We wish you and your family a safe and happy Labor Day weekend!

If you would like to participate in this program, please ask your doctor or our staff for more information.

• Adacel Vaccine (to protect against pertussis)
• Injectable Flu Vaccine

You may get your vaccine along with your child at a scheduled well exam or your may schedule an appointment for one of our day or evening shot clinics. You will be asked to complete and sign a waiver form in order to receive the vaccine(s). These services are offered as private pay and will not be billed to insurance. The cost for the Adacel vaccine is $50 and the injectable flu is $25. Payment in full is due at the time of service. To schedule an appointment for one of the above mentioned vaccines, please contact our future scheduling department at (949) 770-4242.

Please click here to print and complete waiver form in advance.

Most babies are great eaters. The average twelve-month-old will happily eat whatever he is offered. I remember my son eating broccoli and strawberries at his first birthday party and only nibbling at his first cake. Three months later, we were begging him to just try or lick a piece of broccoli. What happened?

Some studies suggest that over 90% of toddlers and preschoolers are described by their parents as ‘picky’. I have three theories about what happens to these formerly stellar eaters:

• Children’s growth velocity slows down dramatically after their first birthday. The average child gains 15 pounds in the first year of life and only 5 pounds in the subsequent year. Most of the food your baby ate went to growth, whereas most of a toddler’s food will go to running around and playing. Therefore, a toddler’s hunger will be variable. There will be days when they are hungrier than other days. It is normal for toddlers to have meals (or even days!) when they eat little. There are also days when they will eat more than I would at a sitting.
• The last thing a toddler wants to do is sit in a highchair for thirty minutes and eat a meal. They want to play and explore. The average toddler or preschooler will eat just enough to get the energy to play more. When their tank is refilled, off they go!
• Kids get smarter as they get older. Eventually my son realized that chicken nuggets taste better than broccoli. And because a toddler has no knowledge of nutrition, he wants to eat what he likes the most. As I will describe later, the biggest pitfall parents can make is to start allowing their toddlers to decide what food will be served. They will obviously choose the junk food that tastes best to them.

So what do you do with your newly picky eater? I was raised in a strict household where my brothers and I were forced and coerced into eating our food. My brothers and I all struggled with obesity as children and were all very picky eaters. My wife’s family had one rule for the table, “Eat what you want, leave the rest.” There was no arguing, bargaining, or forcing in their home. My wife and her brother were always a healthy weight and ate a good variety of foods. Here are some tips that I learned from my wife’s family that I try to pass onto my patients (and are the ways that our children are raised):

• As parents, we are in control of the quality of the food our children are offered. They are almost 100% in control of the quantity that they eat. Toddlers have a fierce independent streak and the more they are pushed, the more they push back. Do not bribe, coerce, or force your children to eat. Sit your toddler down for three well rounded meals per day and at least one healthy snack per day. Make sure that he is offered a variety of healthy foods at each meal. If he eats what is served, that is fantastic. If he does not eat what is served, that is okay, too, but do not offer him anything else. We parents are not short order cooks. If the family is eating chicken, rice, and broccoli, then that is what the toddler should be served. If he is offered macaroni and cheese after he whines that he does not like chicken, then you have essentially taught him that in order to get macaroni and cheese, simply whine and refuse your food. This is the first step in the making of a picky eater. It is better to excuse him from the table if he does not want what he is served rather than give him something else. Children do not starve themselves to death. Place the dinner plate in the refrigerator, and he can have a second chance at eating his dinner if he is hungry later.
• Maximize your opportunities for successful meals by not filling up on liquid calories and snacks. I do not serve milk or juice with meals, only water. If my son has milk with his dinner, he will chug the milk until he is almost completely full. He will then usually eat no food. A ten-ounce cup of whole milk has more calories than an equivalent sized soda. I save milk or juice for snack-time, and limit my children to no more than 16 ounces of milk per day. In fact, I fill a 16 ounce measuring cup with milk each morning so that my children can see exactly how much milk will be allotted for the day. When the cup is empty, the milk for the day is over.
• Give your toddler mutually acceptable choices for snack foods. I will offer my children an apple or a pear for a snack. If they respond that they want Goldfish crackers, I will remind them again that their choices are between an apple and a pear.
• Eat as a family, if at all possible. Children are much more likely to eat their food if they see others eating the same food. It is hard to expect a toddler to eat peas if he is the only one eating them. Even if work schedules make a true family meal impossible, try to have one parent sit with the children and eat small portions of what the children are served.
• Allow the children to participate in the food preparation. Most people are more willing to eat something of which they have ownership. Even something as simple as having your toddler stir the peas and corn may increase the odds that he will eat them.
• If there are foods that you do not want your children to eat, do not buy those foods. Good nutrition starts at the grocery store. If a child’s only options for snacks are fruits or vegetables, it is likely that he will eat them. Most toddlers and preschoolers eventually are smart enough and agile enough to find that stash of Oreos in the cabinet.

