Colic is a condition in infants who cry incessantly and are difficult to soothe or calm down. Colicky infants often seem to be in pain and this can lead parents to worry and become frustrated. A recent review of the research on colic summarizes what we know so far.
The FDA just finalized its new Nutrition Facts Label, which will now include the amount of added sugar found in packaged foods. While this is great news, parents still need to be vigilant when it comes to sources of hidden sugar in foods. This blog highlights key points to remember.
Chronic constipation is so common in childhood, it’s the reason 1 in 4 patients see pediatric gastroenterologists in Seattle, like me. This blog is meant to summarize the answers I give to the most common questions parents ask, regarding this common problem.
It’s not unusual for a child to be nervous about a visit to the doctor. That’s why the staff at Swedish Pediatrics hosts 'Teddy Bear Clinics' at local community events.
It’s common knowledge that over the last few decades there has been a significant increase in the number of children with obesity in the U.S. One of the complications of obesity is a condition termed metabolic syndrome, which consists of the combination of high cholesterol, blood sugar, blood pressure, and waist circumference. Having metabolic syndrome has long been a well-known risk factor for heart disease, but less known is the relationship between obesity, metabolic syndrome and liver disease.
As a pediatric specialist who treats children with liver diseases, I am often asked to see children with a condition called “fatty liver disease.” In fatty liver disease, fat accumulates within the liver as a direct result of obesity and metabolic syndrome. The curious thing about this type of liver disease, however, is that it is identical to the liver disease seen in alcoholics.
As tears well-up in her eyes, I notice her husband's arms reaching over to comfort my patient’s mother. I continue to describe the disease that has been ravaging at their son's intestines, probably for the last several months. Although his parents had suspected something was seriously wrong when their son’s abdominal pain and diarrhea (which had initially seemed like the “stomach flu”) got progressively worse, nothing could’ve them prepared them for what I had just confirmed during his colonoscopy: Crohn’s disease.
Driving home recently, I heard a story on the radio about a state commissioner wanting to reduce restrictions on “junk food” offered in public schools. Surprisingly, this story jarred a long-forgotten memory from my childhood…
A recent consensus statement written by international pediatric nutrition experts has recommended that infants and young children avoid rice-based drinks. This is due to the fact that some types of rice contain large concentrations of inorganic arsenic, a first-level carcinogen. There is no safe level of intake, because any exposure is risky. The longer the exposure to inorganic arsenic, the more toxic its effects.
The newly published report reminds us that rice and derived products such as starch, flour and syrup are used to fortify different foods, including drinks, purees, and snacks. These are foods often fed to infants and young children. Since most of the inorganic arsenic in rice is concentrated in the outer bran layers, the report also highlights that potentially, the most harmful type of exposure is that which comes from products manufactured from brown rice...
On Monday the New York Times published an article about the FDA’s plan to research the safety of a very commonly prescribed medication, polyethylene glycol 3350 or PEG 3350 (most commonly known under the brand name, MiraLAX®). As a pediatric gastroenterologist who often recommends this medication, I wanted to share my personal thoughts after reading the article.
First of all, although the news was certainly a surprise to me, it was a pleasant one. I was ...
As a pediatric gastroenterologist, I’m often asked whether there is any way to prevent a child from developing celiac disease. Based on what I knew regarding how food allergies develop, I used to counsel families that there might be a “window of opportunity”, between four and six months, when it’s possible to introduce grains and other gluten-containing foods that could potentially “teach” the immune system to tolerate gluten and thus lower the risk of developing celiac disease.
However, my “window theory” recently got thrown out the window when the results of two important scientific studies were published in the New England Journal of Medicine.
Recently, there has been a lot of discussion in the media about a severe type of respiratory illness affecting many children, mainly in the Midwest. The respiratory illness, caused by an infection with Enterovirus D68, is scary to parents, because it’s hard to differentiate whether their child is ill from this particular virus or just has one of the many other viruses that cause cold- and flu-like symptoms around this time of year.
Sometimes media reports leave families with more questions than answers, which is why Dr. Dianne Glover, one of Swedish’s pediatric infectious disease specialists, wanted to share this information with you:
Do you wonder if your child might have “lactose intolerance”? Have you ever thought of removing dairy from your child’s diet? If the answer to either of these questions is yes, here are a few things to remember when it comes to lactose intolerance in kids:
While lactose is the carbohydrate (sugar) found in milk, lactase is the enzyme that digests the sugar. This enzyme is found in the lining of the small intestine, breaks down lactose into simpler molecules that are easier to absorb. When there isn’t enough lactase, the sugar isn’t properly absorbed, which leads to the symptoms of “intolerance”, which include gas, bloating, pain and diarrhea.
Although children as young as infants can “transiently” have l...
Despite test results that show no evidence of their children having neither any detectable allergies to wheat nor any signs of celiac disease, many parents choose to have their children follow a gluten-free diet. This is because of convincing stories of how gluten (a protein found in wheat and other grains) seems to cause their kids to have belly aches, nausea, bloating and a variety of other symptoms.
For years, this was hard to explain without a scientific explanation. Gastroenterologists like me had a hard time supporting families who wanted to follow gluten free diets, without a good “medical reason”. Then, in 2011, researchers from Australia conducted a double-blind, randomized, placebo-controlled, rechallenge trial in nearly 3 dozen patients (none of whom had celiac disease or wheat allergy), all of whom described worsening symptoms when unkno...
