(Pediatric & Adult)
Specialty Programs
Allergy
Allergies occur when your immune system reacts to a foreign substance—such as pollen, bee venom or pet dander—that causes symptoms that involve your skin, sinuses, airways or digestive system. Children who are experiencing shortness of breath, wheezing, itchy eyes, a runny or congested nose and swollen sinuses may have allergies. The severity of allergies varies in children and can range from minor irritation to anaphylaxis — a potentially life-threatening allergic reaction to an allergen, causing a constriction of the trachea, preventing breathing. While allergies can't be cured, a number of treatments can help relieve allergy symptoms.
Miller Children’s & Women's uses allergy tests to identify allergens that may be causing the child's allergy symptoms. The allergists at the Children's Pulmonary Institute can then decide what type of medications, if any, and treatments may be needed. By identifying these allergens, changes can be made in the child’s home and living space to potentially improve their health.
TYPES OF ALLERGY TESTS
1. Puncture allergy testing - The most common type of skin test is the puncture allergy test, where tiny drops of purified allergen extracts are pricked or scratched into the child’s skin’s surface. This test is usually performed to identify allergies to pollen, mold, pet dander, dust mites and foods. Children may be tested for as many as 30 environmental allergens during this test. The number could be higher if the child is being screened for food allergies.
3. Patch allergy testing - Usually performed to identify substances that cause contact dermatitis. These include allergies to latex, medications, fragrances, preservative, hair dyes, metals, and resins. This test doesn't use needles; instead, an allergen is applied to a patch, which is then place on your child's skin.
2. Intradermal allergy testing - Usually performed if the doctor suspects a child is allergic to insect venom or penicillin. During this test, small amounts of purified allergen extracts are injected with a small needle syringe into the arm of the child's skin. A child having this test can be tested for up to 14 allergens, each requiring individual injections. A small reaction (similar to that of a bug bite) will appear within approximately 15 minutes if the test is positive. The child may experience some mild discomfort with "itching" from the test.
4. Blood/RAST Test - A radioallergosobent test (RAST) is an allergy test that involves collecting blood. A RAST can be performed when a skin test - the common allergy test - cannot be done due to a skin problem. RAST tests look for substances in the blood called antibodies. These tests are not as sensitive as skin tests but are often used for people who have sensitive skin and are unable to have skin tests.
Severe Asthma Center
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Asthma can be overwhelming even for the most prepared families. With an emphasis on education, the pediatric pulmonary care team is here to support each child on their health journey.
Whether a child is in the hospital as a result of their asthma or at a Pediatric Pulmonary Outpatient Specialty for a check-up, they will be seen by the same care team who works together to create an individual treatment plan to help manage the child's asthma and reduce their asthma attacks.
HOSPITAL ADMISSION
A child may be admitted to the hospital when their asthma is not in control, home treatments have failed, or if symptoms become life-threatening.
Reasons for admission:
✔ Unable to go 3-4 hours comfortably between breathing treatments even after medicines have been given
✔ Unable to keep medicines or fluids in the stomach without vomiting
✔ Low amount of oxygen in the blood
ASTHMA TREATMENT GOALS AT MILLER CHILDREN'S AND WOMEN'S
MCWH sees patients for asthma check-ups in the Pediatric Pulmonary Outpatient Specialty Centers. With a focus on patient-and-family-centered care, the pediatric team looks at the family as a crucial member of the care team. Families are encouraged to be hands on in their child's care to help keep them as healthy as possible.
✔ Free from signs of asthma most of the time
✔ No hospital stays or ER visits due to asthma
✔ Able to exercise and be active without symptoms
✔ No missed school days due to asthma
✔ Sleeps through the night without signs of asthma
For questions about our Asthma Program or for more information about where we treat patients, call (562) 933-8749
Cystic Fibrosis
Miller Children’s & Women's Cystic Fibrosis Center is one of the largest in the region and provides comprehensive, multi-disciplinary care including evaluation, diagnosis and treatment for children from birth to age 21, with cystic fibrosis (CF). The Center offers diagnostic testing, such as sweat tests, genetic tests, throat cultures, sputum cultures, blood work and chest x-rays.
The Cystic Fibrosis Center has earned recognition for its dedication and knowledge to improving the lives of children and young adults with cystic fibrosis (CF). Each child will benefit from the quality of treatment, dedicated care team, leading physicians, ongoing research efforts and more at the Center.
✔ The Center is accredited by the CFF (Cystic Fibrosis Foundation) and follows the clinical guidelines set forth by the Foundation to offer the best care, treatments, and support for those with CF.
✔ The Center has a seamless transition of care program for young adults with CF, ensuring they’re transferred to an adult health care setting without interrupting their care and having to adjust to a new setting. Unique for a children’s hospital, Miller Children’s & Women's shares a campus with Long Beach Medical Center, an adult hospital with an accredited CF center.
✔ Miller Children’s & Women's has the largest number of ongoing active CF clinical trials available to patients in Southern California. The continued research efforts of the CF care team plays a vital role in enhancing patient care and developing more effective medical treatments and diagnostic tools.
