An article in the New England Journal of Medicine in 2018 noted the sad milestone that firearms were causing 15% of all deaths in children and adolescents. Somewhat encouraging, a later study showed states with stricter firearm laws correlated with lower numbers of firearm deaths in children. The relationship was quite linear, as you can see below. The authors had specific criteria for weak vs. strong gun laws: if …
In the past week alone, I have heard the following comments from pediatricians on the front lines: “I’ve been practicing for 21 years, and I’ve never seen things this bad”; “I have been called uncaring because my patient had to wait an hour. But I couldn’t tell my patient that I was running behind because of a suicidal patient”; “I’m considering leaving clinical medicine because it seems like there is …
Earlier this summer, the American Academy of Pediatrics made recommendations that contrasted with those from the CDC, emphasizing the need to do everything possible to prevent COVID infection in children. Specifically, they recommended that even vaccinated adults who were around unvaccinated children in schools continue to mask indoors. This more conservative stance initially caused confusion, but the CDC has since aligned their guidelines more closely with pediatricians. Nevertheless, there remain …
An excerpt from The Addicted Child: A Parent’s Guide to Adolescent Substance Abuse.
How do you know if your teen has a substance problem? The inability to control substance use despite negative consequences is a classic definition of a severe substance use disorder. But substances aren’t the only thing afflicting adolescents. Another dangerous behavior is invading the adolescent population: process disorders. …
Currently, there is an outcry against the pressures of breastfeeding, with an underlying backlash against the stigma of bottle feeding. Commercials from formula companies, such as Bobbie, are playing at the hearts of struggling breastfeeding mothers. Touted as an organic European formula comparable with breastmilk, Bobbie is the solution. Famous stars, like Queer Eye’s Tan France, emphatically narrates his decision on choosing formula over donor milk for their family. Over …
For years, I hated when patients would ask if I had children. I consider myself to be a good pediatrician and trained at a highly rated medical school and residency. I work hard and I care for my patients. I can, however, be socially awkward and did not start dating until later in life. At its most innocent, the question triggered inadequacies about my social and personal life. At its …
I am exhausted.
Mentally, emotionally, physically.
I fear we are reaching our breaking point. We have run a marathon, hoping that we were nearing the finish line as we saw numbers decline in June, only to be told to lace up our sneakers and start over.
Work in outpatient pediatrics is always busy in the summer – seeing our patients for school and sports physicals, marveling at how much they’ve grown since we …
I am a board-certified pediatrician, wife, mother of four, and host of a podcast. I have been interested in nutrition and feeding practices for as long as I can remember. In my practice as a pediatrician, I was constantly bombarded with parent concerns about children’s eating habits. Commonly parents worried that their children were not eating enough, were eating too …
“Children don’t get as sick with COVID-19” and “only children with comorbidities get very sick from COVID-19” are two statements that have concerned me during the pandemic. They have been used as statements to support loosening COVID-19 prevention measures for children, like wearing masks, and rationalizing arguments opposing vaccinating children against COVID-19. It is true that children, for the most part, do not get as sick from COVID-19. Nevertheless, while …
The page comes during a lull on an otherwise busy day in the well-baby nursery (WBN). My pager’s shrill cry rouses me like the blast of a starting pistol.
DI-DI GESTATION. 37 WEEKS. BABY A WITH NON-REASSURING HEART TONES. BABY B BREECH. OPERATING ROOM A. COME STAT.
Translation: Twin birth. Baby A is STRESSED. Baby B attempted a front flip but got stuck. HURRY.
The race is on, and I am determined to …
Some pediatric practices refuse to provide care for children with vaccine-hesitant parents.
Those pediatricians are quick to offer rationalizations for this decision. Many of their reasons are compelling. I’m confident you yourself are thinking of some right now. This piece isn’t intended to be a deep dive into those reasons. No justification for refusing care to certain children changes the outcomes.
We assume that these families end up at organizations like mine: …
Daily cries from parents, pediatricians, the press, and the public to reopen schools in the fall are certainly well-intentioned, but they are overlooking a critical opportunity to advance adolescent physical and mental health long after the COVID-19 pandemic is over. Delaying school start times for teens by an hour, or even two, could optimize a teen’s sleep and their ability to learn throughout the day.
Sleep is critical for teen health …
The COVID-19 pandemic put a pause on institutions that we did not think were pausable, allowing us to ask critical questions regarding their relevance and necessity. One such institution is the United States Medical Licensing Examination (USMLE). During COVID-19, Prometric sites closed, delaying exams for many. In response to public outcry, Step 2 CS has become defunct. Before COVID-19, there had been calls to reform the expensive licensing exams, …
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“Thank you. You’re the first to say it’s OK for me not to breastfeed.”
These words have been said to me before by tearful, exhausted mothers. It had been sporadic, but now, it feels like I hear this every day in the clinic. Each time, I feel a rush of mixed feelings as I explain that other options had not been explored because of the known benefits of breastfeeding. I tell …
The 2020-2021 residency application cycle was profoundly altered as a result of coronavirus disease 2019 (COVID-19) in the United States which led to a completely virtual season for nearly all specialties. At the time of this publication, pediatrics, obstetrics and gynecology, and ophthalmology have announced virtual interviews for the upcoming 2021-2022 cycle. Using lessons from the inaugural “virtual” cycle, many residency …
An excerpt from Tenacity in Children: Nurturing the Seven Instincts for Lifetime Success.
Did you ever wonder why babies quickly develop a social smile and look you in the eyes? Is it surprising to learn that the muscles in your ears are set within the range of women’s voices at birth or that babies prefer looking at women’s faces …
“Why do they book your well-child checks for 15 minutes?” my medical student asked me yesterday. I laughed. I couldn’t help it. Gut reaction – like when you laugh instead of cry. I explained that all of our appointments are 15 minutes – well-checks (regardless of age), to colds, to suicidality or chest pain. I work for a large hospital system, and that is how patients are booked. I the …
Part of your job as a parent is to teach your children, and there’s no way for a child to learn anything without making a few mistakes. Actually, a lot of mistakes. Sometimes these mistakes can be infuriating. They might be self-destructive mistakes. They might be mistakes that can cause harm to their siblings or classmates. They might be mistakes that happen over and over again. They might …
During a casual scroll through social media, I often hear the voice of my friend and fellow pediatrician warning, “Do not engage!”
Generally speaking, this is almost always the correct advice. The rise of various social media platforms, the ability to rapidly share information and disinformation, the growing culture of doing one’s own “research,” and the apparent difficulty in separating reputable from non-reputable sources online has created the perfect storm. In …
“But if thought corrupts language, language can also corrupt thought.”
– George Orwell
The “difficult” family
At 2 a.m., on my first night shift as a pediatric resident, a patient, Casey, transferred from another hospital. She had a rare, progressive chronic illness, was medically complex, and was currently receiving treatment for an acute systemic infection. Shortly after she arrived, she became difficult to arouse. When I asked her mother questions, I was …
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