Four Year Anniversary

Business anniversaries are important occasions for a company, since they provide the physician and staff an occasion to celebrate its achievements

Four years ago, ABC Pediatrics Fresno was born. It has been an exciting year for ABC Pediatrics as we grew very rapidly, in terms of our patients as well as our employees.

We implemented Athena, a state of the technical art Electronic Medical Record System. Our patients have the ability to re-schedule appointments, view billing, pay bills on-line and communicate with the physician and office staff, from the comfort of their homes via internet.

We are excited as the next year begins to continue the excellent care your children receive and enhance new technology to better communicate with our patients and colleagues.

So, we give a hip hip hoorah on our success and four year anniversary!

Immunizations for children and Teens

Timely immunizations (also known as “vaccinations”) help to keep your family and the community healthy. Immunizations are a regular part of well-child visits.

Below you’ll find a general list of vaccines that we recommend for children and adults. Some immunizations are given in a single shot, while others require a series of shots over a period of time. Missed doses can often be made up.

Get answers to frequently asked questions about immunizations and find immunization definitions in our glossary.

Name of vaccine Recommendations
Chickenpox (varicella) 2 doses total: given at 12 months and 4 to 6 years if no prior history of chickenpox. Children 4 years and older who have had 1 dose of vaccine need a second dose.
Diphtheria, tetanus, and pertussis (DTaP) 5 doses total: given at 2, 4, 6, 12 to 15 months, and 4 to 6 years. Minimum age: 6 weeks. Not given to children 7 years of age or older.
Haemophilus influenzae type b (Hib) 4 doses total: given at 2, 4, 6, and 12 months. Minimum age: 6 weeks. Generally not given to children 5 years of age and older. Hib is a cause of pneumonia and bacterial meningitis, particularly in children under 5 years of age.
Hepatitis A (HepA) 2 doses total: given at 12 and 18 months. May be given to older patients (no maximum age) with a minimum of 6 months between the 2 doses.
Hepatitis B (HepB) 3 doses total: given at birth, 1 to 2 months, and 6 months. If receiving combined DTap-IPV-HepB vaccine, an extra dose may be given to infants at age 4 months. May be given to older patients.
Human papillomavirus (HPV) 3-dose series for boys and girls starting at age 11 to 12 years. Minimum age: 9 years.The second dose is given 2 months after the first.The third dose is given at least 3 months after the second dose and at least 6 months after the first dose.HPV causes cervical cancer, anal cancer, and some other types of cancer.
Inactivated influenza (flu shot) Annually starting at age 6 months.Doses: Children 6 months to 9 years who are getting a flu shot for the first time or did not receive the H1N1 vaccine last year need 2 shots, given a month apart.
Live intranasal influenza Annually starting at age 2 years for children who do not have asthma or other specific high-risk medical conditions.Doses: Children 6 months to 9 years who are getting a flu shot for the first time or did not receive the H1N1 vaccine last year need 2 shots, given a month apart.
Inactivated poliovirus (IPV) 4 doses total: given at 2, 4, 6 months, and 4 to 6 years. In California, the fourth dose may be given as young as age 12 months. Minimum age: 6 weeks.
Measles, mumps, and rubella (MMR) 2 doses total: given at 12 months and 4 to 6 years. Single-agent vaccines for measles and mumps are no longer available. If given before age 12 months for international travel or a disease outbreak, 2 subsequent doses are still needed. Minimum age: 6 months.
Meningococcal conjugate (MCV) 1 dose: given at 11 to 12 years or older (up to age 21). Booster dose: given at 16 to 21 years to those who got their first dose before age 16.
Pneumococcal conjugate (PCV) 4 doses total: given at 2, 4, 6, and 12 months. Minimum age: 6 weeks. Generally not given to children 5 years of age and older. Given to children 2 years of age and older with special high-risk medical conditions. Pneumococci are a common cause of bacterial meningitis, pneumonia, and ear infections.
Pneumococcal polysaccharide (PPSV23) Given to children 2 years of age and older with special high-risk medical conditions. Pneumococci are a common cause of bacterial meningitis, pneumonia, and ear infections.
Rotavirus (RV) 3 doses total: given at 2, 4, and 6 months. Minimum age: 6 weeks. Maximum age for the first dose is 14 weeks and 6 days. Final dose in the series is given by age 8 months and 0 days.
Tetanus, diphtheria, and acellular pertussis booster for teens and adults (Tdap)Also available: Tetanus and diphtheria (Td) 1 dose: given at age 11 years and older. (Children ages 7 to 10 years who did not get the complete DTaP series will get a Tdap booster.) Proof of vaccination is now required for entry into 7th through 12th grades in the fall of 2012. Vaccinating teens and adults prevents pertussis cough illness (up to 3 months of cough) and also prevents infants from developing whooping cough, a potentially fatal disease.