✔ Miller Children’s & Women's is one of only 82 accredited CF care centers that make up The Cystic Fibrosis Therapeutics Development Network (TDN) – the largest CF clinical trials network in the world.
There are only nine California hospitals with this distinction and Miller Children’s & Women's is the only children’s hospital in Southern California that shares a campus with an adult hospital – Long Beach Medical Center – that also is an accredited CF center and part of the TDN.
✔ Miller Children’s & Women's has a dedicated pulmonary wing in the hospital offering private rooms for children with CF to help ease anxieties and reduce infections.
The center works closely with the Gastroenterology, Hepatology & Nutrition Center to provide comprehensive care for CF patients who have lung and GI problems.
CYSTIC FIBROSIS JOURNEY
Each patient is treated by the same multi-disciplinary care team while they’re in the hospital, as well as at their check-ups in the Pediatric Pulmonary Outpatient Specialty Center at least every three months.
The consistent, familiar team helps reduce anxiety for patients and families and makes their transition from hospitalization to follow-up care seamless.
While at their check-ups, patients may be seen by a number of specialists and care team members including, but not limited to:
✔ Pulmonologist
✔ Gastroenterologist
✔ Respiratory therapist
✔ Registered dietitian
Each patient’s lung function and body mass index are documented over their entire time with Miller Children’s & Women's, which may be years. The care team presents this data in a graph at each check-up to help patients and families see where they’re progressing and where there is room for improvement.
✔ Physical therapist
✔ Geneticist
✔ Social worker
For questions about our Asthma Program or for more information about where we treat patients, call (562) 933-8749
Immunology
The Immunology Program at Miller Children’s & Women's provides evaluation and treatment for children with various types of immune system disorders. Miller Children’s & Women's allergist and immunologists employ advanced clinical and medical techniques to diagnose, evaluate and manage Primary Immune Deficiency Disorders (PIDS) in children.
CLINICAL ASSESSMENT & EVALUATION
Through comprehensive clinical assessment and evaluation for immunological function, the following tests can help the immunologists determine the basis of immunodeficiency and the possibilities for avoiding infection:
✔ Immunoglobulin levels
✔ IgA subclasses
✔ IgG subclasses
✔ Specific antibody titers
TREATMENT & MANAGEMENT
Medical management is an important part of treatment for a child with primary immune deficiency disorders. Medicines, such as prophylactic antibiotics, can be prescribed to prevent infection. Also, Intravenous Immune Globulin (IVIG) can be administered to children with disorders of antibody function.
SURGICAL CARE
A few patients with chronic upper or lower respiratory infections and subsequent structural changes may need strategic, long-term, broad-spectrum antibiotics, in addition to chest physiotherapy and sinus surgery.
For example, many young children who get chronic ear infections benefit from the placement of tympanostomy tubes in their ears and/or they might undergo endoscopic sinus surgery for chronic sinusitis. However the importance of aggressive medical therapy for the underlying immunodeficiency and its accompanied allergic condition is very important in treating a child with these symptoms in addition to the placement of tubes and/or sinus surgery.
Sickle Cell Pulmonary Clinic
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Sickle cell disease is a genetic (inherited) disorder. Healthy red blood cells look like round discs; but in sickle cell disease, they are shaped like sickles, or crescent moons. These sickle shaped cells become stuck together and block small blood vessels. These prevent blood from moving properly which can lead to pain and organ damange.
The Sickle Cell Clinic provides sickle cell diagnosis, treatment, and long-term health management care from birth through young adulthood.
Our sickle cell care team offers multi-specialty medical care, including assessment, consultation, treatment and preventative care. Psychosocial programs such as family support, education, community support, and school reintegration are uniquely combined into each child's treatment plan.
TREATMENT & PREVENTATIVE MEASURES
We are proud to offer distinguished medical programs staffed by a multi-disciplinary pediatric hematology oncology care team, complete with dentists that provide evidence-based medical care, parent support, and education every step of the way.
In addition to sickle cell treatment needs, Jaques Children's Cancer Institute also is heavily involved in research to help find cures and discover new treatments for serious blood disorders.
Primary Ciliary Dyskinesia (PCD) Clinic
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Primary Ciliary Dyskinesia (PCD) is a rare disorder; consequently, only a limited number of centers have extensive experience in the diagnosis and management of PCD. Patients often receive false-positive or false-negative PCD diagnoses, as physicians are unaware of the pitfalls commonly encountered with ciliary electron microscopy, PCD molecular genetic panels, ciliary motility studies and nasal nitric oxide testing.
Because PCD diagnosis relies on a high level of experience with the disorder and with diagnostic technologies, the PCD Foundation (PCDF) recommends that diagnosis and treatment be done–when at all possible–at a PCD Clinical and Research Network (PCDF-CRCN) site.
Our clinic is modeled after the highly-successful Cystic Fibrosis Foundation Care Centers. Each multi‐disciplinary site will be required to meet stringent criteria for the diagnosis of PCD and to follow PCDF Consensus guidelines1,2. The establishment of a PCDF-CRCN site at Miller Children’s Hospital (MCH) provides high quality diagnostic and treatment options for PCD patients, create a path to clinical trials and will aid to find a cure to PCD.