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.
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.
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.
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.
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.
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.
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.
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.
Have you ever put a piece of clothing or jewelry on your child and then they break out in a rash? Sadly, it's happened to me. I didn't know angora was rabbit fur when I bought a sweater as a teenager, and I didn't know that white gold had a lot of nickel in it. Contact dermatitis, allergic rashes happen more than people realize.
So the most common reasons for allergic skin rashes are due to something your body comes in contact with that triggers the reaction. People who have a history of allergies, asthma, and eczema are more prone to reacting to things they come in contact with. Different fabrics, like any with animal hair, detergents with scents, anything that has latex, including some Band-Aids, and any metal that contains nickel are the most common triggers for contact allergic dermatitis. We see this a lot in kids who have rashes, where the metal snap on jeans rubs against the stomach, for example.
So what does the rash look like? Well, it can look like eczema, or it can look like hives. It will always be itchy. Sometimes if the material is near the face, it can cause swelling of the lips or eyes. When I have earrings in that have nickel in them, I'll know right away because my ear lobes will start to swell, get itchy, and even have clear fluid oozing from a red, crusty rash.
Okay. You've determined your child is allergic to whatever was touching their skin. Now what? First, treat the rash. Just like any other allergic reaction, it's treated with oral antihistamines and topical steroid creams until the allergic reaction resolves. If it's serious and causing breathing issues, you will need to have your child see a doctor right away to see if oral steroids are needed to quickly shut down their immune system's allergic response and keep their airway open.
Next, you will need to keep your child away from whatever it was that triggered the reaction. I was heartbroken to have to let go of the sweater I'd saved up my own money for, but luckily my sister was able to wear it. For the jewelry or metal snap issue, sometimes painting clear nail polish on any part of the metal that touches your child's skin will help. Many places sell nickel free jewelry. So that helps with fashion options. Luckily, pull-on leggings are also in style for girls, and athletic pants with the elastic waists are good for boys. So jeans can be avoided as well, if needed. If it's latex your child is allergic to, there are a lot of good non-latex Band-Aids out there. If it's a certain soap or detergent, then it's time to switch the whole family to dye and fragrance-free products.
Allergic contact dermatitis is very easy for your child's pediatrician to recognize if they have it. Unfortunately, the treatment is to avoid whatever your child is sensitive to. That's the hard part, but it's very doable. Your child's pediatrician can help with tips specific to your child, if needed.
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. Learn more about the condition and how you can treat and prevent those itchy rashes your kid may get with certain materials.
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.
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.
Parents often wonder if their baby is lazy. I have parents use that term all the time. If their child isn't doing everything they think they're supposed to be doing, the parent labels their child as lazy.
For example, I have parents telling me a lot that their 12-month-old is lazy because they're not walking. Your child isn't lazy. Walking can start any time from 9 months until 18 months.
Parents will tell me their child is lazy because they want to be fed. If your child is under 18 months old and still learning how to use utensils, that's not lazy. They're just still learning. If they're 4 and they want you to feed them, that's not laziness. It's them being manipulating and trying to get you to do what they want.
Parents will also ask me about why their child isn't talking. They think that their 18-month-old should be saying sentences and instead only says about five words. Well, the biggest language explosion happens between 18 months and 3 years old. By 18 months, they should be saying four words, in addition to mama and dada. Boys tend to talk later than girls too. Not sure why, but that tends to be what I see. Girls tend to be more social. Boys tend to develop their motor skills faster.
I get the opposite too. Some parents think their children are developing completely normally when, in fact, they're behind on motor or speech milestones. This is one reason we do the autism screening at 18 and 24 months, to catch those kids that are behind and determine: Is this expressive speech delay? Are there not enough opportunities for motor development? Is there a concern for autism? Does the child have a different diagnosis that requires evaluation by specialists?
Now, I'll end with this as a heads-up. There was a recent article published in the "Journal of Pediatrics" outlining about how developmental guidelines for the first five years of life needed updating, and the Centers for Disease Control just adopted these new guidelines.
It will take a little while for everyone to catch up with these new guidelines when pediatricians do their screening evaluations at well-child visits. But we have a general good idea of where your child should be. As pediatricians, we are really good at figuring out if your child is on track developmentally, or if they need to see a specialist for a speech or motor developmental delay.
If you are concerned about a specific developmental issue with your child, be sure to discuss it with your child's pediatrician.
As a new parent, it’s important to you that your child meets all the expected developmental milestones, like walking and talking. But which milestones are backed by research, and how do you know if your kid is meeting expectations? Learn what the important milestones are, how to measure your child’s development, and when you should speak with a specialist.
