Category Archives: Pediatrics

Pediatrics

Ask the Pediatrician: Why is it important to teach children about body … – Union Democrat

The statistics reported by the Rape, Abuse & Incest National Network are sobering: 1 in 3 girls and 1 in 20 boys will experience sexual abuse or sexual assault by the time they reach age 17.

The idea that anyone would sexually abuse a child is terrifying, especially for parents and caregivers. But like with any risk our children might face, we need to be able to empower them with information that will help them recognize unsafe situations.

Children and teens who feel in control of their bodies are less likely to fall prey to sexual abusers. And if they do suffer abuse, they are more likely to tell a trusted adult which can make all the difference in stopping the events and subsequently helping them recover from this painful experience.

Here are some tips to help parents teach their children about body boundaries and safety:

Use appropriate language. Teach children proper names for all body parts, including their genitals: penis, vagina, breasts and buttocks. Making up names for body parts may give the impression that they are bad or a secret and cannot be talked about. Also teach your child which parts are private. This includes the parts of their body that are covered by their swimsuit, as well as their mouth. These places should not be touched or looked at without their permission.

Evaluate your family's respect for modesty. Modesty isn't a concept most young children can fully grasp. But you can still lay a foundation for future discussions and model good social boundaries. If you have kids of various ages, for example, teach your younger children to give older siblings their privacy if they request it.

Don't force affection. Do not force or guilt your children to give hugs or kisses. It is OK for them to tell even grandma or grandpa that they do not want to give them a kiss or a hug goodbye. Teach your child alternate ways to show affection and respect without close physical touch (high-fives, thumbs-up, etc.) Reinforce that their body is theirs to control, a concept called body autonomy.

Explain OK vs. not-OK touches. An "OK touch" is a way for people to show they care for and help each other, like when caregivers help with bathing or toileting, or when doctors check to make sure their body is healthy. A "not OK touch" is one they don't like, hurts them, makes them feel uncomfortable, confused, scared or one that has anything to do with private parts.

Reinforce that people should respect each other. Discuss how it is never OK for anyone to look at or touch their private parts without their permission. At the same time, they should not look at or touch other people's bodies without their permission.

Give your children a solid rule about inappropriate touches. This will make it easier for them to recognize a not-OK touch if one happens and empower them to say no to these.

Remind your child to always tell you or another trusted grown-up if anyone ever touches their private parts or makes them feel uncomfortable in any way. Inappropriate touching especially by a trusted adult can be very confusing to a child. Reassure your children that you will listen to and believe them if they tell you about not-OK touches.

Control media exposure. Make a family media plan. Get to know the rating systems of video games, movies and television shows, and make use of parental controls available through many cellular, internet, cable and satellite providers. Providing appropriate alternatives is an important part of avoiding exposure to sexual content in the media. Be aware that children may see adult sexual behaviors in person or on screens and may not tell you that this has occurred.

Review this information regularly with your children. Some good times to talk to your children about personal safety are during bath time, bedtime, doctor visits and before any new situation. Children meet and interact with many different adults and children every day: at child care, sports practices, dance classes, camps and after-school programs, to name a few. Giving them tools to recognize and respond to uncomfortable situations is key.

Expect questions. The questions your child asks and the answers that are appropriate to give will depend on your child's age and ability to understand. It is always important to tell the truth.

Always let your child know you believe in them and will do everything you can to protect them from harm. Help them understand that they will not be in trouble for telling you about information that should not be kept secret. Empower them to tell another trusted adult if they are too uncomfortable telling you.

If you have any questions about ways to keep your child safe from harm, including sexual abuse, talk with your pediatrician.

More information is available at HealthyChildren.org.

ABOUT THE WRITER

Shalon Nienow, MD, FAAP, is a member of the American Academy of Pediatrics Council on Child Abuse and Neglect Executive Committee. She is division director of child abuse pediatrics at Rady Children's Hospital in San Diego. She also serves as medical director at the Chadwick Center for Children and Families and clinical director of child abuse pediatrics at UC San Diego School of Medicine. As a child abuse pediatrician, she provides medical evaluations for children who may have experienced any form of abuse or neglect.

