Wednesday, April 23, 2014
Inquirer Daily News

Growing Pains

POSTED: Thursday, March 20, 2014, 5:30 AM
Filed Under: Growing Pains | Mario Cruz | Parenting | Tips

Guest blogging today with regular contributor Mario Cruz, MD, is Nova Ashanti, MD, a pediatric resident at St. Christopher's Hospital for Children.

While you may not want to be reminded about your child’s rapidly changing body and emerging sexuality (yikes!), puberty remains a life transition that parents and teens must navigate together.

During puberty, children are especially vulnerable to depression and to participating in a number of risky behaviors. Regular conversations with your child may help them deal better with these physical and emotional changes.

POSTED: Tuesday, February 4, 2014, 9:18 AM

True, they don’t have menstrual cramps and can’t get pregnant.  Nevertheless, teen males may have sexual health issues of their own. Some may be normal variants while others may be abnormal and need medical attention. Here are several; note that some of the links below are to medical illustrations and drawings.

Gynecomastia, or breast development in a male, may occur during puberty.  Understandably, this may cause a teenage boy to stress. It can occur on one or both sides and usually goes away in a few years. Although usually normal, gynecomastia may be a symptom of something else so ask your teen’s doctor to check him.

“Pearly penile papules” are tiny bumps along the base of the glans penis. Not only are they normal, but they are also common: 15-20 percent of male adolescents have them. If your teen doesn’t know that they are normal, my bet is that he will probably be worried about them. (More about this condition may be found on

POSTED: Tuesday, December 17, 2013, 5:30 AM
Filed Under: Growing Pains | Rima Himelstein | Sex

Life is full of double standards. And it starts early. Some of it is harmless. For instance, from day one of life, the name cards on newborns’ cribs are pink for girls and blue for boys.

Research shows how double standards may influence human behavior. In one experimental study looking at this issue, a group of male babies were dressed in pink, and then handed to adults who were told they were girls. The adults described the boys in pink as "adorable, cuddly, sweet and cute." Female babies dressed in blue were called "slugger, tough, strong and stubborn."

In what seems like “the blink of an eye,” our babies become teenagers, and the double standards continue.  Only now it is often the teen boys and girls who have the double standards.  Sometimes they have double standards in their attitudes about sexual behavior:

  • According to the National Campaign to Prevent Teen Pregnancy, boys aged 12-19 are more likely than girls the same age to say they feel pressure to have sex and more likely than girls the same age to think that it is embarrassing to admit that they are virgins (24 precent vs. 14 percent).
  • Teen boys say that they feel pressure to have sex because they think that “everyone is doing it.” In reality, everyone is not doing it: a 2011 survey by the Centers of Disease Control and Prevention of 15,425 students grades 9-12 from 43 states and 21 large urban school district, found that about half of high school males (49.2%) and high school females (45.6%) reported having had sex before.
POSTED: Monday, November 25, 2013, 9:42 AM

A significant part of my work as a cognitive-behavioral therapist specializing in anxiety and related disorders is providing families with recommendations for good resources. “Good resources,” in these cases, are usually books and websites that offer general, up-to-date information on the disorder for which I am treating the child, as well as sound suggestions for at-home interventions (i.e., parent manuals).  Of course I provide such psychoeducation in session, but I like parents to be able to hear the information more than once, from more than one source, and for it to be accessible to them outside of the therapy hour.

What I do not want is for families to garner information or recommendations for treatments from “unsafe” sources – that is, sources that provide information that is not scientifically supported or has been directly contradicted by science.  In fact, I explicitly warn families about this, because there is so much misinformation on the web. During initial sessions, when giving my families handouts printed with what I think are the best and safest sources of information on their child’s disorder and treatment for that disorder, I typically say: “Please DO NOT put the name of your child’s diagnosis into Google search and hit ‘return.’ You will receive millions of hits, many of them from untrustworthy sources having something to sell, and you will feel even more overwhelmed than you already do.  Instead, start with these I am recommending – you can always read more later.”

I've given my recommendations for resources on obsessive-compulsive disorder,for children who have difficulty with pill swallowing, and tic disorders. What follows are my current recommendations for good resources on school refusal.

POSTED: Thursday, October 17, 2013, 5:30 AM
Filed Under: Growing Pains | Obesity | Parenting

Today's guest blogger is Alexis Skoufalos, EdD, associate dean, professional development, at the Jefferson School of Population Health and is a member of the Philadelphia Health Initiative.

“Mom, Dad, am I fat?” It's a question that many parents aren't sure how to answer.

