While tobacco use is at an all time low among teenagers the use of marijuana is on the rise. According to the annual 2012 Monitoring the Future Survey (which is administered annually to over 45,000 students grades 8-2 in both public and private ...
I was recently involved in the care of a 17 year-old boy in our practice who had meningococcal meningitis. Meningococcal meningitis is a rare bacterial infection, but meningococcal disease continues to cause 75-125 deaths/year in the U.S. ...
Welcome your Royal Highness Prince (name to come) and congratulations to new parents Prince William and Duchess Kate.
During our summer vacation, which happened to be overseas, I began to notice a recurring theme. Teenagers from around the world often behave in a similar way. That is, maybe it really is something in a teen's nature that affects behavior and attitudes....
A new study just published in the August online edition of Pediatrics confirms what I see in my practice.
An article in the news caught my eye today when I noticed that The World Health Organization (WHO) called an emergency meeting to discuss the infectious disease known as MERS (Middle East Respiratory virus, formerly known as nCoV). ...
They have been fortunate that no one in their own immediate family had died, and therefore she had never really discussed death with her daughter. I could sense that she was dreading the discussion, just as much as some parents dread discussing sexuality with their children. ..
If you look at a baby's legs it is easy to see how they were folded so that they fit inside the uterus. Those little legs don't get unfolded until after delivery.
I still get a lot of questions about starting solid foods in a baby.
Did you know that the first day of summer, June 21, not only kicks off sun, fun and relaxation, but it is also National ASK Day.
The summer months are typically the time of year when children play more often in homes of their friends, or even other family members. While we parents ASK all sorts of questions to ensure our childs safety, parents need to ASK if there are guns where their kids are playing?
National ASK Day, is a collaboration between The American Academy of Pediatrics (AAP), and the Center to Prevent Youth Violence (CPYV). Statistics show that about 1/3 of homes with kids also have guns, many of which are left unlocked and may even be loaded!
An average of 8 kids and teens are killed by firearms everyday and 42 additional children/teens are seriously injured (according to CDC data). 88% of the children who are injured or killed in unintentional shootings are shot in their own homes or in the homes of relatives or friends.
Other studies show that 42% of parents who own guns keep at least one unlocked, and 25% keep at least one loaded, and UNBELIEVABLY 14% keep one unlocked AND loaded! I cannot believe this myself. Scary!
Children are curious and clever. They may see their parent with a gun and it is left out and suddenly a tragedy has occurred. Accidental? Hard to use that word when this accident may be prevented. Talking to a child about gun safety and the danger of firearms is great, but not enough. Curiosity and availability may win when a child wants to play with the gun. Kids are clever and may f
I just read an article published in the journal Pediatrics which once again validated the importance of family routines. In this study researchers from Ohio State University looked at household routines as they related to childhood obesity, an ever escalating problem.
The research, conducted in 2005, but published this year, analyzed over 8,500 four year old children. 18% of the children were identified as obese. Families were then asked if they regularly ate evening meals together, did their children have a bedtime and receive adequate sleep, and was television time limited within the home? When looked at more closely a little more than half of the children reported having family dinners 6 or 7 evenings a week.
There were 57% of the children who were reported to have 10.5 hours of sleep per weeknight. Only about 40% of the studied children were reported to watch less than 2 hours of television or movie viewing per weekday. When looked at in terms of those children who were exposed to all 3 routines, the prevalence of obesity was 14%, while those children not exposed to any of the 3 routines had a prevalence rate for obesity of 24.5%. The research also found that the number of household routines was a predicator of obesity and that by adding a routine, there was a 17% reduction in odds for obesity as a new routine was added.
