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'babies' Parentelligence posts

Circumcision: Yes or No?

On December 2, the Centers for Disease Control (CDC) released a draft of its proposed recommendation that doctors should counsel all males (including parents of all male children) on the benefits and risks of circumcision.  This comes after a policy statement was published by the American Academy of Pediatrics (AAP) in 2012, stating that the benefits of infant circumcision outweigh the risks. 

The federal regulation has sparked a national debate, which I thought would be a good time to remind families about the pros and cons of the procedure.  

No “window of opportunity” for celiac disease prevention

As a pediatric gastroenterologist, I’m often asked whether there is any way to prevent a child from developing celiac disease. Based on what I knew regarding how food allergies develop, I used to counsel families that there might be a “window of opportunity”, between four and six months, when it’s possible to introduce grains and other gluten-containing foods that could potentially “teach” the immune system to tolerate gluten and thus lower the risk of developing celiac disease.

However, my “window theory” recently got thrown out the window when the results of two important scientific studies were published in the New England Journal of Medicine.

What to do if your child swallows something

With the holiday season fast approaching, the environments around us are about to change. Glitter, lights, tinsel, ornaments, decorations, new toys and many other exciting trimmings are bound to be a part of daily life for a while. It’s no doubt that kiddos will be curious about all of this new shiny stuff!

Many kids will likely explore these things with their mouths. Exploring the world by mouth is a normal part of development for babies, but what should you do if your baby or child swallows an object? The answer: stay calm and think! There are some situations in which your child will require the help of a doctor, however many situations can be managed from home. Many items are small enough to pass through the digestive tract and out in a bowel movement, and in this instance your child will likely have no symptoms.

Here are the red flags to look for if your child swallows a foreign object. If your child exhibits any of these symptoms, seek medical help.

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:  

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