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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 treat babies with forceful vomiting (pyloric stenosis)

Pyloric Stenosis (or infantile hypertrophic pyloric stenosis) is a condition characterized by forceful vomiting in an infant due to hypertrophy of the pylorus muscle leading to gastric outlet obstruction. This means the muscle where the stomach empties into the small intestine becomes too thick and prevents emptying. As a result, after eating, the baby vomits. The reason for this happening is not known but is likely caused by many things and family history can play a role. Pyloric stenosis is rare, occurring in about 3 of  every 1,000 live births, and most often occurs between the ages of 3-6 weeks, is more common in males, and 1/3 of the time occurs in a first-born child.
 
Vomit from pyloric stenosis usually consists of just milk or formula. Any vomit with color should raise suspicion for other diagnoses. Parents report vomiting from pyloric stenosis as forceful and projectile. Infants are often hungry after vomiting, wanting to continue eating, however eating usually continues the cycle of vomiting.
 
How to treat pyloric stenosis
 
To ...

Don’t Leave Your Child in a Hot Car – Understanding the Risks & Consequences

In the span of this hot weather streak, we all need a quick refresher and reminder about how quickly children can suffer from heatstroke if left in a hot car.  Every summer, there are multiple occasions where children are left in hot cars for a myriad of “excuses” by adults.  In 2014 alone there have been 18 deaths of children related to heatstroke obtained by being left alone in a hot car. 

Here are some things you must know:

  1.  No matter how brief – there are no exceptions!  Some adults may think that taking the child in/out of their car seat is cumbersome and they are correct, even if it for what they believe is a “quick stop”.  But, remember – the stakes are too high!  The car temperatures can get very hot in a very short period of time.  There is no safe amount of time to leave children alone in a car.

(Did you know? In 10 minutes a car can heat up 20+ degrees Fahrenheit.  Even if it is only 60 degrees outside, the inside of a car can heat up to approximately 110 degrees. “Cracking” the windows does very little to keep the car cool.)

Talking to kids about traumatic world events

From Hurricane Sandy, shootings at Sandy Hook Elementary School, Boston Marathon bombing, the Oso mudslide and most recently the shooting at Seattle Pacific University, so often now we are given immediate access and awareness to traumatic and sudden events happening around the world and right in our own communities.  As parents we play an essential role in helping our children cope with stress and the emotions that come with a traumatic event.  Sometimes we think it would be better for them not to know about these things or that talking about will make it worse, but it’s important to respect their reactions and provide a place for them to talk about it. 

Why is it important to talk with my child? 

Talking to your child is an important first step in helping them understand and process any life event and especially a large scale traumatic event.  Your child may have already heard about the event through school, social media, friends or other sources.  Taking the initiative to talk with them allows you the opportunity to clarify the facts, answer questions and provides them a chance to share their own feelings. 

What should I tell my child?

Knowing ...

Bellyaches in Kids (and the “Und Here” Syndrome)

Bellyaches, stomachaches, or belly pain in school-age children are a common occurrence.  At least half of the children that get referred to pediatric gastroenterologists like me come for treatment of their chronic, recurrent abdominal pain.  Parents often feel frustrated because despite multiple visits to physicians, even emergency rooms, they are left with more questions than answers all whilst their child continues to suffer.

A typical scenario is a child whose pain seems worst in the mornings after awakening and towards the evening, especially after dinner or before bedtime.  Often the child doesn’t want to eat breakfast and if forced, tells his parents he feels nauseated.   When asked where the pain is, the child most often points to the area around his belly button.

More often than not, depending on a few other factors, the diagnosis ends up being ...

Safety tips for the 4th of July

How often do we hear it on the news, local billboards, or social media to “have a safe 4th of July”? Indeed, July 4th can be one of great celebration for our nation’s independence. But do you want to spend the evening in your local Emergency Department or Urgent Care with your child instead of enjoying it with family and friends?

Fireworks are a big cause of injuries, not only to children, but to adults alike. We collectively spend thousands of dollars on things that make the loudest “BOOM”, the brightest lights in the sky, or provide the longest show. We don’t anticipate spending additional money, hundreds to thousands of dollars, on emergency care that comes from the accidents caused by fireworks.

Here are some tips to help you have a safe 4th of July celebration:

Pet therapy for kids in the hospital at Swedish

During most hospital stays, a patient can expect to be visited and cared for by doctors, nurses, therapists and even social workers.  But did you know that at Swedish, we not only have a wonderful team of caregivers to provide the most optimal health care and we also have additional beneficial services like pet therapy?

Pet therapy is a wonderful service that Swedish provides to all pediatric patients and families who are not on isolation precautions.  A trained handler escorts a certified pet therapy dog room to room, visiting patients and their families at the bedside, taking the time to provide therapeutic services to all who would like it. 

Spending time with an animal has been proven to improve patient’s emotional status and ability to cope with their hospital stay.  Each pet therapy partner ...
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