Children's Health | Mount Sinai Today

What to Expect When You Need to Take Your Child to the Emergency Room

Jun 30, 2022 | Children's Health, Featured, Your Health

It’s a moment every parent dreads. You believe your child needs critical medical care and decide you must go to the hospital.

Christopher Strother, MD, Director of Pediatric Emergency Medicine at The Mount Sinai Hospital, offers some helpful tips on when you should take your child to the emergency room and how to best prepare. The Mount Sinai Hospital recently completed a full renovation of the Children’s Emergency Department, which features state-of-the-art technology and treatment rooms, and specially trained staff.

What are the most common pediatric emergencies?

For children, the three biggest things that we see in the emergency department are infections, such as the flu, stomach viruses that can cause patients to get dehydrated, and high fevers. That’s followed by injuries: falls, broken arms, cuts, and head injuries. In New York, we also see a lot of patients with asthma, especially during the spring allergy season.

When should you take your child to the emergency department?

It’s a tough question. Anytime your child is in pain, or you’re scared, or you’re worried about their safety, we’re here for you 24/7. We’re there for anything, and if you think you need to see somebody right away and you’re not sure where else to go. There are many reasons to come to the hospital, such as severe pain or injuries, or anytime you’re worried about your child’s health and safety. The things we worry the most about are trouble breathing, dehydration, and major injuries.

How does the children’s emergency room at The Mount Sinai Hospital differ from a regular emergency room?

The biggest difference in a children’s emergency room is the people who work there. The doctors and nurses are all pediatric trained and comfortable taking care of sick children. If your child needs medications, an IV, or a procedure, the people who do that are trained to do it with children. We also have child life specialists who will help kids cope with the experience. Our staff will help your child be comfortable. They can educate you and your child on what’s happening and what’s going be next. Our expertise, our staff, and our training and the focus on children really set us apart.

What else is new at the Emergency Department?

The new Emergency Department is tailored to the needs of children and their families, with a separate space from the adult ED that is connected to all services within Mount Sinai Kravis Children’s Hospital.

We’ve increased the size of the Department as well as redone the entire space. It’s brighter and very child friendly, with lots of colors and other features that make the experience calmer and safer for kids. Video tablets have something to keep kids busy, distracted, and calm. We have a whole wall with an interactive video for the kids to look at. It feels like a family environment. We’ve also created are a “low-stimulation room,” which is a single room a little bit apart for children with autism or other neurodevelopmental challenges, where they can be quiet and calm. We also have a separate area with the most advanced equipment where we can take the best care of critically ill children.

How common are children only emergency rooms?

We’re lucky here in New York. We have several children’s hospitals in New York City and around the area. A lot of places in the country don’t have any. A major city might have one children’s emergency department. Most children who go to the emergency department in the United States go to a general emergency department. Pediatric emergency departments are a unique thing.

What else does Mount Sinai offer?

Mount Sinai has two other pediatric emergency departments, one at Mount Sinai-Union Square downtown and one at Mount Sinai Morningside on the Upper West Side. At all of the emergency departments throughout Mount Sinai Health System, we keep in touch with how they take care of children. So even if you’re not in one of our children’s emergency departments, our pediatric specialists are working closely with the other emergency department to make sure that your child gets the best care.

What are some tips for parents taking their child to the emergency room?

If possible, call your pediatrician first. Sometimes you’re worried. Things may look scary, and you feel you must go right away. If you have a minute to think about it, I always suggest giving your pediatrician a call if you can. It helps in a few ways. Sometimes talking to your pediatrician or your regular doctor can actually keep you from having to go. Sometimes they can make an appointment the next day or give you some advice that might allow you to stay home for this visit.
Be prepared to spend some time in the emergency department. If you need to go, be prepared to be there for a while. Bring a charger for your phone, and a book. A visit may last a couple of hours. It can take time to perform X-rays or tests.
·Be ready to tell the medical staff about any medications your child is taking. Either bring the medications with you or write them down. It’s extremely helpful to the staff at the hospital to know what your child has taken already and when they took it. For example, if you have given Tylenol or Motrin, write it down. Let us know when was last time. Or if your child has any allergies to medications, let us know right away.
·Let us know as soon as possible if your child has any chronic medical conditions. For example, if your child has sickle cell disease, when you come into the emergency department with a fever let the first person you talk to know they have a fever and sickle cell disease. Because that can change the way we approach a patient and the tests that are done. Be up front and an advocate for your child’s history.