2023 Tribune Content Agency, LLC.

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Ask the Pediatrician: Why is it important to teach children about body ... - Union Democrat

Pediatrics

Highlights from the Pediatric Academic Societies Meeting – Healio

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This week, Healio provided live coverage of the Pediatric Academic Societies Meeting, an annual collaboration between the AAP, Academic Pediatrics Association, American Pediatric Society and the Society for Pediatric Research.

Program Chair Judith Shaw, EdD, MPH, RN, FAAP, a professor of general pediatrics at University of Vermont Larner College of Medicine, told Healio that the conference highlights a broad issue of interest across the full spectrum of pediatric research, science and education.

At this years meeting, researchers reported new data that showed adherence to the immunization schedule for children improved in the United States from 2011 to 2020, but rates differed by socioeconomic status.

Findings from another study found that most children who present to the ED with anaphylaxis can be discharged following a period ranging from 5 minutes to 2 hours, depending on their symptoms.

Read these and more highlights from the Pediatric Academic Societies Meeting below:

Pediatric vaccine adherence was improving before pandemic, but not for everyone

WASHINGTON Vaccine adherence was increasing among children in the United States in the years before the COVID-19 pandemic, but rates differed by socioeconomic status, researchers reported. Read more.

VIDEO: Observation time for anaphylaxis can safely be reduced

WASHINGTON Study findings suggest that most children who visit the ED with anaphylaxis can safely be discharged after 2 hours of observation or less. Read more.

Reframing HPV shot as cancer vaccine improved uptake among 9-year-olds

WASHINGTON Experts suggested reframing conversations about HPV to encourage parents to get children vaccinated starting at age 9 years. Read more.

VIDEO: Children living in states with lenient gun laws have higher death rate

WASHINGTON Children living in states with more lenient firearm policies have a significantly higher death rate compared with those in states with stricter legislation, a study found. Read more.

Clinician reminders in electronic health records improve pediatric asthma care

WASHINGTON Reminders included in electronic health records improved the use of preventive medication and reduced health care utilization for asthma, data show. Read more.

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Highlights from the Pediatric Academic Societies Meeting - Healio

Pediatrics

Career award to honor pediatric cardiologist Dr. Blanton Bessinger – Moultrie Observer

MOULTRIE The Colquitt County Career Achievement Award will be presented Tuesday, May 9, to a respected physician who was born in South Carolina but grew up in Moultrie.

F. Blanton Bessinger, MD, MBA, will speak at that evenings ceremony at the Arts Center of Moultrie, as well as during an event at Colquitt County High School.

Dr. Blanton Bessinger.

The Colquitt County Career Achievement Award was designed to laud people who graduated from the Colquitt County School System and went on to earn recognition on the world stage.

Bessinger was born in Columbia, S.C., on Dec. 4, 1940. He moved with his parents, Forrest and Melba Bessinger, to Moultrie in 1947, and he entered the second grade at Central Elementary School. He attended Moultrie Junior High School and Moultrie Senior High School, graduating in 1958.

In high school, he was a member of the Beta Club (academic recognition) and the M Club (varsity letters in baseball and basketball). At graduation, he received the Edgar Holmes, MD, trophy for top all-around male student.

He went to Emory University for college, and was inducted into Phi Beta Kappa his junior year. After three years of college, he entered the Emory School of Medicine, receiving his M.D. degree in 1965. He was inducted into Alpha Omega Alpha in his junior year, and he graduated summa cum laude.

His next step was pediatrics internship and residency at the University of Minnesota Hospitals in Minneapolis/St. Paul. He then went on active duty in the USAF Medical Corps from 1967-69. He was stationed at Vandenberg Air Force Base and served as a pediatrician. Returning to the UM, he did a fellowship in pediatric cardiology, and, in 1971, began his academic career in the Pediatrics Department as an assistant professor. He was an active clinician, teacher, mentor to students and fellows, and a clinical researcher. He was the pediatric representative on several medical school committees, and was director of the cardiovascular curriculum for sophomore medical students.

