Search for tag: "child"

Parents will often bring their kids in to see me for skin issues, and I also get a lot of phone calls about rashes. Well, the hard part is I can't see your child's rash over the phone. Rashes are one of those things that your pediatrician will need to see in person or through a video visit in order to determine what the cause of the rash is and what to do about it.

Babies and diaper rashes are one very common concern. Babies get diaper rashes very easily, even within days of being born, because their skin is super sensitive. In fact, their skin is not fully developed until about 6 months old, which is why we say no sunscreen or bug spray until then.

Babies are also in diapers and they pee and poop a lot. Diaper rashes are basically contact skin issues due to the diaper fibers and due to the normal body chemicals and bacteria in the urine and stool.

Some babies are okay with just having diaper rash cream put on their bums. Others get more like burns. We used to even make our own diaper rash cream for our older son. His skin was so sensitive we joked that he would get a diaper rash if we looked at him wrong. We ended up using burn cream mixed with zinc oxide for him.

Parents often ask which diaper cream I recommend. My answer? Whichever works for your baby. I don't have a personal preference, and some creams work better for some babies than others.

If the diaper rash is red and bumpy, though, that's a yeast diaper rash. It's more in the front of the diaper area and less on their bottoms. Any over-the-counter yeast cream can help with that.

Then there are dry skin issues. Every winter, I have parents bringing their children to me for an all-over body rash that can be itchy. That's often either just dry skin dermatitis or eczema. For both, start with a cream that says "dry sensitive skin." And you can try mixing a little over-the-counter hydrocortisone with it and apply it twice a day for a few days.

Some kids with really bad eczema end up needing prescription creams, and that's when a trip to your pediatrician is needed.

There are all sorts of rashes. Most are viral, some are bacteria, but for all other rashes, it's best to have your child seen so we can check it out and see what treatment is needed.

Viral rashes need no treatment. They'll go away on their own. Bacterial ones sometimes just need topical antibiotics, but sometimes need a prescription for oral antibiotics.

If you have a concern about your child's skin, go ahead and bring your child in to see their pediatrician. Chances are we've seen your child's rash before and are able to help.

Interviewer: You've noticed some signs that your child is engaging in self-harm which can be scary and confusing as a parent. So what do you do?

Dr. Thomas Conover is a psychiatrist board-certified in both child and adolescent psychiatry and general pediatrics at Huntsman Mental Health Institute.

Find out how to identify if your child is engaging in self-harm, how you should respond, and resources for help and treatment. What is Self-harm?

Dr. Conover: Self-harm is any deliberate attempt or act to injure oneself. So the term is pretty straightforward, but self-harm includes, from a psychiatrist's standpoint, both non-suicidal self-injury, which is any self-harm that's inflicted without any intent to die and also suicide attempts. Suicide attempts are a form of self-harm, and the difference between the two as we define them is whether the person who's inflicting injury on themselves means to die by doing it.

Interviewer: When I hear self-harm, I tend to think of cutting. Is that the only type of self-harm, or are there other types?

Dr. Conover: Making cuts and scratches on oneself is the most common type of self-harm. We sometimes see teens do other forms such as burning themselves deliberately or hitting themselves, striking themselves with a fist, or headbanging. Those are other forms that are fairly frequently seen. There are numerous other less common acts, but cutting or scratching on oneself is definitely the one that we see most frequently in emergency rooms or psychiatric specialty care. Why do Teens Engage in Self-harm

Interviewer: What leads to that type of behavior?

Dr. Conover: We don't know the exact reasons why any individual might engage in self-harm. You know, for each teen, it may be different. Some of the reasons may be a distraction or relief from some other thought or emotion.

Sometimes it may be kind of the cliché or proverbial cry for help, you know, trying to express some emotion or demonstrate distress that is too difficult for the teen to articulate in words. Those are two of the most common reasons teens engage in self-harm behavior. How Do Parents Discover Their Children Are Engaging in Self-harm?

Interviewer: Have you experienced the teen talking about self-harm before engaging in it with any of your patients? You said that self-harm is a form of communication and could indicate to a parent that I want to have a conversation about something with you, I don't know how to do it, so I'm doing it this way. But could it happen in terms of words before behaviors?

Dr. Conover: It certainly can. It may often be expressed to someone other than the parent, a friend or acquaintance, somebody that the teen is communicating with over texts or social media. And that's often a way that parents discover that their teen is either thinking about or engaging in that behavior.