I was always told in medical school that parents should not “make mealtime a battle.” It was not until I had children that I realized how quickly a lovely family meal could degenerate into a stress-filled ordeal. By applying the simple family rule of ‘eat what you want, leave the rest,’ mealtime at our home is once again a pleasant experience. Hopefully these tips will help to transform your picky toddler into a healthy and happy preschooler.

The contents of this web site are provided as an informational tool. This is not intended to replace medical advice or care administered by a healthcare professional. Common sense should always be used when referencing this site. If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

Dr. Terence Chu of Southern Orange County Pediatric Associates will be providing American Heart Association Heartsaver CPR classes. The cost is $50.00 per student and includes the one-session course, instructional materials and participation card. Classes will be held in our Lake Forest office.

To sign up for a future class or if you would like more information,  please contact Melanie Jackson in our Administration Office at (949) 770-6789.

During the month of April, Lauren Dwinell, M.D. from our San Clemente office spent a life-changing week in Haiti.  As part of a team of eight Southland health care professionals, Dr. Dwinell volunteered her time and expertise by providing medical care to those devastated by the earthquake.  Here Dr. Dwinell shares her story along with personal photos of her experience…

To view the photo gallery, please click here

Sadness…..If I had to pick one word to describe my experience in Haiti, it would be sadness. Sadness for the lack of health care, sadness for the unthinkable conditions in which the people live (no electricity, no sanitation and often no clean water) and sadness for the sheer chaos and disorder of a country in ruins. While the earthquake certainly worsened the conditions in Haiti, the lives they lived before were not a whole lot better. It is hard to imagine that a world like theirs can exist just a few hundred miles off the coast of the U.S., where we all live in such excess.

I traveled with a wonderful team of 8, 5 physicians and 3 nurses. Two other local pediatricians, two ER docs and 3 pediatric and labor and delivery nurses rounded out the team. I knew only two members of the team prior to going, but I feel I have seven new lifelong friends since returning. Our destination was Port-au-Prince, the nation’s capital. The population of Port-au-Prince is 2,500,000. It is estimated that 230,000 lives were lost in the earthquake, probably half of which are still unaccounted for. When you first drive through Port-au-Prince, the images that you have seen on CNN and FoxNews are all around you. The reality of the collapsed buildings, the tangles of rebar and piles and piles of rubble are everywhere. By the end of our stay, we hardly even noticed the destruction anymore given that it was so widespread. What continued to make an impact however, day after day, were the overall conditions of the city. Trash is everywhere. Everywhere. Piles and piles of it litter the streets. They all cook with coal since there is limited electricity; therefore the stench of burning coal mixed with diesel from the cars is overwhelming.

Tent cities have been erected anywhere there used to be a park or grassy hillside. Some of these makeshift communities are home to up to 100,000 displaced people. It is estimated that 1 million people in Port-au-Prince currently live in a tent city. There is no sanitation, the limited port-a-potties are full (and have been for weeks), electricity is non-existent, and there is no running or clean water. And with the rainy season upon them, they are ankle deep in mud. This is a breeding ground for typhoid, tetanus, pneumococcus and measles. These are all diseases that are preventable with vaccines, and ones we give routinely in the U.S. Due to the lack of health care in Haiti, very few of the children actually receive any vaccines. Thus they sit in wait, completely susceptible to these life threatening illnesses.