These household routines seem to be fairly easy to initiate in that they may be accomplished without any cost etc. Establishing good routines for family meals has repeatedly been shown to improve a childs academic success, attention, risk of using alcohol and drugs and overall well being. If it could also reduce the incidence of obesity what a win!! Just one more reason to plan for a family to eat dinner together. This study did not even discuss healthy food choices, which might make the statistics even more compelling, and what about adding eating breakfast togeth
Summertime in the pediatrician's office means lots of check ups, and often this includes those tweens/teens/and college students who were too busy to schedule their doctor's appointments during the school year. The next three months will be busy indeed.
With HPV back in the news after Michael Douglas revealed that his throat cancer was due to HPV, what better time to remind parents and young adults of the need for the HPV vaccine. The HPV vaccine has been available in the U.S. for over seven years, but statistics from the CDC continue to show that the HPV vaccine is still not being given at the same rate as other recommended vaccines. In other words, we doctors need to ensure that every person between the ages of 11-26 who we see is offered the vaccine, this also means we need to educate.
HPV causes CANCER! This is truly the first anti-cancer vaccine, and I am hopeful that I will see more vaccines to prevent cancer while I continue to practice. I am sure that there will be more anti-cancer vaccines in our children's lifetime. This is exciting news as research continues on ways to combat cancer.
But.....for some reason (that is difficult for me to understand both as a parent and a physician), some parents are refusing to have their children vaccinated despite ongoing evidence that HPV is widely prevalent and causes numerous cancers. The fact that this virus is transmitted sexually seems to be the root cause of parental concern. Do parents not assume that their own children will become parents one day as well? Dont they want to be grandparents one day? Well, that means having sex with a partner. At some point in time, our children do become sexually active and shouldn't they all be protected as much as possible?
Giving adolescents the HPV vaccine does not promote sexual activity. In fact, I think that by having a discussion abou
I love talking to parents about behavior modification and that includes beginning to discipline their children. I really think this is one of the most important jobs for parents and it is hard to believe that your most precious, perfect child will at times misbehave. It happens to all of us!
I would recommend to start using time out as a means of behavior modification when a child is somewhere between 15-18 months of age. For those of you who watch Super Nanny, she coined the word the naughty step which is her version of time-out chair.
When you begin time out, pick a small chair in the house which you can use consistently for time-out. Never use a child's crib or bed, as you do not want them to think that bed is for misbehaving. After a child gets used to doing time out you can use all sorts of chairs and do time out anywhere. Like many things it just takes practice.
When putting your child in time out get down to their eye level, explain why they must sit in the chair, and hold them from behind (with your arms wrapped around them like you are a rope). I use a timer even at this young age so your child begins to understand how long they will be sitting in time out. Time out is typically one minute per year of age.
After time out is finished, get back to eye level and explain that the next time you ask them to mind you, they may choose to listen and they will not have to go to time out. These are such important words for a child's entire life, as they need to understand that they are making choices for their behavior. In other words, taking ownership of making a bad choice and knowing that there will be consequences. You will use these words over and over, you made a bad choice therefore....the consequence is....for a young child it is time out, for older children it may be no TV, or no going to a party, or even no driving. All versions of
I saw a young boy (this week) who was bitten by a dog. Very sad as I began to think this is the time of the year that I will start seeing more bites. Why? Warmer weather brings families outdoors and I've noticed more dog parks popping up. I have experience with dog bites as a pediatrician and mom.
We are a dog family and my husband and I had our first dog, Mrs. Brown, before our oldest son was born. She was the perfect dog, a mutt that my brother (who is a vet) had found and gave yo us.
When the boys came along she was wonderful and would follow them around the yard and to the closest neighbors, I would always know where the kids were as Mrs. Brown would be waiting on the porch for them.
Our next dog was a golden retriever, Maddie, that our middle son wanted, and she too was a member of our family for 12 years. Sweet (but a bit lazy), she was so sad as each of our sons left for college. She was suddenly the only child left at home. It broke our hearts when she died and the boys had not gotten a chance to get home to see her.
Thinking we didn't need a dog in a empty house was a mistake. The youngest son felt like he should have a dog (even though he was away at college) and I thought a little dog might be nice. No way, according to the youngest son, we are a big dog family, and so we now have 4 year old Maggie, a yellow lab. Sweet, smart and spoiled is all I can say.