There’s no escaping the fact that people make judgments about who we are based on how we look. For kids who are overweight, especially in the teen years, the bullying can be devastating and have a negative effect for years to come.  And now that school districts are including Body Mass Index assessments as part of children’s physicals, there is the added confusion over what to do if the dreaded “fat letter” arrives saying your child is at an unhealthy weight.

It's hard for parents to know how to talk to their kids about the relationship between weight and health. This is a crucial conversation, now that 1 in 3 American children is overweight, to encourage the healthy behaviors that can lower our kids risk of developing diabetes and other weight-related disorders.

How to answer that difficult question? Some things that you can say to your child depending on their age are:

  • “I love you and I don’t have a problem with how you look, but as your parent, I’m concerned that you are carrying around extra weight and this can hurt your health. It can also mean that you don’t have as much energy or get to do the things that you really like to do.”
  • “Weight is a measure of your health and carrying extra weight can hurt your health.”
  • “Carrying extra weight means your body has to work harder than it needs to. Just like when you don’t like it when your teacher gives you extra homework, your body doesn’t like to do more work than it has to. If we can help your body stop overworking, we can make sure you have enough energy to do things that you like to do and what makes you happy.”
POSTED: Thursday, September 5, 2013, 5:30 AM

Today's guest blogger is Anita Kulick, President & CEO of Educating Communities for Parenting in Philadelphia. ECP offers a variety of programs and services for teen and adult parents, adjudicated delinquent youth, young adults aging out of the foster care system, preschoolers, and children at grave risk of becoming victims or perpetrators of violence.

The hottest non-news story on the morning TV shows early last month was about Rainy MacDuff, the owner of Rainy Days Café in Washington State. She asked two mothers and their young children to leave the restaurant because according to her, they were making a “mess.” 

It didn’t end there. MacDuff took to Facebook and posted the following comment along with a photo, "Like to take a moment to thank our customers with small children whose kids don't make a mess. A couple of ladies came in today and this is the mess their children made."

POSTED: Thursday, August 22, 2013, 6:00 AM

"Why do we need B.O.? What is the function of it? Everything in nature has a reason, has a purpose, except B.O. Doesn't make any sense: do something good, hard work, exercise, smell very bad. This is the way the human being is designed. You move, you stink. Why can't our bodies help us? Why can't sweat smell good?" — Jerry Seinfeld

Why do we need B.O.? B.O., a.k.a. bromhidrosis, results from sweating. Sweating is your body’s way of cooling down when overheated.  Although sweating is part of the way the human being is designed, it can be a real pain. Unfortunately, B.O. usually starts becoming a problem during puberty – a time when teens’ bodies are changing and they’re already extremely self-conscious.

Why can’t sweat smell good? The answer lies in the sweat glands. During puberty, the increasing androgen hormones in boys and girls increase the activity of the sweat glands and alter the chemistry of the sweat. When sweat comes in contact with normal skin bacteria, the sweat serves as food for bacteria, and body odor develops. It’s not just the underarms that are the offenders. With puberty, teens start perspiring in places like the scalp, upper thighs, groin, anal area, and even the feet. Who knew that all of these areas had sweat glands?

POSTED: Tuesday, July 9, 2013, 9:23 AM
Filed Under: Growing Pains | Tips
ILE - In this May 2, 2013 photo, pharmacist Simon Gorelikov holds a generic emergency contraceptive, also called the morning-after pill, at the Health First Pharmacy in Boston. A federal appeals court has decided to permit girls of any age to buy generic versions of emergency contraception without prescriptions while the federal government appeals a judge's ruling allowing the sales. The order Wednesday, June 5, 2013 was met with praise from advocates for girls' and women's rights and scorn from social conservatives and other opponents, who argue the drug's availability takes away the rights of parents of girls who could get it without their permission. It is the latest in a series of rulings in a complex back-and-forth over access to the drug. (AP Photo/Elise Amendola, File)

Today’s guest blogger is Krishna White, MD, MPH, an adolescent medicine specialist at Nemours/Alfred I. duPont Hospital for Children. Now that Plan B will be available over-the-counter without any age restriction, we asked her about how to talk to your teen about emergency contraception.

What is Plan B?

Plan B is a form of emergency contraception (EC). It is essentially a backup method of birth control for preventing pregnancy after unprotected sex. Plan B can be used within 5 days (120 hours) of unprotected intercourse, though it works better the sooner it’s taken. Last month, the federal government announced that Plan B will be available over-the-counter (without a prescription), for anyone regardless of age or gender.

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
Also on
Stay Connected