Whooping Cough

Protect Your Baby from Whooping Cough

Whooping cough (also called pertussis) is a highly contagious disease that is spread from person to person by coughing. It spreads easily in households, schools, and workplaces.

Over the past 30 years, the number of people with whooping cough in the U.S. has been increasing. A person of any age can catch whooping cough, but children, teens and young adults catch it more often.

When babies get whooping cough, it can be life-threatening. Many need to be hospitalized because they cannot breathe. Some also develop pneumonia and other serious complications.

The good news is that vaccines are available to help prevent whooping cough. You can protect your family from whooping cough by making sure all of your family members, including children over 6 weeks of age, get a vaccination.

DTaP is a vaccine for children under 7 years old and is given in 5 doses before kindergarten starts. Infants as young as 6 weeks old can get a DTaP vaccine. Another vaccine for teens and adults, Tdap, also prevents whooping cough and is available to children as young as 10 years old. Only one dose of Tdap is needed to protect teens and adults.

Who Should Get Vaccinated?

• Most infants with whooping cough get it from members of their own household. Parents and other adults or teens in close contact with infants younger than 6 months old should get Tdap vaccine if they have not already had the vaccine. This includes grandparents younger than 65 years old, teenage siblings, day care workers, health care workers, and other adults who are in close contact with young infants. If you are 65 years or older and live with or care for an infant, please talk to your physician about pertussis vaccination.

• Women of childbearing age should get vaccinated. If you are pregnant, and have not been vaccinated you can get Tdap vaccine during your pregnancy or after giving birth. Partners and families can be vaccinated at any time, but preferably before the birth of the baby so they don’t infect their newborn. About half of infants who develop whooping cough get it from their mothers. It is safe for mothers to get Tdap vaccine while breastfeeding.

• Many infants who get whooping cough are infected by teenage siblings. Your pediatrician can protect your newborn baby by giving your children and teenagers Tdap vaccine starting when they are 10 years old.

• If you are not sure if you and your family members have been properly vaccinated against whooping cough, you can find out by viewing your immunization records on – Patient Portal Link  (See top right hand corner of the website) or by contacting your physician’s office.

Ask your doctor or visit our Clinic as soon as possible to get yourself and your family vaccinated so you can protect your baby against whooping cough. Remind others to cover their mouths when they cough and to wash their hands often.




Patient Related Forms

Well Child

Healthy Kids, Healthy Futures*:

Guides for parents about nutrition, development, safety, and other issues

Birth to 1 Week Checkup  2 to 4 Week Checkup    2 Month Checkup      4 Month Checkup
   6 Month Checkup  9 to 10 Month Checkup   12 Month Checkup   14 to 15 Month Checkup
   18 Month Checkup  21 to 24 Month Checkup     3 Year Checkup     4 to 5 Year Checkup
  5 to 6 Year Checkup  6 to 8 Year Checkup   8 to 10 Year Checkup    10 to 12 Year Checkup
  Teens Checkup (and Tips for Teens)

* Source:, The Permanente Medical Group, Inc. All rights reserved.

For travel shots, call ABC Pediatrics Fresno and request Dr. Shahinfar.

