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 still can’t think about the Sandy Hook shooting without starting to cry.
It hit me really hard, because when it happened, I had a first-grader whose classroom was right off the main lobby of his public elementary school. If a shooter like Adam Lanza ever stormed into his school, Liam wouldn’t have a chance.
I can’t imagine life without Liam. If he were to die, I can’t imagine how I would …
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After Sandy Hook: Let’s not let these children die in vain
I click open the x-ray viewer. After 4 years in emergency pediatrics, I am not really surprised that a tibia fracture underlies the bruised ankle I unexpectedly encountered on physical exam. Yet I audibly gasp as the chest x-ray loads. The torso in question belongs to a chubby little cherub of a 3-month-old in room 11, brought in for red eyes. I begin to count the fractured ribs — 1, …
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When children are abused by foster parents
The holiday season means most of us will be socializing with colleagues and neighbors, friends and family. Chances are good this circle of friendly acquaintances and loved ones will include a child with autism.
Why? An estimated 1 in 88 children are now diagnosed with the neurological disorder, with a four times prevalence for boys. Among other challenges, those with autism often have difficulties with social communication (be it verbally or …
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How to talk to a child with autism
It’s the beginning of cold and flu season. That means a lot of kiddos, big and small, are coming to the office with fever.
As docs, we know that fevers can freak moms and dads out. Kids look pretty awful when their temperature climbs, and it is understandable that parents want to bring them to the office for an evaluation.
In the exam room, I often hear worried parents …
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Treat your child’s fever before the doctor’s appointment
I heard the verdict in my car, driving from my birth home, Washington, DC to my new home, Baltimore, MD. I was stunned, my mouth agape and my mind muddled.
Not guilty.
Thoughts raced that hot July night, but mostly I cried and prayed. That Sunday morning I awoke with some clarity, but more sadness and more determination to try to fix this perceived wrong. Reaching out for stability and peace that …
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In the wake of Trayvon: A pediatric resident’s search for answers
I was contemplating writing a blog post about the movement by the Boston-based advocacy group Campaign for a Commercial Free Childhood urging Fisher-Price to recall the baby bouncy seat with an attachment for insertion of an iPad. When I then received an email from a colleague with a link for another product — a potty seat with an attachment for an iPad — there …
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iPad on the potty: A violation of infants’ rights?
Let’s say you were inventing a new flea powder, called Flea-B-Gone. To test it and manufacture it, you’d need a whole mess of fleas. As everyone knows, kangaroo fleas are hardy and docile, so you open up a kangaroo farm to grow your fleas. You treat the kangaroos well, and other than itchiness, they don’t have much to complain about as you scrape off their fleas to make your Flea-B-Gone. …
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Anti-vaccine propagandists and the rogues’ gallery of misinformation
Research shows that about 1 in every 5 pediatric visits for “sick visits” results in an antibiotic prescription. Now not all of those antibiotics are taken; many pediatricians now use the rx pad for “wait and see” or “delayed prescribing” antibiotics. They give a prescription and allow the family to watch and wait — if a child is not getting better, they advise parents to start taking them.
However, in total …
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5 ways to reduce antibiotic use in children
It’s once more cold season, bringing up the question parents commonly face. Should they buy one of those rows and rows of cough, sneeze, and runny nose medicines one finds in every drug store and supermarket?
In a nutshell, no — none of the preparations sold over-the-counter to treat upper respiratory infections in children work, and all could be dangerous. That’s the conclusion of a report some years ago by the Food and Drug Administration, …
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Cough medicines shouldn’t be used in small children
The conversation parents dread even more than the one about the birds and the bees? It’s the one about their kids’ weight.
Sure, the facts-of-life talk is awkward and needs to be age-appropriate and you want your facts straight, but it’s different when you’re talking to your kids about what they weigh. Your children never view such talks as positive, only as being about what’s “wrong” with them. But you can have this …
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How to talk to your child about obesity
The HPV vaccine is in the news again. This time it is Katie Couric’s daytime talk show that is shining the spotlight. And, I am thankful.
A medicine that prevents cancer is worth giving airtime.
In the segment, Couric chose to highlight the experience of 3 mother-daughter duos and their experience with the HPV vaccine. One story ended in loss, one in pain, and one in quiet confidence. Couric also highlighted advice from …
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Katie Couric brings attention to the HPV vaccine
It’s scary being a parent, especially a first-time parent. I mean, talk about the responsibility: an actual human being is relying on you for survival. And basically, you have no idea what you are doing. Sometimes, it seems amazing that our species has made it this far.
So why not turn to technology? Why not wire your …
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Technology and baby monitors: Why this pediatrician worries
When the American Academy of Pediatrics changed the guidelines for ADHD to expand age of diagnosis to include children from age 4-18 (from 6-12), that number of cases would rise was, by definition, inevitable. The recent survey by the CDC, published in the current issue of the Journal of the American Academy of Child and Adolescent Psychiatry, indicating that one in 11 children in the US carry a diagnosis of ADHD, …
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We need a movement to deconstruct the ADHD diagnosis
It is well known that more people today are overweight or obese than in the past. This has been a steady trend for decades, but there is some recent evidence this increase has stabilized. This is promising. Since many obese adults began as obese children, during the last decade physicians who care for children have devoted considerable effort to reversing the trend. This is important because obesity sets up the individual …
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Are we making progress in the fight against childhood obesity?
A concussion is a brain injury resulting from a blow to the head. Not the kind of injury you can see on a CT scan or MRI — there’s no broken bones and no squashed or visibly damaged brain. But nonetheless, the brain is damaged. Symptoms tell you immediately after a concussion that the brain has been affected. Sometimes, a person is knocked out cold, but a concussion can occur …
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How to protect your child from concussions
From gas stations to grocery stores, slender cylinders of nicotine “e-juice” seem to be available everywhere. On my drive to work, in fact, 2 new e-cigarette shops have opened their doors in just the last 3 months. So I was not surprised to read a recent report suggesting a rise in the number of teens trying e-cigs.
E-cigarettes deliver nicotine by heating nicotine-containing fluid into a vapor that is …
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What a doctor learned from a visit to an e-cigarette store
We have long known that sleep is of profound importance to health. It is a requirement for living, much like breathing, but with awake and asleep playing out over longer spans and to slower rhythms than inhalation and exhalation. Sleep is essential. We must turn off if we are to go on.
Unlike many of the factors that affect health profoundly, the impact of sleep is both immediate and intimate. You …
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The impact of sleep is both immediate and intimate
Recently, a family in my practice decided to move out of state, back to where they had lived before. When we said goodbye, the mother said that she was sad to change pediatricians. The pediatrician they would be returning to, she said, “only takes care of strictly medical things.”
Clearly, she meant that I take care of more than the strictly medical things. I was flattered, especially since this was something …
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Going the extra mile for patients: How friendly is too friendly?
Asthma is a common problem in children — nearly 10% now have it — and the number is increasing. Researchers are not sure of the reasons for this steady increase, but decreased air quality, lower activity levels among children, and an increase childhood obesity have all been implicated. Whatever the cause, it means that millions of American children take medicine for asthma. A significant number of these children end up in …
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Asthma in children: A complete primer
