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As a busy parent, it's easy to let your child's routine doctor appointments slip through the cracks. But skipping or missing those check-ups can have consequences for your child's…
Date Recorded
October 23, 2023 Health Topics (The Scope Radio)
Kids Health
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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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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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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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Have you ever put a piece of clothing or jewelry on your child to have them break out in a rash or hives? It’s called contact dermatitis, and it’s more common than you may think.…
Date Recorded
June 05, 2023 Health Topics (The Scope Radio)
Kids Health
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In general, kids do pretty well if they catch COVID-19. But Cindy Gellner, MD, is seeing a significant number of kids experiencing symptoms from the disease for weeks if not months after the initial…
Date Recorded
May 16, 2022 Health Topics (The Scope Radio)
Kids Health Transcription
So we've been dealing with COVID for a while now, and we are seeing kids who have what we call long-hauler symptoms. So what are these and is there anything that can be done?
In general, kids do pretty okay with COVID. Some have mild symptoms, some get pretty sick but recover after a week or two, and some kids have no symptoms at all. But more and more what I'm seeing are kids whose parents are saying, "I didn't know it would be this bad," or, "Why are they still having symptoms?"
Unfortunately, no one can predict who will develop long-haul COVID symptoms. There is a study out of England that shows that up to 15% of kids up to age 16 will still have symptoms five weeks after they initially test positive for COVID.
Long-haul symptoms can happen in kids who have minimal or no symptoms or in kids that have severe symptoms. That's the tricky thing with COVID. It doesn't follow any rules and it seems to do whatever it pleases on its own time frame.
So what are the symptoms of long-haul COVID? The most common are fatigue, brain fog or difficulty concentrating, breathing issues, chest, joint, or muscle pain, chronic cough, and headache. We also see changes in the sense of taste or smell, mood changes, or lightheadedness when standing up.
I know. It seems like anything can be a symptom of long-haul COVID. And not all of those symptoms can be attributed to having had COVID in the past.
How is long-haul COVID diagnosed? Well, that's tricky too. There are no specific tests that can be done. Your pediatrician can rule out other conditions and will usually refer your child to a specialist if their symptoms persist. But there are no good tests.
We have no idea how long it will last, we don't know what causes it, and we don't know what the treatment will be other than supportive care and treating your child's symptoms as best as possible. But there is no cure.
As we continue to move forward with COVID, hopefully we will have more answers as to how to help long-hauler symptoms. Until then, treating your child's symptoms and getting them set up with specialists to help with their specific medical needs is the best we can do. MetaDescription
In general, kids do pretty well if they catch COVID-19. But Cindy Gellner, MD, is seeing a significant number of kids experiencing symptoms from the disease for weeks if not months after the initial infection. The ongoing symptoms seem to impact children regardless of how severe their illness was. Learn more about long-haul COVID in your children and what you can do to prevent and treat the symptoms.
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Young kids can have all sorts of skin issues as they grow up, and Dr. Cindy Gellner, MD, and pediatrician, has seen them all. Learn the basics of diaper irritation, dry skin, eczema, and rashes that…
Date Recorded
April 18, 2022 Transcription
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.
MetaDescription
Learn the basics of diaper irritation, dry skin, eczema, and rashes that you should know as a parent and how you can treat many of them at home.
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What formula should I give my new baby? When should I start introducing other food groups? What do I do if my child only wants to eat junk food? Parents have a lot of questions about the basics of…
Date Recorded
March 14, 2022 Transcription
One question I get a lot is, "What formula should I give my baby?" There are so many choices out there, regular or sensitive, one for spit-ups, one for soft stools, brand or generic. My answer always is there is no one formula I recommend. Some babies do just fine on milk-based. Some need a sensitive version or one that is more for babies with reflux. Only very few needs soy based or special formulas for premature babies, or babies who truly are allergic to milk protein. For many babies, generic formulas are just as good as brand name formulas. It may take some trial and error, but the one your baby takes best and seems to not upset their stomach is the one to stick with.