Now, back to dog bites. I think it is important for children to be around dogs (and other pets as well) but to have a respect for them. Just like we teach children, stranger danger, the same goes for dogs. Teach your children not to approach strange dogs, or reach through a fence to pat a dog. Always ask the owner before trying to pet a dog.
I would not recommend buying your child a dog until they are around 4 years of age. But, if you
I have been receiving a lot of calls, emails and questions on twitter regarding Michael Douglas' admission that his oral cancer was caused by HPV.
Coxsackie virus is rampant once again! I have seen too many kids to count (TMKTC) with symptoms of coxsackie virus and the classic skin rash associated with hand, foot and mouth disease. Many parents are telling me that their day care centers are having outbreaks which is what typically happens at this time of year.
Like many viruses, coxsackie can make some children quite miserable, while others have very few symptoms but never the less are contagious and shed the virus to others. Viruses are just plain ole contagious, even with the best precautions to help prevent spreading the illness. Best prevention continues to be hand washing!
The classic symptoms of hand, foot and mouth disease are a fever, sore throat, and a rash which looks like small red spots or even a bit of a blister, occurring on a childs palms, soles and often in their throats causing pain. We are also seeing many children who have a rash on their buttocks, and legs as well. The rash is often confused for a diaper rash if there are no other associated symptoms.
Coxsackie virus typically lasts from 3 -7 days. While some children are terribly cranky and uncomfortable and will even drool rather than swallow their own spit, other seem to not even notice the rash on their hands or feet. The treatment is totally symptomatic, which means acetaminophen or ibuprofen for fever and discomfort and keeping your child hydrated.
Most kids don't have a great appetite when they have a sore throat (do you?), so I am a big believer in popsicles, Slurpees, ice cream, fozen yogurt, shaved ice.....the list is long. You just want to make sure your child is h
OK, I am back to the subject of squeeze pouch foods or as another cute 2 1/2 year old called it squeegy fruit. I have written about this before as I was fascinated by these when they first hit the market. On the one hand, I get that they are convenient and are easy to use for those first months of pureed baby foods, but beyond that, I think they are given to older children.
It seems that more and more kids are enjoying squeegy fruit and also slurping pureed vegetables. The issue is these pouches foods are being masqueraded as healthy foods. Yes, they are fruits and vegetables often mixed together, but if you read the labels it gets a bit more complicated.
I see so many toddlers in my office who are happily sucking down a packet of apples and blueberries. These parents are adamant that their kids don't drink juice boxes or eat junk food but at the same time they are letting their children suck down several of these pouches a day. This is also often in place of meals, as many of these children are described as picky eaters. I saw a little boy today who had been vomiting, but was on the exam table with pouch to mouth as he drank/at a combo of apples, peas and something else. (note: not recommended when vomiting).
So....I decided to look up the nutritional value of these pouches....many of them although all organic or described as healthy do contain a lot of carbohydrate and sugars. Actually, as much as two fruit roll ups! Yes, I did a little comparison and 2 of the dreaded fruit rolls ups contain 23 grams of carbs and almost 11 grams of sugar.....while a 3.2 ounce pouch has somewhere between 19-24 grams of carbs and between 14-23 grams of sugar.
The point of this is not to say that squeeze pouches are bad, or that a child should never have a fruit roll up. Rather, it is to point out that even healthy snacks can be fu
Parents, you know you can say all sorts of funny things and now here come cute, clever kids comments. This has been a week of kids say the darndest things.
A verbal little 3 year old came in this week and while I was getting his chart opened on the computer, I asked him what's the matter? He is the third child in the family and is quite comfortable coming to the doctor and is always chatty. His response was,I have the God bless you's. Now I admit that I was not quite sure what he meant? Then it hit me! He was sneezing a lot and that was what the God bless you''s meant. How smart is that!
