Pediatrics

Radiation from x-rays and living in Denver: They’re not the same

Conditions

October 9, 2013

My kids were at the dentist this weekend for their routine cleaning and check ups (yes, Saturday hours!) when the hygienist mentioned x-rays. I smiled and mentioned I’d rather discuss the need with the dentist after his exam. This isn’t a dental x-ray thing, this is what I do for every test that involves ionizing radiation.

My son, Oliver, has had more radiation than most people will have. Ever. In fact, …

4 myths and truths about milk

Naline Lai, MD and Julie Kardos, MD

Conditions

October 2, 2013

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We’ve heard some interesting things about cow’s milk over the years. I am going to share with you four myths about milk that I continue to hear from my patients’ parents.

Myth #1: Don’t give milk to a child with a fever; the milk will curdle (or some other variant).

Truth: As long as your child is not vomiting, milk is a perfectly acceptable …

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4 myths and truths about milk

Why online dating is a bad idea for teens

Claire McCarthy, MD

Physician

August 29, 2013

Online dating is a bad idea for teens — especially young teens.

That’s why it wasn’t particularly responsible of Seventeen Magazine to publish a blog in which “dating blogger” Isabelle Furth floated the idea of using sites like Match.com to find dates. To be fair, she had concerns about the idea, and she’s in college, so theoretically old enough to make these decisions. But college kids don’t read Seventeen. Middle school …

Calling a consult: Disrespect from specialists hurts patients

Heidi Roman, MD

Physician

August 26, 2013

A while back I was working in pediatric urgent care and had occasion to do something I have done many times since starting out in medicine. I called a consult. The reason, like many consults, was an abnormality on a study that required a specialist’s opinion. I paged the resident on call for this particular specialty.

When they called back I was treated, right from the get-go, to some serious attitude. This was a legitimate …

It’s time primary care doctors diagnose autism

Denise A. Somsak, MD

Conditions

August 1, 2013

I remember how my son’s autism diagnosis was delivered. He was three years old. It wasn’t a surprise really, merely a confirmation of something that I expected and feared. He was already enrolled in speech and occupational therapy making very little progress. He saw a developmental specialist at age two and two and half who initially believed that he was not autistic but merely delayed with sensory issues. After we …

When does a teen girl need a pelvic exam?

Wendy Sue Swanson, MD

Conditions

July 8, 2013

Typically, teen girls do not need a pelvic exam until they are 21. Most parents are surprised to hear this, especially if they know their teen is sexually active.

About 1/2 of teen girls are sexually active during high school which puts them at risk for sexually transmitted infections (STI) and unwanted pregnancy. However, for routine prevention and care, girls rarely need an internal pelvic or speculum exam during high school. …

When a child can’t feel his poops

Roy Benaroch, MD

Conditions

June 26, 2013

Kathy wrote about her son: “What can cause a 9-year-old boy to poop in his pants occasionally and not feel it? He was completely potty trained at age three. I have found dirty underwear and poop on the bathroom floor–and it just concerns me that he is unaware of it. It has been suggested at checkups that he may be constipated. My mother suggests he may simply not be paying …

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When a child can’t feel his poops

A pediatrician’s approach to dehydration in children

Christopher Johnson, MD

Conditions

June 24, 2013

Our bodies are mostly water — about 60% water, in fact. This varies a little with age and sex, but it is a good rough estimate. Of that 60% water, about a third of it is outside the body’s cells, so-called extracellular fluid, and two thirds of it is inside the body’s cells, so-called intracellular fluid. The easiest way to remember this is the “60/40/20″ rule: total body water is …

A psychiatric disorder or a profound lack of discipline in our kids?

Greg Smith, MD

Physician

June 11, 2013

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It is hard to see a child in pain.

I have seen quite a few children in the emergency departments of South Carolina in the past three years, more than I could have imagined just a while ago.

