Discourage friends and relatives from

handling the baby; ask them to wash their hands first. Sometimes, new parents are unsure of themselves. But, as long as your baby is loved, well fed, and comfortable, you need not worry that you are inexperienced parents.

GENERAL CAREYour baby should have regular medical examinations, though he or she appears well. These visits will give us a chance to check on your baby’s growth and development and to talk with you about baby care. We will also give the baby “shots” (vaccines or immunizations) to protect against childhood diseases. An immunization schedule and record appear at the end of this booklet.

Your baby’s first medical checkup should be between 2 days and 4 weeks of age unless, of course, the doctor’s attention is needed sooner. Please call the office for an appointment.

Attempt to make well visit appointments on Tuesdays, Wednesdays or Thursdays. If it is an emergency, you may proceed to bring the child in the office (preferably at 9:00 a.m. or 2:00 p.m.). It will be considered a “walk in”. Priorities will be assessed when the child is triaged.

Phone us during office hours when you feel you need advice. We will be happy to give you guidance and answer your questions. You will find it helpful to have paper and pencil ready for writing down any instructions we may give. If an emergency occurs, call our office immediately. If you believe that the emergency is life threatening in nature, dial 911.Please call us during office hours for medication refills. Antibiotics CANNOT be refilled. Daily medicine will not be refilled if your child has not been seen in our office within the last 12 months. Signs of Illness:1. Fever, with rectal temperature of 101º F or higher.2. Refusal of feedings or repeated vomiting (not spitting up).3. Excessive crying without obvious cause.4. Listlessness.5. Frequent fluid bowel movements (w/mucus, blood, or foul odor).6. Any unusual rash (not just prickly heat rash).

SAFETYYou want to do everything possible to assure a safe environment for your baby. Beginning from the first car trip home from the hospital, you should always use an infant car seat whenever you take the baby for rides. A baby can get seriously injured if suddenly the car stops while being held in the passenger’s arms rather than secured safely in an infant car seat. We will be happy to help you choose a good infant car seat. The car seat should be properly fastened facing backwards until 20lbs. Check the seat belt in the car as well as the belt of the car seat before driving. To properly strap the baby in the car seat, the belts must be snug tight, not loose. This will avoid the baby to slip thru the belts in case of an emergency stop. Follow always the manufacturer’s

recommendations.There are many simple ways to assure your baby’s safety at home. For example, never leave the baby alone on the table or other high place, where he or she could roll off. Be sure the slats on the crib and playpen are no more than 2 3/8 inches apart, so the baby’s head cannot possibly get caught between them. The mattress should be firm, flat, and fit the crib snugly on all four sides. Keep the crib free of clutter. This means no pillow and no toys in which the baby could become entangled. Babies are attracted to colorful and shiny objects. Keep small objects like buttons and pins away from the baby’s reach so that he or she is not tempted to swallow them.

A baby’s delicate skin can be burned easily. When you take the baby outside, protect him or her from the hot rays of the sun. Always test the water before your baby’s bath to be sure it is not too hot. Smoking cigarettes while feeding or playing with the baby could be dangerous because hot ashes could fall on the baby. Also, don’t hold the baby while cooking. Hot fat could splatter on the baby, or he or she could touch hot pans or their contents.Make sure that you never leave your child unattended near or in the water without supervision.

ROOM TEMPERATURE

Try to keep an even, comfortable temperature in your baby’s room. Windows may be opened in warm weather, if the baby is not in a draft and the room temperature does not fall, below 70º - 76º F.

CRIB

Cover the mattress with a waterproof cover, quilted pad, and soft baby sheet. Do not use a pillow. Cover the baby with one or two cotton blankets, because this limits free movement. No sheep skin blanket.

SLEEP

The position to place an infant to sleep has changed throughout the years. In 1997, the AAP is recommending placing the child on their back to sleep. Preferably while awake, check and change baby’s position every two to three hours: example, left side, then back, and then right side. Make sure the baby sleeps at night and play at daytime. Make sure that pajamas are non-flammable material.

