The Next Step in Quality Pediatric Health Care

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April 14, 2020 OTP Newsletter

Hey everyone and welcome to another edition of the Quarantine Times! Hope you’ve all been staying safe, and making the most of this weird opportunity to simplify life and to connect while we stay apart.

What’s New At The Office?:

Telemedicine: We’ve been doing telemedicine for a few weeks now and it’s going great! Families that have set up appointments have loved the ease and convenience, and we love seeing you guys!  The visits only take a few minutes, and we can evaluate and treat all sorts of issues while you stay safe at home.

Well Visits: Well visits are still essential for our younger patients who should not fall behind on vaccinations.  For our older patients, scheduling a well visit now may be a good idea, as the rush for summer and school physicals should be quite crazy when social distancing ends.  We’re now scheduling the majority of our well visits in the morning, before our sick visits.  Patients get brought into rooms directly from their car. Feel free to call the office to discuss any concerns you may have.

Fact You Need To Know!: The record for the longest living goldfish goes to Tish, from the UK, who lived to the ripe old age of 43 years! (or who had parents that switched it to Tish 2 all the way to Tish 37 without their kids seeing).

Keeping Busy and Entertained: It’s been weeks of this insanity already, and we’re looking at several more.  Parenting creativity is getting tested like never before!  Luckily, there are so many people and organizations in the world that are trying to help.  Here’s just a few ideas and sites.  If you have more, feel free to share on our Facebook page!

  • Cooking classes: Delish has online cooking classes made for parents and children.  You can find them on Instagram or if you’re reading online, click here.  Make a batch of cookies together!  That way, when you’re done, you’ve got cookies!
  • Museum tours: From the Museum of Natural History, to the Boston Children’s Museum, to museums across the globe, there are virtual tours available to see many of the world’s wonders.  For a great list, go to or click here.
  • Reading time: While schools are closed, Audible has a large amount of audio books available free of charge.  Sit with the family, make some popcorn, and listen to a variety of books for everyone from young children to teens.
  • Elmo’s Virtual Playdate: Elmo and the gang will be hanging out with Lin-Manuel Miranda and other famous folk tonight at 7pm (though it will likely be available online after that). You can find it on WarnerMedia Networks including HBO, TNT, TBS, Cartoon Network, Boomerang and truTV and the PBS Kids Video app.
  • Let music tame your savage beasts! Visit the NY Philharmonic Kid Zone for interactive activities designed to introduce your kids to all sorts of instruments and classical music.
  • Finally, there’s, well 1000 more things.  Online art and doodling classes, online singalongs, kids yoga, taekwondo classes.  If you can think it, it’s out there.  And if it’s not, get your kids together and create a class!

Social distancing is not easy, but it’s still super important.  Stay home, stay safe, and know that we’re here for you 7 days a week.



OTP Newsletter (Updates and a few words about anxiety)

Updates and a few words about anxiety

How’s it going out there everyone?  We’re hoping this newsletter finds you all healthy and safe (and inside!).  This is obviously a situation unlike anything most of us have ever experienced in our lifetimes. Each day is filled with an insane mixture of frightening and sad news and uplifting tales of heroism and selflessness.  Each family has been given the task of helping each other survive and thrive through some completely uncharted territory. From the stories we’ve been hearing, you guys are crushing it so far!

FUN FACT: Giraffes can grow up to 14 feet! However, most just have four.

Our office has continued to adapt to the needs of our families.  We’ve expanded our Telemedicine capabilities.  You can now make an appointment to see any of our doctors for most illnesses or concerns.  It’s very easy to set up and fun to do! For people coming in to the office, we’ve separated our sick times and well times, and have eliminated the use of our waiting room. Families with appointments can call from their car and be brought right into rooms. The American Academy of Pediatrics still discourages delaying most well visits and immunizations.  Call us if you have questions or concerns.

TODAY’S ACTIVITY IDEA: Have your children write notes or draw pictures, and send them to your local senior living facility.  Many of those people have much fewer visitors now and can probably use the smiles!