Read about the renovations of Mount Sinai Children's Emergency Department

My Child Has a Heart Condition. What Should I Do?

Updated on Feb 9, 2025 | Children's Health, Heart Health, Your Health

Becoming a parent is exciting, sometimes nerve-wracking, and comes with a heap of responsibility for the health and well-being of your child. And if your child has been diagnosed with a heart condition, anxiety can ratchet up due to the uncertainty of what the condition may mean for their future.

Robert H. Pass, MD, Chief of the Division of Pediatric Cardiology at the Icahn School of Medicine at Mount Sinai and co-Director of the Mount Sinai Kravis Children’s Heart Center, answers common questions that parents may have about diagnosing a pediatric heart condition and explains the safe, minimally invasive treatments that are now available.

How do I know if my child has a heart condition?

Many heart problems in children are obvious nearly from the moment of birth. In fact, the most common types of heart disease in children are congenital heart diseases, which are birth defects that affect how the structure of the heart as well as how the heart functions. Congenital heart disease is the most common birth defect, affecting a little less than one percent of the population.

One of the most common signs of heart disease among newborns is cyanosis, which is when a child has a low oxygen level, which lends a bluish tint to the skin and mucous membranes. Additionally, some newborns have symptoms such as poor feeding or sweating as they feed. Heart problems can also cause poor growth.

Still other concerns—like heart murmurs—are identified only through a physical examination or sonogram. Heart murmurs can be signs of a problem, or they can be what we call “innocent,” which means there’s actually nothing wrong. Some studies suggest that if a doctor listens closely enough, nearly half of all kids have murmurs. Fortunately, though, only a very tiny fraction of this group actually has a heart problem.

How are congenital heart diseases diagnosed and treated?

Most congenital heart conditions are diagnosed either on physical examination or ultrasound and increasingly can be diagnosed prenatally on ultrasound.

Depending on the diagnosis, there are a variety of surgical and non-surgical treatments for congenital heart disease. Non-surgical treatment or the “wait and see approach,” may be the best option for problems such as small holes in the heart and some forms of abnormal heart rhythm which can resolve spontaneously. If your child has a condition that needs surgical intervention, options range from open heart surgery to the use of catheter-based therapies.

What are catheter-based therapies?

Catheter-based treatment is a minimally invasive alternative to traditional open heart surgery in which small tubes are inserted into the blood vessels and allow for diagnosis and treatment of many heart problems. Among many conditions that can be addressed in this way, we use these procedures to close holes between the upper two heart chambers—called atrial septal defects. In the past, we routinely treated this condition with surgery. Now we manage about 75 percent using catheter-based treatments.

During a catheter-based procedure the thin, flexible catheter is inserted through the child’s groin into a blood vessel and up to the heart. A device is then introduced through the catheter to seal the hole. With open heart surgery, the child would spend two to four days in the hospital and another six weeks recuperating at home. Using this minimally invasive approach, most patients are in the hospital only one evening and then back in school within three or four days.

What makes the Mount Sinai Children’s Heart Center special?

Our Children’s Heart Center stands apart due to the integration among our services throughout the expanded Mount Sinai Health System. Our cardiology team works closely with our surgical team, and we seamlessly transition our pediatric patients into our very large and always growing adult congenital heart program headed by Ali N. Zaidi, MD, Professor of Medicine (Cardiology), and Pediatrics; Director of the Adult Congenital Heart Disease Center; and Director of Pediatrics to Adult Transition of Care Program, at Icahn Mount Sinai. We view our work as a team sport, with many players working together to achieve the best possible outcome.

We develop individualized treatment plans for children with a wide range of heart problems, always taking into account the needs of our patients and their families. While there are outstanding cardiologists in many of the major centers in New York City, I have never worked with a group where every single physician is outstanding. It is inspiring for me and keeps me on my toes. Our patients inspire us every day.

Learn more about the Mount Sinai Kravis Children’s Heart Center

How Is the Omicron Variant Affecting Children?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

The Omicron variant is the latest strain of COVID-19 that is causing concern. While far more contagious than earlier variants, there are indications that it causes less serious disease—especially in the vaccinated.