In 1978, he moved from academia to private practice. In-hospital care was mainly at Minneapolis Childrens Medical Center. He was elected Chief of Staff at MCMC in 1982. He supported the pediatric residency training at the hospital with residents from the UM. With other professionals, he spearheaded quality efforts to improve care and improve the experience for families of hospitalized children.

In 1988 he reduced significantly his clinical practice, as he moved into medical management and became the Chief Medical Officer for St. Paul Childrens Hospital. While working full-time, he pursued and received his MBA degree from the Carlson School of Management at the UM in 1992.

Although both remained important, he became more involved in macro management of childrens health and development, different from the micro management of clinical care for a patient. He became deeply involved in child advocacy, joining various boards supporting children in the community. He was a founding member of Ready 4 K, and served as first chair for seven years. On the board were a former mayor and governor, business leaders, child care experts and others pushing a unified voice for the needs of this group in our society.

He was a ClearWay Minnesota director. This was an organization set up with funds from Minnesotas tobacco settlement. It was active in getting clean indoor air legislation, and it spent much effort to decrease and prevent use of tobacco products by teenagers.

Bessinger was an active member in the Minnesota Medical Association, serving as speaker of the House of Delegates in 1997 and

president in 1999. As a Minnesota delegate to the American Medical Association, he was elected to its Council on Constitution and Bylaws and served a total of eight years. He is a Fellow in the American Academy of Pediatrics and the American College of Cardiology.

He has been a member of House of Hope Presbyterian Church in St. Paul for more than 50 years and was part of its governing boards for 30 years.

He has been a member of Midland Hills Country Club in St. Paul for 40 years, serving as president in 1999-2000.

He was a member of the Emory School of Medicine Alumni board for a period of years attending quarterly meetings in Atlanta.

Bessinger stated he feels privileged and grateful to have received recognition with the MMA Distinguished Service Award in 2007, the MnAAP Distinguished Service Award in 2010, and the Department of Pediatrics Gold Headed Cane Award in 2021 (a lifetime achievement award for his efforts in child advocacy).

At his retirement in 2003, the Childrens MN professional staff recognized him with the Blanton Bessinger Advocacy Award presented to a staff member annually. He has had the privilege of presenting it at the annual meeting.

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Career award to honor pediatric cardiologist Dr. Blanton Bessinger - Moultrie Observer

Pediatrics

How to support the breastfeeding parent – Contemporary Pediatrics

How to support the breastfeeding parent | Image Credit: Jnataliaderiabina - stock.adobe.com.

There are multiple tools that pediatricians can equip themselves with when to comes to supporting breastfeeding, according to a session presented at the 2023 Pediatric Academic Societies meeting held in Washington, DC.

Jennifer Zarit, MD, IBCLC, assistant professor at UPMC, Childrens Hospital of Pittsburgh; Patricia Staley, MD, assistant professor of pediatrics at UPMC Children's Hospital of Pittsburgh; Kristin Hannibal, MD, clinical director of primary care center at the University of Pittsburgh School of Medicine; and Mavis Britwum, DO, pediatric resident at UPMC Children's Hospital, sought to explain the process of breastmilk production, provide the benefits of breastfeeding, and know how to respond to questions about lactation in their presentation. They also aimed to explain hand expression of breastmilk to new parents and show the ideal latch and positioning of an infant for maternal comfort and optimal breastmilk transfer.

Zarit, Staley, Hannibal, and Britum began their presentation with a conversation about incorporating inclusive language when it comes to discussing breastfeeding. This includes the different terminology families prefer to use instead of the term breastfeeding, such as chestfeeding. Additionally, the presenters suggested using the term parent or person who gave birth instead of "mother" if the patient requests it.

