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Is regular exercise the key to managing ADHD, anxiety, and depression in children? Pediatrician Cindy Gellner, MD, examines recent evidence that shows how increased physical activity can…
Date Recorded
November 27, 2023 Health Topics (The Scope Radio)
Kids Health
Mental Health
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When do your child's typical worries and stresses become a concern for anxiety or depression? Pediatrician Ellie Brownstein, MD, differentiates typical childhood fears from more serious mental…
Date Recorded
November 22, 2023 Health Topics (The Scope Radio)
Kids Health
Mental Health
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Halloween is filled with spooky fun and sugary treats, but for kids with food allergies, it can be genuinely scary. Pediatrician Ellie Brownstein, MD, provides parents with strategies to ensure a…
Date Recorded
October 30, 2023 Health Topics (The Scope Radio)
Kids Health
Diet and Nutrition MetaDescription
Ensure a safe and joyous Halloween for kids with food allergies. Learn strategies for trick-or-treating and events, and how to participate the allergy-friendly 'teal pumpkin' trend.
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Facing challenges with your child's behavior? Pediatrician Cindy Gellner, MD, provides expert guidance on how to differentiate between normal childhood misbehavior and genuine behavioral…
Date Recorded
April 27, 2023 MetaDescription
Facing challenges with your child's behavior? Listen to expert guidance on how to differentiate between normal childhood misbehavior and genuine behavioral concerns. Learn when to seek professional help from a mental health specialist and when the issue may actually be a result of parenting approaches. Equip yourself with the knowledge to better understand and support your child's emotional well-being.
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There are around 6,000 pediatric ER visits for button battery ingestion every year in the United States. If you even suspect your child may have swallowed a button battery, take them to the emergency…
Date Recorded
April 06, 2023
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Is your young daughter complaining about painful urination when using the bathroom? It could be more than a urinary tract infection. Girl parts can be very sensitive, especially between the ages of…
Date Recorded
December 12, 2022 Health Topics (The Scope Radio)
Kids Health Transcription
So your daughter comes to you and says, "It hurts to pee." Is it automatically a urinary tract infection? Not so fast. Girl parts are super-sensitive, especially between the ages of potty-training to puberty, and there could be a few things going on. So how do you know what the problem is?
Diagnosing UTIs in Children
First, your daughter would need to be seen. We cannot diagnose urinary tract infections in girls over the phone. We need them to actually come into the office and pee so we can do a urinalysis test. That will show if she has a UTI or if she's dehydrated and her burning with urination is due to concentrated urine.
It will also show if there is blood in the urine or any signs of diabetes as well, which doesn't cause burning with urination, but does cause frequent urination, which is another sign of a possible UTI.
Treatments for UTIs in Children
If your daughter does have a UTI, we can treat her with antibiotics while sending her urine off to get a culture at the lab and find out what type of bacteria is causing her UTI and make sure she's on the correct antibiotic.
If your daughter does not have a UTI, then we need to ask a few more questions, like is she drinking enough water? Does she take bubble baths? Is she wiping too hard? Is she wiping at all? Is she wiping in the right direction? Does she have any vaginal symptoms? And yes, we have to ask if anyone has touched her inappropriately down there.
Based on those answers, we can talk about treatments. Will drinking more water help? What about cranberry juice? Which may or may not help, depending on what's going on. Does she need any special creams for her private area? Does she need to work on better hygiene? If she is sexually active, do we need to test for chlamydia or gonorrhea? Is this not a urinary issue but more a vaginal issue?
What NOT to do for Your Child's UTI
Everything is in such a small space in that area that it can be hard to figure out what is going on and what the correct treatment is.
I've had parents ask me about certain home remedies that I can tell you, you should not do. Don't do the following. Don't have your daughter douche to clear out the UTI.
Similarly, I had one mom tell me that she was told to soak a tampon in probiotic kefir and insert it in her vagina to treat a UTI. Neither of those will help because a UTI is in the urinary system and inserting something into the genital system won't help. Just because they're in close proximity doesn't mean that they are treated the same.
Don't put random creams in or on your daughter's privates without finding out what the main cause of her symptoms are. Sometimes, that will make the problem worse.
And don't give antibiotics that were left over from a previous infection, because not all antibiotics will treat urinary tract infections.
So if your daughter has girl-part issues, please bring them in to be seen by their pediatrician. We can help you figure out exactly what is going on and what is best to help them feel better.
MetaDescription
Is your young daughter complaining about painful urination when using the bathroom? It could be more than a urinary tract infection. Girl parts can be very sensitive, especially between the ages of potty training and puberty. Learn the most common causes of pain or irritation in the vagina or vulva, how to prevent them, and what treatments can provide relief to your daughter.