Now, in the interest of full disclosure, I am not a child psychiatrist by trade. Like any general psychiatrist, my training provided me with didactic …

How to know if your baby has autism

Naline Lai, MD and Julie Kardos, MD

Conditions

June 8, 2013

Autism is a communication disorder where children have difficulty relating to other people. Pediatricians watch for speech delay as a sign of autism. Even before your child is expected to start talking, around a year old, you can watch for communication milestones. Problems attaining these milestones may indicate autism or other disorders such as hearing loss, vision loss, isolated language delay, or other developmental delays.

By six weeks of age, your …

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How to know if your baby has autism

Letting your infant cry it out: Will it hurt your baby?

Roy Benaroch, MD

Conditions

June 5, 2013

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Jess, like many parents, has been hearing conflicting information about what crying can do to your baby.

She wrote: “So, my husband and I accidentally let our kiddo (5.5 months) cry it out. So of course, I’m spending all sorts of time on Google finding out that I’ve caused long-term damage to my son and he’ll be more likely to get ADHD and …

Migraine is very much a childhood disorder

Roy Benaroch, MD

Conditions

May 29, 2013

“My wife gets migraines—really bad ones—and now my daughter seems to be getting them too. She’s only 7! Is she just copying what her mom does? Can a child really start getting migraines?”

Oh, yes they can. Migraine is very much a childhood disorder. About 5% of adults have migraines, and half of them started having their migraines as kids.

As in adults, migraines in children can be severe and debilitating. However, …

Is this Fisher Price sleeper safe for infants?

Roy Benaroch, MD

Physician

May 12, 2013

You might think a thing sold by a huge manufacturer of children’s toys and furniture as a “sleeper” would a safe, appropriate place for a baby to sleep. It is, after all, called a “sleeper.” But it is not a safe place for your baby to sleep.

The Fisher Price Newborn Rock ‘n Play Sleeper is a sling-shaped baby holder sort of gizmo, …

Prescribing antibiotics: It’s time to draw a hard line

Wesley Nickens, MD

Meds

May 11, 2013

This is a call to arms to my fellow providers to protect our patients from themselves and our willingness to comply with their requests. We live and practice in a society filled with fear of medications and their side effects. People will not take blood pressure, cholesterol, or diabetic medication because of the side effects they have heard or read about.

However, these same patients will take antibiotics every day of …

How to know if your toddler has autism

Naline Lai, MD and Julie Kardos, MD

Conditions

May 11, 2013

About half of all children in the United States with an autistic spectrum disorder are diagnosed at age five or older, according to a May 2012 NCHS (National Center for Health Statistics) data brief. However, many parents are suspicious much sooner. As part of autism awareness month, we bring you clues into toddler development that can alert you to a potential issue.

Pediatricians often use a questionnaire called the M-CHAT (Modified …

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How to know if your toddler has autism

The rise of ultimatums in medicine: Do they work?

Katie Noorbakhsh, MD

Physician

April 15, 2013

Has anyone else noticed the growing presence of ultimatums in medicine today?

The New England Journal of Medicine published a discussion of the ethics of not hiring smokers. My hospital adopted this policy six months ago, and they are not alone. There is a tobacco blood test that new employees have to pass. If they fail, they can look for a job elsewhere. I do not know the exact details, but …

The baby had a seizure: Why was the mother smiling?

BirdStrike, MD

Physician

March 1, 2013

My first night shift in a stretch of 7 was almost over. It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep. That never makes for a good drive home after a night shift.

“Got time to see one more?” asked Jenny the nurse.

“Do I have …

Sending your child to the chiropractor: Be very careful

Roy Benaroch, MD

Physician

February 28, 2013

There are plenty of things we don’t know about health and illness. Sure, we know a lot more than we did fifty or a hundred years ago—but every day, still, I have questions that aren’t yet answered. I read a dozen or so journals each month. (I know. Nerd.) Each one has at least ten or so good quality studies—good, …

Teaching children how to behave: 5 essential principles

Roy Benaroch, MD

Physician

February 19, 2013

Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function …

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