Pediatrics
The Pediatric Clinic is an outpatient service within the Naval Health Clinic. We serve eligible family members ages newborn to 23 years of age who are TRICARE Prime enrollees. We provide preventive care, care when your child is sick and manage chronic diseases such as asthma and attention deficit/hyperactivity disorder. If your child requires specialty care, we will place a referral and work with the specialist to manage your child's overall health.
Scheduling Appointments
Appointments can be scheduled three different ways:
- Call Integrated Referral Management and Appointing Center at 1-800-404-4506 (M-F 0600-2000, Weekends: 0700-1700, Closed federal holidays)
- Call Pediatrics Clinic at 360-257-9782 (M-F 0700-1600)
- On the MHS GENESIS Patient Portal (24/7)
MHS GENESIS Patient Portal
Through the patient portal you can view your health information, exchange secure messages with your care team, request prescription renewals, view notes from your clinical visits and certain lab/test results, and schedule appointments. To register and access the patient portal, visit
https://patientportal.mhsgenesis.health.mil
MHS Nurse Advice Line- Speak with a Registered Nurse 24/7
- Get evidence-based health care advice from a registered nurse
- Find an urgent care or emergency care facility
- Receive recommendations for the most appropriate level of care
- Schedule same or next day appointments when recommended by a registered nurse and enrolled to a military hospital or clinic
Visit
MHSNurseAdviceLine.com for web chat and video chat, or dial 1-800-TRICARE (874-2273), option 1.
Urgent Care Visits
- Urgent care is care you need for a non-emergency illness or injury. You typically need urgent care to treat a condition that doesn’t threaten life, limb or eyesight and needs attention before it becomes a serious risk to health. Examples includes a high fever or sprained ankle.
- If you are an Active Duty Family Member with Tricare Prime you do not require a referral to go to an Urgent Care. (https://www.tricare.mil/CoveredServices/IsItCovered/UrgentCare)
- TRICARE West beneficiaries have access to Doctor on Demand’s Urgent Care and Behavioral health providers https://doctorondemand.com/microsite/hnfs/()
Referrals
If your primary care manager has submitted a referral for you, do not expect a call to schedule your referral.
For Referrals to a Tricare Network Provider in the Community (majority of Pediatric Referrals):
- WAIT 3 business days and log on to www.tricare-west.com or call 1-844-866-9378 to start checking the status of your authorization.
- You can view the referral status, change the selected TRICARE Network Provider, obtain contact information and print your authorization letter online at www.tricare-west.com
- If your authorization is not available in 7 business days, contact HealthNet at 1-844-866-9378
For Referrals to a Military Healthcare Facility:
- WAIT 2 business Days and call the Puget Sound Military Appointment Center (PSMAC) at 1-800-404-4506, Mon-Fri 6am-8pm, Sat & Sun 7:30am-3:30pm. The call center representatives will inform you of the status of your referral, make your appointment or give you instructions to call the Specialty Care Clinic(s). They will also inform you if you are referred to a TRICARE Network civilian provider.
If you have already called PSMAC and/or Healthnet and still have questions regarding your referral call the NHCOH Referral Management Center at 360-257-9571.
Tricare Dental Program
The TRICARE Dental Program (TDP) is a voluntary dental plan. Sponsors can enroll through the
Beneficiary Web Enrollment website.
Steps to Good Dental Health include:
- Dental Visits every 6 months starting at 12 months of age
- Brushing teeth with fluorinated toothpaste
- For children under 3: use a small smear of fluoride toothpaste (about the size of a grain of rice)
- For children 3-6: Use a pea-size amount of fluoride toothpaste
- A toothbrush should be the last thing to touch your child’s teeth every night
- Do not put your baby to bed with a bottle at night or naptime.
- Brush teeth after receiving last bottle or cup.
Visit
https://www.tricare.mil/TDP for more details.
Exceptional Family Member Program
The EFMP includes identification of the family member's special needs and enrollment in the program, assignment coordination and family support. The Program assists Sailors during the assignment process by addressing the special needs of their exceptional family members (EFM) and ensuring they are assigned to areas where they can access necessary resources. If your Pediatrician or anyone else has recommended enrollment in EFMP, please contact our EFMP office at 360-257-9582, to schedule an enrollment appointment, as the type and timing of appointment needed may vary.
Overseas Screening
The Pediatrics clinic will complete Overseas Screening packets for those moving overseas or to a remote duty station. If your child is seen by a provider outside of the military system, we will need to review medical records prior to your screening appointment. Please allot time during the process to sign a Release of Information with Patient Administration and have records transferred before scheduling your screening appointment. Please note, your child will need to be up-to-date with their well checks to complete an Overseas Screening. For more information on the Overseas Screening process, please contact the Overseas Screening Office at 360-257-9587/9493. If your child has a chronic medical condition, he/she will need to be enrolled in EFMP prior to Overseas Screening. If your child has an Individualized Education Program through the school district this will also need to be included in the Overseas Screening packet.
Common Illnesses:
Fevers
What is considered a fever?
Fever is a higher-than-normal body temperature. A normal temperature is usually 98.6° Fahrenheit (F) or 37° Celsius (C). Most temperatures are considered normal until a temperature is greater than 100.4° F or 38° C (rectal temp preferred in young infants. Fever is a symptom (problem). Fever is not a disease. A fever may mean that there is something else going on in the body. Fever helps the body fight infections. It makes the body's defense systems work better. Fever can be caused by many conditions. The most common cause for fever is viral or bacterial infections, with viral infection being the most common.
How should I check my child’s temperature?
Your child's temperature can be taken many ways, but the best way is to take the temperature in the rectum or by mouth (only if the patient can cooperate with holding the thermometer under the tongue with a closed mouth).