Speaking of infant formulas, some parents worry that their baby will be bored with formula. Babies really don't get bored of having the same thing over and over like we do. Also, formula and breast milk have the best nutrition that your baby needs when they are brand new. A baby's digestive system isn't set up for a lot of variety at birth, or even at two or three months old. Currently, the guidelines are for starting fruits and vegetables and grains at about four months old if your baby's ready. A baby will need to continue to have breast milk or formula until 12 months of age.
What about toddler formula? In most cases, once your child turns one, they can have whole milk and they don't need special formulas. For toddlers who are very limited in their diets, talk to your child's pediatrician to see if they would benefit from one of the toddler formulas.
Next, I get asked a lot, what sippy cup should I give my child? Whichever one they will drink out of. It took seven different sippy cups until we found one that my older son liked that didn't spill all over the place.
Finally, what do I do if my child really only wants to eat candy and cookies and soda and junk food? Two things. One, your child doesn't do the grocery shopping. If you buy those things, of course, your child will want to eat them and not the things that are more healthy. Your child should know that those are special foods for treats and not a main course item. Second, if you eat healthy, your children are more likely to eat healthy. Kids from little on wan to do everything their parents do. So show them by example. Unless we're having something really unusual, my husband and I aren't short-order cooks for our boys. Whatever we made, that's what we serve them. And now they eat, or at least will try, a huge variety of foods. They like fruits, vegetables, foods from other countries. And yes, they still get cookies and candy and soda. But those foods are not the mainstay of their diets and those are treats.
If you have feeding concerns about your child, go ahead and ask your pediatrician. Chances are we've heard your concern before and are able to help. MetaDescription
What formula should I give my new baby? When should I start introducing other food groups? What do I do if my child only wants to eat junk food? Parents have a lot of questions about the basics of feeding their child.
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For infants with a misshapen skull—or craniosynostosis—treatment is critical to ensure proper brain development. Pediatric surgeons Dr. Faizi Siddiqi and Dr. John Kestle explains the…
Date Recorded
December 22, 2021 Health Topics (The Scope Radio)
Brain and Spine
Kids Health Transcription
Interviewer: Three types of surgery can be used to treat craniosynostosis, which one depends on a few different factors. If the synostosis is caught early enough, the newer endoscopic procedure can be used.
Pediatric plastic surgeon Dr. Faizi Siddiqi and pediatric neurosurgeon Dr. John Kestle are here to discuss the three different types of surgery for a synostosis and why they would consider one over the other. So, first of all, how early does a child need to see you for the less invasive endoscopic procedure to be an option?
Dr. Kestle: So the endoscopic method we've been doing since '07, and we've found that the best time to do it is usually between two and three months of age. So we have to see the patient before that and the earlier the better. The surgery is done under a general anesthetic, and the surgery typically lasts about two hours, and most of them spend one night and can go home the next day. Occasionally, they need two nights. It's done with, for example, sagittal synostosis with two incisions -- one just behind the soft spot and one toward the back of the head. And then we work under the skin to remove the fused bone.
Removing the fused bone doesn't really change the shape much at all immediately. It just releases the bone. And then about two weeks after the surgery, they start wearing a special helmet that's designed for surgical patients, that is a little snug front to back and a little loose on the sides, and it just guides the growth so that as the baby's head growing, it's taking on a more normal shape. They wear the helmet for about six months, some shorter, some longer, and we just monitor the growth pattern and make that decision. And they'll go through several custom-made helmets over the course of the treatment as they grow.
Interviewer: Generally, I'd imagine a less invasive procedure is always better. Why is this procedure better than say the traditional treatments?
Dr. Kestle: Well, it's got a shorter hospital stay, a much lower rate of blood transfusion. It's a lot less swelling associated with the surgery. It's easier on the babies, and the results are at least as good.
Interviewer: Is there a reason, other than age, why a child would not be eligible for the endoscopic surgery?
Dr. Kestle: We don't often do it in children that have syndromes where they might have multiple malformations in other parts of the body, such as Crouzon syndrome or Apert syndrome. And in addition to those other malformations, they have synostosis. Those children usually need the more traditional, bigger surgery. But any child that has one suture fused is a great candidate for the smaller surgery.
Interviewer: Dr. Kestle, you're a neurosurgeon. So you handle that part of the procedure?
Dr. Kestle: Yes.
