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.
I am a pediatric resident working, like many residents, in a clinic that sees many of the most vulnerable children in our area. We see many refugees and immigrants coming through our clinic, including many from the countries named in President Trump’s immigration ban.
These refugee children often suffer from afflictions we rarely see amongst our usual patient population: severe vitamin and nutritional deficiencies, intestinal parasites, malaria. They are often thin …
Read more…
Our responsibility to refugee children
Infants with a first-degree relative (parent or sibling) with celiac disease, and who carry an at-risk (DQ2 or DQ8) gene, have a higher risk of developing the autoimmune disorder triggered by gluten-containing foods. Many parents, especially those with a family history of celiac disease, are understandably nervous about introducing gluten into their child’s diet. They wonder whether there is an ideal time to introduce gluten, if they can prevent celiac …
Read more…
When should you introduce gluten to your baby?
Doctor Barbie has a laptop. She comes with other accessories, like a white lab coat and stethoscope of course, but one of her largest and most prominent medical tools is her laptop. As a pediatrician’s daughter, my child selected doctor Barbie from the aisle of infinite Barbie options because she knew I was most likely to purchase this one when otherwise walking the store repeating the mantra “no more toys.” …
Read more…
I am grateful to Doctor Barbie
Having recently returned from a medical mission to the Syrian refugee camps in Jordan, I have become consumed with advocating for the rights of the children outside of our borders. All the while the children I have spent the last five years caring for have been fighting for themselves in this changing political climate. As a pediatrician for an underserved immigrant population, I have seen first hand how a simple …
Read more…
How an executive order can erase an entire childhood
I’ve always wanted to be a pediatrician because I love kids; if you ask most people who work in pediatrics whether nurses or physicians they may say that. It’s a very common response to the question “Why pediatrics?” Or how can you do pediatrics?” when students and physicians are asked. Yes, we love working with children for many reasons. Some love the unexpected unrehearsed things kids say; they will shock …
Read more…
When healthy children die: Pediatricians are not superhumans
To be clear, this is about one person. It warms my heart to know that people want to come and start new lives as Americans. Some of the best doctors got their education and training overseas. Not only have I worked with many of them, I’m related to three by marriage. Most people have heard of Mr. Andrew Wakefield. He used to be a British doctor before being stripped of …
Read more…
The one immigrant who has nothing good to contribute to the American story
As physicians ready themselves for the future of medicine under onerous MACRA regulations, it seems appropriate to glance into the future and visualize the medical utopia anticipated by so many. Value-based care, determined by statistical analysis, is going to replace fee for service.
Six months ago, I received my first set of statistics from a state Medicaid plan and was told my ER utilization numbers were on the higher end compared …
Read more…
MACRA makes it easy to game the system
During the first year of medical school, one of the most nerve-wracking, but exciting, experiences was learning how to interview and examine patients. At that time, we mostly worked with “standardized patients” — people who are trained specifically to play the role of a scripted medical case. Although working with them seemed incredibly challenging at the time, the rules of engagement were in fact very favorable to us. Asking a question …
Read more…
The medical student’s ultimate challenge: children
I am a new mom to a beautiful 8-month-old girl, and I am breastfeeding. I am also a doctor at a large, well-known academic institution. The hospital where I work delivers several thousand babies a year, and highly encourages their new moms to breastfeed. They offer a postpartum consultation with a lactation consultant, keep the baby in the mom’s room 24/7 while in the hospital, and provide several other pro-breastfeeding …
Read more…
Is breastfeeding as a working doctor an impossible task?
A fairly recent article in the Journal of Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students. It is sobering because it describes the potential harm that can come from it — harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything.
“Overdiagnosis” is the term the authors …
Read more…
Overdiagnosis harms kids. Here’s how to avoid it.
We do many things in medicine to patients that are either not helpful or have the potential to harm. If you take the long view of medical history, this should not be surprising. After all less than a century ago, physicians were still giving toxic mercury compounds to people in the form of calomel. And a century before that, physicians were bleeding people because they thought that was a good …
Read more…
Let’s stop therapies that hurt kids
A concussion is a brain injury. A mild one, yes, but one that can lead to longstanding symptoms. What you do after a concussion, immediately and in the weeks that follow, can make a big difference in how your child recovers.
Though it’s a mild injury — there’s nothing to see on a CT, X-ray, or MRI — the effects of a concussion can be significant and uncomfortable for a child …
Read more…
My child has a concussion. What should I do?
William Osler once said, “Listen to your patient; he is telling you the diagnosis.” Anybody who practices medicine knows that is easier said than done. The ability to take a skillful history takes years to develop. There are many nuances in a medical history and physicians must know the right questions to ask. The next step is to avoid asking the wrong questions and the wrong wording of the right …
Read more…
How to navigate the language barrier with patients
One evening this past week, after my wife finished feeding our 5-week-old daughter, I took over baby duty. I sat her up on my lap and gave her a few thumps on the back. Not hard enough to hurt, obviously, but just to make her burp.
She didn’t burp. So I gave her a couple more gentle-but-firm whacks, still without a result.
And then I remembered the phone call I got a …
Read more…
Should we stop burping babies?
On the eve of President Trump signing an executive order on immigration, I lay here awake, silently screaming for the Syrian children. What will become of the hundreds of children I met recently at the Zaatari camp in Jordan whose hopeful eyes searched my own for answers? Unable to return home because of a war that has stretched more than 5 years, where will they go if we turn our …
Read more…
A pediatrician, silently screaming for the Syrian children
Bringing a child into the world is nothing short of a miracle. It’s not comforting to think about, but even if you do everything “right,” there can always be circumstances beyond your control. Whether you have been told to plan for a stay in the NICU or it’s unexpected, here are survival tips from nurses for orienting yourself to the NICU.
1. Try to see your baby as soon as possible. It …
Read more…
8 survival tips for families with babies in the NICU
I spent many sleepless nights in the months after my son’s autism diagnosis fretting whether I could have done something to prevent it. I recounted, in obsessive detail, the course of my pregnancy, the birth, and the two years of child-rearing that led to the moment when our pediatrician confirmed my fears — and life as I’d known it tilted off its axis. In my spare waking hours, I pored …
Read more…
Let’s spend money on autism support, not conspiracy theories
It is clear that the anti-vaccine movement is born out of concern for children and their well-being, and I sympathize with the fear and uncertainty of parents. I do not, however, sympathize with President Trump’s decision to meet with the out-spoken vaccine critic Mr. Robert. F. Kennedy Jr., or his reported decision to have Mr. Kennedy chair a commission investigating the safety and efficacy of vaccines. It is not merely …
Read more…
How a meeting between President Trump and Robert F. Kennedy, Jr. puts lives at risk.