One warning sign and one piece of good advice for any parent of a teen is to monitor the teen's social media use and texts with some frequency because sometimes that's who they may try to talk about.

Now, if a teen is coming to a parent or other trusted adult and expressing thoughts that they may harm themself, I would say, while that's a concerning situation, it's certainly a situation where at least the teen feels trusting enough and supported enough to bring that up verbally before doing it or even after doing it. And in some sense, in that situation, the teen and their caregiver are a step ahead of where they might be if the self-harm thoughts or behavior are completely concealed. Recognizing Self-Harm

Interviewer: Is it generally pretty easy in your experience for parents to recognize if their teen is engaging in self-harm?

Dr. Conover: I don't think it is, but I think the barriers to recognizing it are complex. One of the main barriers is that no parent wants to think that their child is experiencing distress that would lead them to deliberately harm themselves or attempt suicide. And so a certain degree of conscious or unconscious denial is a huge barrier to recognition. So I think to anybody who is listening to a podcast like this, to anybody who wants to know more about teens' mental health, I think having awareness is a way to bring that barrier down. As much as a parent doesn't want to think that their child might be experiencing that distress, some awareness and a level of openness to the possibility brings that barrier down.

Supervision and support is another thing that brings that barrier down. When a parent pays attention to their teenage child, when a parent knows what they are doing, who they're hanging out with, who they're communicating with, when a parent inquires actively and openly with their teen in a way that lets the teen know that they're caring and concerned, those are also things that bring down the barrier and make it more likely that the teen might talk to the parent about such behaviors. How to Talk to Teens About Self-harm Concerns

Interviewer: I would imagine if somebody is listening to our conversation right now and they found it via an internet search, they probably should trust their instincts. Would you say that's a safe thing to say?

Dr. Conover: If the parent has suspicion or concern, they should not dismiss that. The most direct first step is to initiate a conversation. Initiating a conversation about self-harm needn't be accusatory. It shouldn't be because that's a sure-fire way to have a teen shut down in conversation for a parent to approach them and say, "Are you cutting yourself? You should never do that," implies a judgment or seems like you're interrogating.

A better opening line might move from the general to the specific: "You know, some teens might even think about hurting themselves or even hurting themselves on purpose when they're feeling upset or distressed. Have you ever thought of doing something like that?" You know you can hear the difference when you're saying, "Hey, this is not something that you alone might have thought of or done. This is not something that I'm expressing any judgment about. I'm just saying it's something that people might do, And I'm wondering if that's something you've ever thought about."

Asking about thoughts is a little bit of a softer entry too. Because the teen doesn't necessarily have to confess, "Oh, yeah, I did cut myself once." Maybe they're not ready to say that, but they might be ready to say, "Well, yeah, you know, I've known some people who have done that, or I've heard that people do that, or I've even thought about it myself." And then the conversation can proceed from there. It doesn't have to be accusatory or judgmental, and it shouldn't be, but is it going to be a difficult and crucial conversation? Absolutely. There's no way to make that kind of an inquiry easy.

Interviewer: You bring that up with your teen, you ask them if they've ever thought about it, but there are obvious signs that something, you know, is going on. Is that the point that you say, "Well, I couldn't help but notice that on your arm there are scratches or on your legs, there's bruises?"

Dr. Conover: Yeah. Being gentle in inquiry is important, but we don't have to take it to the point of absurdity, right. You know, if what the parent is concerned about is something concrete like, "I found a text where you said to your friend that you were thinking of hurting yourself, or when we were at the beach last Saturday, and you were wearing your shorts, I noticed that you had some cuts on your leg." I think that it's fair for a parent to start with the concrete thing that the parent observed. That's reasonable. Again, not being accusatory or judgmental, right? Not, "What on earth are those that I saw on your leg during our trip to the beach?"

Interviewer: Yeah. "What are you doing to yourself?"

Dr. Conover: "Who does something like that?" Exactly, right? But just saying, "I noticed this, or I found this, or when I was looking at your texts from last week, I saw something that concerned me." I think that mustering some calm and then inquiring with the child is perfectly appropriate. And I think that does point to signs that a parent may look for. You know, it is my experience that most often it isn't the case that the teen will come to a parent and simply say, "I'm thinking about this, or I'm engaged in this behavior." It would be nice if they did. It's a good sign about the parent and child's communication if a child can openly state that.