Interviewer: Okay. And then Dr. Siddiqi, you're a pediatric plastic surgeon. With the endoscopic procedure, both of you are in the operating room at the same time. Just kind of walk me through how the surgery goes. Dr. Siddiqi, you start the surgery.
Dr. Siddiqi: So we're in the OR together. It's a team approach. So once the anesthesia team have completed their part, which is getting the baby asleep and making sure the IVs are put in and everything is safe to proceed, that's when we position the baby for surgery. I would make the initial incisions. For example, for sagittal synostosis, we make two incisions on the top of the scalp. Again, that's one of the advantages of doing it this way versus the bigger procedure because you have two small incisions. Through those incisions, we expose the area that we want to operate on, which is that fused sagittal suture. And once everything's exposed and visible, then Dr. Kestle would take over.
Dr. Kestle: What we do is remove a little bit of bone under each incision. And that allows us to get underneath the bone. Underneath the bone is a layer called the dura, which is a covering layer over the brain. It's kind of like leather, like a thin leather. And we use the endoscope to separate that layer from the bone, and that allows us to safely cut the bone and remove it. Once the bone is removed, we look at the dura and make sure it's okay. We stop any little bits of bleeding, but there usually isn't much. And we check the bone edges, which sometimes ooze, and make sure that any bleeding is stopped. And then at that point, Dr. Siddiqi and his team continue working.
Dr. Siddiqi: Yeah. So we take out or remove additional segments of bone. There are these little triangles we take out, about four them. Again, afterwards, we make sure that the bone edges are, you know, clean. They're not bleeding. Again, that's one of the other advantages to doing it this way. The blood loss is quite small, minimal compared to the traditional way. Most of the time, it's maybe 10 or 15 milliliters of blood. So once those triangles are removed, then we close the incisions. Then the anesthesia team takes over, and the baby's, you know, woken up and then taken to the recovery room.
Interviewer: What does the recovery look like then for a child? And, you know, what kind of outcomes can parents expect?
Dr. Kestle: With the small surgery, they don't need to go to the intensive care unit. They stay in the hospital in a regular room, and the parents can stay with them. The vast majority of those children are here for one night. Occasionally, they need two nights. The criteria for going home are pain control and feeding. They get some swelling toward the back of the head, that gradually goes down over the first week at home. Stitches dissolve on their own. And within a day or two, they're back to their usual self as far as feeding and behavior goes.
Interviewer: And Dr. Siddiqi, how long does it take for the head then to regain more of what would be considered a normal shape?
Dr. Siddiqi: Yeah. So as Dr. Kestle mentioned earlier on, the shape doesn't change after the surgery, right after. It's once they're in the helmet. The helmet is critical for reshaping the head. And typically, they're in the helmet usually two to three weeks after the surgery. It's a custom helmet. You know, it just guides the growth of the head, and over the ensuing, you know, three to six months, we have a more normal head shape. And hopefully, after six months of helmeting, that's all they need.
Interviewer: And the incisions that were talked about out in the endoscopic surgery, are those visible or are those in the hairline?
Dr. Siddiqi: You know, they're in the hairline. And again, another advantage to doing it this way is the incisions are on the top of the scalp, the head, and those scars heal very nicely. They're quite thin and they're barely perceptible. You only notice them when the hair gets wet. Again, with the bigger procedure, you have a much bigger incision from ear to ear, which is much more noticeable.
Interviewer: Let's talk about the more traditional procedures in the event that a parent is in a situation where their child is older than six months old or there's other reasons why they might have to have that. What are the two procedures, and can you explain those a little bit?
Dr. Siddiqi: Yeah. So sometimes, you know, we do see kids who are, you know, two, three months old and they're eligible for the smaller procedure, but for various reasons, let's say they live out of state or they don't want to do the helmeting, they would like to do the traditional, what's called cranial vault reconstruction with orbital advancement. So then we would wait until they're 10 to 12 months of age to do that procedure. Essentially, that's a much more involved procedure, but it's a procedure that's, you know, well described. People have been doing it for, you know, 30, 40 years. You know, the results that you get are comparable to the endoscopic procedure, but, again, it's how you get there.
