Office Information

We see all patients on an appointment basis. The reason for your visit will determine how soon you need to be seen and how much time to allow for your visit. Please schedule a physical/preventative care visit at least two months in advance. If you are unable to keep an appointment, please notify us 24 hours prior to your appointment. Our after-hours office answering system allows you to leave an appointment cancellation message when our office is closed.

Appointment Hours:
Monday, Wednesday & Friday: 8:00am – 5:00pm
Tuesday – Thursday: 8:00am – 8:00pm

We recognize that emergency situations do arise and we will do our best to respond promptly. Please call during regular office hours for nonemergency problems and questions. For emergencies, we have a 24 hour answering service at 909-4670 which gives your number to the doctor on-call who will return your calls as soon as possible.

Our physicians are members of the medical staff at PinnacleHealth System (Harrisburg Hospital and Polyclinic Medical Center) and Holy Spirit Hospital.

• Aetna/US Healthcare - Aetna Golden Choice
• AmeriHealth (not AmeriHealth Administrators)
• Blue Shield (Premier Blue, Blue Chip, POS)  FreedomBlue
• Capital Blue Cross/KHPC (all products including Medicare PPO)
• ChoiceCare/Humana
• Cigna
• First Health (part of Health America effective 2/1/08)
• Geisinger Health Plan
• Great-West
• HealthAmerica (Health Assurance CCPPO, Health Assurance PPO, Hershey Managed Care/Health Style) Advantra Freedom - Medicare Advantage plan ** Medicare Advantra product
• Intergroup
• Medicaid ++
• Medicare/Medicare Advantage PFFS Plans
• Prime Health Services
• PrimeSource Health Network
• Private Healthcare Systems (PHCS)/Acquired by MultiPlan - Non contracted at this time
• Railroad Medicare
• Teamsters (Administered by HealthAmerica)
• Three Rivers ++
• Tricare/HealthNet Federal Services
• United Health Care/Oxford Health Plan - Not PAR with Empire UHC
• Unison aB ++ (former Adult Basic Plan) - No other Unison products accepted

++ Optional

** Please refer to your individual insurance plan for Diagnostic & Lab Study coverage.

NOTE:  Insurances subject to change without notice.

CRNP’s (Clinical Registered Nurse Practitioners) are registered nurses with special advanced education and training. They serve as primary health care providers for acute illnesses, management of chronic medical problems, routine physicals and health teaching. They are able to diagnose and treat, including ordering lab work and x-rays, giving prescriptions, and providing referral to specialists when needed.

In order to process each patient referral, we must have at least three working days notice. This will ensure there is adequate time for your physician/CRNP to review your chart and the referral department to prepare your referral. It is the policy of both your insurance company and this office that paper referrals be hand carried to the specialist. Advance notification and timely pick-up of your referral form will maximize the efficiency of the referral process.

Please remember that most insurance companies require us to authorize all CT and MRI studies. Please ensure these authorizations have been obtained by the office who ordered your diagnostic study.

The referral desk is happy to answer any questions or assist you in any way between the hours of 9:00am and 4:30pm daily.

Our medical secretaries will assist you in making an appointment during office hours. We will make every attempt to schedule a time that is convenient for you. Spaces are made available for ill children so they can be seen in a timely manner. If for some reason you are unable to keep your appointment, please let us know as soon as possible(preferably 24 hour notice) so that the time can be made available to others

This link will answer many of the questions you may have about your new baby. If you are unable to find an answer in this link, write it down as it occurs to you and don't hesitate to ask us about it during your hospital stay, office visit, or via email.

As you read this link, remember each baby is an individual and cannot be expected to be exactly like other babies in behavior, growth or feeding patterns. You will soon discover what is normal for your baby.

Many parents have concerns about the following newborn appearances. In most cases, they are either normal or can be remedied by simple methods.

White dandruff-like flakes are often found on the scalp of infants. These flakes are the result of normal shedding of old, dead skin, and they do not indicate a dry scalp condition. Do not use oils, lotions or Vaseline. They will only make the flakes stick to the scalp making the condition worse.

If you notice thick yellowish scales, this is Cradle Cap. It is very common in infants and results from the accumulation of old dead skin. This condition may occur in spite of washing. Oils, lotions and Vaseline make the condition worse. You can remove the scales with a soft brush and by washing with an adult dandruff shampoo.

The soft spot, or Fontanelle, on the infant's head is a normal gap where the skull bones have not yet joined. The spot is covered with a thick, fibrous tissue and is very tough. You do need to fear hurting the soft spot. The Fontanelle closes usually between 9-18 months of age.

The skull bones contain many bumps, lumps, and irregularities which are not normal.