CLOTHING

A baby does not require any more clothing than the adult. Dress your baby according to the temperature. Some babies are

allergic to certain materials, so watch for rashes in areas of contact with the clothing. No need for shoes until one year, socks only.

OUTDOORS

You can take your baby outside whenever the weather is pleasant. Babies born during warm weather may be taken outside after they are about two weeks old. If you use a carriage or stroller, be sure the wind blows over the top and not into it, directly on your baby. You should avoid taking your baby to crowded places in the first two months of life.

SOAP

Use mild, unscented soap and shampoo.

CARE OF NAVEL

The umbilical cord will fall off within a few weeks. Each time you change your baby’s diaper, use a cotton ball to apply alcohol on the navel. To clean the umbilical stump, pull the stump up and clean the base at least once a day or every diaper change. Keeping your baby’s belly dry until the cord stump falls off is important. Contact our office if this happens. Sometimes, a few drops of blood may appear when the cord falls off. This is no cause for worry.

CIRCUMCISION

If your baby boy was circumcised, leave the gauze around the penis until it has been removed by your doctor, 24-48 hours after the procedure (unless instructed to, or falls off by itself). If there is any bleeding on the incision site then apply a gauze and snug pressure for 5 minutes. If bleeding stops then continue regular care, if bleeding persists then reapply the dry gauze with snug pressure and contact our office or the physician who has

done the circumcision. In the event you cannot get hold of anyone go back to the Emergency Room of the hospital that your child was born. Then apply new gauze with Vaseline or polysporin (double antibiotic ointment) on top of the penis for 7 days. Rinse daily with unscented soap and water. Sometimes a yellow excretion is found in the penis. This is part of the healing process. Just keep washing it gently with soap and water. In case of any bleeding or swelling or the area has a foul odor, contact our office.

BATHING

It is a good idea to have a regular time for bathing your baby. The room should be warm, with no drafts. Keep bathing supplies together to save you steps. Always concentrate on taking care of your child. If the doorbell or telephone rings, take care of your child first.Wash your baby by sponging until the navel (and the penis, if circumcision was done) is healed. Then you can bathe the baby in a small tub containing 3 inches of comfortably warm water. Check the temperature of the water by testing it first with the skin of your elbow.Wash the baby’s face with plain, warm water and unscented soap. You may use a soft cloth, preferably use your hands. To clean around the eyes, use cotton dipped in cool water, wipe the eyes shut from the ears towards the nose bridge. Do not try to clean the inside of either the nose or ears, but clean outer areas with a moist washcloth or cotton ball.Wash your baby’s head with a mild shampoo. Work from front to back, to keep suds away from your baby’s eyes. Clean carefully over the soft spots on a young baby’s head. If you notice a greasy scaling (cradle cap), call the office. Most babies get cradle cap in their first six months of life. It appears anytime, even when your baby’s skin seemed beautifully healthy and clear. There is not much to do to prevent it. You may use mineral oil and comb the hair daily. First try a “no tears” shampoo. If it does not improve, lets us know.

Use a mild soap and warm water to wash the baby’s body. Be sure to wash the folds of the skin. Rinse well. Pat the baby dry. Do not use powder after the bath, because the baby could inhale the powder and have trouble breathing. If the skin is very dry, you may use baby lotion sparingly after the bath.

Trim your baby’s nails with a nail clipper. DO NOT cut them with your teeth or rip them. You may use a file. Cut the hand’s nail circular and the toenails straight on top of the skin. This may be necessary several times a week.

YOUR BABY’S SKIN

In the first several days of life, your baby’s skin may be peeling and flaking. Skin creases like the wrist, the knees, and the feet may crack and even bleed. This peeling is normal. Use lotion sparingly if at all. Let the skin heal itself. If the dryness is severe or the peeling does not subside, please advise the physician on your next visit.