So with this procedure, you have to expose the entire skull. So that means an ear-to-ear incision through the top of the scalp. I would expose that, mark out where I want Dr. Kestle to make the cuts and remove the segments of bone that we want to reconstruct and reshape. Then Dr. Kestle would remove those pieces of bone, make sure that the lining of the brain is okay, make sure everything is okay. Then I would reshape all those bones and reconstruct the skull in a more normal configuration, and everything is stabilized with plates and screws. And these are resorbable plates and screws. They dissolve in about a years' time. So we put everything back together and close the scalp. That's a four or five-hour process. Much more blood loss than with the endoscopic procedure.
They typically would go to the intensive care unit for one night, and they typically would be in the hospital three or four nights. Oftentimes there's quite a bit of swelling. The eyes can get swollen shut, and it would take maybe 10 days to 2 weeks for that swelling to go down.
Again, the advantage is you don't need a helmet. It's all done in one stage. You know, the compromise is that it's a much bigger operation.
Interviewer: If parents are evaluating a center or physicians to do this procedure, what advice would you give to them to, you know, pick out the best place for them?
Dr. Kestle: I think it's a procedure that is usually done very safely, and children do very well and go home quickly. We are exposing the layer over the brain, and there is a potential for bleeding. And so I think that experience matters. And I think that you do want to be treated by people who do this a lot and people who can handle problems, which are rare, but if they arise, they need to be dealt with appropriately. So I think it's a big advantage to being treated by people who have experience with this, who are in a children's hospital with pediatric-trained specialists, including anesthesia and a pediatric intensive care unit if they need that.
Interviewer: And you mentioned a third procedure, a cranial vault distraction, when might that be used?
Dr. Kestle: So there are some children where their brain is in trouble or potentially in trouble because they have presented very late or they have multiple sutures that are closed. And in that situation, we want to make the skull bigger to give the brain room to grow. Probably the best way to do that these days is a procedure called distraction, where some implants are inserted and then the skull is gradually expanded over time.
Dr. Siddiqi: You know, with cranial vault distraction, again, the idea is to give the brain as much room as we can because of the fact that more than one suture is fused. And the way that's done is I would ask Dr. Kestle to make some cuts on the bones. And then I would put these little devices, they're called distractors, on either side of the cuts. And then three days after surgery, we would have the family start turning those distractor devices. Typically, it would be total of one millimeter a day. So over the ensuing three to four or five or six weeks, the bones are slowly being separated. And what happens is that, as they're separated, there's new bone being formed in the gap. And over time, that new bone will solidify. So we're not only expanding the volume for the brain, we're also creating new bone. This is really the only way we can expand the brain to this degree using these devices. We couldn't do it as a single-stage procedure.
Interviewer: Between the two procedures, the endoscopic procedure, the less invasive, and the cranial vault reconstruction, are there any tangible differences and outcomes or how the head is going to look or anything like that?
Dr. Siddiqi: I would say like the overall head shape is probably going to be comparable, just the head shape itself. But again, as I said, it's how do you get there? You know, how long does it take? What are the risks involved? In terms of the shape itself, with the endoscopic procedure, overall the head feels and looks quite smooth at the end of the day when everything is healed. Whereas with the bigger procedure, you know, we're taking all the bones out or in multiple pieces, putting it back together. So when everything is healed in a year, two, three years' time, you do feel some irregularities over where the bones are joined together. But overall, the head shape is probably comparable. But, you know, I think you get an overall smoother head shape. And I think it probably looks a little bit better as well.
Dr. Kestle: And obviously, the scar is different as well. In the endoscopic, there's two scars on the top of the head that hide really well. And the bigger surgery has an ear-to-ear incision, which also usually heals really well. But as people age and start to lose hair, it's a lot more obvious. MetaDescription
For infants with a misshapen skull—or craniosynostosis—treatment is critical to ensure proper brain development. Learn about the procedure options that are available, the pros and cons of those options, and which might be the best for your infant.
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If your child’s thighs, calves, or knees are aching or throbbing, growing pains could be the cause. While extremely common, growing pains can be extremely uncomfortable for kids. Pediatric…
Date Recorded
December 08, 2021 Health Topics (The Scope Radio)
Bone Health
Kids Health Transcription
Interviewer: So what exactly are growing pains, and are they normal? I'm here with Dr. Julia Rawlings, a non-operative sports medicine physician at University of Utah Health. And I just want to start out by asking what exactly are growing pains? Is it the legs actually growing? Or what causes these pains in kids?