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.
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.
"Should I call the on-call pediatrician?" It's a question you've probably asked yourself when you have a question for your child's doctor and the clinic is closed. I'll help you figure out when it's appropriate to call and when a question can wait until the next office day.
As a pediatrician, we all take call, meaning that we rotate with our colleagues when we answer after-hours phone calls from concerned parents.
Usually, the questions parents have are very appropriate. Sometimes parents are just looking for reassurance that they're doing the right supportive care for their little one. Sometimes they're wanting reassurance that taking their child to urgent care or the emergency room is the right decision and that they're not overreacting. And sometimes they just want to know how much fever reducer to give.
One thing I don't think most parents realize is that the job of the on-call pediatrician is to help determine if their child needs to be seen urgently or not.
We cannot diagnose anything over the phone. Parents will often tell me that they know their child has an ear infection, or strep throat, or a urinary tract infection. I can't tell if your child has any of those over the phone, so they need to be seen.
We absolutely cannot call in medications like controlled substances. We cannot call in medications in general, because if your child needs an urgent medication, they should be seen.
If they need a refill of a long-time medication, that's better to be addressed by your child's pediatrician specifically during office hours. Questions that are not urgent should wait until the clinic is open.
I have one colleague who answers her calls, "Hello, this is the on-call doctor. What is your emergency?" One reason for this is we've gotten questions like, "I'm in the baby food aisle at the store. What food should I get my 6-month-old?" or, "My toddler won't take a nap. What can I do to force them to take one?" or, "How old does my daughter need to be to get her ears pierced?" These are all questions I've gotten.
One thing I've noticed in my years of taking call are that parents often think I'm sitting in the clinic just waiting for their calls. More than once, I've been asked if they can just come in and see me or if I can meet them at the emergency room.
When you call the on-call pediatrician, we are at home with our families. We are not in the office. I've answered phone calls from soccer games, while doing landscaping, when I'm doing hospital rounds in the newborn nursery, when out to eat, and of course, from my bed in the middle of the night.
As pediatricians, we want to be there for you when you have concerns. Kids don't come with instruction manuals, and often things happen when the office is closed. If you have an urgent concern, you are always welcome to call and we will give you the best advice we can. If your concern is not urgent, it will be better handled by your pediatrician during office hours.
Your pediatrician knows your child and your family. They can address non-urgent concerns better than one of us who has never met your child before.
As a parent, your pediatrician can be your lifeline whenever you have a question about the health of your child. But what should you do when you have a pressing question or concern after-hours, and the clinic is closed? Learn when you should reach out to the on-call pediatrician and when it can wait until morning.
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.
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.
Dizziness, especially in teenagers, seems to be a common concern I'm seeing lately. Is this something really concerning or a symptom of other more common issues?
Lately, I'm having one or two teenage patients a week coming to see me with the chief concern of dizziness. It's usually girls, usually around 15, but sometimes boys too. A conversation about their symptoms often points me down one or two paths -- vasovagal syncope or anxiety.
Kids who have vasovagal syncope feel lightheaded when they stand up too quickly. Their blood pressure drops and down they go. The most common reason is they aren't hydrated and their blood pressure can't compensate fast enough for how quickly they stand up. This type of reaction also happens with fear and strong emotions, such as seeing needles.
Often, if kids stay hydrated, which means drinking enough water so that when they pee their pee looks like water, their symptoms improve.
Parents often ask me, "Well, how many glasses of water is enough?" But there's no simple answer other than to monitor their urine. Everybody is different with their water needs.
With anxiety, the dizzy feeling is more a nervous system response. Along with the dizziness, they will say that they're hyperventilating or their heart rate goes up or they're sweaty or they're shaky. That's a panic attack.
Unfortunately, the treatment for that kind of dizziness is a bit more complicated than just drinking water. Drinking water won't help anxiety. The first step for anxiety is learning some coping skills to help stop the panic attack. Have your child learn some deep-breathing exercises such as square breathing.
You may ask, "What is square breathing?" We'll have your child use their finger to draw a square in the air in front of them. Every time they draw a side of the square, they either take a deep breath in or they let their breath out.
There are several free apps to help with meditation also. The schools will often use Calm. We've used Relax Melodies at our house.
If that doesn't help, the next step is finding a therapist who can help your child manage their anxiety.
Finally, if your child is still having panic attacks despite therapy, your pediatrician can help you find a mental health provider who can work more closely with your child on their anxiety.