Positive Parenting Tips

Positive Parenting Tips

Educational Materials

This is a unique web site tailored specifically toward the concerns and interests of todays parents. The site was developed and created by well-respected medical leaders in the field of pediatrics and adolescent medicine.

KidsHealth has separate areas for kids, teens, and parents – each with its own design, and appropriate content and tone. There are literally thousands on in-depth features, articles, animations, games and resources -all original and all developed by experts in the health of children and teens.

This web site is published by the American Academy of Family Physicians (AAFP), which promotes and maintains high-quality standards for family doctors who are providing continuing comprehensive health care to the public

This website’s mission is to empower people with trusted solutions for healthier lives by providing credible information from the most trusted sources.

Easy to use Health Encyclopedia contains thousands of pages of information on pediatric diseases, conditions and treatments, as well as sections on how to keep kids healthy. You can find what you want by using the Quick Links on the right or by searching the whole encyclopedia using the search box. We suggest you search - you’ll find what you want quickly! The encyclopedia is also available en espanol

The mission of this web site is to empower people to manage their health by providing useful and up-to-date information and tools that reflect the expertise and standard of excellence of Mayo Clinic, it gives you access to the experience and knowledge of the more than 2,000 physicians and scientists of Mayo Clinic.

This site features links to information on diseases and conditions and a pregnancy center for the expecting parents.

Patients can get the latest health care information through articles and videos over many health-related topics.

HealthTalk interactive connects patients with people who can answer questions through interactive Web broadcasts that are designed to offer more than clinical medical information. HealthTalk allows patients to ask questions of experts in the web casts, then archives the programs and transcripts on its web site.

This is an internet-based medical site providing highest-quality health information, daily medical news, a health library, resources, drug information, articles, references, free medical questions and answers with experts, informative material, community support groups, live health chat, real-time interactive tools and more.

Learning disorders, ADHD, 504 Plans, etc.

Patient information: Breastfeeding

1) Breastfeeding

Do doctors recommend breastfeeding for most babies? — Yes. Doctors recommend that, when possible, women feed their babies only breast milk until the baby is 6 months old. Breast milk has all of the nutrition that babies need until they are 6 months old. Breastfeeding can also help prevent babies from getting ear infections, lung infections, or diarrhea.
When can I start breastfeeding? — Most women can start breastfeeding within a few hours after giving birth. For the first few days, most women make only a small amount of yellowish milk called “colostrum.” Colostrum has all of the nutrition a newborn needs. Most women start making more milk after 2 or 3 days.
How should I hold my baby during breastfeeding? — There are different ways you can hold your baby during breastfeeding (figure 1). You can try different positions to figure out which way works best for you and your baby.
What does “latch-on” mean? — Latch-on is another word for when a baby makes a tight seal with his or her mouth around the nipple and the areola (the dark skin around the nipple) (figure 2). A good latch-on helps the baby get enough milk and can prevent the mother’s nipples from getting hurt. But even with a good latch-on, it can be normal for women to feel a little pain when a feeding starts.
How often should I breastfeed and how long should a feeding last? — A woman should breastfeed when her baby shows signs of being hungry. A baby can show that he or she is hungry by:
  • Waking up from sleep
  • Moving the head around as if he or she is looking for the breast
  • Sucking on his or her hands, lips, or tongue
Babies can breastfeed on different schedules and for different amounts of time. For example, some babies finish a feeding in 5 minutes, but others might take 20 minutes or longer.
Doctors recommend that women finish breastfeeding on one side so that a baby gets all the milk from that breast. Then, a woman can see if her baby wants to drink from the other breast.
How do I know if my baby is getting enough breast milk? — You can tell if your baby is getting enough breast milk by:
  • Checking his or her diapers – By day 4 or 5 after birth, babies should have at least 6 wet diapers a day.
  • Checking his or her bowel movements – By day 4 after birth, babies should have 4 or more bowel movements a day. By day 5, their bowel movements should be yellow.
  • Having your doctor or nurse check to see if your baby is gaining weight
Does my baby need any other food or drink? — For the first 6 months, most babies need only breast milk. But your doctor might recommend that your baby take a liquid vitamin, too.
When a baby is 6 months old, he or she can start eating and drinking other foods. Ask your doctor or nurse which foods you can feed your baby and when.
What problems can happen during breastfeeding? — Some women have problems during breastfeeding that can include:
  • Swollen, hard, and painful breasts
  • Painful or cracked nipples
  • Breast or nipple infections
  • Blocked milk ducts, which can cause red and painful breast lumps
How are breastfeeding problems treated? — Breastfeeding problems are treated in different ways. Treatment will depend on the problem. For example, women with swollen, hard, and painful breasts often feel better if they:
  • Use their hand or a breast pump to let some milk out.
  • Use an ice pack or take pain-relieving medicine to treat the pain
  • Take a warm shower to start their milk flow and let some milk out
Talk with your doctor or nurse if you are having problems with breastfeeding. Most breastfeeding problems can be treated. Some women also find it helpful to talk with a breastfeeding expert called a “lactation consultant.”
Should I see a doctor or nurse? — Call your doctor or nurse if you have:
  • A blocked milk duct that does not get better
  • A fever and a hard, red, and swollen area of the breast
  • Blood leaking from the nipples
  • Pain that lasts for the whole breastfeeding session
Do I need to eat or drink more when I am breastfeeding? — Yes. Women need to eat extra calories and make sure that they drink enough fluids. Ask your doctor if there are vitamins you should take, or foods or medicines you should avoid.
When should I stop breastfeeding? — Women choose to stop breastfeeding at different times and for different reasons. But doctors do not recommend that women stop breastfeeding all at once. Instead, when you decide to stop breastfeeding, you can drop one feeding every 2 to 5 days, or breastfeed for fewer minutes each feeding.

