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Inquirer Daily News

Archive: February, 2013

POSTED: Tuesday, February 12, 2013, 6:05 AM

Rice cereal first and then vegetables? What about fruit? I get these questions often from my patients. The timing of when to introduce solid foods to infants can be confusing for parents, and the recommendations can vary slightly from doctor to doctor.

The research is ongoing, but there is a growing body of evidence which suggest introducing solid foods early may increase tolerance and reduce incidence of allergies.

In one recent study, researchers followed 3,781 Finnish children for five years to examine the association between duration of breastfeeding and timing of introduction of complementary foods and the development of allergic disease and specific IgE sensitization to foods and inhalants. (IIgE is an antibody involved in immune system response and allergic reactions.)

POSTED: Thursday, February 7, 2013, 9:00 AM
Filed Under: Gary A. Emmett

What exactly is an ear infection? Doctors are not always as precise in their language as they should be and this has lead to many different kinds of diseases being called “ear infections.” 

An outer ear canal infection occurs when water that is too alkaline gets into the outer ear and causes irritation and/or bacterial infection.  This often happens after swimming in a pool that did not have its acidity controlled well.  This condition can be painful and may have a peculiar sweet odor and is also called a “swimmer’s ear.” 

Outer ear infections are treated with antibiotic drops. They can be prevented with a combination of alcohol and vinegar drops in the ear after getting out of a pool. This is not the middle ear infection that pediatricians are usually looking for in their patients.    

POSTED: Wednesday, February 6, 2013, 9:00 AM
Filed Under: Hazel Guinto-Ocampo

We often dread taking our children to the emergency room. It can be a stressful experience for both the child and parent. In a two part series this week, Hazel Guinto-Ocampo, M.D., chief of pediatric emergency services at Bryn Mawr Hospital, talks about how to make the visit to the ER run more smoothly. Yesterday, she gave tips on how to prepare for the ER. Today, you’ll find out what you can expect once you get there and how you can help your child through the visit.

Here is a list of what will likely happen once you arrive at the ER, and tips to make the visit more pleasant and worthwhile.

1. Expect to wait and spend a few hours in the ER. Unlike other doctor visits where you have a specific appointment time, your turn depends on the severity of your child’s sickness, and how many patients are in the ER within the time period you arrive.  

POSTED: Tuesday, February 5, 2013, 6:00 AM

Taking your children to the emergency room can be a stressful experience. In a two part series this week, Hazel Guinto-Ocampo, M.D., chief of pediatric emergency services at Bryn Mawr Hospital, offers tips on how to prepare for a visit to the ER. Tomorrow, she’ll go over what to expect in the ER and how to get best care for your child.

Having been involved in a recent fender-bender accident, it made me think that parents taking their child to the ER can be like an accident in some ways. Although you are mindful of preventing one and would want to avoid it at all cost - sometimes it happens anyway. This is especially true now that we're in the middle of another flu epidemic.

Here’s how you can prepare for that unforeseen trip to the ER:

  1. Pack for a potential wait. Although most ERs are streamlining processes to minimize waiting times, patients do wait especially in the fall and winter. Therefore, bring items to keep your child occupied and comfortable. Bring books, electronic games, and comforting items such as a blankie or favorite toy. Pack drinks and snacks, but always check with your nurse or doctor first before feeding your child.
  2. Make arrangements for your other children if needed. Call relatives or friends to take care of your other children who may need to get picked up from school, or cared for at home. If at all possible, tag team with your spouse or older child, or make arrangements so you don't have to bring young siblings to the ER with you. This way, you can focus on the needs of your sick child, and your other children do not have to endure the waiting time, or watch their sibling undergo uncomfortable procedures.
  3. Be ready to provide relevant information. These include: health insurance;  your primary doctor and other doctors' names and contact information;  allergy, immunization, past medical and surgical history; list of medications; and a chronological sequence of events leading to your child's ER visit.  You may be asked this information by multiple providers.
  4. Pack for a longer stay. Be prepared for the possibility that your child will get hospitalized.  Pack items necessary for you and your child's hospital stay.
  5. Understand that some of your expectations may not be met. Remember that emergency departments are set up so the ER physician can diagnose and start treatment mostly for life threatening conditions, and to provide comfort and pain relief.  Even the most astute ER physician often cannot make an exact diagnosis for common complaints.  

For example, a 10 year-old girl comes in with a sudden onset of right lower belly pain. Examination and tests are done, conditions such as acute appendicitis, twisting of the ovary, kidney stone, or urine infection are ruled out, and her pain is manageable at home. At this point, she may be ready to get discharged although an exact reason for her pain was not found.

Arriving at an exact diagnosis during the ER visit is especially difficult for long standing conditions. These are best evaluated and managed by the appropriate specialist during an office visit.

A good number of patients are referred to the ER because of a concerning complaint heard or finding seen by the primary physician during a phone call or office visit.  The same finding may be gone once the patient is seen in the ER either because conditions change with time, or treatment recommended or started by the primary physician has taken effect.  Therefore, your child might not always get the tests or treatments suggested by your primary physician.

A good ER physician's primary responsibility is to first, do no harm.  Some tests and treatments may be unnecessary, can be uncomfortable, or can be potentially harmful or risky.

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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