FEEDING TIMEFeeding is one of your baby’s pleasant experiences. At feeding time, the baby receives nourishment from the food and a feeling of security from parents’ loving care. The food helps your baby to grow healthy and strong. Parental love starts in the development of a secure and stable personality. Both you and the baby should be comfortable at feeding time. Choose a position that will help you relax as you feed your baby. For your baby’s comfort, be sure he or she has a dry diaper.

A SCHEDULE WITH FLEXIBILITYA feeding schedule is usually most satisfactory if it is flexible, allowing the baby to eat when he or she becomes hungry. Very young babies usually want to be fed every two to 4 hours, but

older babies may wait up to five hours between feedings. Although crying is the only way a baby can complain of hunger, crying may mean other things as well. If your baby occasionally cries within two hours after feeding, hunger probably is not the problem.

TYPE OF FEEDINGBreast milk is the best feeding for a baby. If you do not choose to breast feed, we recommend an infant formula, probably one fortified with iron. Breast milk or an infant formula is the only food your baby needs in the first four to six months of life. Breast milk, infant formula, or other nutritional beverages specifically designed for older infants should be continued until your baby’s first birthday. The cow’s milk that the rest of the family drinks is not an appropriate feeding for a child less than one year old.

FEEDING POSITION

Whether breast-feeding or bottle-feeding, hold your baby close. The baby’s head should be slightly raised and rested in the bend of your elbow.

TECHNIQUE OF BREAST FEEDINGBefore feeding your baby, rinse your breast with plain water, and pat them dry. You may need to help a newborn baby start nursing. Do not push the baby toward the breast. Instead, as you hold the baby, gently stroke the cheek nearer the breast. The baby will respond by turning his or her head to the breast seeking the nipple. The nipple and the dark area around it (the areola) should be in the baby’s mouth. Pressure of the baby’s mouth on the areola releases milk from your breast. You may need to place a finger or two on your breast to keep it away from your baby’s nose. Otherwise, the baby may have trouble breathing.Use both breasts during each feeding. When you first begin to

nurse, put the baby to each breast for about five minutes. Gradually build up to 15 to 20 minutes at the first breast. Continue at the second breast until your baby is satisfied. Many babies will suck for a long time, maybe longer than 15 minutes. Prolonged nursing can be exhausting for you and your baby. Begin each feeding at the breast you finished with the previous time, especially if the baby did not feed long on that breast. We suggest you to unsnap one clasp on your nursing bra flap to remind yourself which breast to begin with at the next feeding. Breast-feeding moms must drink up to five to seven glasses of fluids a day and may eat everything that they prefer to eat not excessively, unless specified by a professional. If your breast hurt, try applying cabbage (cold) on to the breast. Also use of ice packs once in a while helps relieve the pain too.If you need to separate yourself from the baby at feeding time, you can leave either a bottle of milk that you “expressed” (squeezed) from your breast or a bottle of prepared infant formula. If you use supplemental formula, we recommend the one checked below:SUGGESTED SUPPLEMENTARY FEEDING(see Formula Preparation instruction below) Enfamil Lipil with Iron Enfamil Enfamil Lactose Free Concentrated Liquid, ___1__oz, plus __1___ oz of water Powder ___1__ level scoops, plus __2___ oz of water Ready To Feed, do not dilute.

FORMULA PREPARATION

A simple way to prepare formula is to mix it and pour it into clean nursing bottles, and then to keep the formula sterile in the bottle. You should prepare your baby’s formula this way until we tell you otherwise.You will need the following things to prepare formula:

- Sterilizer or deep pot with rack*- Dishwasher (maybe used to sterilize bottles

too)- Can opener- Bottle brush

- Nursing bottles, nipples, and caps- Quart measuring pitcher- Tongs- Long-handled spoon- Formula

All, items used in preparing your baby’s formula must be clean. Scrub bottle, nipples, and caps with hot water and detergent, using a bottle brush. Squeeze water through the nipple holes. The measuring pitcher, can opener, and other articles also should be washed well. Rinse everything thoroughly with hot water. Just before you mix the formula, wash your hands well. Then wash the top of the formula can with soap, rinse it, and dry it before opening. Be sure you check the expiration date on the can; do not use the formula after that date.