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A majority of children will not develop 20/20 vision until they are four to six years old. During those first few years, what should parents do to make sure their kids maintain healthy vision?…
Date Recorded
December 05, 2022 Transcription
Parents often ask me when I will be able to tell if their baby can see normally. That's hard. But vision screening is something that we do at well-child visits if your child does not already see an eye doctor. Today, I'll discuss the basics of vision screening in kids.
Vision Screening for Children Under Age 3
For children under age 3, any vision concerns need to be referred to a pediatric ophthalmologist, who is a medical doctor who treats eye issues. Some optometrists, who are doctors of optometry, or ODs, will see kids as young as 6 months old, but not usually.
Now, as pediatricians, we look at the eyes of kids starting at birth. We look to see if they have congenital cataracts, if their red reflexes are good. You know, when you take a picture of your kid and they have really bright red pupils, that's actually a good thing. We'll see if they have lazy eye or any other eye concern for which we need to have them see a specialist. But it's hard to check in the office to see if they need glasses at that age.
The American Academy of Pediatrics last updated their vision screening guidelines in 2021. We start doing vision exams at well-child visits starting at the age of 3. I usually tell kids at their 2.5-year well-child visit that when they come back to see me at 3, we'll have them play a picture game with my medical assistants.
It's actually the screening for visual acuity, which is to evaluate to see if they need to see an eye doctor for possible glasses. But a picture game sounds a whole lot more fun.
Vision Screening for School-age Children
Kids up until age 4 normally have 20/40 vision, and by age 5, they will have 20/30 vision. After that, their vision should be 20/25 or better. 20/20 is what most people know as normal vision, and that's what they should ideally have by age 6.
Often, the schools will want a child's vision screened before kindergarten. They will also do vision screening in the schools periodically. The parents will be notified if their child fails their vision screen, and we can repeat the vision exam here to make sure of the results, especially if the screener at school did not document on the letter what the child's visual acuity was.
Then we can help the family find an optometrist that can do a more in-depth vision evaluation and see what kind of glasses the child may need.
The forms that the schools send home usually require a signature from an actual optometrist to prove that the child saw an eye doctor. As pediatricians, we are not qualified to complete those forms and they will be returned to the parents if we fill them out. So if your child gets one of those forms, they do need to see an actual eye doctor.
How Often Should Your Child Have Their Vision Screened?
We recommend that a child has their vision screened at least once a year. That's why we do them at the well-child visits, which also happen once a year.
If your child wears glasses or contacts, the optometrist will let them know how often they need to be seen. Normally, it's still every year to make sure their prescription has not changed.
If you have any questions about your child's vision, talk to your child's pediatrician and we will evaluate what we can and let you know if your child needs to see an optometrist or an ophthalmologist for further testing.
MetaDescription
A majority of children will not develop 20/20 vision until they are four to six years old. During those first few years, what should parents do to make sure their kids maintain healthy vision? Learn the vision screening expectations during the first years of your child’s life, how to navigate school vision screening requirements, and when your child may need to see an optometrist.
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The rate of eating disorders among children under 12 has increased by 119% since 2020. Anorexia is the third most common chronic disorder among kids, behind asthma and obesity. Pediatrician Cindy…
Date Recorded
November 21, 2022 Health Topics (The Scope Radio)
Diet and Nutrition
Kids Health
Mental Health Transcription
Eating disorders have been around for a very long time, but they have skyrocketed in recent years. A recent report from the Centers for Disease Control and Prevention found that emergency room visits for mental health issues have increased at an alarming rate for kids aged 5 and up just since 2020. This is not just for anxiety and depression, but it seems that eating disorders are also increasing, especially among teen girls.
Why Eating Disorders are Increasing in Children
Why? Researchers who are studying the trends think that lack of structure in the daily routines of teens, emotional distress, and even fluctuations in whether families had food available or not, all contributed to the increase.
Eating disorders can develop at any time, but we see it most often in teens and more likely to be girls than boys. The National Eating Disorders Association reports that the rate of eating disorders has risen by 119% in kids under 12 just in the last few years, and anorexia is now the third most common chronic illness in teens only behind asthma and obesity.
Kids who are predisposed to anxiety, such as having a strong family history of anxiety or depression, seem to be more prone to eating disorders. Some clinical studies by psychologists also indicate that teens who spend more time on social media may be more at risk because they can exacerbate poor body image and constantly bombard kids with diet trends, and those can trigger eating disorders.
Teens with eating disorders often compare their bodies to peers and can feel bad about themselves if they don't have what they believe to be the perfect body.