Yellow-orange discharge from the ears is called Cerumen or ear wax. It is a normal product of the ear canal lining and will periodically discharge itself to the outer ear. It can be easily wiped from the outer ear. Do not put a cotton swab into the ear canal.

Many infants appear to have slightly crossed eyes. This is most often caused by a temporary muscle imbalance. Also, sometimes the wide skin area across the nose makes the eyes appear crossed when they are not.

Yellow drainage from both eyes sometimes accompanied by redness or swelling may occur during the first 5-7 days of life. This is generally caused by the eye ointment put into the baby's eyes after birth and will clear itself without treatment. If it persists beyond 1 week, please contact the office for treatment.

Some infants have white dots over thier nose. These are called Milia and are harmless. They will disappear without treatment

Pimples on cheeks and chins are called newborn ance and are one of the most common newborn rashes. This rash will resolve itself in 6-8 weeks. An effective treatment is to clean the area with mild soap once or twice daily. Oils, lotions, and creams will only worsen the problem.

Many newborn girls have a whitish vanigal discharge. Do not worry about this. Simply clean the area with a cotton ball soaked in water, wiping front to back. Occassionally some girls will have a scant bloody vaginally discharge which should last only 1-2 days. This is a response to hormones the baby was exposed to in the womb.

It is also normal for both boys and girls to have a thin discharge from their nipples or to have swollen breasts after birth. No treatment is necessary since the condition will go away. I you notice any definite redness of breasts when they are swollen, please notify us.

A few babies begin teething at 3-4 months but most don't start until about 6-7 months. Most babies are not troubled by teething, but some are irritable, eat poorly, and have trouble sleeping. If your baby seeems uncomfortable, you may give him or her acetaminophen(TEMPRA or Tylenol) according to the dosages on page 8 in this booklet. You may want to apply a topical anesthetic or use teething toys.

If your baby seems happy and content, if he or she is eating normally and has no symptoms of illness, do not worry about minor stool changes. Changes in stool frequency, color and consistency are normal.

The number of stools a baby has daily varies. Some babies have a stool with every feeding, or they may have a stool every 1-2 days. The color and consistency of stools will also vary from day to day. Breast fed infants often have very liquid, yellow or mustard colored stools. Breast fed infants normally have runny stools this is not an indication of illness. Formula fed infants usually have yellowish-tan stools. All babies occassionally have green, brown or gray colored stools.

Babies often strain, grunt, grimace and turn red in the face when having a bowel movement. This is not a sign of a problem. Constipation is present when stools are small and pebble like. Constipation has nothing to do with the number or frequency of stools. Do not use enemas, suppositories or laxatives until you have talked to us.

Diarrhea is present when stools contain a great deal of water, they leave a water ring in the diaper and soak through. If your baby has diarrhea for more than 2 days, call us.

The best cure for diaper rash is prevention. Change your baby's diaper as soon as possible after each bowel movement or wetting. Wash the area with plain water and apply Vaseline, A&D ointment or Desitin if your baby is prone to rash.

If your baby is prone to diaper rash, the following suggestions may be helpful:

1. Leave the diaper off for about 15-30 minutes 4 times a day to air dry the area.
2. Try a different brand of disposable diaper or try cloth diapers.
3. Use mild soap to clean the diapers if you use cloth diapers.
4. Do not use fabric softener or bleach on the cloth diapers.
5. If the rash contains whiteheads, wash the area 2-3 times a day with mild soap such as Dove and apply an ointment(ex. Desitin or A&D)

Babies should be positioned on their back during sleep for the first 6 months. Belly sleeping may predipose to Sudden Infant Death Syndrome(SIDS)

Most newborns will wake up for feeding every 2-4 hours. Usually babies begin sleeping through the night at about 2 months of age. An occassional baby will sleep through the night sooner or right from birth. Sometimes parents think starting solid foods will make their baby sleep through the night, but there is no evidence that it will. Food is not a sedative and should not be added to the diet until 4-6 months of age.

By about 5-7 months of age your baby may return to waking at night. This is normal stage of development and does not reflect hunger. If this occurs, let the baby stay in bed, comfort him or her, pat his back and change him if necessary. The pattern of nighttime sleep will be re-established quickly.

A runny nose, congestion or mild cough, unless accompanied but vomiting or fever can usually be handled at home. Most newborns have an increased amount of mucous during the first few months of life which can result in sneezing or noisy breathing. The nasal bulb you were give at the hospital can be used to remove this mucous by inserting the tip straight back in the nose approximately 1/2 inch. Salt water nose drops can be purchased or made at home with 1/4 teaspoon of salt in one cup of water. One or 2 drops can be instilled into the nose to loosen the mucous and remove in a few seconds with the nasal aspirator. A cool mist vaporizer in your baby's room at night may also be helpful.