He then proceeded to tell me that he had been sneezing and coughing. He also happens to have asthma, so I asked him if he had been wheezing as well. His response to all of these questions was equally bright. He said , I haven't had to use my puffer, my breaving is okay.
I examined him (by this time he is watching a cartoon on his iPad) and he was spot on. His lungs were clear as a bell, he had a clear watery runny nose and his nasal mucosa was swollen. He also had allergic eyes. He was using an antihistamine but not his steroid nose spray.
So I tweaked his allergy medicines a bit and reminded his mom to have him bathe or shower after he had been playing outside. I also suggested that they use a nasal saline rinse on him as well, as this would help to get the pollens out of his nose after he had been outside, and may be one of the best cures for the God bless you's.
Who says children can't give a good history? I often find that the young patient is a great communicator and may open a doctor's eyes to different ways of relaying a new symptom. Whether is from a 3 year old, a tween or a teen, having a patient that you know and that is comfortable talking to the doctor is the key to a good history. This is was a great remind
Here is another one of the can't believe what I hear at the office! I was on call the other night and it was around bedtime when I walked in the exam room to see 2 little girls (actually they are part of a triplet set but their brother was home). Their dad had brought them in because they had rashes and bug bites. Nothing too serious. They are adorable 2 years old and very well behaved.
So, after examining the rashes and bites and determining that they could be dealt with a bit of cortisone cream, the dad and I were discussing a few more things. Of course the girls got bored, and as you know a bored 2 year old typically doesn't sit still, especially when it is time for bed. So as the girls jumped up and down off the table and picked out more stickers their Dad was getting tired as well. By the way, he is a great father and he and has wife have handled having triplets with such ease. They were meant to have multiples.
Well, before we could finish up the appointment the girls had gotten into the diaper bag, pulled out snacks and were enjoying themselves. As much as he was ready to go, they were not ready to pack up and leave and he was having a hard time getting them to listen.
Here comes the line of the night! He turns to the girls in a moment of what to do next and says,if you don't behave and listen to me, Dr. Sue is going to make you sick! LOL! I have heard a lot of Dr. Sue will give you a shot if you don't behave, but I have never heard this one. While I don't believe in threatening kids with shots at the doctors, this was a new one.
After I stopped laughing I told the girls that this was not true, doctors would and could not make them sick, but they did need to listen to their dad!!
I know that we all say things out of desperation, but please don't use the lines the doctor will give you a sh
The surge in allergies this year has been due to a very wet winter and the weather this spring has brought erratic temperatures and lots of wind. The perfect storm for the "allergic cascade" to inflict itself on everyone's nasal mucosa. The best preventative for nasal allergy symptoms (allergic rhinitis) has been the use of intranasal steroids. These steroid sprays have been used for the past 15 years and clinical studies have shown that intranasal steroids are superior to oral antihistamines. Intranasal steroids function by inhibiting the production of chemical mediators such as histamine and prostaglandin that cause inflammation and mucous production. In other words they are more of a preventative medication, while an antihistamine is treating the histamine that was released once you inhaled the offending tree or grass pollen. Intranasal steroids may also help eye allergy symptoms too. The problem is getting young kids to let you use a nose spray on them. The same holds true for the older tween and teen crowd who complain that they "just don't have the time to use it everyday" (it must take all of 15 seconds to use on yourself!) They have been shown to be effective within 3-12 hours, although will reach their maximum effectiveness after several days to weeks of use, so using it daily and throughout the allergy season is going to give you the maximum therapeutic effect. There are many different brands available and everyone seems to have their favorite. If one spray seems to bother your child due to scent, or intensity of the spray ask your doctor to try another brand. Many times they will have a sample and give you several to try and then prescribe the one that is easiest to get your child to use. It may be trial and error, but finding the right nasal steroid may just change your allergy season. That's your daily dose, we'll chat again tomorrow. Oh, God Bless You! Send your question to Dr. Sue!