However, I often see parents discovering signs that this might be happening. Signs that one might look for include finding items that someone might use to harm themselves in a place where you wouldn't expect to find that thing, like a kitchen knife in a bedroom, or old-fashioned razor blades, you know, that you might use to peel paint or do things like that hidden somewhere in a child's room, pieces of glass or metal. Certainly, if any of those items look like they've been used because they have, you know, blood or something that looks like that on them.

So finding items that a youth might use to harm themselves, that's one very common sign that parents might first come upon. A very common way is through monitoring social media or texts. I think it's very important to note that monitoring social media and texts should be given and what I advise parents to do before they let kids use those technologies is to set down a very clear contract and expectation that they will be monitoring their activity because that's necessary and it also avoids the conflict that would arise if a parent was monitoring those things without having set that expectation. When Should a Parent Seek the Help of a Professional About Self-harm Concerns

Interviewer: When a parent recognizes these signs, and they have addressed them with their teen, and they've started out the way that you've recommended, being very non-accusatory, talking about the physical things that you're seeing as opposed to passing judgment and you get that conversation going, you had mentioned that sometimes self-harm is a way of communicating that there's something else going on. I love keeping that in mind. I think as you're having this conversation is ultimately the point then to get to what the actual problem is that's causing the symptom of self-harm or is that the time you would want to involve a professional, or where would you go from that point?

Dr. Conover: An older view in mental health was that deliberate self-harm or suicidal thoughts or acts were always secondary to some other problem or a symptom of another disorder, and that you would need to treat the disorder in order to treat the self-harm behavior or the suicidality. To an extent, that is true, but a more current and up-to-date view is that while self-harm and suicidal acts can be associated with another problem like depression, or trauma, or abuse being two of the most common, they do constitute a problem in and of themselves. I don't think that a parent is best served to then become the behavioral health provider or a detective, right? You know, to say, "I'm going to get to the bottom of this. I'm going to get to the bottom of this and find out what's ailing you and what's causing this problem you're having." That's not something a parent wants to pursue on their own.

I think the first step of asking your child, "Hey, what's going on? I noticed this, or I noticed that. I'm concerned about you." That is definitely the parent's job. The parent's next job is then to help their teen by seeking some additional help and support. Self-harm thoughts, self-harm behavior, those are always a concern and virtually always merit some further support, whether that be through seeking some crisis services, or counseling, seeking some outpatient therapy, getting some additional support from a medical provider like a primary care doctor or other practitioner who maybe already knows the family and the child as a first step are what I would advise if that first conversation happens, really, no matter how that conversation goes, because a parent can do the right thing and ask the question, but the teen may still respond with denial. And I don't think that I would be giving good advice if I said, "Okay, ask these questions and ask them in a non-judgmental way." And you think they might be hurting themselves and you ask, and they say, "No, mom, I'm not doing that." You can't really close the book on the conversation with just that negative reply if you've seen signs or have a strong suspicion.

Interviewer: So the purpose of this conversation is to really have a mutual acknowledgment that this thing is happening. That's the place that a parent wants to get to with their child, expressing concern them so then that they can have a conversation about what we're going to do about it, which is ultimately going to lead to going to a professional to assist at that point.

Dr. Conover: That would be the way that I would advise that things would go. Not all teens who deliberately harm themselves make suicide attempts, but there is a strong correlation between the two. So engaging in self-harm without an intent to die is a strong risk factor and has a strong correlation with eventually making a suicide attempt. And so taking it very seriously when there are signs of such behavior or when there is an admission or confirmation of such behavior is really important because ultimately, you know, we're not concerned about the long-term health implications of having a few cuts or scars on your arm or your leg. What we're concerned about is bigger issues of health and wellbeing and ultimately safety and preventing any very serious injury or death. Resources for Parents Concerned about Self-Harm

Interviewer: Do you have resources that could go beyond this conversation that could help a parent that finds themselves in the situation where they have to have this conversation?

Dr. Conover: Resources that a parent might reach out to would include primary care providers. I think that primary care providers are a great first resource for families for a number of reasons. Primary care providers such as a pediatrician or a family practitioner generally have an ongoing relationship with the teen and the family. And so any discussion or decisions that are made will have a lot of context, and that there's a higher likelihood that the teen and family will feel trusting and agreeable to any advice or interventions that a primary care provider can give. Also, unfortunately, we don't have enough mental health providers as far as specialty mental health providers like psychiatric providers and therapists, and so it may be easier and more accessible to start with primary care. At any point where self-harm thoughts or behavior, including suicidal thoughts or suicide attempts are a concern, a parent can always access the crisis services that are available.