Finally, a word about anxiety.  In times of stress and turmoil, anxiety is prevalent and can be demonstrated in different ways in different people, including children of all ages.  Even infants who are not understanding the specifics of what is going on can sense the change in routine, and the stress in others.  As stressors continue, your children may be experiencing sleep pattern disturbances, behavioral regression, acting out, or increased fighting among siblings.  All of these things can be signs of anxiety.  While the source of this stress may not be going away soon enough, there are ways to help how you and your family handle these days as they come. There are many online resources with strategies and advice. If you’d like to discuss this with a familiar voice, that’s what we’re here for!  Set up a telemedicine visit and we can share ideas.

Please stay safe, stay isolated, stay healthy.  And let us know if we can help.

Old Tappan Pediatrics COVID-19 Update and Schedule Changes


As the COVID-19 outbreak continues, Old Tappan Pediatrics will be taking precautionary measures to help keep our patients and our staff safe. In addition to screening all patients about any potential exposure risks, starting this upcoming Monday, March 16 we will be changing our scheduling practices as outlined below.

-Until further notice, only 1 family member or caregiver will be allowed to accompany the patient to any visit. Please call the front desk to discuss any potential issues related to this guideline.

– While we will continue to open early for sick visits on Mondays (8:30), we will be suspending our walk-in capabilities.  Please call the office for an appointment before coming in.

– During our normal weekday hours, we will see our sick or same-day patient appointments in the morning.

– After our sick patients are gone and the office has been recleaned and disinfected, we will reserve our afternoons for patients with no known exposure to come for physicals and non-respiratory sick visits (injuries, follow-ups, ADHD visits, etc.)

-Late afternoon and evening hours will be reserved for sick appointments only.

-Any patients with fever and cough will be asked to call our office from our parking lot so we can direct them to the appropriate entrance and room number. We will have masks available in the room for the patient and caregiver to wear during the visit.

– We are enabling telemedicine appointments.  If you have worries that you should be bringing your child to the Emergency Room, or if your child has an issue that can be resolved without a visit to the office, you will have the opportunity to have a video visit with one of our doctors.  To set up telemedicine capabilities on your phone, click this link:

– At this time, we have no capabilities to test for COVID-19

We appreciate your understanding during this time. As always, we are 100% committed to keeping you and your children safe and healthy. Please contact our office if you have any questions or concerns.

The Real Battle Royale…Getting Your Kids Back From Fortnite



Ever since the introduction of Pong by Atari (ask grandpa), children have been drawn to video games.  Over the past 40 years they have developed in countless ways.  Graphics are better, games are portable (they can be played on tv’s phones, tablets, etc), games are more socially interactive (they can be played with groups of friends at different locations), and they have become infinitely more addictive.  The new gold standard exemplifying all these qualities is a game called Fortnite.


If you’re already well aware of the ins and outs of this monster, feel free to skip this paragraph.  For everyone else, here’s a quick information catch up.  Developed in 2017 by Epic games, Fortnite is divided into three distinct type of games. There’s a standard zombie-killing, save the world game, a more creative build your own battle world game, and then there’s the most popular of the three, Battle Royale.  Fortnite Battle Royale is sort of where video games meet the Hunger Games.  Up to 100 players compete in each mini game to become the final survivor.  Well over 200 million people worldwide compete in Fortnite Battle Royale, and the game generates hundreds of millions of dollars monthly.


What has made Fortnite the international phenomenon that it is?  There are several answers, all of which were carefully thought out by its creators. While all video games, and games for that matter can be addictive, Fortnite seems specifically designed to be universally appealing, and deeply compelling.  While it is loaded with violence, there is no bloodshed or gore.  Players just disappear when they are killed.  This makes it more palatable for parents, and more acceptable for younger audiences. Parts of the game are decided by chance, giving the gamers a feel of gambling rush.  When the final player of Battle Royale wins, the remaining 99 often don’t feel like they lost, but that they almost won, and jump at the chance to give a go in the next game.  Finally, there’s a huge social aspect to the game.  Not only can groups of friends play together from their own homes, but just playing can link you with all that is hot in social culture.  Just ask your kids to floss or dab, and you’ll see.


Your next question might be, “so?”  Yes, lots of children like video games, yet have active lives, good academic achievement, and occasionally shower.  For other families however, these and similar video games have led to significant sleep deprivation, school issues (failure to compete assignments, study for tests, or even attend school), detachment and isolation from family constructs, and, in worse scenarios, introduction to unknown internet solicitors and predators. There is already a niche of therapy dealing with video game “rehab”.