Mixing Formula and Preparing Bottles of Concentrated Liquid or Powder Formula (Always read the instructions on the container)

1. Fill a quart-size pitcher with _____ ounces (oz.) of water.2. Add _____ scoops of powder formula* or _____ once (oz.)

of concentrated liquid formula. Stir well with a long-handled spoon.

3. Pour the mixed formula into _____ clean nursing bottles. Divide the formula equally among the bottles, so that each bottle contains at least _____ ounces (oz.). This is the amount that we prescribe for a single feeding.

4. Put nipples upside-down on the bottles. Put on caps, leaving them loose so that steam can get under them.

5. Sterilize by the method below.

STERILIZATION1. Stand bottles of formula on a wire rack or clean, folded

towel in a sterilizer or pot. Caps should be loose, not screwed tightly. Put about 3 inches of water in the sterilizer or pot. Bring water to a boil over moderate heat. Cover the pot, and boil gently for 25 minutes (Caution: do not use a microwave oven).

3. Remove the pot from the heat. Do not lift the lid until the

pot has cooled enough for you to touch it. This usually takes about an hour.

4. Remove the cooled bottles, and tighten the caps.5. Store the bottles of formula in the refrigerator.6. Use the prepared formula within 48 hours. Do not leave

milk in cans. Use plastic containers. Throw away any formula left after this time.

7. You may also use the dishwasher to sterilize the bottles, as the hot water cleans the bottles and nipples well.

* Notes: If you do not have a sterilizer, a kettle or pot with a well fitting lid will be satisfactory. It must be deep enough so the tops of the bottles do not touch the lid. And the bottles must not rest on the bottom. If you do not have a rack that fits the pot, a clean, folded towel will do.

READY TO FEED FORMULANever add water to ready-to-feed formula, and do not sterilize this kind of formula. Just pour ____ ounces (oz.) of ready-to-feed formula into a clean sterilized nursing bottle, and give it to your baby. Open cans of ready-to-feed formula should be covered and stored in the refrigerator. Throw out any left after 48 hours.

TO WARM FORMULA

If your baby prefers warm formula, remove a bottle from the refrigerator just before feeding and put it in a pot of hot (not boiling) water for a few minutes. Or use a bottle warmer. Do not use a microwave oven, because the formula may become scalding hot while the bottle remains cool to the touch. You do not have to warm the formula with every feeding, teach your child to drink cold milk too, is refreshing and satisfactory.

Before feeding the baby, test the temperature of the formula by shaking a few drops on the inside of your wrist. It should feel warm, but not hot.

TECHNIQUE FOR BOTTLE FEEDING

Hold the bottle so that the neck of the bottle and the nipple are always filled with formula. This helps your baby receive formula

instead of air. Air in the baby’s stomach may give a false sense of being full and may cause discomfort.

Sucking is part of the baby’s pleasure at feeding time. A baby may continue to suck on a nipple even after it has collapsed. So take the nipple out of your baby’s mouth occasionally to be sure it has not collapsed. Never prop a bottle and leave your baby alone to feed. The bottle could slip and make the baby gag. Also, drinking from a propped bottle may be related to tooth decay (cavities) in older infants. Remember, too, your baby needs the security and pleasure of being held at feeding time. Face to face contact is very important for your baby. Never leave a baby sleeping with a bottle in their mouth, it would cause tooth decay of the frontal teeth.

