Tags
Blog

'pediatric' posts

Child’s Belly Discomfort Caused By Allergies

This is one of the most common questions that I get asked in the office. Allergic diseases are certainly becoming more and more prevalent in the developed world. General pediatricians and specialists are on ‘high-alert’ for this when evaluating a child that may be sick. Within the realm of intestinal diseases, however, a true allergy is actually not very common. To understand this, we must first understand what ‘allergy’ means.

An allergy is a biologic response from our body’s immune system. When our body senses a foreign invader, our army of immune cells attacks it. It does this by releasing chemicals into the blood stream and/or in to the organs where the threat may lie. Those chemicals are meant to destroy the invader, but often hurt our healthy organs as well. For example, airborn pollen may land in your eye, the immune system senses that pollen, releases those chemicals, and as a consequence we get itchy, puffy, watery eyes. The same thing can happen in the bowel if we ingest food that we are allergic to.

Intestinal manifestations of food allergies

One of the more common sites of an allergic response to food is in the esophagus—the food pipe. When the esophagus gets inflamed, it can manifest in a few different ways: heartburn symptoms, chest pain, chronic dry cough, upper abdominal pain, frequent regurgitation, or food that is stuck the chest. The name of this is Eosinophilic Esophagitis. Food allergies lower in the bowels can cause diarrhea, blood in the stool, abdominal pain, weight loss, anemia, and fatigue.

There are usually other red flags

One of the most important things to remember is ....

The 'pigeon toed' problem

Have you noticed that your child walks with his or her feet rotated inward instead of pointing straight ahead? This could be described as intoeing and is sometimes referred to as being “pigeon toed.”

As a parent, you may raise concerns with your child’s physician about how your child is walking or running, or perhaps a concern was raised by the child’s grandparents who may have known a child years ago who was treated with a brace or special shoes for a similar issue. Intoeing gait is a common reason for referral of your child to a pediatric orthopedic surgeon.

Intoeing stems from one of, or a combination of, three areas: the foot, the lower leg and the hip. Which area is contributing determines the likelihood that it will resolve over time and determines up until what age one may expect improvement.

The most frequent case of intoeing in infants and young toddlers arises ...

Mother Nature’s Role in Healing Our Children

I am a pediatric hospitalist. That is, I am a pediatrician who takes care of children sick enough to be hospitalized. So my writing about the importance of children spending time outdoors and enjoying nature might be surprising. Even though I may only take care of a child for the worst few days of their life, I am still quite passionate about the fundamental role of outdoor play in a child’s health and well-being.

Even during acute illness, I find that children often heal faster when they are given more opportunities to be playful and (illness-allowing) go outdoors to allow Mother Nature to heal them from within. So needless to say, I am often amazed at how little exposure many of these children have had, even prior to becoming ill, to spend time playing outdoors and getting to know their environment.

Now especially, as the days begin to get longer, and the refreshing spring air returns to our beautiful Pacific Northwest, I start thinking about all the wonderful outdoor fun I used to have as a child, and the importance such activities had on my own health and overall sense of well-being.

I worry that children of today encounter ....

When a belly ache or stomach pain might mean appendicitis

As a pediatric surgeon, I am often asked when to “worry” about abdominal pain. Children often report aches or pains near the belly button (umbilicus), and the question arises around when this might mean something significant such as appendicitis.

Appendicitis is a common occurrence affecting about 7% of people over their lifetime, and it begins with vague abdominal pain of the central abdomen. Once the appendix becomes obstructed and begins to suffer from lack of circulation (ischemia), the body can detect more accurately the exact source of the pain. After this localization occurs, children older than 6 or so can identify that the pain is most severe in the right lower part of the abdomen. The localization usually occurs within 24 hours of feeling unwell. The pain is typically worse with movement of the appendix during activities such as walking, coughing, and change in position. I often ask children to jump up and down (on their bed is something kids are excited to do!) and watch their face to see if they wince. Typically with appendicitis, a child will either refuse to jump or may try it once but will not continue due to the pain.

Distraction is also frequently used in children that seem to be particularly “focused” on their pain. In gently feeling the abdomen of a child with early appendicitis that is distracted, the abdomen is soft until palpating the area of the appendix. This right lower part of the abdomen is...

Free Class on Nutrition for Young Athletes to be Held at Swedish/Issaquah Feb. 20

ISSAQUAH, WA, Jan. 23, 2013 - With spring sports starting, don't drop the ball on nutrition. Nutrition is just as important as physical conditioning for athletes. So, as spring sports begin, let Swedish help you and your children prepare to hit it out of the park. Join Registered Dietitian Ally Colson for an interactive training on game-winning meals and snacks and help your young athlete become a nutrition champion.

Increasing Your Child’s Comfort with Nitrous Oxide

You may be familiar with “laughing gas” as something you find at the dentist’s office but did you know it can also be used when your child is a patient at Swedish? Laughing gas is a mix of nitrous oxide and oxygen, but you might hear your pediatric nurses just call it “nitrous.” In pediatrics, we use it to help a patient relax and feel more comfortable during certain procedures such as IV placement or urinary catheterization.

Once your doctor or nurse has determined that your child is a good candidate for nitrous (without any contraindications such as conditions where air may be trapped in the body, pregnancy, or impaired level of consciousness), your nurses and certified child life specialist (CCLS) will explain the process: Your child will choose a flavor for the inside of their mask used to administer the gas. They will be on a stretcher or bed and have a saturation probe attached to a finger to monitor their oxygenation. One nurse will administer oxygen, then the nitrous, gradually increasing the amount until your child is suitably relaxed for the procedure, while remaining responsive to directions. Another clinician will perform the procedure, e.g., place the IV. A doctor is also available.

As a parent ...

Introducing solids to your infant

As your baby grows, you’ve probably started wondering when and how to start feeding your infant solid foods. Here are some general tips to consider:

Is there a safe age to start feeding solid foods to my infant?

Yes, most infants this is between four and six months of age.

Why is there a ‘safe’ age to start feeding solids?

There are a few reasons why this age is safest. The first reason is because prior to four months of age, an infant is not developmentally ready to safely eat from a spoon.

To be able to swallow solids safely, an infant needs good head control; to be able to sit well with support; and to have lost the “extrusion reflex” (the reflex which enables newborns to tightly latch and suck from a nipple, but makes them shove a spoon out of their mouth).

The second reason an infant should be fed solids between four and six months is something many families are not aware of: it is also a strategy to prevent common food allergies. This is one of the strongest reasons I passionately advocate for infants to be exposed to as many foods as possible during this crucial three-month window.

Starting solids and preventing food allergies:

In the past, healthcare providers have advised parents to avoid potential allergens such as peanuts, eggs, and milk. New evidence is now showing that this practice might have played a role in the increased incidence of childhood food allergies in the U.S

Why might this occur? The ...

Results 36-42 of 51