How to Know if Your Child Has an Eating Disorder
So what are some signs to look out for if you think that your child may be at risk for an eating disorder? Well, look for behavioral changes. Kids, when they are struggling with body image issues, will often isolate themselves, withdrawal from social activities or seem overly sad or angry.
Some big behavior changes that parents should watch out for according to the National Alliance for Eating Disorders is hiding food, eating in secret, starting a new diet, obsessing over physical activity, or going to the bathroom every time after eating a meal.
Next Steps if You Think Your Child Has an Eating Disorder
The first step, if you think your child might have an eating disorder, is to make an appointment with your child's pediatrician. We can check their height, weight, and body mass index and look for any alarming trends. If there are concerns, we can do labs and possibly an EKG.
If the labs and EKG are reassuring, then the next step is to get a psychiatrist involved. If the labs or EKG are not okay, then your child may be admitted to the hospital to medically stabilize them while they start working on treatment options for their eating disorder.
A psychiatrist needs to be involved because these are brain-based illnesses with biological, psychological, and social components, not just something your child chooses to do usually.
Parents need to educate themselves too. Some good resources are the National Eating Disorder Association, Project HEAL, and the National Association of Anorexia Nervosa and Associated Disorders, also FEAST.
Your child needs their feelings and struggles supported, and with the stigma of shame around eating disorders that can make the problem worse. This is a disease that affects entire families. There is help out there. Your pediatrician is the first place to start. But be aware this is not something your pediatrician will manage. It involves a lot of therapy and work with a mental health provider.
MetaDescription
The rate of eating disorders among children under 12 has increased by 119% since 2020, making anorexia the third most common chronic disorder among kids behind asthma and obesity. Learn what could be causing this increase and how to identify the most common red flags of potential eating disorders. As well as what steps can be taken to help get your child the help they need.
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No one likes to be poked with a needle, whether for a vaccine or a blood draw. But for children, getting a shot at the doctor's office can be frightening and lead to some emotional outbursts.…
Date Recorded
November 15, 2022 Health Topics (The Scope Radio)
Kids Health Transcription
Needle phobia. It's something that as a pediatrician I see every day, several times a day. At least two-thirds of children have a fear of needles. It's hard to tell who is worse with it though, little kids or teenagers.
Unfortunately, vaccines are still given as shots at this time, and kids get a lot of shots to help build their immune system. At the mere mention of being due for vaccines or blood work, some kids will just burst into tears.
So what can you as a parent do to help when your child is due for a vaccine or needs blood work done? I always will tell parents and kids at the well visit before they are due for vaccines that the next time they have a checkup, there are shots involved.
Mainly, I do this to avoid surprises. Often parents will say that they had no idea their child was due for shots. So when I tell the kids, they remember the next time and that actually seems to help them be better prepared. It's the surprise "you need a shot" announcement that catches kids off guard more and their anxiety goes through the roof.
Parents also feel better knowing that they can tell their child that, "We talked about this," and that they can prepare their child in advance, not spring it on them on the drive to the office or once they get here.
One thing we as pediatricians ask that you don't do is tell your kid that if they don't behave, they'll get a shot. I hear that all the time as a scare tactic and it really bothers me. I'm not going to give your child a shot if it's not needed.
If you tell your child in front of me that I will give your child a shot if they misbehave, I will tell your child that I don't give shots for behavior, but I do have time out spots in the clinic.
And for the teenagers, if they get out of hand, we do have security officers who can help with behavior outbursts. And yes, sometimes that has been needed when the teenagers become violent.
Kids often will ask me if the shots hurt. Well, they are shots. They're not fuzzy caterpillars. Same with the needles we use to draw blood. I tell kids that, "Yes, they hurt just a little, but it's over quickly," and, "We have to use the needles, but for a good reason," and it's to make sure that they are healthy.
I try to be upfront and honest with the kids. Even little kids understand when you tell them the truth in a calm manner and explain why we are doing what we are doing.
I had a vaccine one day and I saw a patient later who was afraid of getting a shot. I showed her my Band-Aid and she was so surprised. She was like, "But you're the doctor." And I said, "Yes, I am, and I sometimes have to get shots too." She then said if I was brave enough to get one, then so was she.
I also tell kids when they're old enough what vaccines they're getting and why they're getting them. I ask if they have any questions about the vaccines, and that seems to help them understand the importance of the vaccines.
Same with the blood work. I explain everything to them so that they know I'm not ordering labs just because I want to torture them. It's because I'm trying to figure out what is going on in their bodies and how to make them healthier.
I also have the advantage of telling kids and parents that my medical assistants are who I trust with my own family and who I trust to draw my blood and give me any immunizations. So they know that they're in good hands.