Patient information: My Child is Overweight

2) My Child is Overweight

How do I know if my child is overweight? — Your child’s doctor or nurse will tell you. He or she will measure your child’s height and weight and use those measurements to calculate a number called the “body mass index” or “BMI.”
The doctor or nurse will use your child’s BMI to tell if your child’s weight is healthy for his or her height. To do this, the doctor or nurse will compare your child’s BMI to the BMIs of other children of the same age and sex. If your child’s BMI is high compared to other children, he or she is overweight. When a child’s BMI is much too high, doctors sometimes use the terms “obese” or “obesity.”
Why is it important for my child to have a healthy weight? — It’s important to have a healthy weight, because children who are very overweight can have:
  • Liver problems
  • Asthma – This is a lung condition that can make it hard to breathe.
  • High blood pressure
  • Knee or back pain
  • Sleep apnea – This is a condition that makes people stop breathing for short periods during sleep.
It’s also important that your child have a healthy weight so that he or she will have a healthy weight as an adult. Being overweight as an adult can lead to medical problems such as high blood pressure, diabetes (high blood sugar), heart attacks, and some types of cancer.
What causes children to be overweight? — Children can be overweight for different reasons. Some children simply gain weight more easily than other children. These children can become overweight by eating too much, eating unhealthy foods, or not getting enough exercise. When children gain weight very easily, they have to work extra hard to get to and stay at a healthy weight.
Although uncommon, some medicines and medical conditions can also make children gain weight more easily.
Will my child need tests if he or she is overweight? — Maybe. The doctor or nurse will talk with you and your child, and do an exam. He or she might do blood tests to check for:
  • A condition that could be causing your child to gain weight easily
  • Health problems that can happen when children are overweight
How can I help my child get to a healthy weight? — To help your child get to a healthy weight, you need to help him or her eat healthy foods and be more active. Making these lifestyle changes can be hard, especially at first.
To help you and your child start making lifestyle changes, think of the numbers 5-2-1-0. Each of these numbers stands for a goal you can try to reach every day to help your child be healthier.
  • 5 – Have your child eat 5 servings of fruits or vegetables each day. Frozen fruits and vegetables count towards the goal, but fruit juice does not. A serving is usually 1 whole fruit (such as an apple or banana) or ½ cup of vegetables. If your child does not like vegetables or fruit, start slowly. Eat these foods yourself to set a good example, and have your child keep trying them.
  • 2 – Limit your child’s “screen time” to 2 hours or less each day. Screen time includes watching TV, playing video games, or using the computer for things other than homework.
  • 1 – Have your child do physical activity for 1 hour or more each day. This can include doing a sport, dancing, or playing outside.
  • 0 – Your child should have 0 sugary drinks each day. Sugary drinks include soda, sports drinks, and all juices.
You and your child might not be able to meet all of these goals at first, but that’s OK. Choose 1 or 2 goals to try first. Later on, you can try to meet all of these goals.
Is there anything else I can do to help my child? — Yes. You can:
  • Avoid bringing unhealthy food into your home. If you have unhealthy food in the home, your child is likely to eat it even if you tell him or her not to.
  • Involve the whole family. Have everyone in the family eat healthier and be more active, even those who have a normal weight. Try to do physical activities as a family. This can be as simple as going to a playground or taking a walk.
  • Tell your child that the goal is for him or her to be healthy and strong. Let him or her know that the way to be healthy and strong is to eat healthy food and be active.
  • Get help if being overweight is causing your child to be sad, worried, or have a hard time in school. Ask the doctor or nurse for ways to get help for your child.
  • Work with your child’s doctor or nurse. See him or her for regular check-ups, so that he or she can follow your child’s BMI over time. Let the doctor or nurse know if you are having trouble meeting the 5-2-1-0 goals. He or she can help you get started or give you some tips. He or she might also recommend that you talk with a dietitian (food expert). A dietitian can help you choose healthy foods and plan meals.

