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Understanding fever in kids

August 05, 2015
As a Pediatric Emergency Physician in practice for 18 years, I have seen a great many children with fever. I also see a great many parents and other caregivers who are very concerned about fever, but are reassured when factual information about fever is provided to them.

Fever is a marker of illness and is very concerning in specific circumstances. Fever over 100.4 in any infant less than 60 days of age is reason to seek urgent medical evaluation. However, once children get beyond the newborn period, fever is much less concerning to medical professionals. The following information can help you better understand fever, and help you care for your child without unnecessary worrying. Fever myths lead to fever phobia while in fact, fevers are harmless and often helpful.

Let these facts help you better understand fever:

Screen Time Suggestions for Kids

July 27, 2015
Like everyone else, I like making resolutions from time to time. While some goals have been easier to attain than others, one resolution that has been frustratingly difficult to achieve has been “digital disconnection. Especially in today's hyper-connected world, it is almost impossible to "unplug". While it may be desirable, and even necessary to be proficient at computers and technology, it is equally important that we also learn to be healthy "netizens", and serve as smart examples for our kids. Children, even infants, are being exposed to a barrage of electronic devices. If smart phones, tablets, computers, televisions and video games weren't enough, we now have toy versions of the same! In fact, the iPad has even become the go-to baby sitter for a lot of families. The negative effects of such unrestricted and early exposure are very wide ranging, and only of late has science been able to shed light on some of these.

What can we do to mitigate this epidemic? There is no one-size guidance for all, but here are some suggestions. Like anything else in life, common sense should be our guiding light.

Helping Kids Deal with Chronic Pain

July 13, 2015
When a child hurts it is upsetting to everyone. It is natural for the first response to be alarm and fear. New pain in a child needs to be investigated with tests and examinations. There are times a clear reason for the pain is found. Other times, the reason for the pain is not well understood. In both cases, a child that is hurting is important and deserving of care.

One of the hardest elements of pediatric pain is to know how to support the child.

Life with multiple sclerosis for children and parents

May 20, 2015

A patient of mine said that if he did not tell his children about his MS, he would have missed 10 years of their support.

The article, Informing the Children When a Parent Is Diagnosed as Having Multiple Sclerosis, mentions chronic neurological disease in one person affects the entire family and has a significant impact on the lives of children. Typically, when a person is diagnosed with MS, information from the health care provider is disseminated to the "ill" person, who then informs the rest of the family. However, children in the family are seldom the primary recipients of information delivered by health care professionals. Unfortunately, it has been reported that children without "thorough" information about their parents' MS have lower emotional well being than those who are better educated.

Prosser Kid Refuses to Let Multiple Sclerosis Steal his Childhood

May 15, 2015
12 year old Luke Merritt deals with MS everyday but refuses to let the disease steal his childhood.

Musician David Osmond Tours the Multiple Sclerosis Center with Dr. James Bowen

May 08, 2015
Musician David Osmond, from the famous musical Osmond family, visited the Swedish Multiple Sclerosis (MS) Center, touring the clinic with medical director, James Bowen. Having been diagnosed with relapsing-remitting MS in 2005, Osmond was interested in learning more about comprehensive care for MS.

The "Leaky Gut" Hypothesis

March 09, 2015
Have you heard of the term “leaky gut”? It’s used to describe a (scientifically unproven) theory, which proposes that the lining of the gastrointestinal (GI) tract could be abnormally permeable to dietary and other environmental substances, which then “leak” into the blood stream to trigger inflammation. Sometimes, the “leaky gut” theory is put forth as the cause of a variety of poorly understood diseases, ranging from autism to autoimmune disorders such as multiple sclerosis.

As a gastroenterologist, trained with the knowledge of how the internal mechanics of the gut lining are designed to make it an effective barrier, I have always found it hard to accept this hypothesis. I wanted to share the findings of a recent publication showing that in a group of children known to have food allergies and gut inflammation, their GI tract was no more “leaky”, compared to the intestinal tracts of healthy children.

Feeding peanut to infants decreases the risk of peanut allergy

February 24, 2015

This week an important new study in the New England Journal of Medicine showed that infants and toddlers exposed to peanut at a young age have a significantly lower risk of developing peanut allergy.

The study took place at King’s College in London, and involved 640 infants at high risk for developing peanut allergy (infants who already had severe eczema or egg allergy). Starting as early as 4 months of age, half of the babies in the study began eating peanut on a regular basis.  The other half of babies completely avoided peanut until they were 5.

When the children in the study reached their fifth birthday, researchers compared the rates of peanut allergy in the two groups:

Are trampolines safe for kids?

February 02, 2015
Trampolines are fun and children get a good amount of exercise when using them. However, thousands of children every year are injured on trampolines. In 2009, 98,000 people were seen in emergency rooms with injuries sustained while on trampolines. While many of these injuries were bumps and bruises, others were fractured bones that required casting and injuries requiring hospitalization and surgery. Sadly, a small percentage of people sustained life-threatening and permanently life-altering injuries, including closed head injuries and spinal cord injuries. Both the American Academy of Pediatrics and the America Academy of Orthopedic Surgeons have discouraged the recreational use of trampolines. What do we know about how these injuries occur and can we avoid them?

About 75% of injuries happen when more than one child at a time is on the trampoline. The smallest children are most at risk, because:

Tips for parents dealing with toddler's diarrhea

January 16, 2015
Toddlerhood is a time when children are going through a lot of changes.  Children enter pre-school, toilet-training begins, diets change, and sometimes stooling patterns become different as well.  The latter issue often leads to parental worry.   One of the most common changes that parents of toddlers bring up during visits with me is that their toddler’s stools seem very loose or watery (“diarrhea”).  More often than not, the diagnosis ends up being “toddler’s diarrhea”, a harmless type of diarrhea that generally starts after a child is weaned.  (Other names for this condition include “functional diarrhea of childhood” or “chronic non-specific diarrhea of childhood”.)

Toddler’s diarrhea occurs due to a relative immaturity of the intestinal tract of young children.  Relatively speaking, sugars and some fluid get poorly absorbed.  The stools often contain undigested food particles (carrots a...
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