Forceful, persistent vomiting with or without fever in an infant under 6 months, or in any child associated with fever and abdominal pain, should be reported to us. Vomiting after a bump on the head should also be reported to us. If you child is over 6 months, alert and has no fever or pain, vomiting from a virus or an upset stomach can be handled.

Fever is a temperature of 100.4 F or higher. You should take your baby's temperature with a rectal thermometer to be sure it is an accurate measurement. A fever in a baby less than 2 months old should be reported to us immediately. First be sure the fever is not due to being overdressed in a room that's too warm or outside on a warm day. Medications like acetaminophen(Tempra or Tylenol)can be given when the temperature is over 101 F ( see the dosage chart below). When your baby has fever give extra fluids.

If your child's temperature is over 104 F, sponge your child off with room temperature or a little warmer water or give your child a bath in the same temperature water for 20 minutes while waiting for the acetaminophen(Tempra or Tylenol) to take effect. Do not make the water too cold or use alcohol since this may chill your child. Ice baths should never be used at home.

There are several types of circumcisions. Some children will have a platibell (plastic ring) around the penis that will fall off in 4-7 days. The tip, or glans, of the penis is initially red and may have thin yellowcrusts in spots. This is normal. Usually the skin of the glans will look more normal in 2-3 weeks. Keep the penis clean with soap and water. Vaseline may be applied if irritation is noted.

The umbilical cord will fall off by itself in 1-4 weeks. Be sure to pull the cord to the side and apply alcohol to the base with every diaper change. Do not worry if the navel oozes spots of blood or a clear moist discharge after the cord falls off. This is natural. If the oozing persists for more than 2 days, or if it has a foul odor,if you notice redness of the skin around the cord, or if a fever is present, notify us.

Until your baby's umbilical cord has fallen off and, if your baby is a boy, and has been circumcised, the circumcision has healed, your baby can be kept clean with a soft damp washcloth and mild soap such as Dove. After the umbilical cord and circumcision have healed, you can use the tub for bathing. When you bathe your baby, be sure the room is warm and free of drafts and the water temperature is about 85 degrees. Bathing is necessary only every few days. If your baby's skin seems dry, use a mild soap, not baby bath soap. Do not apply baby lotion, as this might irritate the skin.

Formula and breast milk contain adequate amounts of vitamins. Please check to see if your water is fluoridated. Fluoride will be prescribed after 6 months of age if it is not in your water supply.

You should keep your baby on breast milk or formula until the end of the first year. Solid foods should not be introduced until 4 to 6 months of age, except in special situations.

Your newborn may need to be fed as often as every 2 hours, but keep in mind your baby does not need to be fed everytime he or she cries. Consistent crying at short intervals may mean more milk is needed at each feeding, or your baby may be uncomfortable from soiled or wet diapers, colic, swallowed air, or an environment that is too cold or too warm. You should not get into the habit of offering frequent, small feedings to pacify all crying. Before you feed a crying baby, make sure the crying is not the result of other discomforts.

Let your new baby establish its own feeding schedule. Don't watch the clock. Your baby will decide how often and how much to eat. You should not awaken your baby for a feeding unless the baby goes more than 5 hours without eating. Do not wake your baby at night (after 10 o'clock) for feedings if he or she has fed 6-8 times during the day.

Length of feedings vary, but generally breast fed infants nurse 10-15 minutes on each breast and need to be fed every 2-3 hours. Most formula fed infants take 2-4 ounces of formula every 3-4 hours during the first week and will gradually increase their formula consumption to 6-8 ounces.

Many parents want to know if their baby is eating enough. The most accurate gauge of this is growth. That's one reason your baby will need to see us often during the first 2 years of life- so we can measure growth. Besides growth, there are several signs which will let you know if you baby is eating enough. They are:
a. satisfaction after eating;
b. wetting 6 or more diapers daily;
c. having stools

Breastmilk is the ideal nutrition for babies during the first year of life. It provides just the right balance and amounts of nutrients most babies need for growth and developement, and certainly contains factors that help protect babies against certain illnesses and allergies.

If you are breastfeeding, you will need to eat a balanced diet that provides 500-600 more calories a day than the diet you followed before you were pregnant. You should eat a diet high in protein and rich in calcium. If you or the baby do not tolerate a high intake of dairy products, you should consult your physician about a calcium supplement.