I let them know that I don't like getting needles poked in me either, so they know they're not alone and that I get it.
I talk directly to the kids so they know they're heard and we are doing what we can to make this as easy an experience as we can. And they know that they get a sticker when they're done for being so brave, no matter how old they are.
So while needle phobia is a real thing, there are ways as parents that you can help make immunizations and blood draws less scary, which goes a long way when the kids are here in the office.
MetaDescription
No one likes to be poked with a needle, whether for a vaccine or a blood draw. But for children, getting a shot at the doctor's office can be frightening and lead to some emotional outbursts. Pediatrician Cindy Gellner, MD, explains what she does in her practice to ensure kids are not overly afraid of needles, and shares some tips for parents to get their child the medical treatment they need while avoiding a tantrum.
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In adults and young children, respiratory syncytial virus (RSV) can look a lot like the common cold. But for little ones under two years old—especially preemie babies—RSV can be severe…
Date Recorded
February 15, 2024 Health Topics (The Scope Radio)
Kids Health
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For new parents, it can be hard to keep your child’s vaccines straight. When do they get DTAP? What is MMR? Does my child really need all of these shots? Pediatrician Cindy Gellner, MD, has the…
Date Recorded
August 01, 2022 Health Topics (The Scope Radio)
Kids Health Transcription
Parents will often come into well-child visits with their little ones and are shocked to learn that their child is due for shots, or they're pleasantly surprised to find out their child doesn't need any shots. So here are the basics on when kids are due for childhood immunizations.
This is the schedule from the Centers for Disease Control in conjunction with the Advisory Committee on Immunization Practices, which help set out the schedule based on a ton of research.
First, it's the hepatitis B vaccine, and that's normally given with the vitamin K shot at birth.
The next set of vaccines is given at 2, 4, and 6 months old. Now, this will seem like a lot of shots, but it's designed to give babies the maximum protection against bacterial and viral illnesses that hit infants and toddlers most and provide protection after they lose the natural immunity they got from their mothers through the placenta before birth.
At the 2-, 4-, and 6-month well-visits, they get three shots and they get one oral vaccine. The shots are Pediarix, which is a combination vaccine containing DTaP for diphtheria, tetanus, and whooping cough. It also contains hepatitis B and polio.
The second is Hib, for Haemophilus influenza type B, which can cause ear infections and meningitis, a bacterial infection of the lining of the brain and spinal cord, which can be fatal.
The third is Prevnar, and that protects against streptococcal pneumonia bacteria that cause ear infections, meningitis, pneumonia, and infections of the bloodstream.
The oral vaccine is called RotaTeq and protects against rotavirus, which is a nasty viral infection that causes vomiting and diarrhea severe enough to hospitalize babies due to dehydration. This is a virus that I saw a lot when I was in residency. The vaccine didn't come out until just after my oldest son was 4 months old. The first dose has to be given before 3 months old, so he didn't get it. I was pregnant with him when I caught rotavirus after being on the inpatient service and he got it at 5 months old. It was definitely not fun.
At 9 months, unless it's influenza season, babies get a break from shots, but they are still due for a well-visit.
The next well-visit is at 12 months. At that age, they get their fourth Prevnar, and then they have completed that series. They also get their first hepatitis A vaccine and they get vaccines to protect them from measles, mumps, rubella, and varicella, also known as chicken pox.
Then at 15 months, they get the DTaP and the Hib again, which completes the Hib series.
And at 18 months, they get the second hepatitis vaccine and complete that series.
Then we give kids a break again.
The next vaccines are what most parents call the kindergarten shots. We give them at age 4, but they can be given any time after age 4 and before the child starts kindergarten. The schools will need documentation that your child has had these when you register them.
The kindergarten shots are combination vaccines also, which is good because, again, it means fewer pokes for more protection.
The first is Kinrix, which is DTaP and polio. The second is called ProQuad, which is measles, mumps, rubella, and varicella. This finishes the polio, measles, mumps, rubella, and varicella series.
The next vaccines are given at 11, and many parents call these the junior high vaccines.
Now, let me clarify. There are current recommendations to start the HPV, human papillomavirus vaccine, at age 9. That is a new recommendation that is just now being put out. The HPV vaccine protects them from a virus that causes warts and cancer in the mouth, throat, and genitals. It's the one that causes cervical cancer in women, and one of the biggest causes of oral cancer in men.
The other junior high vaccines include the first dose of Tdap, which is the adult dose of tetanus, diphtheria, and whooping cough. The P stands for pertussis, which is whooping cough.
And people still need them every 10 years pretty much for the rest of their lives. This is the one that everyone asks about if they have a puncture wound. The whole "if you step on a rusty nail, you have to have this vaccine." Yeah, it's that one.