Dr. Rawlings: Yeah, so the name growing pains is a little bit misleading. Children are growing, but that is not causing pain. There's no evidence that growth itself causes pain. What we think is actually happening is that when a child is just very active during the day, the muscles get a little tired and achy. And we'll see that kids get this achy, throbbing muscle pain that usually happens later in the afternoon or evening, or it can even wake the child up at night.
Interviewer: Geez. So it doesn't have anything to do with bones getting longer, muscles getting stretched. It's just them being active kids?
Dr. Rawlings: That's what we believe, yes.
Interviewer: When do kids usually start experiencing growing pains, if they do?
Dr. Rawlings: So there are two peaks that we typically see growing pains. It's usually the preschool age group, and then the preteen, so kind of 11, 12, maybe early teen, 13.
Interviewer: And it's normal, right? There's nothing . . .
Dr. Rawlings: Completely normal. It doesn't affect growth.
Interviewer: It's just a little uncomfortable?
Dr. Rawlings: Or quite uncomfortable. It can be pretty painful, yeah.
Interviewer: And let's say a kid is experiencing some severe pain in their legs, it's maybe keeping them up at night, etc. What are some ways that maybe you could treat it at home to give them a little bit of relief?
Dr. Rawlings: Yeah, so I think starting with just some massage, rubbing their legs is helpful. You can try a heating pad, or if they prefer it, you can even try ice. Sometimes just a dose of ibuprofen or Tylenol can be very helpful. And if they have this pain that comes up pretty frequently, you might even see if they'll be willing to stretch a little bit during the day and see if that helps at night.
Interviewer: Just running stretches, yoga stuff?
Dr. Rawlings: Yeah, yoga for kids, that's perfect.
Interviewer: Oh, fantastic.
Dr. Rawlings: Yeah, just some hamstring stretches probably is a good place to start.
Interviewer: Sure. And say a parent is listening right now. When can we expect these growing pains to stop?
Dr. Rawlings: Yeah, hopefully they'll stop after they leave those peak periods, so after they've left the preschool years or they enter their teen years. They can continue throughout the teenage years, but usually not through adulthood, into adulthood.
Interviewer: And until then, you've got stretches, ibuprofen, anything to help. MetaDescription
If your child’s thighs, calves, or knees are aching or throbbing it may be growing pains. While extremely common, growing pains can be extremely uncomfortable for kids. Learn what growing pains are and shares some simple remedies you can do at home to help get your kid some relief.
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Most kids will experience pains in their legs at some point whether it be through overuse or the aching associated with growing pains. But if your child’s leg pain is severe or lasting longer…
Date Recorded
November 15, 2021 Health Topics (The Scope Radio)
Kids Health Transcription
Interviewer: Now, if your child is complaining of leg pains, could it be growing pains, or is it something more serious?
Dr. Julia Rawlings is a nonoperative sports medicine physician here at University of Utah Health. And let's start with the type of leg pain I think just about every kid, at some point, experiences. One point or another, it seems pretty benign. What exactly is growing pain? What are growing pains, I guess?
Dr. Rawlings: Yeah. So growing pains, the name came kind of early in the 1930s and 1940s when people thought that growth was related to these pains that children get, usually later in the afternoon, evening, or maybe even wakes them up at night. But we know now that it's not related to growth, but it's more likely just related to children being very active during the day. So it's just these pains that come on later in the day or at night, mostly from kind of overuse of muscles.
Interviewer: But it's not like the bones are stretching or anything like that. It's just . . .
Dr. Rawlings: No, it doesn't have anything to do with growing. It does happen in children, but it doesn't affect their growth. It's not directly related to growing.
Interviewer: My understanding is it's pretty normal for kids to be having this and just as part of, like, I guess being active and running around.
Dr. Rawlings: It's very common. And the places where it's most common, usually it happens in the calf, the thigh, or the back of the knee. So those are some of the spots that we look at.
Interviewer: Okay. And it's like an aching or just like . . . I guess, how do we know that it's like that kind of pain?