What’s a parent to do if every child, teenager, and Major League baseball player is hooked on this? As with every aspect of parenting, it’s all about increasing communication and involvement, setting limits, and using reward and consequence as tools to modify behavior.


Here are some tips to keep your little gamer from getting out of hand, or to reel them in if they’re already “knee deep in the dab” (okay, that’s not a thing, but you get the idea).

If your children are just entering the world of gaming:

  • Keep all gaming (and as much internet access as possible) in family areas of the house. Internet use should be monitored by parents, not behind closed doors. Gaming is no exception.
  • When possible, join in, interact, and use gaming as a tool to bring you closer to your children. (Be careful though…it’s not just addictive for children).
  • Set limits and ground rules early. Gaming and screen time, like any other entertainment or distraction, should be thought of as a privilege. If school assignments aren’t getting done, responsibilities at home are being overlooked, etc., you still have to supply food and water, but not video game time.


If you’ve already lost your children to the nite…

  • You will be much more effective at altering your child’s habits by adding activity as opposed to subtracting. Instead of saying “no more” of the games, have the alternatives planned. “Today we’re going to ride our bicycles to the ice cream place you like”.
  • Understand the timing and social aspects of the games. In Fortnite the games are fairly short, and kids are often playing with a group of other players, depending on each other. Saying, “stop playing the game NOW” may be met with lots of pushback and fighting. Saying, “this has to be the last game for today” may get you to a mutual agreement more easily.
  • While Fortnite is a free game, there are lots of purchases that can be made (character costumes. weapons, or the Battle Pass – ask your kids). If these are items your children are interested in, what better way to reward them for getting chores done, getting homework done without a fight, or just being the kind citizens you’re trying to raise.
  • If you think your child has a serious issue, with academics, athletics, and social interactions being negatively affected, now is the time to do something about it. Contact your doctor, school counselors, or any of a number of centers to get more information.


Video gaming will not be a passing fad.  Companies are making more money, and technology keeps advancing.  Alas, parenting isn’t going anywhere either.  The more you can involve yourself in your children’s activities, set firm limits, and keep communicating, the more likely you’ll be able to keep a healthy amount of video gaming in your home. You may even wind up with a somewhat tolerable teenager! Good luck out there.

Whose Homework Is It Anyway?- Reducing the after school frustrations and fights.

Whose Homework Is It Anyway?

We’ve all seen the Staples commercial; Dad dancing down the aisle, getting school supplies, relishing the approaching day when his kids will be sent back to their schools.  No longer his responsibility, no more refereeing, no more attitudes. Peace at last.

Now, back to the cold reality.  Yes, your children are begrudgingly pushed onto buses and out of carpool doors, but, in the blink of an eye, they’re back, and they have homework. It seems like homework is becoming a larger and larger portion of children’s education, and completing it has brought many families whole new challenges, frustrations, battles, and questions of self-worth, for student and parent alike.

At the bottom of this blog there is a link to a comprehensive article published by the National Association of School Psychologists.  But just in case you’ve only got a few minutes before it’s time for you to decipher the new method of division (“MOM, YOU’RE DOING IT WRONG!!!”), here are the bullet points.

  • Important Points to set as law starting the year:
    • Homework is considered important in your home – getting it completed and handed in on time is his/her responsibility, and he/she will be held accountable.
    • You will be there for support, within reason. Your presence during homework can be comforting for a child feeling overwhelmed.  Be there to answer questions, and aid with refocusing and self-confidence.
    • You will not be there to do the homework. This interferes with your child’s education, and promotes the feeling that he/she can not succeed on their own.
  • Ways you can support your child with homework:
    • Establish clear homework routines: timing, a place in the house,
    • Check in daily. Not to micromanage, but to find out what things are due and when.  This can help your child organize things, and even remind them of things they’ve forgotten.
    • It takes a village! Split the support with your spouse (pick your best subjects), or utilize other family members, local high school students, etc.
    • Incentives help. Giving your child something to look forward to at the end of a homework session or project could be the stimulus they need.
    • Keep communications lines open with teachers. Find out if homework is being handed it, if assignments are coming home correctly, or if there are things you or the teacher can be doing to make your children more successful.

