Pediatricians and the clinicians who care for children writing on KevinMD about child health: childhood illness, development, vaccines and the parents who refuse them, breastfeeding and the pressure around it, childhood obesity, prevention, and the realities of caring for young patients and their families. Most contributors are pediatricians. For a maintained record of what pediatricians have said about children's health since 2004, from fever and sleep through obesity, abuse, teenagers, and Medicaid, see Children's health: what pediatricians say, in their own words. For what physicians have said about vaccines and vaccine hesitancy, from the autism claim through measles, exemptions, and federal policy, see Vaccines: what physicians say, in their own words. For what child psychiatrists and pediatricians have said about children's and teens' mental health, see Mental health: what psychiatrists and physicians say, in their own words. For what pediatricians have said about breastfeeding and postpartum care, see Women's health: what physicians say, in their own words.
When a baby arrives dead in your emergency department …
… the world stops. You stop breathing. You are gasping for air. She is limp; she is cool; she is pulseless. Chest compressions on the tiniest six month old I have ever met are done with the finger pads of my index finger and middle finger. Quick, synchronized beats. I look at her blue, blue lips. It should never be like this.
Her eyes …
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When a baby arrives dead in your emergency department
Most doctors well into their tenure of medical already have a general idea about how other specialists spend their days (except for radiation oncologists, where no one else knows what they do). However, as a medical student, I had incredibly limited insight into the variety of means to practice medicine. Even as an attending physician, I am still discovering how creative some medical specialties allow one to be. For instance, …
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The clinical and financial life of a pediatrician
Heart health starts in childhood to avoid cardiovascular disease, hypertension, obesity, and diabetes. Kids today have developed so many bad health habits that they are facing heart attacks in their 30s. Many experts predict they will be the first generation to have a lower life expectancy than their parents. But it doesn’t need to be this way. Parents like you have a significant influence over your kid’s habits. By modeling …
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Heart health begins in childhood: 5 tips from a pediatrician
You may have noticed your child seems to be bored of their bag lunch and most of it being brought back home or dumped in the garbage. Lunch is an important meal to get kids the energy they need to get through the second half of the school day. Strive to include some protein, fruits, veggies and healthy sources of fats. Now, you don’t have to buy gourmet or even …
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6 easy hacks from a pediatrician to make healthier kids’ lunches
My story makes even the hardened among us cringe … but I am not here to tell you that story. My real story begins after.
In order to stand up for my values, I recently walked away from a booming practice. What I had built felt sacred to me, almost miraculous. As a pediatrician, I realize it is no small matter that parents entrust me with the care of their children. …
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A physician leaves her practice and finds beauty in the struggle
My husband recently found a bag of breast milk in the freezer as he scrounged for dinner ingredients. This milk was pumped over four years ago for my third baby who turns five next week. Just like I did for her older siblings, I religiously pumped breast milk at work until her first birthday. On the day that she turned one, I stopped lugging my pump bag to work, stopped …
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When this doctor and mom stopped breastfeeding
Do you feel like you’re always saying “no” to your child and not getting the response from them that you are looking for? Do you end up repeating yourself over and over, so frustrated you begin to yell or just given in to your toddler’s demands? Unfortunately, I hear this way too often from moms, so I wanted to give some tips on the art of saying “no” that will …
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How to say “no” to kids
It’s no secret that in today’s health care market, insurance companies are calling the shots. As a pediatrician in private practice for almost two decades, I’ve seen insurance companies transform into perhaps the single most powerful player in today’s health care landscape — final arbiters whose decisions about which procedures or medications to authorize effectively end up determining the course of patient care.
Decisions made by insurers, such as MassHealth, have …
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How an insurance company auditor tried to destroy a physician’s career
Chances are that if you have kids, you’ve had at least one unplanned visit to the hospital. Taking care of children in the emergency department (ED) is a special challenge for many reasons including the fact that the child’s parents don’t choose to see me specifically, they are usually meeting me for the first time, and they’re meeting me under very stressful circumstances.
When I started practicing medicine 20 years ago, …
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The unsung heroes of sick kids
I found his obituary today. Kids do not always have obituaries. I am not sure why. Perhaps it is because children are not supposed to die and no one quite knows what to say. Still, I always look for them.
He loved the color green.
His death was so unexpected. I have never seen a child become so sick so fast. I was the pediatrician covering the hospital ward that night. He …
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When a child dies, this pediatrician grieves
I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person.
I left slightly broken.
Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patient who died on your watch, or the realization that you have not changed the world. It could be the constant fear of failure or punishment by …
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A reflection on the last day of residency
Peanut allergies can be a serious problem, and many exposures happen when our kids are at school. On average, there are probably about 5 peanut-allergic children in each of our nation’s 100,000 school buildings. What’s the best policy for schools to use to help protect these kids from potentially fatal reactions?
Different schools have taken different approaches, and as far as I can tell there is no authoritative national guideline …
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Peanut allergies: What is the best policy for schools?
The over-the-counter sale of probiotics is a huge industry. They are heavily promoted on social media as a cure-all for a wide variety of ills. Probiotics are live cultures of what are often called “good bacteria,” and there are solid physiological reasons for recommending them. But, and this is a huge but, actual clinical data demonstrating their usefulness behind some well-defined disorders is pretty scant. Their potential usefulness in many …
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Using probiotics in children: a pediatrician’s take
About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that something was wrong. M was transferred to our pediatric hospital as a trauma and was found to have an unstable vertebral fracture. Conservative treatment with …
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Non-therapeutic relationship or human kindness?
Yes, med-peds is a real residency! It is a real specialty! And it is a practicing profession by many physicians today! It can open doors for so many wonderful professional opportunities. It is a discipline that can provide patients and communities extremely comprehensive medical care. People need to know more about this unique and sometimes under-recognized field. And here is why:
Like many people today, I didn’t even know what med-peds …
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The myths and truths about med-peds physicians
Stefania was a 17-year-old Russian girl who presented herself to a port of entry in the United States seeking asylum. Stefania’s journey to this point was an unimaginable one. In her home country of Russia, she was a happy high school student living with her mother. Her father died of a heart attack six months prior. Then one day on her way home from school, she was kidnapped by the …
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The value of an immigrant child
“You’re going to fall in love with her,” the nurse warned me, as I stood outside my eleven-year-old patient’s room ready to wake her up for surgery pre-rounds at 5:30 a.m.
I offered back a tired smile and knocked on the door timidly. “Naomi?” I whispered.
To my surprise, I was greeted with a chirpy “Good morning!” and entered the room to find a bright-eyed eleven-year-old sitting up in her bed with …
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How a young girl helped me find the light in pediatrics
November 2017. I was on my pediatrics rotation at a local community clinic. My attending asked me if I could see Johnathan (identifying information and event details altered to protect confidentiality), an eight-year-old boy who has been increasingly fatigued since the start of the school year. I walked down the hallway laden with paintings of Amazon animals and knocked on room #13.
“Good afternoon, Ms. Sanders. My name’s T.J., and I’m …
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The first time I felt I truly helped a patient