They also get one for meningitis groups A, C, W, and Y. There are several brand names for this vaccine. Menveo is the one we give at our clinic. This vaccine protects against the Neisseria meningitidis bacteria that causes meningitis. They get the second dose at 16.
There is an additional vaccine for meningitis group B that some teens need for college. It can be given from ages 16 to 23.
So those are the basic vaccines, the ones that are needed for school specifically. Of course, there are always other vaccines like for influenza and COVID.
Also, if you are traveling outside of the United States, there may be other vaccines you need to visit other parts of the world. For those, you would be best to check with the health department or a travel clinic of your local hospital, as your pediatrician would not have those vaccines at their office.
If you have any questions about any of these vaccines, please talk to your child's pediatrician. MetaDescription
For new parents, it can be hard to keep your child’s vaccines straight. When do they get DTAP? What is MMR? Does my child really need all of these shots? Pediatrician Cindy Gellner, MD, has the answers about vaccines for kids—from birth to college. On this episode of The Basics, learn more about recommended vaccines, when they should be received, and how to ensure your kid grows up with the maximum protection against infections.
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Newborns make a lot of strange movements and exhibit unexpected behaviors during the first year of life. They can startle at nothing, suck at the air, cross their eyes, breathe funny, and more. New…
Date Recorded
July 18, 2022 Health Topics (The Scope Radio)
Kids Health Transcription
Newborns do a lot of strange movements and behaviors that quite often scare parents. What are normal newborn reflexes, and when should parents worry?
The first one most parents know and call the startle reflex. It's technically called the Moro reflex. Parents often tell me it's when their baby gets scared, but that's not really the reason. Babies don't get scared as newborns. It's due to their nervous system response to a sudden change in sensory stimulation.
And it's a good thing, actually. In fact, it's able to be seen on ultrasounds when a mom is only 16 weeks pregnant, and a baby's own cry can even stimulate it. It lasts until babies are about 2 to 3 months old.
So when should you worry? Well, if you had a difficult labor and there was concern that your baby might have had some oxygen deprivation, then an exaggerated Moro reflex could be concerned for something called hypoxic-ischemic encephalopathy. Basically, the brain is hurt by having the oxygen supply cut down.
Neurologists can help evaluate and treat this, and the good news is it's picked up really closely after birth. And if there's any concern, your baby will be in the intensive care unit really quickly for a full evaluation. If your baby is otherwise in the normal newborn nursery and goes home, there's a good chance this is not what your baby has.
Another normal reflex is the suck or rooting reflex. And that's just what it sounds like. It's basically what helps the baby learn to find a food source and eat. This reflex doesn't start until about 32 weeks of pregnancy, which is why preemies have such a hard time learning how to eat. This reflex is fully developed at about 36 weeks.
Now, when parents see this, they automatically think their baby is hungry and often that's true. It could be that it's just the reflex and they suck on their fingers and hands as a self-soothing behavior. I see a lot of parents trying to force their babies to eat and then the babies get over-full and throw up.
Then there's the tonic neck reflex. We call it the fencing reflex because they have one arm outstretched and one bent and they're about to say, "En garde!" Some parents worry that there is a problem because both arms aren't in the same position or both arms aren't being used the same way at the same time. But this is normal, and it can last until they're about 7 months old.
Finally, this isn't a reflex, but it's something parents ask me about all the time at the newborn checkups. It's called periodic breathing. Babies do this weird thing where they look like they're breathing really fast, then they can hold their breath for up to 10 seconds, and then they take a big breath in and then they're back to normal breathing. And it can happen when they're sleeping or when they're awake. And it usually lasts until they're about 6 months old.
Babies' lungs are still developing and their brains are still trying to figure out how to send messages to the lungs to remind them to breathe. Basically, they are still trying to figure out this whole breathing thing and breathing patterns. And it looks scary, but it's normal.
So when should you worry about your baby's breathing? If they're consistently breathing more than 60 times a minute, if they're having retractions where it looks like their stomach muscles are sucking in under their ribs, if they are making grunting noises with each breath, or if they hold their breath for more than 20 seconds and turn blue, those are not periodic breathing, and that needs to be evaluated right away to see if your newborn's oxygen is low. Depending on how severe the symptoms are, the best place for your newborn to be evaluated for breathing issues may be the emergency room.
One last thing. What about those eyes? Well, babies have very little control over their eye movements right away. That's why they always look at you cross-eyed. They're trying to figure out how to control their eye movements and learn to focus on things.