Despite this sliver of good news, reports of increased pediatric hospital admissions has many parents and guardians worried that this variant may be more dangerous for children. Pediatric infectious disease specialist Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai, dispels that belief and explains how to protect yourself and your family. The key takeaways: if eligible, get vaccinated; wear a high-quality face covering while indoors; and practice social distancing.

Is the Omicron variant more of a risk to infants and toddlers than older kids and adults? What are the symptoms?

The Omicron variant is very widespread and it affects people of all ages. That includes infants, toddlers, school-age kids, adolescents, and adults. It does not discriminate by age—everybody is at risk.

For the vast majority of children, symptoms of this variant are very similar to other common illness of childhood. This includes fever, a runny nose, cough, congestion, a sore throat, and/or difficulty swallowing. Some kids also complain about abdominal pain and diarrhea.

My child has COVID-19. How can I treat them at home?

Treatment depends on how ill your child is but the vast majority can be treated at home using over-the-counter medications. For instance, children who are experiencing minor symptoms, like fever and body aches, can be treated with acetaminophen (Tylenol) or ibuprofen.

However, if you think that your child is sicker than you can handle at home or if they are having difficulty breathing or eating so little that you are worried about dehydration, call your doctor right away.

How can we protect children from the Omicron variant?

Vaccination goes a long way toward protecting children—and adults—from the Omicron variant, and a booster shot provides additional defense against the virus. So, if you (or your child) are eligible for a booster but have not received one, I encourage you to schedule an appointment. By protecting yourself, you are protecting your child.

In addition to getting vaccinated, wearing a mask and maintaining social distance are very important. Since COVID-19 is circulating at very high levels, try to avoid crowded places. Also, make sure that your child understands the importance of washing their hands frequently, either with soap and water or an alcohol-based sanitizer.

If your child happens to feel sick, keep them home from school so that you can prevent an infection from spreading to others. If you think somebody in your family has COVID-19, reach out to your doctor about testing for the virus. If your child attends a daycare or school, you might need to alert them as other close contacts of your child may need to get tested. Be sure to follow whatever directives their daycare/school has outlined.

My child is not yet eligible for vaccination. How can I protect them from contracting COVID-19?

Unfortunately, the vaccine is not available yet for kids who are younger than 5 years of age. In that case, it’s even more important for parents, older siblings, and whoever else lives at home to be fully vaccinated and to get a booster shot. In addition, all household members should diligently follow the rules we have followed throughout this pandemic: avoid crowded places, wear a face covering, maintain social distance, and wash your hands frequently.

Why Vaccination Is Critical to Protect Your Child From COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As we see an uptick in pediatric hospitalizations for COVID-19, it is important to reemphasize the significance of vaccination.

“Most of the children that we’re seeing in the hospital with COVID-19 have not received a vaccine—or have only received one dose,” says Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai.

In November 2021, the U.S. Centers for Disease Control and Prevention (CDC) endorsed COVID-19 vaccination for children ages five and up. But, if you have been hesitant to schedule an appointment for your child, Dr. Posada explains vaccine safety and why vaccinating—and, if eligible, boosting—your child is a critical step in avoiding COVID-19.

Should all children ages five and older get the COVID-19 vaccination? What if my child had, and recovered from, the virus?

Yes, the CDC recommends that everyone age five and up get vaccinated. The vaccines are very, very effective at both preventing serious disease caused by COVID-19 and keeping people out of the hospital if they do get the virus. The vaccine is extremely safe and has been tested in patients of all ages. Serious side effects are very, very rare.

Vaccination is recommended even if you have had COVID-19. This includes children who are eligible to receive all the doses of the vaccine, including the booster. Why? Because vaccination offers higher protection than previous infection.

Children ages 12 and older get the same dose as adults. Children ages 5 to 11 get a lower dose of the same vaccine. Currently, only the Pfizer vaccines have been approved for children ages 5 to 11.

Does the vaccine give children full protection against COVID-19?

Children who have been vaccinated for COVID-19 have a high level of protection against the disease; but it is not 100 percent. People who’ve gotten the vaccine are much less likely to get sick. But if they do contract the virus, it’s much less likely that they’re going to get severely sick from it.