How can I prevent my child’s fever?
- Generally, nothing can be done to prevent fever.
- Avoid putting your child in the heat for too long.
- Give more fluids than usual when your child has a fever. (Fever causes the body to lose more water)
- Ibuprofen (if older than 6 months) or Acetaminophen (Tylenol) may be given to reduce a fever. For dosage calculation based on your child’s weight, please refer to below.
Acetaminophen Dosing
| Weight (LBS) |
Children's Oral Suspension (160 mg/5 mL) |
Jr. Meltaway Chew Tablets (160 mg) |
| 6-11 lbs |
1.25 mL |
-- |
| 12-17 lbs |
2.5 mL |
-- |
| 18-23 lbs |
3.75 mL |
-- |
| 24-35 lbs |
5 mL |
1 tab |
| 36-47 lbs |
7.5 mL |
1.5 tabs |
| 48-59 lbs |
10 mL |
2 tabs |
| 60-71 lbs |
12.5 mL |
2.5 tabs |
| 72-95 lbs |
15 mL |
3 tabs |
Ibuprofen Dosing
| Weight (LBS) |
Children's Suspension (100 mg/5 mL) |
Chewable Tablets (100 mg) |
| 12-17 lbs |
2.5 mL |
-- |
| 18-23 lbs |
4 mL |
-- |
| 24-35 lbs |
5 mL |
1 tab |
| 36-47 lbs |
7.5 mL |
1.5 tabs |
| 48-59 lbs |
10 mL |
2 tabs |
| 60-71 lbs |
12.5 mL |
2.5 tabs |
| 72-95 lbs |
15 mL |
3 tabs |
**Ibuprofen should not be given to infants under 6 months**
When should I seek medical attention for my child’s fever?
- Your child has an a fever lasting greater than 3-5 days
- Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.
- Your child becomes fussy (irritable) or floppy.
- Your child develops a rash, a stiff neck, or severe headache.
- Your child develops severe abdominal pain, persistent or severe vomiting or diarrhea, or signs of dehydration.
- Your child develops a severe persistent cough, shortness of breath, or sustained rapid breathing
Diaper Rash Treatment
- Change dirty diapers as soon as possible
- If possible allow your infant periods of rest without a diaper
- Be gentle when cleaning the diaper area. Use water and a soft washcloth or baby wipes that are alcohol and fragrance-free. If the rash is severe, use a squirt bottle of water to clean the area.
- Apply a barrier cream with zinc oxide or petroleum with every diaper change. There is no need to remove all the cream with each diaper change.
- Seek medical care if the rash does not clear within 2-3 days of the above measures OR if your infant develops fevers, blisters, or pus that drains from the rash.
Conjunctivitis (Pink eye)
Conjunctivitis is commonly called "pink eye." Conjunctivitis can be caused by bacteria, viral infection, allergies, or injuries. There is usually redness of the lining of the eye, itching, discomfort, and sometimes discharge. There may be deposits of matter along the eyelids. A viral infection usually causes a watery discharge, while a bacterial infection causes a yellowish, thick discharge. Pink eye is very contagious and spreads by direct contact.
How do I know if my child’s pink eye is bacterial or viral?
The signs and symptoms of bacterial and viral conjunctivitis can appear similar. Bacterial conjunctivitis is less common in children older than 5 years of age. These germs are spread from person to person (contagious). The white part of the eye may look red or pink. The eye may be irritated, watery, or have a thick discharge. Viral conjunctivitis is caused by a virus and is also associated with a clear, watery discharge. If a discharge is present, there may also be some blurred vision in the affected eye.
What can I do to help my child’s pink eye and how can I lessen the likelihood of it spreading?
- Only have your child take medicine as told by your doctor.
- Apply a cool, clean washcloth over closed eyelids.
- Gently wipe away any fluid coming from the eye with a warm, wet washcloth or cotton ball.
- Do not share towels or washcloths. This may spread the infection to others.
- Make sure your child washes their hands often with soap and water or alcohol-based cleaner. Use paper towels to dry your child’s hands.
- Change or wash your child’s pillowcase every day.
When should I seek immediate medical care for my child’s pink eye?
- Your child’s eye is not better after 3 days of medicine (if prescribed).
- A yellowish white fluid (pus) is coming out of the eye.
- The redness is spreading.
- Your child’s vision worsens or becomes blurry.
- Your child has eye/face pain or puffiness (swelling) around the eye.
- Your child is older than 3 months with a fever lasting more than 3 days.
- Your child is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.
Could my child have allergic conjunctivitis?
Allergic conjunctivitis is common in people who have other signs of allergic disease, such as hay fever, asthma, and eczema. It is caused by the body’s reaction to certain substances to which it is allergic, such as:
- Pollen from trees, plants, grasses, and weeds
- Dust mites
- Animal dander
- Molds
- Contact lenses and lens solution
- Cosmetics
Diarrhea
Diarrhea is watery stool. The most common cause of diarrhea is a virus. Other causes include:
- Food poisoning
- Bacterial Infection
- A food intolerance like lactose intolerance
- Too much juice/sugary beverages
What can I do to help with my child’s diarrhea?
- Have your child drink pediatric formulated electrolyte containing fluids (such as pedialyte). This can stop your child from losing too much body fluid (dehydration).
- Have your child drink enough fluids to keep the urine clear or pale yellow.
- Avoid giving dairy products for a few days.
When should I seek medical attention for my child’s diarrhea?
- The watery stool lasts longer than 3 days.
- Your child has a fever >3 days duration.
- There is blood in your child’s stool.
- Your child also has persistent vomiting.
- Significant drop in number or amount of wet diapers or urine output
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