Most babies feed for 15 to 20 minutes. Sometimes the baby will take all the formula in the bottle and sometimes not. Don’t worry; this is normal. You should never force your baby to eat or to finish every bottle. Throw out any formula left in the bottle. When your baby regularly finishes the entire bottle at each feeding - and sometimes cry for more - it may be time to increase the amount of formula. Your baby will need larger amount of formula as he or she grows. When the baby is born the baby may drink about 2 oz at each feeding. You should try to increase by half an ounce every bottle every five days. When the bottle is empty you may want to increase about ¼ to ½ an oz per feeding up to a maximum of 8 oz per feeding and about 20 – 28 oz per day. DO NOT FEED WHILE BABY IS SLEEPING AND DO NOT SLIP A BOTTLE TO THEIR MOUTH WHILE SLEEPING EITHER. IT IS BAD PRACTICE AND MAY CAUSE YOUR CHILD TO BE OBESE. After feeding time, rinse the bottle with cool water and squeeze water through the nipple hole. Although you will wash the equipment thoroughly later, nipple holes may be clogged if they are not rinsed right after use.

Test nipples regularly to be sure the holes are the right size. Do not make any holes in the nipples. Buy new nipples. If the nipple holes are too small, the baby may tire of sucking before getting all the formula he or she needs. If the holes are too large, the baby will get too much formula too fast. The baby may also get so much air that he or she spits up all or part of the feeding. When the nipple holes are the right size, warm infant formula

should drip smoothly, without forming a stream.

BURPINGBurping your baby helps remove swallowed air. To burp your baby, hold him or her upright over your shoulder, and gently pat or rub the back. Another way is to place the baby face down across your lap and gently rub the back. Or you can sit the baby on your lap, leaning slightly forward, with your hand supporting the chest. Burp the baby several times during, as well as after, each feeding. Sometimes, the baby will not be able to burp. Do not try to force the baby to burp if the first few attempts are not successful. Do not be alarmed if your baby spits up a few drops when being burped.

OTHER FEEDINGEspecially in hot weather and bouts of diarrhea, you may offer your baby lukewarm, boiled water (cooled off) in a nursing bottle once or twice a day. Don’t give your baby so much water that he or she becomes full and uninterested of the breast milk or formula.Do not give your baby sugary liquids, like soft drinks or juices, to drink from the bottle. They can harm your baby’s teeth or cause diarrhea. Regular milk, even if boiled, also is not as good as breast milk or infant formula for a baby in the first year of life. Regular milk in the first year has caused bloody stools and low blood counts. You should wait to give solid foods to the baby until he or she is 2 to 6 months old. When that time is near, we will discuss with you the addition of new foods to the baby’s diet.Note: Use the scoop with the formula. Do not use any kind of spoon or measure. Powder is also available in packets. If you buy packets or powder formula, always follow the preparation instructions carefully.

VITAMINSWhen your baby is _____ weeks old, begin giving the vitamin the Pediatrician checks below.Prescription Vitamins Over-the-counter Vitamins Poly-Vi-Sol® drops Poly-Vi-Sol® w/ iron drops

Tri-Vi-Sol® drops Tri-Vi-Sol® w/ iron drops Poly-Vi-Flor® drops Poly-Vi-Flor® dropsDosage: 1/2 cc 1 cc dropper daily.To give vitamins, place the dropper between the baby’s gum and cheek, almost halfway back in the mouth. Slowly squeeze out contents of the dropper.