Also, it's not uncommon for a baby to roll their eyes when they're sleeping or when they're almost asleep, like when they're going to sleep or trying to wake up. But this should not be the norm. If they are not rolling their eyes but doing more of a rhythmic back and forth, something called nystagmus, that is absolutely not normal.
If your baby rolls their eyes often, that is not normal. If your baby's eyes roll and your little one also has stiffness in their arms or legs or has shaking that doesn't look like the startle reflex, that could be a seizure and that's an immediate trip to your local children's emergency room.
Many things can cause seizures in a new baby, including low blood sugar, low calcium levels, metabolic diseases, or brain abnormalities, in addition to epilepsy and high fevers. Your child will probably be admitted to the hospital and see a neurologist for tests to determine why they are having these weird movements and possible seizures.
So while a lot of these normal behaviors look concerning, they are often just part of your baby adjusting to being in the outside world. If your baby has any of the not-so-normal behaviors I talked about, please have them see their pediatrician right away or go to your closest pediatric emergency room. MetaDescription
Newborns make a lot of strange movements and exhibit unexpected behaviors during the first year of life. They can startle at nothing, suck at the air, cross their eyes, breathe funny, and more. New parents may be a little worried about what is and isn’t normal. Learn the most common reflexes seen in newborns and how to identify whether or not they're something worth concern.
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As a parent, you’ve seen commercials saying you need to give your kid chewable vitamins or special, expensive supplement drinks for them to grow and develop properly. Do children really need…
Date Recorded
July 06, 2022 Health Topics (The Scope Radio)
Diet and Nutrition
Family Health and Wellness
Kids Health Transcription
A lot of commercials will tell you that your child needs special vitamins or supplements, or they won't grow properly or have the best brain development they can. But what vitamins or supplements do healthy kids really need? Well, the answer might surprise you. Even if they're a picky eater, they don't need special vitamins, supplements, or nutrition drinks.
Many of us grew up on chewable vitamins. I know I did. That's what parents did. I remember taking a daily chewable Flintstones vitamin every morning as a kid. And I was kind of a picky eater too, but I never had a problem growing.
We really don't see vitamin deficiencies in the United States like in some other countries. Everything seems to be fortified in our stores. Cereals provide a good balance of vitamins and minerals. Milk has added vitamins A and D. Even orange juice can be bought with extra calcium.
Yes, ideally, kids should have a balanced, healthy diet. They should have at least three servings of dairy, five servings of fruits and vegetables. They should have protein from meats and eggs and beans, and they should eat whole grains.
Often, parents will think that their child has fatigue or anemia, look pale, or be so picky that they aren't getting enough nutrients. Most kids, unless they are having excessive dairy intake, do not have iron-deficiency anemia. Toddlers can, but again, that goes back to the milk intake.
If they have true fatigue or pallor, your child's pediatrician can do blood tests to see if they are anemic.
For other vitamins, we do not routinely do blood work to check those vitamin levels unless there is an underlying medical reason for checking them. Also, insurance companies often will not pay for those extra tests either.
If your child has a lot of eating restrictions, say, due to food allergies, digestive or genetic conditions, which cause problems with digestion, or autism, then a daily vitamin would be a good idea. Same with if they are on a vegan diet.
If your child just isn't eating a good variety of foods because they want to eat fast food or junk food a lot, then it's more a matter of getting your kids to understand that this is not healthy eating and work on the eating habit rather than letting them continue their food choices long term. Instilling a good relationship with healthy foods when kids are little will help encourage them to eat more healthy their entire lives.
If you do give your child vitamins or supplements, be sure to follow the dosing guidelines exactly. Some vitamins and minerals can be bad in doses too large for children. Make sure your kids can't just help themselves to the vitamins. They come in tasty forms now, and kids may think they're more like treats and they should be treated more like medicine.
Also, make sure your child is a little bit older if taking chewable vitamins. They can be choking hazards for kids under 4.
Basically, the bottom line is most kids don't need extra vitamins and supplements. They need encouragement and education on eating a good variety of healthy foods.
Nutrition from food itself is better absorbed than that from a tablet. Start them off eating healthy. Don't fall for those cute faces that beg and plead for fast food or cookies or candy all the time. It's okay if they don't eat sometimes because eventually they will, even if only healthy foods are offered.
And stay strong. It's hard, but if you stick with teaching your kids about healthy foods, you will teach them a lesson that will help them for the rest of their life. MetaDescription
s a parent, you’ve seen commercials saying you need to give your kid chewable vitamins or special, expensive supplement drinks for them to grow and develop properly. Do children really need supplements? Probably not. Learn why even the pickiest eater is probably getting enough of their daily vitamins and minerals without the need for additional supplements.