“Every time my child eats, his belly hurts. I think he must have a food allergy. Can you help us?”
Countless times have I heard this from parents of children worried about foods being the cause of their child’s gastrointestinal (GI) complaints. Some families wonder whether their child should start a “gluten-free” or other type of dietary change. More often than not, families have already tried a few diets before meeting with me.
Parents considering these types of elimination diets need to be aware of a few key points:
The difference between “food allergy” and “food sensitivity”:
Time is running out if you want your opinion to be heard when it comes to the FDA’s proposed changes to the iconic food label that we’ve all come to rely on when buying packaged foods.
This is a big deal. For those of you who haven’t heard, highlighted below are the key proposed changes:
Require information about the amount of "added sugars". A review of this was discussed in Dr. Thekke Karumathil’s blog a few months ago.
Remove the “calories from fat” label
Update serving size requirements
Present "dual-column" labels to differentiate "per-serving" and "per-package"
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.
A 4 week-old infant and his mother came to my office last week. The mother had started seeing small flecks of blood and stringy mucous in the infant’s diapers a week prior. The baby was fine in every other way, breast feeding normally, and looked quite healthy when I examined him.
I diagnosed the infant as having cow’s milk protein-induced proctocolitis, the term referring to allergic inflammation of the lower gastrointestinal tract from exposure to cow’s milk.
This is a diagnosis I make often. Here's what you should know about infants with milk allergies:
I remember one day during my pediatric gastroenterology fellowship, a mother and child were walking in front of my professor and me, as we made our daily rounds in the hospital. When the pacifier fell out of the toddler’s mouth and the mother picked it up and put it right back into the child's mouth, my professor remarked to me, "mark my words....that child will never get Crohn’s disease!" My professor was referring to the theory of the "Hygiene Hypothesis". This theory is thought to explain (at least in part) why so many more people in developed nations become afflicted with autoimmune diseases such as Inflammatory Bowel Disease (IBD - Crohn's disease and Ulcerative Colitis) as well as food allergies, compared to people in non-developed nations.
In non-developed countries, where children are...
Magnets, a common household object with which we are all familiar, can be surprisingly dangerous, especially to children. If this statement is startling to you, here’s what you need to know.
Beginning in the 1970s and 80s, scientists discovered a new type of magnet, the so-called “rare-earth magnet”. Made from some of the “rare earth” metals of the periodic table such as “Neodymium”, these new magnets are not only the strongest, most powerful magnets known to man (magnetic forces up to ten times that of other magnets), they are also permanent and relatively inexpensive to manufacture. These properties revolutionized the production of many household products, even toys. Basically, magnets we find in everyday items today are no longer made using old-fashioned magnets from a generation ago!
As a pediatric gastroenterologist, I am writing this blog to warn you of the dangers, should these powerful magnets be accidenta...
Eosinophilic Gastrointestinal Disorders (“EGIDs”) are a severe form of gastrointestinal inflammation that results from food allergy. Children and adults in the U.S. are increasingly being diagnosed with this condition that unfortunately requires strict elimination diets, and many times, a life-long inability to eat foods that most of us take for granted each day, including dairy, wheat, soy, and eggs.
For children requiring such restrictive diets, pediatric gastroenterologists like me work hard to find adequate alternate sources of nutrition. For my patients with EGIDs, I often prescribe special “elemental formulas” as a treatment to both heal the intestinal inflammation and prevent further harm. These formulas are completely allergen-free while meeting 100% of a child’s nutritional needs.
However, in the state of Washington, most ....
As your baby grows, you’ve probably started wondering when and how to start feeding your infant solid foods. Here are some general tips to consider:
Is there a safe age to start feeding solid foods to my infant?
Yes, most infants this is between four and six months of age.
Why is there a ‘safe’ age to start feeding solids?
There are a few reasons why this age is safest. The first reason is because prior to four months of age, an infant is not developmentally ready to safely eat from a spoon.
To be able to swallow solids safely, an infant needs good head control; to be able to sit well with support; and to have lost the “extrusion reflex” (the reflex which enables newborns to tightly latch and suck from a nipple, but makes them shove a spoon out of their mouth).
The second reason an infant should be fed solids between four and six months is something many families are not aware of: i...
Is your child under the age of 6 and having problems with feeding or weight gain? Swedish’s GAINS program can help you and your pediatrician by doing a full assessment and providing specific recommendations. The Growth and Integrated Nutrition Service at Swedish (GAINS) is a multidisciplinary program, which includes doctors, nurses, dietitians, behavioral specialists, and feeding therapists.
There are many medical conditions that lead to growth and nutrition problems in children. We are experts at working with children with:
Here are some frequently asked questions about the GAINS program:
Dr. Pisharody is one of the designated Principal Investigators (PI) for an international research study which collects data on children with Inflammatory Bowel Disease. The name of the study is: DEVELOPTM : An Inflammatory Bowel DisEase Multicenter, ProspectiVE, LOng-term Registry of Pediatric Patients.
She is also one of the PIs for "A Long-Term Non-Interventional Registry to Assess Safety and Effectiveness of Humira (Adalimumab) in Pediatric Patients wtih Moderately to Severely Active Crohn's Disease (CD)"