Also, we are beginning to see the significance of booster doses of the COVID-19 vaccine. Research shows that protection starts to decrease a number of months after the second COVID-19 vaccine dose. A booster dose provides an added layer of defense against the virus, including protection against the Omicron variant.

Are children eligible for a COVID-19 booster dose?

Everyone over age 12 is eligible to receive the COVID-19 booster dose five months after their last shot. Since children over 12 have been eligible for the COVID-19 vaccine since May 2021, some may be ready for their booster dose. If they are, I highly encourage parents to book an appointment to administer the shot.

Children ages 5 to 11 are not yet eligible for boosters but they just became eligible for the COVID-19 vaccine in October 2021, so they would not need a booster at this point.

Is Your Child Afraid of Getting a Shot From the Doctor? Here’s How to Help Them

Nov 9, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

A trip to the doctor is a common childhood fear. But when kids are afraid of needles, even a simple checkup can cause problems for children and their parents or guardians alike. With the proper preparation and planning, you can help make your next doctor’s visit as smooth as possible, and that’s more important than ever for those getting a COVID-19 vaccine.

In this Q&A, C. Anthoney Lim, MD, the Director of Pediatric Emergency Medicine for the Mount Sinai Health System and the Medical Director of the Pediatric Emergency Department and Pediatric Short Stay Unit at Mount Sinai Beth Israel, explains how you can help calm your child’s fears and ease their anxiety about the doctor’s office and needles. And if needed, how you can talk with your doctor in advance about key issues, including medications that can help reduce the pain. Certified child life specialists and music therapists will also be present at the Mount Sinai vaccination pods to help support children of all ages using play, preparation, distraction and relaxation strategies.

“We have plenty of experience with children who are afraid of injections, so we can work with you and your child to ensure they get immunized in a safe and comfortable manner,” says Dr. Lim, who recently gave his own seven-year-old son the vaccine. “We are creating a very family-friendly space for the COVID-19 vaccine because you will need to bring them back in three weeks for their second shot, so it’s especially important that your child has a positive experience.”

How common is it for kids to be afraid of needles?

It is a very common fear. We see it among children who may have been hospitalized or have chronic illnesses and are in the doctor’s office a lot. But a healthy child without any medical problems is equally prone to needle-phobia.

How can I talk to my child who is afraid of needles?

There are many things you can do to help normalize the process, and it’s important to prepare. A lot of it is knowing your child and if they are at an age that we can talk about their fears. Then, prepare them by having a conversation in advance, letting them know what is going to happen at the doctor’s office and explaining what the process may look like. It can help quite a bit. Not all kids want to talk about it. But they are generally pretty smart, and they will know they are going to the doctor and what they are going for. It’s also worth remembering: Kids will often follow your lead. So if you are prepared and calm, your children will more likely be prepared and calm

Anything more specific?

For younger kids, play can be a really helpful way to prepare for a doctor visit. It provides children the opportunity to approach the event with a sense of control while creating a safe environment to express feelings and to practice coping strategies. One option for younger kids is showing them with their stuffed animal or having them play doctor to get used to what happens when you get your vaccine. For instance, when we were teaching kids how to use masks, we had them make a mask or put a mask on their teddy bear so they can see what it looks like. This is a similar process.

What about bringing something to distract my child?

You can bring a toy to distract them or a doll or plaything they can squeeze really hard. Tablets or smart phones are fine, so make sure your devices are charged. You can bring a cold pack because sometimes that will numb the area a little bit and that is often helpful. There are special cold packs for kids that also include a vibrating tiny bee that can help soothe and distract young children.

Any other techniques?

There are many relaxation strategies that children of all ages can use when feeling anxious and worried. One example is deep breathing—taking deep breaths right before the shot, and then breathing out as the shot is being delivered, can help minimize the discomfort. For younger kids, there are specific positioning techniques you can use, basically a big hug that exposes their arm for the nurse to administer the shot.

What about medications?

Most of the time, approaches that do not involve medications work really well in kids. Prescription medications require a visit or a discussion with your doctor beforehand. There are prescription products, like EMLA or ELA-Max, which are creams that contain a local anesthetic we sometimes use for children for some injections and vaccines. You put the cream on your child’s arm before you go to the doctor’s office because it takes about an hour to kick in. Over-the-counter topical creams are also available.

