Parentelligence Blog

Think about injury prevention when returning to baseball season

Melissa Ballance AT/L, ATC

Melissa Ballance AT/L, ATC
Athletic Trainer, Swedish Pediatric Specialty Care, Sport and Dance Medicine

Baseball season is finally here! As we watch our Major League Baseball heroes take the field this April, kids of all ages will be returning to the field after winter break and time off from practicing. 

It is important that our kids return safely to help prevent overuse injuries from occurring during the season. Common overuse injuries in baseball are injuries to the elbow (ulnar collateral ligament, UCL) and shoulder in the throwing arm. A proper warm up, maintaining an age appropriate pitch count and good throwing mechanics are essential to preventing overuse injuries. 
 
Here are some specifics to keep in mind:

New Washington State Law to Help Children with Food Allergies

Uma Pisharody, MD, FAAP

Uma Pisharody, MD, FAAP
Pediatric Gastroenterologist

It is with great happiness that I update an earlier blog posted several months ago with the news that patients with food allergies now have a law that helps them afford their treatment.  On Friday March 28th, Governor Jay Inslee signed a law that makes Washington the most recent state in the country to set a mandate for medical coverage of elemental formulas in the treatment of Eosinophilic GI disorders (EGIDs).  EGIDs are a severe form of gastrointestinal inflammation that results from food allergy. 


New nutrition labels, same healthy eating advice

Dinesh Thekke-Karumathil, MD

Dinesh Thekke-Karumathil, MD
Pediatric Hospitalist

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:
 

If your newborn is diagnosed with hypospadias

Beth Andersen, MD, FAAP

Beth Andersen, MD, FAAP
Pediatric Urologic Surgeon

As a pediatric urologist, I am frequently asked to consult with parents whose newborn son has hypospadias.  

Hypospadias is usually diagnosed during the physical exam right after the baby is born.  When parents see the abnormal penile anatomy they naturally want to learn about the diagnosis and understand what, if anything, needs to be done. Answering these questions, discussing options, and performing reconstructive surgery to help restore normal penis appearance and function are some of the most rewarding things I do as a pediatric urologist. 

I would like parents who have a son born with hypospadias to be reassured that the anatomy can be reconstructed, the surgery is well tolerated, and a good outcome with a normal, or near normal, penis appearance and function can be achieved.

It is not urgent to treat newborns with hypospadias because they can usually pee (urinate) just fine through their existing urinary opening.

In fact, when hypospadias is the only condition noted in a newborn physical exam there is a low chance of additional developmental abnormalities. Additional tests and studies on the baby are usually not necessary.

It is important to note that if any unusual shape of the penis or urethral opening (where the pee comes out) is present then circumcision (if desired) should not be performed until after the child is examined by a pediatric urologist. This is because the pediatric urologist may need to use the foreskin tissue for the surgical repair. 

Here are answers to some commonly asked questions:  

Lymph nodes in children

Robert L. Weinsheimer, MD

Robert L. Weinsheimer, MD
Pediatric General Surgeon

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?

Elizabeth Meade, MD

Elizabeth Meade, MD
Pediatric Hospitalist

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 ...

FDA finally defines gluten free

Uma Pisharody, MD, FAAP

Uma Pisharody, MD, FAAP
Pediatric Gastroenterologist

On August 5th, 2013, the U.S. Food and Drug Administration (FDA) at long last published a formal rule regulating the use of the term "gluten free" on foods and beverages.  Even though this came with a big sigh of relief to the millions of people with celiac disease living in the US, consumers should be aware that the law gives manufacturers one year to be in full compliance (and goes into effect August 5, 2014).

As we head into the final months before the law’s final compliance date, I thought I’d highlight a few other key points about this brand new law:

1. No symbols needed.  The law does not require or recommend manufacturers use any particular symbol or food label, but if a label should include any of the following phrases, compliance must be ensured:
    •    “Gluten-free”
    •    “Free of gluten”
    •    “No gluten”
    •    “Without gluten”

2.  It’s voluntary.  A manufacturer may produce gluten-free foods, but just choose not to label them as such.   

3.  “Gluten-free” does not mean “zero gluten”. The new law defines "gluten-free" to mean that a food contains less than 20 parts per million (20 ppm) of gluten.  (This tiny amount can be visualized as less than a tenth of a grain of salt on a slice of bread, and is acceptable as the standard for people with celiac disease).

4.  As with any rule, there are exceptions.  Although ...
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Top Authors

Jennifer Wojciechowski
Uma Pisharody, MD, FAAP

Uma Pisharody, MD, FAAP
Pediatric Gastroenterologist

Robert L. Weinsheimer, MD

Robert L. Weinsheimer, MD
Pediatric General Surgeon

Elizabeth Meade, MD

Elizabeth Meade, MD
Pediatric Hospitalist

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