Dr. Rawlings: Yeah, it's like an aching or a throbbing pain. Sometimes children will grab the back of their legs or grab their thighs or just be more cranky. It's usually at the end of the day. It can wake them up at night though.
Interviewer: And so your child's complaining of pain. I guess, as a parent, if you're worried, you know, what should you be on the lookout for to find out if it's something more than just typical growing pains?
Dr. Rawlings: Yeah. So growing pains usually happen intermittently. So it can happen every night, but that's a little less common. So growing pains typically are intermittent. They're usually in both legs, not necessarily at the same time. And the child usually wakes up in the morning completely fine and running around like there's nothing wrong. Those are all very typical for growing pains.
Interviewer: So say a kid is, you know, maybe continually complaining about leg pain or maybe they're getting it through the day. As a parent, what are some of the signs and symptoms that you should be on the lookout for to kind of let you know this isn't growing pains, it's something more serious?
Dr. Rawlings: Yeah, great question. So if your child is complaining of pain, particularly during the day, if they are complaining of pain in the same leg, if the pain stops them from participating in sports activities or from running with their friends, if they are limping with the pain during the day, or if you see anything else that seems abnormal, so swelling of the leg, redness of the leg, if they're getting fevers with it, all of that is something besides growing pains, and you should be seen for that.
Interviewer: And not to, say, worry parents, you know, prematurely, but what could be going on with their child?
Dr. Rawlings: So it could be something as simple as an overuse injury. Lots of times, in children that play sports, we see overuse injury at the growth plates actually. That's probably one of the more common things. If they're very active, say a teenager running, they could get a stress injury. They could just have tight muscles, and stretching could be helpful. All the way up to the more serious things that are very rare and uncommon, like childhood arthritis or bone cancer.
Interviewer: If your child is, say, showing some of these symptoms, what kind of doctor should you be going to, to, you know, treat the leg? Is it a primary care pediatrician? Is it a sports medicine specialist?
Dr. Rawlings: I think, initially, if your pain is kind of vague and you're not sure what's going on, starting with the pediatrician is a great place. If it's something more serious, like they're not limping, they can't get into the pediatrician, it is reasonable to go to an urgent care or the emergency department, particularly if they won't walk at all. We need to see what's happening. There are . . . sometimes toddlers will have a small fall and twist their leg, and they won't walk, and they'll have a little fracture that you won't even pick up on. And so that's one of the more common reasons we'll see toddlers stop walking, and that's something that can be taken care of either by a pediatrician, a nonoperative sports medicine provider, or in an urgent care emergency medicine setting.
Interviewer: And is there anything, maybe a home remedy, something they could try at home before they, say, take them into a doctor to maybe alleviate any of the pain that they're experiencing?
Dr. Rawlings: Yeah. So if they're experiencing more of these growing pains, kind of intermittent pains in the evening or at night, you can do things like massage the legs, massage the muscles. Warm packs, heating pads are helpful. If it's severe, you can try some acetaminophen, Tylenol, or ibuprofen. And sometimes if it's pretty frequent, you can have them do some stretching during the day and see if that helps as well. MetaDescription
Most kids will experience pains in their legs at some point whether it be through overuse or the aching associated with growing pains. But if your child’s leg pain is severe or lasting longer than a day, it may be something more serious. Learn what signs and symptoms parents should be on the lookout for that may indicate something more serious than growing pains.
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A condition that causes a newborn’s skull to be misshapen, craniosynostosis occurs in about 1 in 2,000 births—and it should be treated. Plastic surgeon Dr. Faizi Siddiqi and neurosurgeon…
Date Recorded
November 10, 2021 Health Topics (The Scope Radio)
Brain and Spine
Kids Health Transcription
Interviewer: Craniosynostosis. It's a condition that causes a newborn's head to be misshapen. And it should be treated. To learn more about the condition, how to identify it, and why it needs to be treated, we've got Dr. John Kestle, he's a pediatric neurosurgeon, and Dr. Faizi Siddiqi, he's a pediatric plastic surgeon. And they are experts. They do the surgery that actually treats craniosynostosis.
So let's start with the first question, which is very basic. Dr. Kestle, what is craniosynostosis?
