Pediatrics

A story of medicine’s stolen children

Conditions
November 17, 2021

It was a Monday two years ago. I was still fresh from coming back from having been out of school from a COVID break. I was no older than 22, and I was in my pediatrics clerkship. I was greener than a freshly watered lawn, and I felt every bit of it. It was one day into this rotation that I met Adam.

He was a 7-year-old boy the size of …

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Why you should vaccinate your kids

Conditions
November 16, 2021

I am definitely getting my daughter vaccinated, and I acknowledge a minimal risk. Here is my reasoning, and perhaps this can help your family decide to get the vaccine for the kids in your family, too.

Coronavirus is going to be with us for a long time — years, decades, probably for the rest of our lives like influenza. It is even widespread in deer now, another reservoir …

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The success of Australian firearms regulation: What it could mean for children

Policy
October 24, 2021

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 …

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The pediatricians are not alright

Physician
October 10, 2021

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 …

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Why pediatricians think about COVID differently

Physician
September 27, 2021

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 …

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Self-harm and eating disorders in teens

Conditions
September 20, 2021

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. …

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Treating formula as medicine may increase breastfeeding rates

Conditions
September 20, 2021

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 …

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How becoming a mother made me a pediatrician

Physician
September 12, 2021

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 …

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Physicians have gone from being heroes to villains

Physician
September 2, 2021

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 …

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The surprising power of family meals

Physician
September 2, 2021

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 …

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A perspective on comorbidities and severity of illness in children with COVID-19

Conditions
August 30, 2021

“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 …

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The Apgar Olympics: The race is on

Physician
July 28, 2021

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 …

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The non-acceptance of vaccine-hesitant families is a problem in pediatrics

Physician
July 26, 2021

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: …

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Teens need later school start times

Conditions
July 22, 2021

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 …

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It’s time to end the USMLE Step 3 exam

Education
June 14, 2021

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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Breastfeeding is not the end all be all

Conditions
May 31, 2021

“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 …

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#PedsMatch22 and the social media imperative

Education
May 25, 2021

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 …

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We need to stop blaming the doctors

Physician
March 3, 2021

“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 …

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