STOOLSStools of newborn babies vary considerably in size, color, consistency, and frequency. Bowel movements may be every feed or once a day or every other day. A baby may have one or several bowel movements daily, or none for a few days. Stools may be yellow, brown, or green, and maybe firm, loose, or pasty. Soft, loose, pasty stools are typical for breast-fed infants If there is no bowel movement in two to five days, please call.Change your baby’s diaper as soon as possible after each bowel movement. Clean the diaper area and wipe it gently, preferably with a cotton ball moistened with water. You may use wipes when not at home.One of the most common illnesses among infants and young children is diarrhea. Diarrhea is considered an increased frequency of bowel movement from the usual. Usually, diarrhea lasts only for a few days and can be managed at home. During bouts of diarrhea, regular feedings, especially milk should sometimes be replaced with special fluids containing important nutrients (electrolytes) in amounts similar to those lost in stools. We suggest you buy a few bottles of Pedialyte* so you have them on hand if you need them. Please call our office for instructions if your baby has diarrhea for more than a day, especially if accompanied by vomiting or fever or if the child doesn’t look well at any time.

CONCLUSIONThis is a joyous time in your lives. You have a baby product of your love that has come to compliment your household and make of you a family. Make decisions together, rather against each other. Rub Pediatrics and staff congratulate you and your new bundle of joy.

OFFICE HOURSMonday through Friday: 8:30 am - 5:00 pm. Please call for an appointment. Saturdays: 8:30 am - 12:00 noon at our Aventura Office (sick visits only). We provide 24 hour Pediatric service. After hours we can be reached by calling our office telephone numbers: (305) 696-9490 or (305) 932-1007. Your call will be taken by an answering service that will transfer you to a nurse that will triage your call and discuss your child’s medical problem. If necessary, they will contact the physician on call.ENJOY YOUR BABY!

IMMUNIZATION RECORDImmunization Date

GivenLocation Administered

PEDIARIX (DTaP, IPV, HEP B): 3 DOSES 2 MONTHS4 MONTHS6 MONTHSHEPATITIS B: 3 DOSES1 MONTH3 MONTHS9 MONTHSDIPHTHERIA, TETANUS, PERTUSIS (DTaP): 5 DOSES2 MONTHS4 MONTHS6 MONTHS18 MONTHS4 YEARSPOLIO (IPV): 4 DOSES2 MONTHS4 MONTHS18 MONTHS4 YEARSHAEMOPHILUS INFLUENZAE TYPE B (HIB): 4 DOSES2 MONTHS4 MONTHS6 MONTHS15 MONTHSPNEUMOCOCCAL CONJUGATE VACCINE (PREVNAR): 4 DOSES3 MONTHS5 MONTHS7 MONTHS>12 MONTHSCHICKEN POX (VARICELLA): 1 DOSE12 MONTHS>4 YEARSMEASLES, MUMPS, RUBELLA (MMR): 2 DOSES15 MONTHS4 YEARSDIPHTHERIA TETANUS TOXOID (Dt): 1 DOSE (UNDER 7 YRS)UNDER 7 YEARSTETANUS DIPHTHERIA TOXOID AND PERTUSSIS (TD): 1 DOSE (EVERY 10 YRS AFTER 12 YRS)12 YEARS +

PNEUMOCOCCAL (PPV): 1 DOSE>24 MONTHS

INFLUENZA (FLU): 1DOSE (GIVEN SEPT TO JAN)6 TO 35 MONTHS ( ½ DOSE)3 YEARS + (.5ML)HEPATITIS A (HEP A): 2 DOSES 6 MONTHS APART2 YEARS +2 YEARS +TUBERCULOSIS (PPD): HIGH RISK AFTER 1 YEAR)PPD RESULTS:PPD RESULTS:PPD RESULTS:PPD RESULTS:PPD RESULTS:PPD RESULTS:PPD RESULTS:PPD RESULTS:SYNAGIS: HIGH RISH RSV GIVEN MONTHLY FOR 2 YEARSSYNAGIS 1SYNAGIS 2SYNAGIS 3SYNAGIS 4SYNAGIS 5SYNAGIS 6SYNAGIS 7SYNAGIS 8SYNAGIS 9SYNAGIS 10SYNAGIS 11SYNAGIS 12SYNAGIS 13SYNAGIS 14SYNAGIS 15SYNAGIS 16SYNAGIS 17 SYNAGIS 18SYNAGIS 19SYNAGIS 20SYNAGIS 21SYNAGIS 22SYNAGIS 23SYNAGIS 24SYNAGIS 25OTHER: OTHER: OTHER: OTHER:

NAME: DOB:

NAME: DOB:

SAMPLE VISITING SCHEDULE

VISIT HT WT HC Questions0-4 weeks1 month2 months(checkup)3 months4 months5 months6 months(checkup/labs)8/9 months12 months15 months18 months24 months(checkup/vaccines)30 months36 months40 months(eye/hearing/labs)48 months(checkup/vaccines)5 years(checkup yearly)6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years

RAISING CHILDREN

Raising children is not as difficult as people may think. We all want to be perfect parents and we all want to have the smartest and most beautiful child. In order to answer some of the questions you may have about taking care of your child, we would like to share a few pointers with you that we have learned from practicing medicine and dealing with children for many years. The following are 12 easy things to remember:

1. It is important for us, the doctors, to work together with you, the parents.

2. Children are inclined to be good-natured, but society can spoil them.

3. Just as we consider the fact that all children are alike, we can also say that all children are unique.

4. If you are using formulas, feed your child every 4 hours a day. You can offer your baby water, 1 hour after feedings, 3 times per day.

5. Child should be taught to be awake during the day and sleep at night.

6. When speaking about breast feeding, the baby should be fed as much as he/she wants to eat, not as often as he/she wants to eat. Try to breast feed your child every three hours during the day, the first month, and every four hours, the next several months.

7. Have a positive attitude: The glass is half full; not half empty.8. How much does a child eat? As much as the child wants.

The child knows his/her needs better than anybody else.9. Try to keep from telling your child what not to do. It

would be easier and more effective to tell him/her what he/she can or should do. Your child will be more cooperative.

10. Children are prone to getting infectious diseases more often than adults. This is normal until they build defenses

to combat them. Only bacterial infections need antibiotics. Viral infections are more common. A cold may last for two weeks, while allergic symptoms may remain from 4 to 5 weeks.

11. Children are not “hyperactive”, they are just full of energy. We can get tired watching the number of activities they do all day.

12. Children do not “break” toys. They are simply curious to see what is inside them.

13. Focus on your child’s development and alert us when there are issues. Most of the time there are normal issues, but early intervention may be the key to help your child optimize their best.

DIET SCHEDULE 0 - 2 MONTHS

6:00 am Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree7:00 am WATER10:00 am Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree11:00 am WATER2:00 pm Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree3:00 pm WATER6:00 pm Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree

Bathe your child10:00 pm Breast Milk or Enfamil LIPIL,or Prosobee, LactofreeAfter 10:00 pm Water Only or Breast Milk (may offer during the night).

DIET SCHEDULE 2 - 5 MONTHS

6:00 am Cereal, Breast Milk or Enfamil LIPIL,or Prosobee, Lactofree7:00 am WATER10:00 am Fruit/Juice, Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree11:00 am WATER2:00 pm Vegetable, Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree3:00 pm WATER6:00 pm Cereal (Bath), Breast Milk or Enfamil LIPIL, or Prosobee, Lactofree10:00 pm MilkAfter 10:00 pm WATER ONLY.

SINGLE GRAIN BABY CEREALPORTIONS1st day: a tablespoon plus mother’s milk, formula or water.2nd day: two tablespoons plus mother’s milk, formula or water.3rd day: three tablespoons plus mother’s milk, formula or water.Thereafter: four tablespoons per servingRice Cereal, Barley Cereal, Oatmeal

FIRST FOODS FRUITS INFANT JUICES

2.5 oz. Jar Portions Portions1st day: 1/2 jar 1st day: 1 fl. oz.2nd day: 1/2 jar 2nd day: 1 1/2 fl. oz.3rd day: 1/2 jar 3rd day: 1 3/4 fl. oz.Thereafter: 1 Jar Thereafter: At least 2 fl. oz. Applesauce but most babies enjoy a full container. Pears Peaches Apple Juice Bananas White Grape Juice Prunes Pear Juice

