Children’s Health

NYC Health + Hospitals/Bellevue offers high-quality, accessible, and comprehensive services to children, adolescents, and families. Our physicians were among the first to standardize the study of pediatric disease, and we pioneered the development of children’s services. Throughout our history, discoveries by pediatricians at NYC Health + Hospitals/Bellevue have led the way in improving medical care for children. In 1873, Bellevue Hospital opened the first children’s clinic in the nation. World-renowned figures in the history of pediatrics, including Dr. Abraham Jacobi (“Father of American Pediatrics”) and Drs. Jonas Salk and Albert Sabin, who developed the first polio vaccines, have held appointments in our Department of Pediatrics. Other pediatricians at NYC Health + Hospitals/Bellevue have pioneered advancements such as the development of intravenous fluid therapy, the development of hepatitis B vaccine, and prevention of HIV infection in newborns. In 2000, we continued a tradition of firsts by inaugurating the first child protection and development center in a public hospital.

Renowned not only for the provision of comprehensive primary care, but also for the treatment of complex medical, psychosocial, and developmental issues, the NYC Health + Hospitals/Bellevue pediatric service uses a multidisciplinary team approach in the care of children and their families. Your care team may include primary care pediatricians, pediatric surgeons, pediatric nurse practitioners, public health nurses and other nursing support staff, specialists in child psychiatry and child development, social workers, and nutritionists. We continue our care beyond the NYC Health + Hospitals/Bellevue campus by having strong linkages to community and social service organizations, health care providers and facilities, day care centers, and schools throughout New York City.

All of our services are delivered by professional staff with pediatric-specific training and certification.

Outpatient Services

We offer primary, specialty, and enhanced outpatient services for children and adolescents in an attractive, modern setting, with spacious exam rooms equipped with the latest diagnostic tools and equipment.

Primary Care

Available by appointment, our comprehensive primary care services are provided in a ‘medical home’ setting, which means that the team of professionals caring for your child is focused on providing care that facilitates partnership between patients, physicians and families. We are committed to providing primary care that is accessible, continuous, comprehensive, patient- and family-centered, coordinated, compassionate, and culturally effective. Pediatricians, pediatric nurse practitioners, pediatric nurses, social workers, nutritionists, child life / child development specialists, and pediatric care associates work together to provide the full range of primary care services, including well-child check-ups, immunizations, preventive screenings, developmental assessments, and management of minor acute illness care.

Our adolescent medicine primary care services address the specific needs of teenagers, including general medical care, gynecology, reproductive health, prenatal services, and parenting programs. After-hours and confidential care services are available.

We provide a variety of specialized, multidisciplinary primary care services, including:

• A high-risk newborn clinic for follow-up care of premature babies
• A breastfeeding consultation clinic
• An adolescent parenting program to provide special support for teenage parents and their children
• HIV primary care for children, adolescents, and family members with HIV-related conditions
• Two school-based health clinics that provide on-site routine health maintenance, chronic illness management, and minor acute illness care, with referrals to NYC Health + Hospitals/Bellevue for specialty care. These clinics are located in Manhattan at the Norman Thomas High School campus and P.S. 51 Manhattan-the Elias Howe School.

Medical Specialties

The full spectrum of pediatric medical specialty care is provided by board-certified pediatric specialty physicians.

