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.
“If only there was just one more creative way to increase my child’s sugar intake,” said no parent ever.
As a pediatric cardiologist, I spend much of my day counseling parents of children with obesity, hypertension, and hyperlipidemia. I tell them to increase their physical activity. Remove all junk food from the house. Join a sports team. Cut back on refined sugars. And of course, I am always thrilled when a …
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How youth sports might be a risk factor for heart disease
I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …
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The Wild West approach to PICU practice
You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC.
Acute flaccid myelitis (AFM) is a sudden illness that causes weakness in one or more extremities – one arm or (less likely) a leg, or any combination of arms and legs. The words in the name express the key …
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What you need to know about acute flaccid myelitis
Imagine this scenario. Your two-year-old son has had a runny nose for a day or two and an occasional cough, but seemed no worse to you that everyone else in his preschool class. Two hours after you put him to bed you hear him coughing, only this cough is like none you have ever heard from him before. It sounds like a barking seal at the circus — a brassy, …
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Everything you ever wanted to know about croup
This is not a story about anti-vaxxers. This is a story about primary care.
Running a smaller practice, as I do, has inherent rewards and challenges. There is literature on both sides of the Atlantic that patients prefer small practices. Lately, consolidation of practices has been frequent, mostly under the auspices of hospitals, sometimes into larger private groups. Although vertical integration appears to have increased costs and by various mechanisms inadvertently …
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A physician who is afraid of shots
While riding shotgun in the family minivan on the way home from a fall break water park trip, I received the following text message:
I thought of you today! One of the residents here had done a great job with a complex (and really sad) labor and delivery patient, and the nurse was telling me how awesome she was … so I thought to myself that I should do what you …
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This attending learned so much from her residents
At the age of 17, my younger sister Elisabeth noticed a change in her body — enlargement of the front of her neck. “I just thought I was building muscle from working out,” she innocently rationalized. A series of laboratory tests and imaging followed and led to a much more grave discovery — cancer.
There are days my family will never forget, like the day of my sister’s diagnosis. My older …
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This is what the face of resilience looks like
For those of you who have been following my story since this summer of 2018, you will remember that I quit my nine-to-five job to pursue a career in public speaking on a more semi-permanent basis. I started working essentially full-time with a national telemedicine company. I am extremely excited about the opportunity and very satisfied with the options it has given me to stay home — while I complete …
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Does that patient really need antibiotics?
As pediatricians who care for fragile, premature babies — we know firsthand the road to child health runs through quality health insurance coverage. Our patients require breathing machines, customized intravenous nutrition, expensive, specialized equipment and 24/7 monitoring in the neonatal intensive care unit, often with a dedicated nurse.
The high-tech care our patients require is supremely expensive. And quality health insurance partially supports these costs, which for premature babies, can be …
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This is how your vote affects children’s health
For many pediatricians, the thought of providing care to children who live outside of gender norms is daunting. But it is time for the pediatric community to awaken to the realities of our world. We need to stand behind our gender-expansive and transgender children, because their well-being depends on it.
Under our current administration, we as the pediatric community have the opportunity to define our goals and our vision as a …
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Gender-diverse youth need pediatrician advocates
I have worked most of the last 20 Halloweens in the pediatric emergency department (ED), so I’ve seen how a split second can ruin your child’s holiday. Here are some things you can do to plan ahead and avoid the ED.
1. Avoid trip hazards
It’s a recipe for mishap. Your child is in a costume that may have long hems or unusual shoes or a mask limiting their normal vision. A …
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How do I keep my kids out of the ER this Halloween?
Have you ever felt so cold? I mean bone-chilling cold. I don’t mean the same kind of cold that northern winters can leave you feeling. I am talking about working in a hospital that is climate-controlled, and you are undoubtedly shivering.
I still remember my first day on the job as a neonatology fellow. I was anxiously walking to the operating room to attend the delivery of a 25-week infant. As …
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A physician loves the adrenaline surge
I first posted about this subject a couple of years ago but it’s so fascinating to me I’m writing about it again. I happened to run across this study containing some amazing information. It’s from a publication called The Journal of Voice. The link is to the abstract — the complete article is behind a paywall but I can get it for anybody who’s interested in reading the whole study in …
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When babies cry, your tone matters
“Check it out,” my boyfriend said, angling his rash-covered arms in front of the camera. Despite his best precautions, after a day of yard work, he was covered in poison ivy. Over video chat, he showed off the pustules that had erupted on his feet; I cringed.
“It’s fine,” he said, wincing while putting his socks back on. “I’m glad to know how awful it feels. I’ve seen a bunch of …
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How physical should medical training be?
Not knowing what else to do after finishing my pediatric residency 15 years ago, I became a general pediatrician. Not knowing how to find a job halfway across the country and closer to home, I relied on a recruiter from a smallish town in South Dakota to woo me into private practice. Not knowing how to choose my future partners, I let them choose me.
Despite my unbelievably naive approach to …
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This physician is a better hospitalist because of the time she spent in the clinic
A few weeks ago, I saw a young patient who was suffering from an ear infection. It was his fourth visit in eight weeks, as the infection had proven resistant to an escalating series of antibiotics prescribed so far. It was time to bring out a heavier hitter. I prescribed ciprofloxacin, an antibiotic rarely used in pediatrics, yet effective for some drug-resistant pediatric infections.
The patient was on the state Medicaid …
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A physician’s breakthrough against prior authorization