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New parents may be surprised at just how often their baby cries. It is their main form of communication after all. Hungry, bored, in need of a diaper change, they will cry for many reasons - and…
Date Recorded
June 20, 2022 Transcription
Today, I'll discuss some questions I get about crying children.
So let's start with babies. Babies cry a lot. Babies cry because they have no other way to communicate. Babies cry when they want a clean diaper, they cry when they're hungry, they cry when they're tired, they cry when they're in pain, they cry when they're over stimulated and want to be left alone, they cry when they're scared. Basically, again, they cry a lot.
Babies from 2 weeks to 3 to 4 months cry even more sometimes because they are in the period of purple crying. They can cry and cry for what seems like no reason at all, and it's actually a normal developmental stage.
Then, on to toddlers, they cry mostly because they're trying to figure out their emotions. It seems like they are very stubborn and negative. And you can tell because their favorite word is "no," but they're learning how to get what they want. They're learning that if they're told no and they cry, sometimes they'll get what they want. Sometimes they won't. And it's almost as if they start training you as parents to give in to their cries to keep them quiet. Yes, toddlers are sneaky that way.
This is where trying to reason with a toddler is like trying to reason with a pet rock. You can talk to them, but they're hardheaded and often don't listen. Trust me, you'll get through that phase. Just be patient and do everything consistently. And eventually, they'll come through.
School-age kids cry too. Often, again, because their feelings are hurt or their bodies are hurt. These are legitimate tears. School-age kids cry for a reason. And often, they can tell you why. And this is good because they are learning the communication skills they didn't have as toddlers. As a parent, you know you can help them through whatever is causing their hurt.
Teenagers, well, often they'll either cry all the time or they'll hold their emotions in and never cry. Teenagers are harder to decode, but if you keep the lines of communication open with your teen, then when they do show emotion, you'll be able to start having more in-depth and maybe even adult conversations with them and try to help navigate them and navigate what is bothering them as they struggle through the teenage years and become those young adults we all want them to become.
Every age and stage has their own reasons for crying. If you have concerns about your child's crying, go ahead and ask your pediatrician. Chances are we've heard your concern before and are usually able to help. MetaDescription
New parents may be surprised at just how often their baby cries. It is their main form of communication after all. Hungry, bored, or in need of a diaper change, they will cry for many reasons - and often. Learn how to understand your child’s crying and how best to respond with advice from an expert.
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Many parents in the United States are scrambling to find baby formula. What are you supposed to do with a hungry baby at home and empty shelves at the store? Pediatrician Cindy Gellner, MD, shares…
Date Recorded
June 06, 2022 Health Topics (The Scope Radio)
Kids Health Transcription
It's been an issue for several weeks now, parents scrambling to try and find baby formula amid the shortage. So what are you supposed to do? You have a hungry baby who needs to eat.
Like many women, I was unable to completely provide enough breast milk to feed my boys. Trust me. It wasn't for lack of trying to increase my supply with supplements, medications, pumping, working with my OB and five lactation consultants. And we learned, for me, I have a medical condition that just won't allow me to make as much as my kids needed, so I had to supplement. And I find this is often the case for many of my patients' mothers.
Often, some women just choose not to breastfeed, and they want to just give formula. And that's okay too. Most important is for the baby to be fed and loved.
So what exactly happened to cause this formula shortage? The manufacturer of Similac products, Abbott Nutrition, recalled powdered formula brands due to bacterial contamination in some of their batches. This, combined with supply chain issues, triggered a nationwide formula shortage.
For families that were affected, this has triggered a lot of questions about what to do. The easiest thing that parents can do is to just switch to a different infant formula. I know that sounds scary, but many store brands and other brands, like Enfamil and Gerber, have formulas that are equivalent to Similac.
Most babies do just fine on a cow's milk-based formula, and there are a ton of variations for whatever your babies might need — gentle formulas, formulas for soft bowel movements, formulas for breast milk supplementation, formulas with extra ingredients to help with digestion and brain development. There are so many options out there.
I often recommend generic or store brand formulas because they're cheaper, but they still have the same nutritional quality as the brand names. We used generic versions of gentle formulas for both of our boys and found they actually tolerated them better than the brand names.
What if your baby is on a special formula, like for milk protein allergy or prematurity? The good news is these formulas really aren't affected by the shortage as much. Your pediatrician can help figure out what is best for your baby in those situations. There are milk banks where women who have excess breast milk donate their milk, and that's a great source for babies who are preemies. Neonatal intensive care units often work with milk banks to get milk for preemies. The milk is strictly screened and totally safe.