• Asthma Management – multidisciplinary care is provided for children and adolescents with asthma, with an emphasis on preventing asthma attacks and optimizing health.
• Allergy – evaluation and treatment of allergies by a physician who is board-certified in pediatrics and allergy-immunology
• Bellevue Nutrition and Fitness Program (BENUFIT) – comprehensive evaluation and treatment for children and youth with weight management problems
• Cardiology – evaluation and management of children with congenital heart disease, heart rhythm disturbances, and other conditions affecting the heart and circulation
• Child Protection and Development – the Frances L. Loeb Center, providing comprehensive medical, psychosocial, and developmental evaluation for children who are victims of physical, sexual, or emotional abuse
• Pediatric Dentistry – includes the full range of dental services for children, from routine preventive care to operative management of complicated dental disease
• Dermatology –a widely recognized service for the care of children with skin disorders
• Developmental/Behavioral Services – comprehensive evaluation and management of children and adolescents with behavioral or developmental delays and disorders, autism and pervasive developmental disorder (PDD), attention deficit hyperactivity disorder (ADHD), language and learning disorders, and intellectual disability/mental retardation.
• Diabetes – evaluation and management of children with Type I or Type II diabetes, using a multidisciplinary approach
• Endocrinology – evaluation and management of disorders of growth, puberty, and sexual development, and disturbances of thyroid, pituitary, and adrenal glands
• Gastroenterology – evaluation and management of children with disorders of the gastrointestinal (GI) tract
• Genetics – evaluation and management of children with genetic disorders
• Hepatitis Clinic – evaluation and management of children with various forms of liver infection
• Infectious Disease and Immunology – evaluation and management of children with tropical diseases and unusual, uncommon, or recurrent infections
• Nephrology – evaluation and management of children with disorders of the kidney
• Neuro-Developmental Clinic – assessment of young children who may have delayed development due to a neurologic condition
• Neurology – evaluation and management of children with seizures and other diseases of the nervous system
• Pulmonology – for children with lung diseases, such as complicated asthma, chronic lung disease of prematurity, sleep apnea, and chronic complications from pneumonias, and for children dependent on ventilators or other technologies
• Rehabilitation Medicine/Physical Therapy – evaluation and treatment of children with physical limitations, including assessment for braces and other accommodative devices and management of complex physical therapy programs
• Rheumatology – evaluation and medical management of children with disorders that affect the joints and other body organ systems, such as juvenile arthritis, childhood lupus, Lyme disease, and dermatomyositis
• Tuberculosis – a clinical service devoted specifically to the assessment and treatment of children with tuberculosis infections

Pediatric Surgical Specialties

Pre-hospitalization Program: As a support service for all children who undergo elective surgery, this program provides medical and psychosocial pre-screening to ensure that children and families are prepared for the surgery and know what to expect. Developmentally specific approaches are used to assist children in coping with the surgery and hospitalization experiences. The program is staffed by pediatricians, a pediatric nurse practitioner working with anesthesia, nurses, a social worker, and child life/child development specialists.

• ENT – evaluation and management of children with diseases affecting the ears, nose, and throat, such as chronic/recurrent ear infections, sinus disease, chronic laryngitis, and tonsil and adenoid diseases
• Neurosurgery – pediatric patients are seen in the adult neurosurgery clinic, or in the offices of the pediatric neurosurgeons for follow-up of neurosurgical problems, such as head trauma, hydrocephalus, and craniosynostosis.
• Ophthalmology – evaluation and management of eye problems, including diminished vision/amblyopia/blindness, need for corrective lenses, complicated eye infections, and eye movement disorders
• Orthopedics – evaluation and management of bone and joint disorders, including hip dysplasia, foot deformity, neuromuscular diseases affecting the limbs, traumatic injuries, tumors, and infections
• Pediatric Surgery – surgical care and postoperative management for infants, children, and youth with such conditions as appendicitis, gall bladder disease, intestinal obstructions, abdominal trauma, and intra-abdominal tumors
• Plastic / Reconstructive and Hand Surgery – highly specialized services available for children and adolescents
• Urology – surgical and postoperative management of conditions such as congenital anomalies of the urinary tract and chronic urinary tract infections with obstruction to urine flow, as well as diseases of the bladder

Pediatric Inpatient Services

The care of children on the pediatric inpatient unit is managed by a pediatric hospitalist, a physician who coordinates and oversees the care of the child during hospitalization. The hospitalist communicates closely with the child’s primary physicians or surgeon and also manages the discharge and return of the child to his or her primary pediatrician. Outpatient specialty services are also available to provide inpatient consultations on an as-needed basis.

Our state-of-the-art inpatient facilities for children include:

• Pediatric Medical Unit
  This 15-bed unit provides care to children who are hospitalized with a wide range of medical and surgical conditions, such as asthma, bronchiolitis, pneumonia, appendicitis, trauma, and infectious diseases. The full range of needed medical and surgical care, including nursing support, nutritional services, respiratory therapy, radiology, and child life services, is provided. The unit also provides a playroom and teen room for therapeutic activities and educational services.
• Newborn Nursery
  Routine newborn care is provided to mothers and infants. Special emphasis is placed on mother-infant bonding, breastfeeding support, and counseling regarding newborn care.
• Pediatric Intensive Care Unit (PICU)
  Children who are seriously ill and require specialized monitoring, cardiac, and/or respiratory support receive highly specialized care under the supervision of board-certified pediatric intensivists, with the consultation of other pediatric specialty services as needed.
• Neonatal Intensive Care Unit (NICU)
  This 20-bed, state-of-the-art unit, which opened in 2010, incorporates the latest research-based design to promote a premature child’s development. The Vermont Oxford Network, a non-profit collaborative dedicated to improving the quality and safety of medical care for newborns, ranks NYC Health + Hospitals/Bellevue as consistently exceeding the national benchmark for survival of very low birth weight infants (less than 1,500 grams). In 2010, the survival rate for these infants was 94% at NYC Health + Hospitals/Bellevue, compared to the national benchmark of 84%.The innovative design of the NICU includes the following unique features:
  • High-tech incubators and monitoring devices to control excessive light, noise, and room temperatures
  • Modern, multi-function beds that convert from radiant warmers to incubators with the touch of a button to eliminate the stress of moving fragile preemies
  • A “Launch Pad” – a home-like private room where parents can spend a night or two caring for their pre-term babies with the assistance of medical staff before the baby is discharged from the hospital. Evidence shows that if parents are properly prepared to care for their pre-term infant before they leave the hospital, they are better able to provide competent care for the baby after discharge.
  • A fully networked and integrated sound system (Sonicu) – the first in New York State – to monitor sound from inside the incubator and advise staff visually when the noise level is too high. Research has shown that controlling sound levels in the NICU reduces infant stress and promotes better oxygen saturation and steadier heart and respiratory patterns.
  • A satellite pharmacy staffed by a pharmacist with clinical experience in the preparation of medication doses tailored specifically to the needs of tiny patients
  • More room for family members at the bedside, a Family Lounge/dining area, and shower facilities on the unit to accommodate parents who spend long stretches of time at the hospital
  • 24-hour visitation policy for parents and family members. Parents participate in medical rounds that are conducted twice daily by staff to update the care team members on the condition of the infant.
  • Breastfeeding education room and a breast milk refrigerator and freezer room, in addition to a separate nourishment station for mothers
  • Multipurpose family room for parenting classes, consultation, CPR training, or a private place to make a phone call
  • Instruction in comprehensive developmental care, including infant-driven feedings, swaddle bathing, and skin-to-skin or kangaroo care.

Pediatric Emergency Services

This state-of-the-art facility designed specifically for the care of children and youth includes examination rooms and treatment bays, asthma/respiratory care treatment area, and a major shock-trauma treatment room. The unit is staffed and run by board-certified pediatric emergency medicine specialists and nurses who specialize in the emergency care of children.

Parenting Support Services

Bellevue’s child life team provides innovative support services for parents and children related to parenting issues, mental health issues, and adjustment to both acute and chronic disease. These services are provided throughout all pediatric service areas, including outpatient, inpatient, emergency, and intensive care areas. In addition, our professional staff is actively involved in research designed to prevent obesity and optimize child development and school readiness.

Child Life Support Services: Outpatient

• Reach Out and Read Program – encourages reading aloud through provision of free children’s books at many visits, modeled reading activities and guidance, and linkages with community-based services
• Health Education and Literacy for Parents (HELP) – helps parents navigate the health care system
• Early Learning Group – parenting support program for promotion of optimal child development
• Adolescent Mothers Group – parenting support for adolescent mothers
• Pre-hospitalization program – prepares parents and children for surgery

Child Life Support Services: Inpatient, Intensive Care, and Emergency Services

Child life staff are present and available in all hospital settings. They assist children and families in coping with the stressors of illness, pain management, and adapting to the management of chronic conditions.

Maximizing Health
Innovative research-based programs working with parents to prevent obesity and optimize child development and school readiness include:

• Obesity prevention programs:
  • Greenlight educates parents about nutrition at pediatric well-child visits.
  • Starting Early prevents obesity through parent-support groups.
• Child development/school readiness:
  • BELLE (Bellevue Project for Early Language, Literacy, and Education Success) gives all children a chance to succeed in school.
  • Video Interaction Project (VIP) makes videos of parents and children playing and reading together on days that they come to NYC Health + Hospitals/Bellevue for pediatric check-ups. These videos are watched together with a child development specialist to teach parents skills that they can use at home to help their children learn language and control their behavior.

Child Psychiatry Liaison, Outpatient Emergency and Inpatient Services

Child Psychiatry Liaison Service – mental health evaluation and support services are provided for children receiving pediatric medical/surgical care in our outpatient and inpatient settings.

Other Related Pediatric Services

• Radiology – the full range of imaging services including x-rays, CT scanning, MRI, and nuclear medicine. Pediatric radiologists oversee this clinical service.
• Audiology, Hearing, and Speech – certified audiologists and speech pathologists with specialized pediatric training, offering audiology and speech evaluations, speech therapy, recommendations for hearing augmentation when needed, and fitting for hearing aids
• Phlebotomy – technicians with training and experience in drawing blood from children, both in the pediatric clinics and on the inpatient units