Here locally in Salt Lake City and in the entire state of Utah, the Utah crisis line is one such resource and the Huntsman Mental Health Institute crisis line, which are actually staffed by the same, very skilled, highly-trained crisis-intervening staff.

A parent might question, "Oh, is this big enough of a problem for me to call the crisis line?" As a practitioner, I would always give the advice, don't second guess yourself on whether you think this is a crisis. You are not going to call the Utah crisis line with a question about your child's self-harm or potential suicidal behavior and be told, "Hey, this isn't a problem. Why did you call us?"

updated: March 1, 2022
originally published: July 9, 2021

Announcer: "Health Hacks" with Dr. Troy Madsen on The Scope.

Dr. Madsen: Well, today's health hack is a trick to try and get a raisin or any other sort of foreign body out of your child's nose. Now, this health hack is a little bit gross, but it works, and it could save you a trip to the ER.

So if your child sticks something up their nose, a raisin or anything else they find around the house, you can't see it to pull it out and you're thinking to yourself, "There's no way I'm going to get this out." One trick is to have your child lie down on a couch or on a bed. You place your mouth on your child's mouth. You blow into their mouth forcefully, quickly, only maybe a second or two of forceful air into their mouth. That air then gets forced up through the nose and that is going to ideally force this raisin or whatever else is in there out of their nose.

Now, it's a little bit gross because you've got to put your mouth on your child's mouth, you have to blow in there, and most likely that raisin or whatever else is in there is going to get blown out onto your face with some mucus. But the good news is you avoid the trip to the ER. If you were to come to the ER with the same problem, I would probably ask you in the ER, "Are you willing to try this here? Because it can avoid a whole a lot of trauma to your child, a whole lot of probing around in their nose." So, if this happens at home, give it a try. There's good evidence that this works well. It can save you a trip to the ER.

Announcer: For more health hacks, check out thescoperadio.com. Produced by University of Utah Health.

Dr. Gellner: Drug and alcohol use in adults seems to be on the rise, and that means more kids are being exposed to substance use. How do you know if your child might be using drugs or alcohol? We'll discuss some signs on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: We've all heard the ads about teens and peer pressure about using drugs and alcohol. They've been around for years as public service announcements. Kids, teens especially, are faced with peer pressure to be cool, and that means making the choice to use or not to use when their friends offer them drugs or alcohol. Figuring out if your child is using can be a challenge, as many of the signs are also those of typical teen behavior, and of depression and anxiety.

Behavior changes are one of the first things to note. Are they hanging out with the same friends they've always had, or do they have new friends whose behaviors you question? Are they chewing gum or mints all the time to cover up breath odors? Do they go out every night, lock the doors more, or make phone calls in secret? Have their sleep patterns changed, where they have periods of extreme high energy followed by long periods of catch-up sleep? Mood changes are common in teens due to hormones, but if your child has extreme mood changes, seems overly hostile or hyperactive compared to their norm, that could also be a red flag.

Hygiene is also a challenge for teens, in general, but if your child completely lacks any effort to keep clean, their clothes have odd odors as opposed to normal teenager body odor, or they want to wear long sleeves, or pants even, when it's hot outside, perhaps in an effort to hide track marks, pay attention.

School changes can be one of the biggest signs that there's a problem. A child who normally doesn't miss school is all of a sudden ditching classes, not keeping up with assignments, or the teachers are calling with concerns about your child's behavior or performance.

Finally, look around the home. Are prescription medications disappearing, alcohol bottles getting less full, money missing from your wallet? Does the car smell odd, or strange wrappers and trash are left behind?

The first thing you should do if you suspect drug or alcohol use is to have a conversation with your teen, and tell them you want them to be completely honest. Be prepared if they say yes, they're using, and don't fly off the handle. Keep calm and let them know that you are by their side to get them help. If they say no, they're not using, don't assume they're lying. This may be the time to talk to your pediatrician about getting help with a mental health provider.

Announcer: Want The Scope delivered straight to your inbox? Enter your email address at thescoperadio.com, and click "Sign Me Up!" for updates of our latest episodes. The Scope Radio is a production of University of Utah Health Sciences.

It can be really scary to see your child get bonked in the nose. Some noses seem to be trauma magnets and when they get hit, they get bloody, bruised and swollen. Luckily, in most cases, the nose isn't broken.

