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'babies' Parentelligence posts

Putting the science into action: helping children benefit from reading

It is astonishing to me how important it is to read to children from an early age. Research tells us there are short term and long lasting benefits from exposing children to books and language from the beginning. In an exciting progression, the idea of early literacy has moved from academia to policy. Supporting parent engagement and early literacy programs is a core part of Washington’s Early Learning System.

Early literacy does not mean early reading. Early literacy emphasizes positive exposure to a literacy-rich environment. Many important reading concepts begin before kindergarten. Studies show us that a child’s early literacy environment (age 0-3) plays a crucial role in school success and reading ability. Children enter kindergarten with different knowledge levels. Those who enter with the least knowledge of beginning reading skills are at academic risk.

The benefits of early literacy do not stop at kindergarten; it continues throughout the school years. Frequent positive literacy experiences in preschool is directly associated with:

Newborn screening testing in Washington

For most parents, the newborn period is a time of profound joy, incredible challenges, and LOTS of questions.  As pediatricians, some of the questions we are frequently asked are related to a simple blood test done on all infants in Washington State.  Commonly referred to as the “newborn screen” or “NBS”, “PKU”, or “newborn metabolic testing”, this test checks for several congenital disorders that are rare but can be life-threatening. 

Often parents want to know:

  • What does the test involve? The newborn screen is done by pricking the heel of the infant at around 24 hours of age, then collecting a few drops of blood onto a piece of test paper.  This is dried and then sent to the state lab, where the testing is performed.  Because some of the conditions may take several days to show up, the test is repeated at 7-14 days old (usually by your primary care doctor; it can also be done in the hospital if the baby is still there for any reason).

  • Does it hurt? The needle prick is performed by trained nurses and is done quickly.  It may feel similar to pricking your finger to test blood sugar.  And you can significantly decrease the discomfort of the quick poke by breastfeeding your baby during or immediately after the test!

  • Why do we need this? The diseases we check for are typically rare, but if undiagnosed and untreated can cause a variety of complications, including blindness, poor growth, brain damage, and even death.  The reason that testing every baby is essential is that babies with these conditions can look and act perfectly healthy even while the disease is damaging their bodies, until they get so sick they need to be hospitalized or have permanent damage.  Starting treatment as early as possible can prevent many of the complications.

  • What are you testing for? The ...

How to eat more vegetables

Did you know half of your plate should be from vegetables? Here are some ways to get more vegetables into your family’s meals and snacks.
 
1. Experiment with a new vegetable each week or each month!

Check out your local farmers market or produce aisle for something new and seasonal. Search the web or your favorite cook book for ideas on preparation, and don’t be afraid! Find recipes with some of your other favorite flavors or styles and you may just find your new favorite vegetable.

2. Get sneaky

  • Pureed peppers, zucchini or carrots can be “snuck” into tomato sauces for pasta or pizza. Not even the pickiest eater will notice!
  • Cauliflower, carrots or sweet potato can be steamed and pureed into mashed potatoes or a casserole.
  • Have a ...

If your newborn is diagnosed with hypospadias

As a pediatric urologist, I am frequently asked to consult with parents whose newborn son has hypospadias.  

Hypospadias is usually diagnosed during the physical exam right after the baby is born.  When parents see the abnormal penile anatomy they naturally want to learn about the diagnosis and understand what, if anything, needs to be done. Answering these questions, discussing options, and performing reconstructive surgery to help restore normal penis appearance and function are some of the most rewarding things I do as a pediatric urologist. 

I would like parents who have a son born with hypospadias to be reassured that the anatomy can be reconstructed, the surgery is well tolerated, and a good outcome with a normal, or near normal, penis appearance and function can be achieved.

It is not urgent to treat newborns with hypospadias because they can usually pee (urinate) just fine through their existing urinary opening.

In fact, when hypospadias is the only condition noted in a newborn physical exam there is a low chance of additional developmental abnormalities. Additional tests and studies on the baby are usually not necessary.

It is important to note that if any unusual shape of the penis or urethral opening (where the pee comes out) is present then circumcision (if desired) should not be performed until after the child is examined by a pediatric urologist. This is because the pediatric urologist may need to use the foreskin tissue for the surgical repair. 

Here are answers to some commonly asked questions:  

Lymph nodes in children

One of the most common referrals to my pediatric surgery practice is (in the parents’ words) “to check out this lump and make sure it’s nothing to worry about.”  Lymph nodes are part of the less publicized part of the circulatory system: the lymphatics.  Lymphatics play a key role in our body’s immune system, and lymph nodes grow in response to an infection in the “neighborhood” to produce cells necessary to hopefully resolve the infection. 

About half of all children will develop enlarged lymph nodes (cervical lymphadenitis) in the neck for example, and the vast majority of these are in response to a minor infection in the area (sore throat, sinus infection, ear infection, etc.).  Often the infection is quite subtle and might not be identified.  These nodes typically go through a pattern of growing and then receding in size once the infection resolves.  This process can take several weeks to months.  The nodes may become tender, warm, and there may be some redness of the overlying skin.  Your child might complain of pain in the area, be fussier, have fever, and/or have decreased appetite.  If the node itself becomes infected, it can turn into an abscess and would require antibiotics and a drainage procedure.  Any possibly infected lymph node should be evaluated by your doctor.
 
Some enlarged lymph nodes ...

When do kids need antibiotics?

Winter can seem like one long continuous “sick day” for families - kids pick up frequent infections at school or daycare and pass them around to everyone at home.  Often it feels like by the time the illness has worked its way through the household, a new one has started!  Even for physicians, it can sometimes be difficult to distinguish between viral and bacterial infections.  Since antibiotics cannot treat viruses, they are often over-prescribed - which can lead to significant side effects in children and also contributes bacteria becoming resistant to existing medications.  In November 2013, the American Academy of Pediatrics released an updated guidance regarding antibiotic treatment, helping answer the frequently asked question about when kids need antibiotics.

Here's what you should know about antibiotics in these situations:

  • Ear infections ...

Parent's guide to newborn testing, screening, and prevention measures

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
 
Love also means keeping them safe. 
 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
 
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...
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