Dr. Kestle: So it's a condition where the bones that are normally separate are fused. And it restricts growth and creates abnormal head shapes. The pattern is usually present at birth or very soon after birth. That's different from the benign conditions where the head shape gets distorted because the baby is laying on one side. Those babies have a normal shape in the beginning and their head shape gets distorted over the first couple of months of life because they're lying on one side.
Interviewer: How does a parent generally find out that their child has craniosynostosis or synostosis?
Dr. Siddiqi: When they're born, they're usually told that after delivery, as Dr. Kestle mentioned, the head is going to be a little misshapen from the birthing process. And that usually corrects within two to three weeks. If that doesn't correct, then they're kind of suspicious and they visit their pediatrician. And then hopefully that's when they're referred for further evaluation by us.
Interviewer: And then what does that head shape look like? We do have a link to a pamphlet that you have that can help a parent. But just describe it briefly.
Dr. Kestle: So the typical head shapes, number one, most common is sagittal synostosis. It makes the head long and narrow, and the forehead and the back of the head kind of stick out. And the back of the head is narrower than the middle of the head. You can see those features when you look down from above.
Probably the second most common type is metopic synostosis. And that's when the suture down the forehead closes early and the forehead looks like the bow of a boat, or a triangle.
The other two types are less common. One is coronal synostosis, and that misshapes one side of the forehead so the forehead is pulled back, and the nose is sometimes crooked, and the eye socket on that side is usually a little bit elevated. And then the very rare one is the lambdoid synostosis, where the back of the head is flat on one side and the ear tends to be pulled back toward the flat side.
Interviewer: So how is it diagnosed then? So a parent recognizes that their child might have a misshapen head, they're concerned, they would go to a pediatrician first?
Dr. Siddiqi: Certainly they visit with their pediatrician and then they're referred to our synostosis clinic for further evaluation.
Interviewer: Okay. The pediatrician doesn't do any sort of imaging or anything like that generally?
Dr. Siddiqi: Sometimes they do. Oftentimes they don't because they don't want to subject the child to a CT scan unless they've seen a specialist and they're confident of the diagnosis. So we would see those kids in the clinic. Most of the time, it's a clinical diagnosis.
Interviewer: Meaning it's just visual, you're visually confirming it?
Dr. Siddiqi: Yeah. But once we decide it is and we talk about surgery, then we would want to get a CT scan, generally speaking, to be definitive about the diagnosis. And the scan also gives us information about the brain, which is helpful as well.
Interviewer: Why do you choose a CT scan over, say, an X-ray or some other sort of imaging?
Dr. Siddiqi: A CT scan gives much more detail of not only the bones, but, as I said, also the brain as well.
Dr. Kestle: The X-ray is very unreliable in making the diagnosis. And the CT scan has been changed over the years so the dose of radiation that's received is lower and lower. So now it's a very reasonable thing to do. It gives excellent anatomy, helps us with planning a surgery, makes the surgery safer.
Interviewer: And, Dr. Siddiqi, when do you generally like to treat a synostosis then?
Dr. Siddiqi: So if we see a baby with, let's say, sagittal synostosis that comes in at 2 to 3 weeks of age, then we've seen that the optimal time for surgery would be somewhere around 3 months of age. Between 2 and 4 months of age. That's why we stress the importance of early referral.
And the reason for that is if we can get the kids in by that time, we can get the surgery done, and then we can get them in the helmet and the duration of a helmeting would be as short as six months. So if we see these kids later on, the helmeting duration is much longer.
Interviewer: And, Dr. Kestle, if a child doesn't receive treatment for a synostosis, what could be the potential outcome then?
Dr. Kestle: So the natural history is that the shape will stay the same or get progressively worse because everything is growing except the fused suture. So number one, it's an issue of shape and appearance.
Number two, there are potential effects on the brain if it's left untreated. There's an incidence around 15%, maybe 20%, in the kids with sagittal synostosis that the brain growth will be restricted. And that can lead to brain problems, chronic headache, possibly visual problems.
With the other types of synostoses, that number is a little higher. And so it's nearly impossible to predict which baby with synostosis is going to get into those brain problems later. But that incidence of raised pressure is enough that we worry about leaving it alone.