It is important to instill as many of these tips as possible early in the year.  When kids fall behind with school, a level of pressure can get added that makes even simple challenges seem insurmountable.  Make sure your family is getting the support it needs, both children and parents!


Again, you can click for the full article from the NASP entitled Homework: A Guide for Parents


You’ve got this!!

But if you need some support, you know where to find us!


When Cute Feet Go Bad…Tackling Foot Odor

When Cute Feet Go Bad…Tackling Foot Odor

It’s Summertime.  The sun is shining, ice cream and watermelon abound, and…Oh my!!! What is that smell? You look to the back of the minivan in horror, wondering what sort of animal has met its demise.  Could it be?  Could that rancid odor be coming from the feet of my pig-tailed beauty?  How is that possible?!

That scenario, shocking as it seems, is actually quite common.  Yes, children’s foot odor is one of the better kept secrets of parenthood.  Children’s feet tend to sweat much more than those of adults, making it a good environment for bacteria to grow. The bacterial culprit is kyetococcus sedentarius (be sure to remember to answer in the form of a question if asked on Jeopardy).  These bacteria live on the oils and dead skin cells of feet and produce sulfur-like byproducts, hence the powerful odors.

The good news is there are things you can do to help.

Handy (footy) Tips:

  • Washing – Now, this isn’t to say that your child’s feet smell because they are dirty, but showering daily and having your feet be in soapy water may not be enough to remove the skin cells and bacteria causing the problem. Specialized soaks and exfoliating foot scrubs will do a better job of removing bacteria (there is no evidence showing that anti-bacterial soaps are effective).
  • Avoid using lotions on feet that can clog pores and increase sweating. Try to use powders for any conditions needing treatment.
  • Try to avoid plastic and rubber footwear that could cause feet to perspire more. More breathable fabrics are preferred (leather, canvas, modern mesh). Cotton or moisture wicking socks are helpful too.
  • It can be helpful to have a few pairs of footwear, allowing you to switch daily, and give sneaker a chance to dry and air out.
  • Sock changes after exercise or whenever wet.
  • Finally, some footwear has removable shoe inserts that can be washed separately.
  • If all else fails, send them to grandma and grandpa’s for the summer!!

Foot odor in your children can be frustrating and even embarrassing, but don’t be discouraged. With some preventative measures, and detailed cleanings, your children’s feet will be the envy of the carpool!


Old Tappan Pediatrics Receives National Recognition as a Medical Home

Old Tappan Pediatrics Receives National Recognition as a Medical Home

Old Tappan Pediatrics has been awarded recognition by the National Committee for Quality Assurance (NCQA).  The NCQA is a private, non-profit organization dedicated to improving health care quality. The Recognition Programs were developed to help clinicians and practices support the delivery of high-quality care. The Recognition Programs are built on evidence-based, nationally recognized clinical standards of care.  Simply put, these are evidence based guidelines to show that we dedicate ourselves to the complete care of our patients, during a time when more and more fast-food health care centers are opening, trying to treat patients in 3 minutes or less.

We continue to improve ourselves to serve our patients better, 24 hours a day, 7 days a week.  And now we’ve got the national recognition to prove it!  If you have any questions about our certification, please feel free to ask.

Camp and Sports Physicals

It’s that time of year again.  Our phones start ringing, the voices of frantic family members on the other end.  “My son just let me know that if he doesn’t get a check-up in the next 6 1/2 hours, he can’t play baseball, his future will be ruined, he’ll be destined to work on a corner in New York City, squeegee in hand”.  That’s a lot of pressure for a few well intentioned Pediatricians.

Physical season comes every year, like taxes and Taylor Swift romantic interests (sorry TSwift, but it’s true).  We do our best to accommodate as many appointments as possible, but we need your help to get everyone taken care of.  Often the requests come in bunches, and some patients are left going to school sports physical “car wash” events, where a group of health care people check various parts of your children for a few seconds, and claim them “fit for sports”.  These events relieve the schools of some liability, but do not do your child justice.  Yes, “breathe in, breathe out, turn your head and cough…done”, is very convenient, but we like to think that an annual physical should encompass a great deal more than that.

So pick up your date book, look ahead to the next few weeks, and make an appointment as far in advance as possible.  Set up a well visit for your child. Help us help you.

Enjoy your summer!