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Kids and lactose intolerance

Do you wonder if your child might have “lactose intolerance”?    Have you ever thought of removing dairy from your child’s diet?  If the answer to either of these questions is yes, here are a few things to remember when it comes to lactose intolerance in kids:

  • Lactose is broken down by lactase.

While lactose is the carbohydrate (sugar) found in milk, lactase is the enzyme that digests the sugar. This enzyme is found in the lining of the small intestine, breaks down lactose into simpler molecules that are easier to absorb.  When there isn’t enough lactase, the sugar isn’t properly absorbed, which leads to the symptoms of “intolerance”, which include gas, bloating, pain and diarrhea.

  • True lactose intolerance is rare in young children.

Although children as young as infants can “transiently” have less lactase in their digestive tracts (most often, this happens for a week or two after an infection), lactase production remains ...

Gluten intolerance or low FODMAPs?

Despite test results that show no evidence of their children having neither any detectable allergies to wheat nor any signs of celiac disease, many parents choose to have their children follow a gluten-free diet.  This is because of convincing stories of how gluten (a protein found in wheat and other grains) seems to cause their kids to have belly aches, nausea, bloating and a variety of other symptoms.  

For years, this was hard to explain without a scientific explanation.   Gastroenterologists like me had a hard time supporting families who wanted to follow gluten free diets, without a good “medical reason”.  Then, in 2011, researchers from Australia conducted a double-blind, randomized, placebo-controlled, rechallenge trial in nearly 3 dozen patients (none of whom had celiac disease or wheat allergy), all of whom described worsening symptoms when unknowingly ingesting small amounts of gluten.  The results of this study described a condition termed, “Non-celiac gluten intolerance”.    It was after reading this landmark study that many physicians, including myself, began to validate parents’ concerns about gluten being the culprit behind their children’s gastrointestinal (GI) problems.

But then in 2013, just as word of non-celiac gluten intolerance was gaining popularity amongst physicians like me, the exact same group of researchers from Australia published a follow-up study on a similar set of about 3 dozen patients.  The findings of this 2nd study showed that instead...

Does your child have a food allergy or food sensitivity?

“Every time my child eats, his belly hurts. I think he must have a food allergy. Can you help us?”

Countless times have I heard this from parents of children worried about foods being the cause of their child’s gastrointestinal (GI) complaints. Some families wonder whether their child should start a “gluten-free” or other type of dietary change. More often than not, families have already tried a few diets before meeting with me.

Parents considering these types of elimination diets need to be aware of a few key points:
The difference between “food allergy” and “food sensitivity”:

Helping kids with Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD): Do you know what it is?  Do you know what symptoms people suffer from? Do you know that 1.4 million Americans have IBD, and that it can affect both children and adults alike?  The gastroenterology team at Swedish takes care of both children and adults who suffer with this chronic, disease of the gastrointestinal tract

As the pediatric gastroenterology nurse who works intimately with the pediatric IBD patients at Swedish, I know all too well that many can suffer with the “ups and downs” of this sometimes debilitating disease.  Often, I tend to hear from kids when they are “down”, but my favorite time to hear from them is when they are excited about upcoming special events like the “Take Steps” walk, or Camp Oasis (a camp just for kids with IBD), both events sponsored by the CCFA.  It’s often at these events, that children first say that they start to feel “normal”. 

This year, we want to invite you to ...

How to Manage a Sports Related Concussion

What is a concussion?
A concussion is a mild brain injury that causes a change in mental status that can occur with direct insult to the head. A concussion may also occur with movement of the body that cause acceleration/deceleration forces to the head.
 
What are the symptoms of a concussion?
  • Headache
  • Dizziness
  • Loss of consciousness
  • Amnesia
  • Difficulty concentrating
  • Confusion
  • Nausea and/or vomiting
  • Difficulty balancing
  • Sensitivity to light
  • Sensitivity to noise
  • Ringing in the ears
  • Drowsiness
  • Irritability
  • Sadness
When should I seek medical attention for a concussion?
  • A healthcare provider should evaluate every child or adolescent suspected of a concussion. 
  • If this occurs during a sporting event, the child should sit out the rest of the game
  • Your provider may conduct a standardized neuropsych assessment to help guide return to activities/sports
What is the best treatment for a concussion?
  • Rest, rest and more rest!
  • Absence from school may initially be necessary until one can concentrate on a task without exacerbating symptoms
  • Avoid excessive time texting, on the computer, watching television, playing video games or listening to loud music
  • Return to activity too soon can lead to worsening and prolonged symptoms.  A second injury to the brain while the brain is healing can lead to severe brain injury that is life-threatening
When can a child return to sports after a concussion?
A person with a concussion should not return to play until they no longer have symptoms at rest for at least 24 hours.  Return to play should then be a step-wise progression.  The child/adolescent should be symptom free for 24 hours before progressing to the next level of play:
  • Light aerobic exercise (e.g.: walking)
  • Sport-specific exercise
  • Non-contact training drills
  • Full contact practice
  • Return to play (Must first be cleared by a provider)
What resources are there for concussions?
Swedish’s Spine, Sports and Musculoskeletal Medicine team has developed a Sports Concussion Clinic with the following resources:
  • Baseline neurocognitive testing with a computerized exam called ImPACT can be done prior to playing a sport to assess changes and recovery if a concussion occurs.
  • Comprehensive concussion management, including clearance for return-to-play
Click here to learn more about the Sports Concussion clinic.  The team includes sports medicine physicians, psychiatrists, an athletic trainer, physical therapists and a neuropsychologist that can deliver individualized care for every athlete

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 ...

How to prepare your child for a stay at the hospital

We all know that Swedish provides top-notch pediatric services for the emergent needs of children and their families.  You may be surprised to find out that many children come to Swedish for a planned inpatient stay as well.  There can be various reasons why a child and their family might be anticipating a hospital stay.  Some examples may include having a surgical procedure that requires them to be monitored for a set period of time afterward, neurological video monitoring, or medical preparations for a procedure the following day.

Regardless of what service your child will be receiving at the hospital, there are ways in which you can better prepare them and yourself for what to expect during your stay.

At Swedish, Child Life Specialists help children and families cope with the hospital process.  Child Life Specialists are available to help educate and prepare children and families prior to surgery and/or an inpatient stay.  Some tips on how to prepare your child for an inpatient stay include .....
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