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Worrying about your child's growth

The above letters reflect many of our children’s feelings when they are first seen by Dr. Kletter. They and their families arrive to the Pediatric Endocrinology clinic with hope that something can be done.

Children are usually followed by their pediatrician or primary care provider. The following questions are guidelines for parents who are worried about their child’s growth. While any “yes” to the questions may not indicate a problem, it warrants a discussion with your child’s healthcare provider.

  • Is my child the shortest or tallest in the class?
  • Is my child unable to keep up with children of the same age in play?
  • Is my child growing less than 2 inches or more than 3 inches a year?
  • Is my child showing signs of early sexual development (before age 7 in girls and before age 9 in boys)?
  • Has my 13 year old girl or 15 year old boy failed to show signs of sexual development?

An experienced pediatric endocrinologist will evaluate the following possible causes of short stature and growth failure:

Three summer safety tips - sunscreen, heat exhaustion, water

Summer is in full force! With sunny weather, long days, and loads of activities it can be easy to forget the basics to keep you and your children safe this summer. Here are an additional 3 summer safety tips (see Dr. Lee’s blog for tips on helmets, open windows, and fires):

1. Sunscreen

All children of any age need sunscreen if they’re going outside in the summer, even if it’s for a short period of time on an overcast day. Sunscreen is the best way to prevent sunburns and future skin cancer. Babies under 6 months of age should be kept out of direct sunlight as their skin is thinner and more sensitive. Sunscreen should be greater than 30 SPF and applied 30 minutes prior to exposure. Be sure to read the label to ensure it protects against both UVA and UVB rays. Most products need to be reapplied at least every 3 hours or sooner if your child has been wet or in the water. A “waterproof” sunscreen should be reapplied every 30 minutes while your child is in the water.

2. Heat exhaustion

Heat reactions in children are caused by high temperatures and excess water loss. Here are a few things you should remember:

What to tell kids when a loved one is ill or in the hospital

When a loved one in the family is in the hospital or dealing with a chronic illness it can be hard to know what to say to the youngest family members.  It’s natural to want to “protect” them by not telling them or talking to them, but chances are the kids already know that something is going on.  An honest conversation can help to ease any misunderstanding they may have. 

Here are some important areas to cover when navigating a discussion about the illness or hospitalization of a loved one:

  • Honesty – Use words and descriptions that are appropriate for their age. If they are older they may ask specific details about the illness.  It’s good to call the diagnosis by name.  They may come back at a later date with other questions or even ask the same questions more than once. 
  • "Can I catch it?" – Children often have the fear that they can “catch” illnesses. They need to know, if in fact it isn’t a contagious disease, that they can not catch the illness from their loved one by being near them, hugging them and visiting with them.  This is particularly important if it is a brother or sister who is ill.
  • "Did I cause this?" – Many ....

What to expect when your child is in the Pediatric ICU (PICU)

Just the mere mention of the Pediatric ICU (PICU) can be frightening to both kids and parents.  But having a basic understanding of what people and equipment can be found in the PICU can help to lessen the anxiety.

What is the PICU?

The PICU at Swedish is a section of the hospital that provides the highest level of medical care for your child (0 to 18 years).  The PICU is different than just the regular pediatric floor because it allows for more intensive nursing care of your child and advanced continuous monitoring of their blood pressure, heart rate, breathing and more.  Patients in the PICU may also require more intensive therapies such as ventilators (a breathing machine) and certain medications that require close monitoring.

Who is hospitalized in the PICU?

Kids who are seriously ill whose medical needs cannot be met on the regular Pediatric unit will be in the PICU.  PICU patients may have breathing problems such as asthma or pneumonia, have had a lengthy surgery, have seizures or any other physical condition.  Time spent in the PICU depends on....

Wheezing in children

Wheezing is one of the most common symptoms in children and adults. Wheezing refers to the high pitched, "musical" sounds generated from the respiratory tract. It may originate in multiple areas, from the nose, to the throat, to the lungs. When physicians use the term "wheezing", they are usually indicating the sounds produced by tightness in the lower airways ("bronchial tubes").

Wheezing is especially important in pediatrics because children have frequent respiratory infections. These infections are generally caused by viral infections which cause much irritation in the airways. In addition, the airways of children are small and more "sensitive," predisposing them to wheezing. The location of the irritation may be in the upper or lower respiratory tract. This means that wheezing can occur with just a cold as well as bronchitis or pneumonia.

Wheezing in most children will respond to treatment with ...

New Level II Nursery Opens at Swedish/Issaquah July 8; Service Provides Premature, Sick Infants with Special Care, Support

ISSAQUAH, Wash., June 20, 2013 — Swedish/Issaquah will open its new Level II Nursery on Monday, July 8, having recently received state approval to provide this vital service to the community. The Level II Nursery allows for premature and ill babies — born as early as 34 weeks gestational age — to stay at Swedish/Issaquah to receive the specialized, around-the-clock care they need from a specially trained team of experts.

Ketogenic diet as a treatment for seizures

The ketogenic diet is a high-fat, low-carbohydrate diet that has proven to be effective in the treatment of seizures. In fact, the ketogenic diet is one of the oldest and most effective treatments available for patients with seizures regardless of age, from infancy through adulthood. The ketogenic diet must only be started under direct medical supervision.

Here are some frequently asked questions about the ketogenic diet:

What is the ketogenic diet?
The ketogenic diet is a special high-fat diet that often includes heavy cream, butter and vegetable oils to provide the necessary fat. The diet eliminates carbohydrate rich foods such as bread, rice, cereals, pasta, cookies, and cakes.

How effective is the diet at controlling or eliminating seizures?
Studies that have followed children on the diet for long periods reveal that at least 2/3 of all children on the diet have a significant reduction in seizures by over half. 1/3 of children on the diet will have a greater than 90% reduction in seizures, with half of these children ....

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