Is it okay to take over-the-counter pain relievers?

We recommend pain relievers like Motrin or Tylenol but only if your child experiences muscle pain or fevers after they receive the shot, and not beforehand.

How is Mount Sinai helping to make the vaccination process easier for young kids?

At our hospitals, we are setting up special areas for vaccinations for young children. We want to make it a child-friendly, family-friendly environment. We want to make sure that they have a great experience

What should I do if I have more questions?

There are some great resources online, such as from the American Academy of Pediatrics and from the Meg Foundation, an organization that helps families with pain management. A conversation with your pediatrician is very valuable.

Get more information about COVID-19 Vaccination, Appointments and Resources

What You Need to Know About COVID-19 Vaccines for Children Ages 5 to 11

Oct 28, 2021 | Children's Health, COVID-19, Vaccines, Your Health

The moment many parents have been waiting for is approaching: Federal regulators are expected to decide soon whether to authorize COVID-19 vaccines for children ages 5 to 11. Vaccines for kids ages 12 to 15 were authorized in May.

The Food and Drug Administration (FDA) first authorized COVID-19 vaccines for adults in December 2020, and the safety and efficacy of vaccines has been widely discussed ever since. But those with young children still have many questions.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai, answers some of the questions most commonly asked of pediatricians and explains why the vaccines are extremely safe and highly effective.

How effective is the new Pfizer vaccine for children ages 5 to 11?

The new vaccine is highly effective at protecting children from severe COVID-19 disease. The studies, which included more than 4,000 children, showed children developed essentially the same level of antibodies that result in 90 percent or higher protection in adults.

How safe are they?

The vaccines are extremely safe, the same as with adults. There were minor side effects, such as pain at the site of the injection, fatigue, and headache. Importantly, there were no serious adverse events at all related to the vaccine among the more than 4,000 children that were part of the studies.

What about concerns about rare cases of heart inflammation in young men and boys?

Myocarditis is an inflammation of the heart, and a side effect that has been seen very, very rarely, mostly in young adult males. It was not seen in the recent studies of young children; there were no cases, and although the studies were too small to estimate what the rate might be in the general population of children, we expect it to be lower than in adolescents.

Will children experience any side effects from the vaccine? What can I do about that?

It is very likely that children who receive the vaccine, just like adults and older children, will experience pain at the site of the injection or headache. Those are expected to go away within a day or so. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be very helpful in managing the symptoms. Parents should follow the guidance of their pediatrician as to how to administer those medications to their children.

If my child had COVID-19, do they still need to get a vaccine?

Anyone who already had COVID-19 should still get the vaccine. That’s because cases of a second COVID-19 infection can happen in people who already had a first infection. The vaccine provides more protection against subsequent infections for people who already had COVID-19.

What are the benefits of vaccinating children ages 5 to 11 against COVID-19?

First of all, vaccinating young children protects them from getting seriously ill from COVID-19. We know that children have a lower risk for developing severe COVID-19 infection compared to adults, but that doesn’t mean they cannot develop severe COVID-19 infection. In fact, as an infectious disease specialist, I have seen children in the intensive care unit with complications of COVID-19. In addition, we know that even if children don’t get very sick themselves from COVID-19, children who have COVID-19 can pass it on to other people—to their parents, their siblings, their grandparents, and to kids and other people at school. So vaccinating children can also protect our community at large, including people that are at higher risk from COVID-related complications.

What if my child is afraid of injections?

It is not uncommon for children to be afraid of injections. Pediatricians have been giving vaccines for decades. Our staff are experienced in working with children who are afraid of injections. They will work with you and your child to make sure your child can get immunized in a safe manner.

Can the vaccine affect the fertility of my child?

It’s a very common misconception that the COVID-19 vaccine can affect fertility. There’s no evidence at all that the COVID-19 vaccine has that effect.

My child is 11 and about to turn 12. Should I wait and get them the adult vaccine?

We recommend that children get vaccinated at the first opportunity. Studies show that children age 11 responded very well to the pediatric formulation of the vaccine.

How do I get more information?

Parents who want to get more information about the COVID-19 vaccine for their children should contact their pediatrician for specific advice.