Many teen girls that I am seeing for dizziness also admit to cutting or other self-harm behaviors as a coping mechanism. So a mental health provider can also help with this.
Many parents often ask me to do blood work for anemia for their teen's dizziness. In boys, because they don't have periods, this is rarely the case. In girls, if their periods are really heavy or frequent, that could be the cause. But I do not find that they are anemic for the most part.
Abnormal thyroid labs can also cause dizziness and anxiety, even depression. More so in older teen girls than boys, but this too is usually not the case.
Parents often want me to check vitamin levels because their kids don't eat as healthy as they should. That's not something that a pediatrician will usually do. Unless the teen has a specific underlying medical condition, vitamin deficiencies are not very common. And if a parent is very worried about vitamin deficiencies, they can just have their teen take a daily multivitamin designed for teens. There are several on the market, and they come in tablets and gummies.
The bottom line is if your teen says they are dizzy, try hydration first. And talk to them. See if they're anxious about anything. If the problem persists, then it's time to bring them in to see their pediatrician.
Your teenager complains of constant dizzy spells or vertigo. Could it be a symptom of something serious? According to pediatricians, dizziness is a pretty common condition—especially for adolescents. Learn more about the causes of dizziness in children and treatments that can help.
Boys in puberty. Most people think of teen boys eating them out of house and home, needing new clothes because they outgrow them every two weeks, and interesting smells. Well, there's more than that, and I'll help you navigate puberty in boys on today's Scope.
I've got a teenager at my house and one who is about to be a teenager. I can definitely say that all of those things that I just mentioned are absolutely true. But what exactly is going on in their bodies? There's going to be a lot of changes that they may come to you as parents to ask questions about. Puberty in boys can start as early as 9 but really hits between 11 and 14 and lasts for 3 to 4 years. Boys can continue to grow until they are 18 or even 20.
The first thing your boy will notice is that his private area will be changing. His testicles will get bigger, his penis will grow, and he will get pubic hair. Then comes hair under the arms and on his body, and that's usually when the body odor starts too. And you'll need to make sure to get your son some deodorant and you'll probably also need to stress the importance of hygiene.
Voice changes are next. Often boys get pretty embarrassed about how their voice cracks as it gets deeper. At our house, we pretty much just laugh about it because my boys know it's normal and it's happening to all their friends as well.
Their bodies will also start to bulk up, and their muscles will be getting bigger and stronger thanks to testosterone. Testosterone is also what triggers some mood changes in boys, especially the anger issues. So be prepared.
This is also when romances start to blossom so be sure you have the talk with your boys about your family's view on sex, birth control, and protection against sexually transmitted diseases.
Something else that testosterone causes is acne. Acne is not caused by not washing your face or by what you eat but by changing hormones. There is a lot of treatments for acne, including many that are over the counter.
Like I said, boys can continue to grow until they are 18 years old. They will usually have a growth spurt of about four to six inches towards the end of puberty. That's also when more body and facial hair shows up and boys need to learn about shaving beards and mustaches.
What about some of the more uncomfortable things that you may need to talk to your teen boy about? Well, boys start getting erections more, and sometimes they happen at embarrassing times like in the hall at school. They also start having nocturnal emissions, otherwise known as wet dreams. This is when they have erections and ejaculations during their sleep. It's normal. They have no control over it, and it can happen up to a few times per week.
Remember, puberty happens to all of us who make it to adulthood. While things change from each generation to generation, some things are constant, like the changes that happen to a boy's body as they go from being a little kid to being a man. It's a tricky time for kids, and if you or your child have any questions about what's going on in their bodies, be sure to ask your child's pediatrician for help.
As a boy begins to mature, their body and mind go through a lot of changes. It can be tough not only for kids, but their parents too. From growth spurts - and the appetites to match - to strange smells to general moodiness, learn how parents can prepare for raising a boy going through puberty.
There have been concerns by some parents that they don't want their kids wearing masks because they believe their child will be inhaling their own carbon dioxide with prolonged mask wearing and that will cause oxygen deprivation. Some say that children will inhale up to six times the safe limit of carbon dioxide.
Let me help clear the air on this one. It's not true. Here's the science behind the truth. Carbon dioxide poisoning or hypercapnia from re-breathing the air we normally breathe out doesn't happen because carbon dioxide molecules are extremely small, even smaller than the respiratory droplets, which is what we are protecting against when we wear the masks. They cannot be trapped by cloth or medical masks or any sort of breathable fabric. Those tiny molecules just pass right through the material.