Patient information: Vitamin D for Babies and Children

3) Vitamin D for Babies and Children

Why is vitamin D important for babies and children? — Babies and children need vitamin D to grow normally and develop healthy bones.
What can happen if babies and children don’t get enough vitamin D? — Babies and children who don’t get enough vitamin D can get a condition called “rickets.” Rickets can make bones thin and weak. Some children with rickets have legs that bend to the side, called “bow-legs”
Is my baby or child at risk of getting too little vitamin D? — Maybe. If your baby only gets breast milk, or breast milk and some formula, he or she needs extra vitamin D. Breast milk has most of the nutrients a baby needs, but it does not have enough vitamin D in it.
Babies and children can also be at risk if they:
  • Have dark skin
  • Do not drink enough milk or eat other foods with vitamin D in them
  • Take certain medicines
  • Were born premature
  • Have a medical condition that makes it hard to get enough vitamin D, such as cystic fibrosis or celiac disease
  • Spend most of their time inside or live in a place with little sun
How can I make sure my baby or child gets enough vitamin D? — Vitamin D supplements are the best way to make sure your baby or child gets enough vitamin D for healthy bones. Supplements are pills, capsules, or liquids that have nutrients in them.
How much vitamin D does my baby or child need? — Experts recommend that all babies and children take 400 to 600 international units of vitamin D a day starting a few days after birth. If your child has a condition that makes it hard to get enough vitamin D, he or she might need to take more.
Talk to your child’s doctor or nurse about which type of vitamin D to give your baby or child, how much, and when to give the supplements. The right dose will depend on your child’s diet, whether he or she has any medical conditions, and other factors.
It is important not to give your child too much vitamin D. Giving too much vitamin D can make your child sick.
Is there a test for vitamin D? — Yes. Your child’s doctor or nurse can do a blood test to check your child’s vitamin D levels.
Can my baby or child get vitamin D from foods and drinks? — Yes. Foods and drinks that have a lot of vitamin D include
  • Baby formula, milk, orange juice, or yogurt with vitamin D added
  • Cooked salmon or mackerel
  • Canned tuna fish
  • Cereals with vitamin D added
  • Cod liver oil

Your baby or child can also get vitamin D from the sun. The body uses sunlight that shines on the skin to make vitamin D. Playing outside can help your child exercise and get vitamin D at the same time. But it is important to ask your child’s doctor or nurse how much sun is enough. Your child should wear sunscreen at least part of the time to prevent sunburn and other conditions caused by too much sun