What about mixing infant formula differently to make it last longer? This is a big fat no. Adding extra water to make diluted formula is bad. I've seen it happen more than once, where parents do this and it has actually landed their babies in the intensive care unit. What happens is that too much water upsets the balance of salts in their body because the babies' kidneys can't process that much water. That causes the babies' sodium levels to drop to the point that the babies have seizures, and it could be fatal.
Babies will not get the correct amount of nutrients if the formulas are diluted. That is why we have specific instructions on how to properly mix formulas.
What about all of those homemade baby formula mix recipes? Those aren't a good idea either. While, in the past, people made their own baby formula, that was before we had a really good handle on the specific nutritional needs of infants. And those homemade baby formulas don't provide the right concentration of nutrients that we now know babies need. Some babies have even been hospitalized after being given homemade formulas.
Finally, what if your baby is close to turning 1? Can you start milk early? Well, it depends on how early. Babies actually need the nutrition that is in formula until they're 12 months old. I would say that if they're within two weeks of turning 1, you can start transitioning to whole milk. Transitioning before that puts them at risk of iron deficiency anemia because milk has no iron in it. Also, once they start drinking milk, they need to limit their consumption to 16 to 24 ounces per day, or they could develop iron deficiency anemia as toddlers.
Parents often ask what milk kids can have if they don't want to give their kids cow's milk. Luckily, there are a lot of alternatives. Soy and pea milk are the most similar to whole milk in terms of nutrition. They can also have oat milk or nut milks, like almond or cashew milk. Plant-based milks are good for calcium and vitamin D, but they may not have the best nutrition when it comes to protein, fat, and calories, things toddlers need from ages 1 to 2, as their brains are still developing. And other milks, like goat's milk, can cause pernicious anemia due to vitamin deficiencies.
The good news is there are reports that the formula shortage should start to improve in a few months once the factories get the okay from the Food and Drug Administration to resume production. Until then, hopefully, parents are able to find alternatives. MetaDescription
Many parents in the United States are scrambling to find baby formula. What are you supposed to do with a hungry baby at home and empty shelves at the store? Learn how you can feed your baby and support other parents in this difficult time.
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Sensory disorders in children have recently been added as an official psychiatric diagnosis and are estimated to impact as many as 15% of kids in the US. These conditions are marked by a significant…
Date Recorded
May 30, 2022 Health Topics (The Scope Radio)
Mental Health
Kids Health Transcription
It seems there has been a big increase in the number of children being diagnosed with sensory disorders. One reason may be that kids with sensory issues actually have other diagnoses, such as ADHD, anxiety, PTSD from abuse, and autism, just to name a few examples. Other times, some kids may just be sensitive to some things but not others and don't actually meet the full criteria. It has only recently been added to the psychiatry diagnosis textbook, the DSM-5.
Sensory processing disorders are basically where kids are sensitive to sounds, textures, or other stimuli to the point where it is beyond normal childhood behavior and causing a disruption in the child's life and also in the life of the family. Any of the five senses, taste, touch, smell, sight, and sound can be affected. Often children with sensory issues also have poor fine motor skills or have a hard time with social cues and interactions. They have a hard time regulating their emotions.
One study shows that sensory processing disorders affect 5% to 15% of school-aged children. Another study showed that there may be a biological cause with abnormalities in the white matter of a child's brain that could explain sensory issues.
Some children are hypersensitive to things and may think everything is too loud or too bright. They are the ones who are covering their ears often or have a low pain threshold or are super picky with eating certain textures. They have a hard time focusing and controlling their emotions, and they don't like to be touched. Other children are hyposensitive and they crave input, trying to get more sensory input. They're more likely to have a high pain threshold, put things in their mouths, hug too tightly, invade other people's personal space, or rock and sway.
One big issue is that there is still so much to be learned about sensory processing disorders. Your pediatrician can suspect your child has a sensory processing disorder but cannot actually make the diagnosis. Again, there are so many other brain issues that can present with similar symptoms so it takes a developmental or a behavioral specialist or even a neuropsychologist to get an official diagnosis. Your pediatrician will refer your child to someone who can help do a full and complete evaluation to get the correct diagnosis. The mainstay of treatment for sensory processing disorders is occupational therapy. Occupational therapists can help kids and parents learn ways to manage their sensory needs.
If you have concerns that your child may have a sensory issue, please talk to your child's pediatrician and ask them for a referral to a specialist who can get them the right diagnosis and treatment. MetaDescription
Sensory disorders in children have recently been added as an official psychiatric diagnosis and are estimated to impact as many as 15% of kids in the US. These conditions are marked by a significant sensitivity to sounds, textures, tastes, or brightness and can be quite disruptive to their behavior and development. Learn why these conditions are on the rise, and how a parent can identify and accommodate them.
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