Pediatrics

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.

A child’s father knew when to let go. The health care team didn’t.

Niran S. Al-Agba, MD

Physician

June 2, 2016

Physicians are accustomed to seeing patients at the end of their lives. It is difficult to let families know they may lose their loved one. Clinicians are often accepting of patients DNR orders before family members are ready. This story is about a time where the health care team was ill-prepared, yet a parent made the difficult decision to discontinue intervention. It taught me an unforgettable lesson.

During the first ICU …

Why now is the time to talk to your children about terrorist attacks

Marjorie S. Rosenthal, MD, MPH

Conditions and Diseases

May 25, 2016

It’s field trip season in middle school.

Which means that all over the country young adolescents are headed to memorials and museums. In New Haven, Connecticut, field trip season means the 8th graders are going to the World Trade Center in New York City. Which means that at my kitchen table, my daughters and I are discussing how safe it is to be at the World Trade Center. Two of us think it’s one of the …

Maybe it’s time to go back to index cards for medical records

Niran S. Al-Agba, MD

Physician

May 25, 2016

During our dermatology section in medical school, a classmate recounted having had Henoch-Schonlein purpura as a child. Over a holiday break, he visited his primary care physician and asked if he could review his records out of curiosity. His family physician pulled out the index card that served as this man’s medical record. Yes, you read that correctly. It was not a chart or computer printout; rather a 4 x …

This pediatrician declined to do MOC. See what happened to her.

Meg Edison, MD

Physician

May 17, 2016

voluntary

The American Board of Medical Specialties says “board certification is a voluntary process, and one that is very different from medical licensure.” This is echoed by my board, the American Board of Pediatrics, who says, “Board certification is a voluntary process that goes above and beyond state licensing requirements for practicing medicine.”

Over the past few years, …

A letter to a suicidal transgender teen

Florencia D. Kantt, ARNP

Physician

May 17, 2016

To the suicidal transgender teen I had the pleasure of meeting,

I have been thinking about you a lot recently.

I have been thinking about your struggle and how to support your transition into a healthy and happy adult who feels like the world is a safe place.

I have been thinking about how to best help alleviate your fears about being ridiculed, discriminated against, bullied, threatened, abused, assaulted, or killed.

I have been …

Read more…

A letter to a suicidal transgender teen

My relationships with patients last generations

Niran S. Al-Agba, MD

Physician

May 16, 2016

At 6 a.m. one morning, I was playing tennis at our local athletic club a few months ago. Sam, working at the front desk came running down onto the courts. “There is an emergency and a woman on the phone says she needs your help.”

I will be honest; I panicked a little. My husband was home asleep as were my four children. My thoughts as I raced up two flights of stairs …

A patient encounter that almost pushes this doctor over the edge

Raj Waghmare, MD

Physician

May 16, 2016

It’s the beginning of October, it’s Sunday, and it’s been an uneventful shift thus far. However, in exactly seventy minutes, a patient that I’ve just seen — one that I think has nothing more than an upset stomach — will collapse and begin a fight for her life.

I’m at the nursing station scribbling on a chart when a lanky man leans over me, a toddler in his arms. He’s looking at the …

Is grunting baby syndrome a real thing?

Roy Benaroch, MD

Conditions and Diseases

May 14, 2016

A reader writes: “Grunting baby syndrome. Is this really a thing? My 6-week-old son grunts, strains, and writhes from approximately 3 to 6 a.m. every night. Most of the time he sleeps through it. My GP suspects reflux but ranitidine has not helped. Also, he’s very happy/calm all day rarely fusses or cries. My Google searching came across grunting baby syndrome. Is that a real thing? When do babies grow out of …

Read more…

Is grunting baby syndrome a real thing?

It’s time to formally classify pediatric intensive care units

Christopher Johnson, MD

Physician

May 13, 2016

There are over 400 pediatric intensive care units (PICUs) in the USA, as most recently estimated by the Society of Critical Care Medicine. These units vary widely in size, from 4 or 5 beds to fifty or more. The smaller units are generally found in community hospitals; the larger ones are usually in academic medical centers, often in designated children’s hospitals, of which there are 220.

Given this size range, it is not …

The story of an exhausted doctor daughter

Shelley W. Collins, MD

Physician

May 12, 2016

I am a doctor daughter. I am exhausted. My emotions are bubbling close to the surface, and I fear that at any moment, someone will do or say something to me that will cause me to lose control, which I’m not allowed to do because I’m also a female physician in a leadership role, and our emotions must be held in check.

