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'children' posts

New nutrition labels, same healthy eating advice

We all know that as a nation, we are getting bigger and heavier. Worse still, our future - our children- are becoming obese and unhealthy at increasingly younger ages. For decades, the scourge of obesity was blamed on a high calorie, high fat diet. Turns out, we have probably been doing it wrong all these years and our bulging waistline attests to this colossal failure. Research and the medical community now have increasing evidence that the real villain of the story is a very sweet little molecule called fructose. Fructose is what gives us the sweetness in table sugar (sucrose)…also in brown sugar, honey, agave, and of course, high fructose corn syrup. Call it by any name, but sugars are dangerous to our health. Fructose is addictive, much in the same way as alcohol and illicit drugs are. In fact, sugar (fructose) metabolism closely replicates alcohol metabolism except for the acute effects on brain. Sugar has been likened to alcohol without the buzz!

You may already have heard about First Lady Michelle Obama’s work with the FDA which has led to newly proposed changes to nutrition labels on packaged foods. The amount of sugars, specifically, “added sugars” will be part of that new label. I am not implying that a zero added sugar diet will be the panacea for the pandemic of obesity and ill health. We still need to eat healthy and exercise right. There is no magic pill, no startling new advice. Remember what our grandmothers used to say:
 

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 ...

Tips for keeping young athletes safe and healthy

We all know exercise is an important factor in maintaining an active and healthy life. However, over-exercising can lead to a rare, but serious complication known as rhabdomyolysis – a medical team that literally means ‘dissolution or destruction of skeletal muscle’. There has been a recent increase in rhabdomyolysis amongst teen athletes so it is important to recognize the warning signs and learn how to prevent them.

The classic triad of rhabdomyolysis is dark urine, muscle weakness or fatigue, and muscle pain. Although exercise can be the primary factor, other key contributing elements such as dehydration, genetic conditions (e.g. sickle cell), metabolic disorders, nutritional supplements, drug use, and heat stress can exacerbate muscle damage. Without appropriate medical evaluation and care, rhabdomyolysis can cause permanent damage to the kidneys and may even be life-threatening in severe cases. Here are some tips to help your young athlete remain active and healthy:

  1. Maintain adequate hydration – preferably with plain water.  Sports and energy drinks may often contain caffeine and excessive amounts of sugar which can cause dehydration.  On average, children that are 6-10 years old should have about 1L of fluid a day, children 10-14 years old should have 1.5L/day and teens over 14 years should have at least 2L of fluid a day. It is important to increase fluids with increased activity due to the additional fluid losses that occur.
  2. Eliminate protein supplements. A recent study by the American Academy of Pediatrics found ...

What parents and teens should know about marijuana

In 2012, Washington passed legislation to legalize marijuana use for people 21 and over.  While still illegal for those under 21, it is important to understand how this might affect adolescents and children.

Facts about marijuana and teens:

  • In a 2009 national study, 32.8% of 12th graders had used marijuana in the last year, and 20.6% within the last month.
  • One in eight adolescents who start using marijuana by age 14 become dependent.
  • When prolonged marijuana use starts in the teen years it is linked to a significant drop in IQ points - and the decrease is irreparable.
  • Marijuana can affect memory and concentration, cause or exacerbate depression/anxiety/hallucinations, and negatively affect asthma and other chronic lung diseases.
  • Marijuana is much more potent now than in the past.  In 2012 the average concentration of THC in marijuana was 15% (compared to just 4% in the 1980s).
  • Harmful effects occur whether marijuana is smoked, ingested, or vaporized.  “Edibles” are becoming more popular, and present unique risks.  It may take longer to feel the effects when ingested rather than smoked - this often leads to users consuming more than intended and experiencing severe side effects.
  • Adults cannot “share” with teens - it is felony to provide marijuana to a minor.

What you can do as a parent:

  • Start the conversation early - begin talking to your child about marijuana and other substances by about age 10.
  • Set clear expectations that marijuana is like any other drug, and is illegal for anyone under 21.  For example ...

How to give safe gifts to children during the holidays

As the holidays approach, parents often wonder what toys are safe for their little ones.  When making your list and checking it twice, here are some tips to ensure that toys are appropriate for the age and developmental stage of your giftees.

For younger children/infants:

  • Make sure all parts are larger than the child’s mouth.  Most children age 3 and under consistently put toys in their mouth, and some older children do as well.  A small-parts tester, or “no-choke tube” is about the size of a small child’s airway and can be purchased to test parts if you are unsure.  If a part or toy fits inside the tube, it’s too small to be safe.
  • When buying stuffed toys, look for embroidered or secured parts rather than pieces (such as eyes or noses) that could be removed and swallowed.  Remove all loose strings and ribbons.  Avoid animals with stuffing made of small pellets or material that could cause choking. Be aware that stuffed toys given away at carnivals, fairs, or in vending machines are not required to meet safety standards, so be especially careful with these!
  • When buying hanging toys for cribs, ensure that the child cannot grab any portion, and that strings or wires are short.  These types of toys should be removed when the infant can push up onto his or her hands and knees.
  • Keep plush toys and loose, soft bedding out of the cribs of infants and young children as these can cause suffocation.

For all children:

  • Look for labeling on the package that indicates what ages the toy is appropriate for.  Remember that this doesn’t have to do with how smart your child is, it is based on physical and developmental skills for his or her age group and should be followed.
  • Ensure that batteries are  ....
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