Foods in your diet seldom have a disturbing effect on your baby. It takes 4-6 hours for food to affect your milk. Occasionally, however, certain foods such as tomatoes, onions, to much milk, cabbage, chocolate and spicy foods may cause your baby to have loose stools and excess gas. If your baby has these symptoms, eliminate the offending food from your diet. Likewise, certain medications such as sedatives, laxatives, and antibiotics may be passed through your milk. Always check with your physician before taking any medication, even over-the-counter medicines.

You should nurse from both breasts, completely emptying one breast before going to the second. The next feeding should begin at the breast where you last feeding was completed. A safety pin on the brassiere will help remind you where to start the next feeding. Total nursing time will vary from 10-15 minutes on each breast. During your first few feedings you may want to limit your nursing time on each breast to 5 minutes to prevent sore nipples. Changing the baby's position may also help prevent soreness.

You should avoid skipping breastfeeding during the first few weeks while your milk supply is being established. After your milk is established, however, a supplemental feeding of formula or pumped breast milk can be given when its impractical to nurse. If you have to miss a feeding you may supplement with a formula such as Enfamil with Iron or Similac with Iron.

Infant formula provides the best alternative to breast milk if you choose not to breastfeed or if you stop nursing before the end of the first year. We recommend a formula such as Enifamil with Iron or Similac with Iron be fed until your baby is one year old. Cow's millk(whole or 2%)should not be fed to your baby before the end of the first year.

Your newborn baby will probably take 2-4 ounces of formula per feeding. When you see your baby is emptying a bottle, gradually increase the amount in the next bottle.

As you feed your baby, you should sit in a chair in which you can be comfortable and relaxed. Your baby should be hungry and fully awake, warm and dry. Hold your baby in the nursing position, with the head slightly raised, resting in the bend of your elbow and close to you. You should not have to spend more than 30 minutes trying to feed your baby.

Hold the bottle so the formula fills the nipple, this avoids the chance of your infant swallowing air. Too much air not only gives your baby a false sense of being full but might also make your baby more uncomforable later.

The size of nipple hole should never be large enough that milk drips at a steady rate without forming a stream. If milk pours out to rapidly, discard the nipple.

You should never prop your baby's bottle to feed him or her. Bottle propping not only deprives your baby of physical contact, but may also be dangerous to small infants who may choke on formula if left unattended.

Bottles and nipples should be sterilized the first time they are used. Subsequently, washing them in hot soapy water or dishwater is sufficient. It is not necessary to boil the water used in prepearing formula if you are sure your water is of good quality. Prepare only enough formula for 24-48 hours at a time. After this, discard any unused formula. Similarly, only put as much formula in the bottle as your baby will likely take at each feeding. Discard any formula your baby did not drink within one hour of starting the bottle.

Burping your baby helps remove air swallowed during feeding. You can burp your baby after feeding or at intervals during feeding as your baby seems to need it. There are three good methods for burping your baby:

1. Hold the baby so the head rests on your shoulder and the baby's chest rests on yours. Pat your baby's back or rub gently upward with your hand.
2. Lay your baby face down on your lap and rub or pat baby's back.
3. Sit your baby up in your lap sideways. Support baby's head and back with one hand and baby's chin and chest with the other. Gently rock your baby back and forth as if making baby bow.

All babies will occasionally spit up or wet burp small amounts of breast milk or formula after a feeding. This spitting is not cause for alarm. It may be reduced to a minimum by burping your baby more frequently during a feeding.

Here's what you should know about introducing solid food into your baby's diet:

1. Nutritionally, solid foods are unnecessary during the first 4-6 months except in special situations. Breast milk or formula will provide all the nourishment your baby needs during this time. Please do not introduce solid foods until discussing it with us.
2. The earlier food is introduced, the greater the likelihood your baby will have problems with it or develop allergies.

No more than one new food should be added to your baby's diet every 5 days. If you add a new food and it results in vomiting, diarrhea, constipation or rash, stop giving the food and try it again when your baby is older.

Most newborns weigh between 5 1/2 and 10 pounds, with the average being about 7 1/2 pounds. During the first few days of life, infants generally lose 4-10 ounces before they start to gain weight. Breast fed infants may lose slightly more weight at first without cause for concern. This weight loss is from excess body water and is perfectly normal. Most infants will regain their birth weight by 10 days of age, double it by 4 months and triple it by one year, averaging about 2 pounds a month for the first 4 months.

It is the law in Pennsylvania for infants and children under 4 years of age and under 40 lbs. to be in a car seat.

Place your infant in the back seat, especially if an airbag is present.

Until your baby has a chance to build up resistance to infections, you should try to hold to a minimun the number of visitors, especially children, who handle your baby. We also suggest that you avoid taking your baby into large crowds for the first few weeks. Your infant can be taken outside dressed appropriately for the weather(one more layer than you are wearing is usually appropriate).