Surgeons, nurses, respiratory therapists, all of us in the medical profession, in fact, wear our masks for hours and hours during the day. Studies done by having surgeons wear oxygen monitors during their entire time in the operating rooms show that masks have no effect on the amount of oxygen they have in their bodies.
If your child is wearing their mask properly, covering their mouth and their nose and fitting snugly over their face with the ear loops or ties, then your child will be protected from the respiratory droplets we don't want going through the breathable fabric, but still letting them breathe in oxygen and exhale carbon dioxide through their masks.
The bottom line is masks work. Last year during what is usually a very busy winter season, I hardly saw any sick kids. Now we are seeing RSV and rhinovirus and all sorts of other winter viruses because people have loosened up on mask wearing and viruses are taking advantage of that. Hospitals are full with kids who are having respiratory virus complications. I've had parents of children with asthma tell me that since their kids wore masks, the last school year, they didn't get sick and didn't have any asthma flare-ups. We can do this.
The kids I've spoken to have no problem wearing their masks. They like to coordinate their masks with their outfits and get cool ones with princesses and superheroes on them. I tell them they actually are little heroes. They tell me they have no problem wearing masks all day at school either. My own kids even say that they're so used to their masks, they don't even think about them anymore. And they're in junior high and high school. So mask up. And if you have any other concerns about COVID and COVID precautions, be sure to talk to your child's pediatrician.
There is a lot of evidence showing how masks work at preventing the spread of COVID-19. But could wearing a mask increase the amount of carbon dioxide your kid breathes through the day? Learn about this mask myth and explains the science behind why masking is safe for long-term use - even for children.
Learning disabilities are a common concern that parents bring to pediatricians. I'll be discussing those on today's Scope.
I have a lot of parents coming to me to see if their child has a learning disability. Usually it's dyslexia, which is a reading disability. But sometimes is dyscalculia, which is a math disability, or dyspraxia, which is a developmental disorder that affects motor skills like writing. Parents normally notice that their child is struggling in only one subject and does fine in others, or they notice that their child is writing letters, words, or numbers backwards. The teachers may be the first to recognize if there is a problem and tell the parents to have their child see their pediatrician for an evaluation.
Now, here's where it gets tricky. Yes, most of us can identify if there is a learning disability. However, we as general pediatricians are not the ones who can do a full evaluation and diagnosis. Even behavioral and developmental pediatricians are not usually qualified. Why? Because there is a lot that goes into determining if this is truly a learning disability or if there are other reasons for the difficulty in a particular area. We as pediatricians are the right place to start the process though. Schools also. School psychologists can actually do a lot of the testing to start the process, and that is what most of us recommend. While schools start doing the initial learning evaluations, pediatricians do full physical exams to rule out other medical reasons, such as ruling in or out movement disorders, ADHD, anxiety, depression, or speech issues.
The final evaluation and where the actual diagnosis is made is with a neuropsychologist. These are specialists who will do a huge evaluation with a lot of specialized tests, including IQ tests, standardized tests in reading, math, language skills, things like that, to get a good idea of how the brain itself is working, or not working, and be able to come up with the exact diagnosis specific for the child. This can be a long process, but it is necessary to get the correct diagnosis.
Once a child has been diagnosed with a learning disability, the next step is to notify the school and have them come up with an IEP or individualized education plan. This is a written contract stating what the child's disability is and what the school is able to do to help the child learn successfully. It's drafted with the parents, teachers, and school psychologists all involved and goes off of the results from the neuropsychology report. This IEP should follow the child all the way through graduation. It should be reevaluated every six months to make sure that the child's needs are being met and that there are not new issues coming up.
There are no medications to help with learning disabilities. As pediatricians, we can help direct you to resources that can help your child. Our relationship with your child will not change. And we too, like the schools can adapt if your child has problems with learning.
What your child needs most is encouragement and a lot of positive reinforcement when they get something right. Let them know that this is something that they can totally be successful with. Let them know some of the famous people that have had dyslexia, such as Keanu Reeves, Albert Einstein, Steven Spielberg, even Ozzy Osborne. They've all been successful. Henry Winkler had both dyslexia and math problems. Even Ben Franklin was thought to have a math learning disability.
Having a learning disability will make things harder, but not impossible. And often those who have a learning disability in one area often have exceptional abilities in other areas. Encourage your child to focus on what they are good at while they work hard things out that don't come easy. Remind them that they are not defined by their learning disability only by their abilities.
Could your child have a learning disability? It’s a frequent question for pediatricians. Whether it be dyslexia, dyscalculia, or another learning disorder; learn what the common signs to look for and when you should speak with your pediatrician about getting the help your child needs to succeed.