FIRST FOODS VEGETABLES2.5OZ JAR PORTIONS1st day: 1/2 jar2nd day: 1/2 jar3rd day: 1/2 jar

Thereafter: 1 jar Carrots Peas Squash Green Beans Sweet Potatoes

DIET SCHEDULE 6 - 12 MONTHS 20oz/day formula

6:00 am Egg, Cereal, Ham, Sausage or cheese, Enfamil/Breast

Milk7:00 am WATER9:00 am Fruit or Juice10:00 am WATER12:00 pm Meat, Vegetables, Fruits, Pasta2:30 pm Formula or Breast Milk3:30 pm WATER6:30 pm Cereal, Fruits, Vegetables

Enfamil or Breast Milk Bathe your childAfter 6:30 pm WATER ONLY7:00pm-8:00pm SLEEP

CEREAL

Portions1st day: A tablespoon plus mother’s milk, formula or water.2nd day: Two tablespoons plus mother’s milk, formula or water. 3rd day: Three tablespoons plus mother’s milk, formula or water. Thereafter: Four tablespoons per serving. Rice Cereal Barley Cereal OatmealMay start pasta as cereal at 12pm or 6:30pm

VEGETABLES

2.5 oz Jar Portions1st day: 1/2 jar2nd day: 1/2 jar3rd day: 1/2 jar Thereafter: 1 Jar Carrots Peas Squash Sweet Potatoes

INFANT JUICES:

Apple , Pear, Prune, White Grape, Orange, Peach

DISCLAIMER: ALL THAT IS WRITTEN IN THIS PAMPHLET ARE RECOMMENDATIONS THAT OUR PRACTICE BELIEVES AND UPHOLDS IN ORDER TO HELP PARENTS WELCOME THEIR NEW ADDITIONAL MEMBER OF THE FAMILY AND BY NO MEANS CLAIM THAT THESE RECOMMENDATIONS ARE FOR EVERY CHILD.

This book was written and created by Jose M. Rub, M.D. and Beny Rub, M.D.

J. Mark Rub, M.D.Born in Peru, Dr. Mark studied medicine at Universidad Peruana Cayetano Heredia. He trained in Pediatrics at North Carolina Moses Cone Hospital, University of North Carolina. Since 1989, he has been practicing pediatric medicine at Rub Pediatrics MD PA. He is a fellow of the American Academy of Pediatrics and is Board Certified. Dr. Mark is also former Chief of Staff and former Chief of the Dept. of Pediatrics of North Shore Hospital. Dr. Mark and

his wife Eva have 3 children. During his spare time, Dr. Mark enjoys windsurfing, soccer, and walking.

Beny Rub, M.D.

Dr. Beny has been practicing pediatric medicine since 1990 at Rub Pediatrics MD PA. He studied medicine at Autonomous University of Guadalajara. He trained at North Shore University Hospital in NY and University of California at Irvine. Dr. Beny is a Fellow of the American Academy of Pediatrics and is Board Certified. He and his wife Marta have 3 children. During his spare time, you will find him on the tennis court or spending time with

his family.

Rashida N. Joemmankhan, P.A.-C.

Bianca T. Vega, P.A.-C.

RUB PEDIATRICS MD PA

RUB PEDIATRICS MD PA - MEDICAL STAFF

www.rubpediatrics.com

BABY BOOKWritten by:

Jose M. Rub, M.D. and Beny Rub, M.D.

North Shore Medical Arts Building1190 N.W. 95th Street, Suite 409Miami, FL 33150 305.696.9490

Biscayne Medical Arts Building21110 Biscayne Boulevard, Suite 308Aventura, FL 33180 305.932.1007

Fax: 305.696.6225 info@rubpediatrics.com