The hospitals are primitive. We worked in one named Diquini. The ER consists of some cots in what looks like a hallway. Patients are lying everywhere. The pediatric “ward” is a room the size of an average master bedroom in Orange County. It has the capacity for 12+ patients. Cots, cribs and bassinets are scattered about the room. There is no full census; no one tells you the beds are full. You just keep finding a new corner or hallway to put patients. There are no sheets for any of the cots or cribs and there is no housekeeping that cleans and sterilizes between patients. Children may get their scheduled meds, or more likely, they may not. There is one nurse, maybe, that takes care of all the patients on the ward and one day when I was there she took an afternoon nap in the back room. Thus, you get the idea of the circumstances.

The children that get admitted do not have routine illnesses by US standards. They are sicker than the average hospitalized child in our hospitals. They have malaria, typhoid encephalitis, sickle cell crisis, status asthmaticus, intestinal worm infestation, staph scalded skin, tuberculosis infection of the bone, just to name a few. These were all actual diagnoses that we cared for while we worked at the hospital. There is a Labor and Delivery unit, although only 1 in 4 babies in Haiti are born with a health care worker present. Most are born at home. We met a woman with infant triplets that had delivered them vaginally at home….. in her tent. They were all doing great. While I am the first to admit that our health care system needs an overhaul, I realize now how lucky we are to have what we do. I get irritated when I do not have a lab back in a couple of hours. In Haiti, two days is the norm and that is only if they can find the log entry or the sample didn’t get lost.

Unfortunately, the people of Haiti suffer from a government that is horribly corrupt, a culture that does not reward hard work (50% of Haitians make less than $1/day, only 50% of adults are literate) and conditions that even the poorest Americans would find unacceptable. There are many volunteers in Haiti, from all over the world, helping out in different ways. I was humbled by the dedication of many of the volunteers that I met. Many have been in Haiti for weeks, months or longer, fighting for a better life for the people. There are many good people in this world and I was lucky to meet some of them during my trip. They have inspired me, taught me about true selflessness and showed me how much one person can accomplish.

The need is so overwhelming that at times you get a sense of futility, I felt like a tiny drop in an ocean of need. About half way through the trip I was working at a particularly grim clinic, it was long hours, 100 degree heat and 200 people waiting to be seen. I was physically not feeling well and it all just seemed too much to handle. I was ready to go home. A woman sat down with her 2 children. She engaged me in conversation with the interpreter, asked me if I was a mother, how old were my children, who was taking care of them at home. This was unusual. Most of the Haitian adults were very businesslike and often difficult to engage at all. They rarely smiled and definitely made no small talk. She was a lovely woman, full of questions about my life. We completed the visit. The children had simple illnesses that were easily treated. Before she walked away, she reached out to hold my hand, looked directly into my eyes and said a few simple words to me. A few simple words that changed my life. Through the interpreter she said, “Thank you for leaving your children behind, so that you could be here and take care of mine, may God bless you always.” Her graciousness was overwhelming. I knew at that moment that my trip to Haiti had been the right choice. Perhaps one person really can make a difference.

Click thumbnails to view larger images

In addition to Dr. Ball, SOCPA’s Board of Directors includes John Mersch III, M.D., Regina Brown, M.D., Stephen Tang, M.D. and Terence Chu, M.D.

We congratulate Dr. Ball in this new and exciting endeavor, and are confident that his involvement on the Board will only help us to continue to provide Great Care to Great Kids throughout Orange County!

For more information on keeping your child safe in the sun and around water or anytime, please visit  ockeepkidssafe.org, the website for The Injury and Violence Prevention Program for California Chapter 4 of the American Academy of Pediatrics.

Dr. Dwinell sees patients in our San Clemente (Talega) office.  Check back soon as Dr. Dwinell will share her experiences in Haiti upon her return to SOCPA.   We wish her a safe, fulfilling and productive trip!