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Archive: February, 2013

POSTED: Thursday, February 28, 2013, 6:00 AM
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Although the American Academy of Pediatrics did not issue any radical new ideas on preventing middle ear infections in children in a new report released yesterday, they did emphasize three issues, two of which were lifestyle issues.

  1. Breastfed babies simply get less middle ear infections and so breastfeeding, especially with a strong family history of middle ear infection, is greatly encouraged for a minimum of 6 months.
  2. Any smoking in the house greatly adds to the incidence of middle ear infections in children in that house.
  3. In children over 24 months who mainly have pain in their ears and little else in symptoms, treating middle ear infections with pain medication such as acetaminophen and ibuprofen by mouth and lidocaine ear drops in the ear should be tried for 3 days before adding antibiotics. Such treatment has less side effects and works over 75 percent of the time.

Also, see my blog of 2 weeks ago on the different types of ear infection and their treatment. Similar to the recommendation in the report, my blog emphasizes not all ear infections require antibiotics and can get better on their own.

POSTED: Thursday, February 28, 2013, 11:27 AM
Filed Under: Rima Himelstein
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Maybe you and your teen heard the news report earlier this month about the 22-year-old who jumped to her death from the George Washington Bridge in New York. It’s not an easy thing to talk about … but we have to talk about it if we are going to prevent it. 

 The numbers are staggering: 4,600 young people end their own lives each year  in the United States, according to the Centers for Disease Control. Suicide is the third most frequent cause of death among people ages 10 to 24; and each year, 157,000 receive medical care for self-inflicted injuries at Emergency Departments across the country. A nationwide survey of youth in grades 9–12 found that 16 percent of students reported seriously considering suicide, 13 percent reported creating a plan, and 8 percent reporting trying to take their own life in the 12 months before the survey.


The biggest risk factor for suicide is a prior suicide attempt. One third of people who attempt suicide will try again within a year.

POSTED: Monday, February 25, 2013, 11:20 AM
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As parents, we often don’t like to admit when our kids have a problem, and a new poll confirms that usually happens when it comes to them being overweight.

According to their parents, 15 percent of children are a little or very overweight, while national data suggest more than twice as many, or 32 percent of all children, are overweight or obese, found a poll conducted by NPR, the Robert Wood Johnson Foundation, and Harvard School of Public Health.

Underestimating a child’s risk of being overweight or obese could impact them as adults. Adult obesity is associated with a number of serious health conditions including heart disease, diabetes, and some cancers.

POSTED: Thursday, February 21, 2013, 6:00 AM

This is the first in an ongoing series that will examine mental illness in teens. Blog contributor Rima Himelstein, M.D., a Crozer-Keystone Health System pediatrician and adolescent medicine specialist, opens the series with how to recognize signs of depression in teens. In the following weeks, we'll go more indepth into how depression can accompany other mental illness, treatment options available for teens, and the risks for not treating depression such as suicide.

Teen depression is a problem with many faces. I learned this from my patients.

POSTED: Tuesday, February 19, 2013, 8:00 AM
Filed Under: Fitness | Lauren Falini
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Today’s guest blogger Lauren Falini, BS, is an exercise physiologist in the division of weight management at A.I. duPont Hospital for Children in Wilmington, De.

Fifty years ago physical activity was just part of daily life.  It didn’t need to be planned, or even thought about. That isn’t true in today’s world.

Children wake up and go to school, they sit in a desk anywhere from six to seven hours, maybe one time a week they will have gym class for 30 minutes, and they may have recess if they are in elementary school.

POSTED: Sunday, February 17, 2013, 5:00 AM
Filed Under: Fitness | Major diseases | Nutrition
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Today’s guest blogger is Frances Zappalla, D.O., a pediatric cardiologist at the Nemours Cardiac Center at the Alfred I. duPont Hospital for Children in Wilmington, De.

We often think of heart disease as an adult condition, but heart disease starts in childhood. Teens, preteens and even little kids have heart-disease risk factors that once only happened to adults.  Autopsies on soldiers from the Korean and Vietnam Wars showed evidence of heart disease in young men in their early 20s. If they had certain risk factors, which included smoking, high blood pressure, high cholesterol, diabetes, there was more plaque in their arteries.  