I watched one of my mentors be memorialized last …

This pediatrician learned why it’s so important to listen to a parent

Niran S. Al-Agba, MD

Physician

May 8, 2016

Medicine can wear down our hearts and souls. My journey in pediatrics has been filled with many rewarding experiences but haunting ones as well, like this one from my third year of residency. By that final year of training, I was no longer certain medicine was really the right choice for me. I was struggling with the notion that after almost 11 years of education, the destination was not quite …

A pediatrician writes to the politicians about the state of medicine

Sharon S. Jellinek, MD

Physician

May 3, 2016

This is the first letter I’ve ever written to a political figure, and I pray that someone on your staff will bring this letter to your attention. I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care: the physician-patient relationship. Without this, …

Vaccinations are more about trust than science

Niran S. Al-Agba, MD

Conditions and Diseases

April 26, 2016

I am going to confess that I am my children’s pediatrician. I have given them every vaccination they have ever had and probably would not trust another provider to do it. I endorse the vaccination schedule recommended by the American Academy of Pediatrics; I believe it is safe and prevents disease. I completed medical school and three years of pediatric training that helped shape this belief. I have seen death …

Are new, small NICUs convenient or risky?

Eric Ruthford

Patient

April 26, 2016

Five months in the NICU made the daily 20-mile drive to see our son at Swedish Medical Center in Seattle quite tiresome. He was born prematurely at 22 weeks and 6 days of gestation, and we felt uprooted, wondering if we would ever get him home. Then we met some Alaskans in the waiting room, who told us stories about being hustled on to air ambulances when pre-term labor was …

How a physician suicide 30 years ago affected this doctor today

Niran S. Al-Agba, MD

Physician

April 22, 2016

Physicians have one of the highest rates of suicide of any profession: nearly twice the rate of the general population. 400 physicians commit suicide each year in the United States. The stress of being a doctor is constant and unrelenting. The majority of us are perfectionists with a strong work ethic: your classic Type A personality. Maybe we set ourselves up for failure and then cannot accept when it inevitably …

Meals for new parents is food for the soul

Katie Lockwood, MD

Physician

April 20, 2016

When I had my first baby, one of my friends coordinated a meal train where coworkers could sign up to bring our new family a dinner every other night. Those first few weeks of motherhood were such a chaotic blur that I do not even remember how many weeks this meal delivery went on for except to say that it was both long enough and over too quickly. There was …

We are born with our arms wide open. We die in much the same way.

Jordan Grumet, MD

Conditions and Diseases

April 11, 2016

We are born with arms wide open, and we die in much the same way. It is that which we carry, in the time between, that defines us.

The newborn, caught in the primordial stew of beginnings, is unable to recognize the difference between self and other. She grasps and roots at inanimate objects with the same voracity she reaches for her mother. It is a time of differentiation, a time …

Making your own infant formula at home is a recipe for disaster

Alexandra Sowa, MD

Physician

April 9, 2016

Recently, former reality television star Kristin Cavallari released a potentially lethal recipe for homemade baby formula in her new lifestyle book, Balancing in Heels. Cavallari, who rose to fame as high-schooler on MTV’s Laguna Beach, is attempting to rebrand herself as an all-organic Suzy homemaker and offering dangerous medical advice along the way.

In her book, Cavallari goes against all conventional medical wisdom, advocating for feeding young babies a homemade concoction instead …

We must do a better job of contraceptive counseling

Poppy Daniels, MD

Conditions and Diseases

April 2, 2016

Decisions about how many children to have (if any) or what type of contraception to use are complex. For patients who are not health care providers, the doctor-patient relationship remains a critical relationship by which these sometimes difficult decisions are navigated. As a practicing gynecologist for 13 years, I continue to be mystified at how many women report to me a nearly complete lack of counseling prior to being prescribed …

How safe are home births? A pediatrician explains.

Christopher Johnson, MD

Conditions and Diseases

March 30, 2016

The debate over the safety of giving birth at home, both for the mother and for the infant, has been debated for years. I’ve written about the issue myself. From time immemorial until about 75 years ago or so most babies were born at home. Now it’s around 1 percent in the U.S., although it’s much higher than that in many Western European countries.

The shift to hospital births …

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