Occasionally, we'll see an older child who had a CT scan for another reason, like maybe a concussion, and we identify a fused suture. But their shape is normal, and they're healthy, and their brain is developing normally. That's the situation where we might just follow them. But the baby that has the abnormal shape soon after birth is the ones where we recommend treatment.
Dr. Siddiqi: I would just add that . . . echo what Dr. Kestle said. The two indications are the shape and the risk of pressure on the brain. But the shape is important. A lot of families ask, or even other providers say, "Is this cosmetic?" It's not cosmetic. Cosmetic means, by definition, it's normal and you're making it better. It's not normal to have craniosynostosis. I just wanted to make that clear.
Dr. Kestle: I just want to really emphasize that it's visual. It's the shape that makes the diagnosis. So much so that what we do for almost every patient is have the family send photos. And we can pretty much make the diagnosis from the photographs and then decide if they need additional testing, how quickly we need to see them, and so on. But it's really a visual inspection of the head shape that tells you the diagnosis 90-plus percent of the time.
Interviewer: So really at 3 weeks, if a parent suspects that their child might have a synostosis, they should get in contact with a couple of specialists or a specialty center such as yourselves. You would encourage them to do that as quickly as possible. Is time really of the essence?
Dr. Kestle: For sure. And we can make plans based on photos, and we can see them in the clinic and talk about it, and then targeting between 2 and 3 months for corrective surgery. MetaDescription
A condition that causes a newborn’s skull to be misshapen, craniosynostosis occurs in about 1 in 2,000 births—and it should be treated. Learn how to identify the condition, how it’s treated, and why it’s so important for your infant to have the procedure sooner rather than later.
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A lot of parents are concerned about keeping their kids safe during the COVID pandemic. Parents and teenagers may be vaccinated, but younger kids are not eligible to receive the shot yet. Is it safe…
Date Recorded
August 02, 2021 Health Topics (The Scope Radio)
Kids Health Transcription
A lot of parents of younger children are now asking themselves a big question. I'm vaccinated against COVID, but my kids are too young for the vaccine. Can I let them play with their friends again? Do they have to wear a mask?
Kids have usually seemed to fare better with COVID than adults. But we know this isn't always the case. There are those kids who get COVID and then are affected by MIS-C, the multi-inflammatory system complication that will land a child in the intensive care unit. That is seriously scary. And that's why so many of us pediatricians worry about kids around COVID.
Another big concern has been that younger children would bring the virus home to vulnerable adult family members, and those would be the ones who would become significantly ill. So now that many places are not requiring masks anymore and places are opening up, it puts many parents in a situation where they're not sure what to do with younger kids. These kids have missed a whole year or more of socialization with friends and are really wanting to get back to playing.
The current recommendations are that if a person is not vaccinated, they should continue to wear a mask. That said, if your child is playing outside with friends that you trust and who have also been following precautions, it may be okay to let the kids play outside without masks on. There is evidence that kids who play outdoors have a low risk of being infected. There are also a lot of summer camps now, where masks are still being required. But they offer a lot of fun activities for kids who are too young to be vaccinated.
Adolescents ages 12 and up can be vaccinated now. My kids are both fully vaccinated now, and it was their choice, especially knowing that next year there will be no masks in junior high or high school in our area. They asked a lot of good questions about the vaccine and understood the science behind the vaccine. They both said it was such a relief to know that they are now protected. Vaccine trials are now underway for kids older than six months old at the time I'm recording this. The current projections are that kids ages 5 to 11 may be able to be vaccinated as early as September. And kids ages six months to four years may be able to be vaccinated by next spring.
The more people around your child who are vaccinated, the safer they will be. The bottom line is this is a choice your family needs to make. Are others in your family at high risk? Do you know who your kids are playing with? Are they outside? Is anyone sick? Or has anyone been exposed to COVID within days of the playdate? There is hope in sight for the youngest population, and science is working as fast as possible to get everything back to normal as quickly as we can. MetaDescription
A lot of parents are concerned about keeping their kids safe during these uncertain times.You and your teenagers may be vaccinated but younger kids are not eligible to receive the shot yet. Is it safe to let them return to playdates? Should they be wearing masks? Learn current recommendations and considerations parents should take before letting their children return to play.
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