I am no longer surprised. The presentations are varied. ‘‘I think I have wax in my ear.’’ ‘‘He keeps tugging at his ear.’’ ‘‘I hear a buzzing in my ear.’’ Sometimes it’s the shocked look one of my new pediatric residents gives to me, stating, ‘‘I think I see a bug in his ear.’’ By the end of the third year of their residency, regrettably, this surprised reaction fades as cases of ‘‘cockroach ear’’ become commonplace. Read more
It’s a rainy weekday morning in North Philadelphia, and once again, as I have been doing for the last 15 years, I sign on to our electronic health-records database and prepare for the 26 young patients, ages 1 month to 20 years, on my schedule. It’s a few days after the White House’s 2018 budget proposal, “A New Foundation for American Greatness,” was released last month.
Most of my patients are on Medicaid, although I also check to see whether any have insurance benefits such as discounted gym memberships, a big help for low-income families struggling with obesity.
Reviewing clinical notes, I’m reminded that several of the families have what’s known as food insecurity, Read more
Time-out is over and your 18-month-old is still flailing on the floor, pig-tails flying and tears streaming down her face. “Time out is over,” you say, trying to console her, but she continues to cry. She cries so long she forgets why she started.
Here are ways to help your heated up, frustrated toddler “cool off”:
–Offer a favorite stuffed animal or “blankie.” Gripping his familiar Read more
Questions: Why does that child run into the road? Why does that child hit other kids?
Answer: Because no one ever taught him not to.
Toddlers need lots of teaching, so where do you start? To help teach your on-the-move, act-first-and-ignore-the-consequences toddler how to become more civilized, first make sure BOTH parents agree on the rules. Teach your toddler that you mean what you say. When you call your toddler and he does not come right away, GO TO HIM AND LEAD HIM BY THE HAND OR PICK HIM UP no matter what the situation. Also remember that civilizing a toddler is a work in progress, not an afternoon project. Read more
When your baby turns 1, you’ll realize he has a much stronger will. My oldest threw his first tantrum the day he turned 1. At first, we puzzled: why was he suddenly lying face down on the kitchen floor? The indignant crying that followed clued us to his anger. “Oh, it’s a tantrum,” my husband and I laughed, relieved he wasn’t sick.
Parenting toddlers requires the recognition that your child innately desires to become independent of you. Eat, drink, sleep, pee, poop: eventually your child will learn to control these basics of life by himself. We want our children to feed themselves, go to sleep when they feel tired, and pee and poop on the potty. Of course, there’s more to life, such as playing, forming relationships, succeeding in school, etc., but we all need the basics. The challenge comes in recognizing when to allow your child more independence and when to reinforce your authority. Read more
The Zika virus in the news these days reminds us of another microcephaly-causing virus which scourged our world in the not-so-distant past. In the years right before the Two Peds doctors were born (late 1960s), the virus rubella routinely swept through the United States and the rest of the world. The airborne germ rubella, just like the mosquito-spread Zika virus, caused most people just a mild illness that they usually never even knew that they had. After they were sick, they became immune to the virus. But when pregnant women contracted rubella early in pregnancy, their unborn children sometimes ended up with microcephaly.
Microcephaly is a condition where a small, underdeveloped, or abnormal brain leads to a small head at birth. Many children with microcephaly have significant mental disabilities. Read more
We are all born with primitive reflexes. Their presence is critical to the survival of the infant. They serve as the training wheels for the brain early on in the infancy and show that the infant’s nervous system is functioning normally. On the other hand, if primitive reflexes persist to exist long after the expected integration age, they may hinder the healthy development of the child.
Primitive reflexes are automatic muscle reactions in response to outside stimulation that are typical in a newborn and naturally integrate during the baby’s first year. Read more
Proposed federal budget cuts threaten to defund programs that help children and families meet basic needs or recover after a difficult life event. On Friday, April 21, Sen. Bob Casey joined advocates and community members at Calvary United Methodist Church in Philadelphia to discuss how these cuts could impact millions of Pennsylvanians.
Casey said, “What some extreme members of Congress want to do is cut basic programs in ways we have never seen before, so wealthy Americans get more of a tax break.” He pointed out that the Trump administration’s proposed repeal of the Patient Protection and Affordable Care Act was “a big tax cut bill” that would Read more
Parents’ smoking habits could contribute to the most common form of childhood cancer, according to a new study.
A new study by researchers in California suggests exposure to parents’ tobacco smoke, especially during pregnancy and early childhood, may be linked to gene changes commonly found in acute lymphoblastic leukemia (ALL).
Acute lymphoblastic leukemia is a blood cancer that occurs Read more
There was widespread and well-deserved derision when a photo circulated of Vice President Mike Pence with dozens of Republican men from the far right “Freedom Caucus” at the White House last week as they discussed elimination of the ten essential (as in mandatory) health benefits for insurance plans under the Affordable Care Act. Why? Because one of the ten essential benefits is maternity care. It would have taken only one mother in that room to ridicule these men engineering a return to the good old days when maternity coverage was not always included in coverage and a woman could be denied maternity coverage after she became pregnant because it was a “pre-existing condition.”
Yet women are not the only population seriously threatened in this picture. Children are especially at risk, because both maternity, as in pre-birth care, “newborn care” and “pediatric services, including oral and vision care” are essential health benefits as well. Read more