If your child's nose is hit, first, take care of the bruising and the swelling, by putting ice on the nose for about 20 minutes, and repeat this again in an hour.

You can give your child Tylenol or Motrin for pain. If there is a cut on the nose, clean the area with soap and water, and then cover it with gauze to stop the bleeding. Once the bleeding has stopped, you can put on antibiotic ointment and a Band-Aid to keep the area clean.

Be prepared for a nose bleed because this will happen. Noses have a great blood supply which means, they can make a literal bloody mess. Bleeding that goes on continuously for more than 30 minutes, though, that's concerning. When to Seek Professional Help

If you're not sure if your child's nose is really broken, wait a few days and let the swelling go down. If you're not sure, and your child can breathe okay, and the nose isn't crooked, wait about four to five days, to see what the nose looks like after the swelling is gone. If it still looks odd, ENT needs to see them quickly, because the nose will need to be reset by ten days after the injury.

If your child's nose is crooked, or they can't breathe out of it, they need to be seen in the ER. X-rays won't help diagnose a broken nose, and if there's a concern that your child's nose needs ENT to see them urgently, a CT scan may be done to see how bad the damage is, and how quickly it needs to be fixed.

Noses will get hit, but most heal fine by themselves.

updated: October 3, 2022
originally published: September 26, 2016

Dr. Gellner: Latex allergy is more common than you might think. I have it, and it's one of the main reasons latex is not found in medical offices anymore. How do you known if your child is allergic to latex or not, and what should you do about it? I'm Dr. Cindy Gellner on The Scope.

Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kids Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Latex is a substance made from a milky fluid that comes from the rubber tree. With a latex allergy, the body treats certain proteins in latex as if they were harmful and triggers an allergic immune response. This may happen when products made from latex touch your child's skin, mouth, or even if they are just inhaled. Children who have chronic diseases, such as spina bifida, or have a lot of surgeries, may be exposed to latex from the medical procedures. They may become sensitive to it.

Children who have allergies to certain foods may also develop a latex allergy. Both the foods and the latex have some of the same proteins. These include fruits such as bananas and kiwis, vegetables including avocadoes and tomatoes, tree nuts, peanuts, and shellfish. If you think your child is allergic to latex, it is important to get a diagnosis from your health care provider or allergist.

Symptoms of a latex allergy can develop over several hours, or they may be immediate and severe. The most common reactions are skin reactions, such as hives and eczema flares. If latex is around the mouth or inhaled, your child may have wheezing, trouble breathing, itching and swelling around the mouth, and a rapid heartbeat.

It is possible to have an allergic reaction called anaphylactic shock. This is a serious reaction that is sudden, severe, and can involve the whole body. It can cause swelling of the mouth and throat, dangerously low blood pressure, and trouble breathing. This type of reaction is an emergency. It is treated with antihistamines and injectable epinephrine. Usually, parents or caregivers of children who have severe allergic reactions carry their own epinephrine in case of an emergency. If epinephrine is used, or your child has a reaction, and epinephrine is not available, call 911 immediately.

Many things contain latex, including baby bottle nipples and pacifiers, rubber bands, balloons, Band Aids, IV tubing and catheters, many kinds of medical gloves, and dental dams used in dental procedures. In general, any item that can be stretched may contain latex. There are many things that can be used instead of things that contain latex. These are made from vinyl, plastic, or silicone.

If your child has been diagnosed with a latex allergy, teach your child to known and avoid latex products. Make sure your child wears a medic alert bracelet or necklace. Know what to do in case of an emergency. Ask your child's health care provider about a prescription for injectable epinephrine in case of emergency.

Finally, be sure to tell all dentists, health care providers, teachers, daycare providers, babysitters, friends, and family members that your child has a latex allergy. Anyone your child's going to be spending time with needs to know about this. Something as simple as going to a birthday party with latex balloons can trigger a serious reaction. Be sure you are always prepared for your child.

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Dr. Gellner: It's hard to imagine someone intentionally hurting a child, yet nearly a million children are abused every year just in the United States alone. Child abuse is today's topic on The Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kid Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Child abuse happens when a parent or other adult causes serious physical or emotional harm to a child. Child abuse can take the forms of physical abuse, sexual abuse, neglect and abandonment, or emotional or psychological abuse. The most serious cases of child abuse can end in death. Those who survive may suffer emotional scars that can linger long after the physical bruises have healed. Kids who are abused are more likely to have problems building and maintaining relationships throughout their lives and they are also more likely to have low self-esteem, depression, and thoughts of suicide.