We know that treating high blood pressure and high cholesterol early in childhood can protect at-risk children from future heart disease.  The first line of treatment is a healthy diet, daily exercise, and maintaining a healthy weight.

Here are my top tips for keeping kids’ hearts healthy:

  1.  All children should have blood pressure done at every doctor visit or at least once a year starting at the age of two years. Healthy blood pressure levels for teens depends on their age, gender and height. For example, healthy blood pressure for a  13-year-old girl of average height is around 109/64 and for a boy, around 110/63.
  2. All children should get a baseline lipid panel or get their cholesterol level by the age of 10 years. The ideal LDL cholesterol level for kids and teens is below 110. They should get tested sooner if they are at high risk for heart disease. High risk factors include:
    a. If there is a family history (especially a parent, aunt, or uncle) with high blood pressure, high cholesterol, or heart disease (stroke, stent, by-pass surgery, or heart attacks before the age of 50 in men or before the age of 60 in women).
    b. Child has diabetes (type 1 or type 2)
    c. Child has a BMI (body mass index) over the 85th percentile
    d. Child has kidney disease
    e. Child has/had cancer
  3. Drinks of choice for all children should be water and milk (one percent or skim after the age of two years).  If you start young infants/toddlers on water instead of apple juice, they will actually enjoy water when they get older instead of developing a sweet tooth.
  4. Juices - even orange and apple juice - should be limited to four ounces per day for toddlers and young children, and six ounces per day for older children and teens. It’s always better to EAT your fruit than drink your fruit.
  5. Soda, sweetened ice tea, lemonade, etc. should all be served sparingly – once or twice a week – not a daily basis.
  6. Children and teens should not consume energy drinks.
  7.  Exercise – at least 60 minutes a day. Activities can be as easy as running, swimming, kicking a soccer ball, or jump rope. When the weather is bad outside, kids can do jumping jacks, sit-ups, push-ups, or workout videos.     
  8. Limit screen time to NO MORE than 2 hours a day. This includes TV, handheld devices, and computer outside of homework. Regarding the Wii and Xbox – only if the child is actually up and moving all extremities (not just thumbs), does it count as exercise.
POSTED: Friday, February 15, 2013, 6:00 AM
Filed Under: Psychology | W. Douglas Tynan

What type of treatments help kids who have witnessed shootings, been caught in a storm, or who have been abused themselves? What treatments help kids cope with a serious illness? What treatments have serious side effects? Therapists deal with these issues every day and desperately need help in deciding what to do for their young patients suffering from post-traumatic stress disorder symptoms.

A review was published in Pediatrics earlier this week that looked at 6,647 studies that asked the question “what helps kids after a terrible thing has happened?”. The government-sponsored review concluded that there was insufficient hard evidence on the best interventions to help kids who experience PTSD.

This review first points out how difficult it is to do a study with a vulnerable population. Results can be biased, families can drop out, the clinics might not gather the right data, and often everyone gets treated so its difficult to compare treatments. Often results are biased in favor of the treatment under study. Thus, out of the 6647 papers reviewed, only 25 were found worthy of a further look and evaluation of their results. Of those 25 unbiased papers, 22 had sufficient data for analysis.

POSTED: Wednesday, February 13, 2013, 9:24 AM
Filed Under: Allergies and Asthma
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Valentine’s Day usually means celebrations and exchanges with chocolate and other treats, and marks a popular time for parties and dates involving food. While it’s tempting to just dig in, children and teens with food allergies need to be aware that many of these foods contain common allergens.

Today’s guest bloggers Terri Brown-Whitehorn, M.D and Lynda Mitchell answer questions about the risks associated with food allergies on Valentine’s Day, as well as the precautions families should take to keep their children safe.

Brown-Whitehorn is an allergist/immunologist in the division of allergy & immunology at The Children’s Hospital of Philadelphia and an associate professor of clinical pediatrics at the Perelman School of Medicine, University of Pennsylvania. Mitchell is the president and founder of Doylestown-based Kids With Food Allergies, one of the largest nonprofit organizations for parents of food-allergic kids with more than 22,000 members.

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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