When people think of child abuse their first thought is of physical abuse, such as striking, kicking, or shaking a child. But physical abuse can also include holding a child underwater, tying a child up, intentionally burning a child with scalding hot water or other objects like cigarettes, using an object to beat a child, starving a child, or failing to provide a child with food intentionally. Abusive head trauma or Shaken Baby Syndrome is a specific form of child abuse and is the leading cause of death in child abuse cases in the United States. Most incidents last just a few seconds but that's enough time to cause brain damage and kill a baby.

Sexual abuse happens when a child is raped or forced to commit a sexual act. It's also any sort of sexual contact with a child that is meant to sexually arouse the abuser. So in addition to having sex with a child or even just inappropriate touching with a child, sexual abuse includes making a child pose or perform for pornographic pictures or videos, showing a child pornographic material, forcing a child to undress, not just normally like changing your clothes, but forcing a child to undress in front of you for gratification purposes, and flashing a child or showing one's privates.

Neglect is any action or inaction on the part of a caregiver that causes a child physical or emotional harm such as withholding food, withholding warmth in cold weather, or not providing proper housing. Basically anything that interferes with a child's growth and development constitutes neglect. This also includes failing to provide medical care when a child is injured or critically sick, locking a child in a closet or a room, and placing them in a dangerous situation that could lead to physical injury or death. Abandonment is a type of neglect.

Emotional abuse or psychological abuse is a pattern of behavior that has negative effects on a child's emotional development and sense of self-worth. Ignoring a child or withholding love, support, or guidance is considered emotional abuse. Just like threatening, terrorizing, belittling, or constantly criticizing a child.

Child abuse due to substance abuse problems include allowing a child to drink alcohol or take illegal drugs, manufacturing, ingesting, or distributing illegal drugs in the presence of a child, and in some states, exposing a fetus to illegal drugs or other substances while pregnant.

It would be easier if all child abusers followed a pattern and were easy to recognize, but the truth is that child abusers come from all walks of life. It's also sometimes difficult to tell the difference between ordinary scrapes and scratches of childhood and a physical sign of child abuse. Pediatricians often can tell the difference but not always.

Some ways that kids who are being abused might act include sad or angry, they may act withdrawn, fearful, have low self-esteem, or engage in self-harm, and many have persistent nightmares. Those who are abused usually have trouble developing and maintaining relationships. They are often unable to love or trust others, especially adults with whom they can be afraid of. A telling sign that something is just not right is when a child fails to seek comfort from a parent or other caregiver who happens to be their abuser.

Kids who are abused sometimes act out. They may lose interest in activities they once loved. They may turn to drug and alcohol abuse as well as sexual promiscuity. Other kids might not act out in the typical ways but will avoid going home after school or doing any activity that would cause them to spend time alone with the abuser. But just because a child is showing these signs doesn't necessarily point to abuse. Children who are going through stressful situations, like a parent separation or divorce, a family move, or the loss of a friend or family member, may also may undergo changes in their mood or disposition.

So what should you do if you suspect some child that you know is being abused? Remember that abuse is not a private family matter, although it most often occurs within families and is often kept as a family secret. Once you suspect child abuse, you need to act to protect the child from further possible harm.

It is your responsibility to contact your local child protective services agency, police, hospital, or emergency hot-line. You may remain anonymous. Pediatricians, by law, are required to call child protective services if there is any concern that a child has been abused. If you think you may have abused your own child or you're worried that you might make sure the child is somewhere safe away from you. Speak to a trained professional and that can be an effective way to work through the reasons behind your abusive feelings.

If you suspect that someone you know is abusing a child, keep the child away from that person until authorities have been notified. Never threaten a person or take the law into your own hands. Let the legal system decide an appropriate punishment for the abuser.

Pediatricians recommend that children who are suspected abuse victims be taken to a local children's hospital where the initial diagnosis can be made and treatment can be given. Hospitals often see abused kids, especially battered children, and they can do the needed X-rays or cultures for a diagnosis to be made. They also work very closely with social workers, child protective services, and the police department to file all the necessary paperwork for the child abuser to be charged.

Psychological help is also strongly recommended. Without it, children who may have been abused may suffer emotional problems or repeat the pattern of abuse with their own children.

Abuse does not have to ruin a child's life as long as it is stopped and dealt with. The earlier abuse can be identified and stopped, the less destructive it will be.

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