They also touched on some of the benefits of breastfeeding mentioned by the presenters included immune system development and has shown a decrease in lower respiratory tract infections, acute otitis media, obesity, and diarrhea. There are also maternal benefits to breastfeeding such as a decrease in the risk of developing type 2 diabetes, hypertension, as well as ovarian and breast cancer.

Despite these benefits to both mother and child, there are some situations when parents should avoid breastfeeding, including when maternal infections are present (HIV, herpes on the breast, and active tuberculosis), inborn errors of metabolism (such as galactosemia), and maternal exposure to drugs of abuse, medications, and environmental agents, according to the presentation. However, they mentioned that it is OK to breastfeed if the mother smokes, ingests CT/MRI contract, or is on opioid maintenance.

The presenters stressed that any amount of breastmilk is beneficial (however the range of benefits is dose-dependent), and while it is ideal that every baby be given 100% breastmilk, any breastmilk is considered good breastmilk. Any amount of breastmilk or any time spent breastfeeding will be beneficial for the mother and baby, said Zarit, Staley, Hannibal, and Britum.

Additionally, they provided 2022 updates to the American Academy of Pediatrics Policy Statement Breastfeeding and the use of human milk. Some of these updates include promoting exclusive breastfeeding for approximately 6 months of age as well as the continuation of breastfeeding along with the introduction of complementary foods after approximately 6 months. As for patients 2 years and older, the update recommends breastfeeding can continue if it is both desired by the mother and child.

The priority of the presentation was spent providing different case scenarios to the audience regarding what clinicians can do when a patient is breastfeeding, including:

The workshop presentation concluded with attendees partaking in a lactation simulation to provide examples of how to help patients breastfeed.

Reference:

Zarit J, Staley P, Hannibal K, Britwum M. Skills to support breastfeeding through simulation. Presented at:Pediatric Academic Societies Meeting, April 27-May 1, Washington, DC.

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How to support the breastfeeding parent - Contemporary Pediatrics

Pediatrics

Outcomes of traumatic brain injury during pregnancy – Contemporary Pediatrics

Outcomes of traumatic brain injury during pregnancy | Image Credit: pressmaster - pressmaster - stock.adobe.com.

Traumatic brain injury (TBI) during pregnancy leads to increased odds of cesarean section (CS), according to a recent study published in The Journal of Maternal-Fetal & Neonatal Medicine.

Over 10 million people worldwide are affected by TBIs per year, often caused by falls, traffic accidents, and sports. Associations have been made between TBI and menstrual cycle disorders in fertile-aged women, with almost half of women reporting amenorrhea after TBI.

There is currently little understanding on the effects of TBI on pregnancy and delivery. However, TBI may cause elevation of intracranial pressure, which is associated with a decrease in functional capacity, lower cognition, and increased mortality risk.

During delivery, cerebrospinal fluid pressure increases in response to pain, potentially leading to risks associated with TBI shortly before childbirth. To determine the impact of TBI during pregnancy on pregnancy and delivery, investigators conducted a nationwide retrospective register-based matched cohort study.

Data was collected from the Care Register for Health Care and the National Medical Birth Register (MBR), both of which are maintained by the Finnish Institute for Health and Welfare. The study period was between January 1, 2004, and December 31, 2018.

Participants included women aged 15 to 49 years hospitalized with a TBI diagnosis. TBI was determined during a hospitalization period using International Classification of Diseases 10th revision codes.

TBI included concussion, traumatic cerebral edema, diffuse traumatic brain injury, focal traumatic brain injury, epidural hemorrhage, traumatic subdural hemorrhage, traumatic subdural hemorrhage, other specified intracranial injury, and unspecified intracranial injury.

MBR data included pregnancies, delivery statistics, and perinatal outcomes. Pregnancy dates and dates of TBI diagnosis were used to associate pregnancies with TBI. Multiple pregnancies were excluded from the analysis.

The sample contained 392 pregnancies with TBI and 722,497 pregnancies without TBI. Each patient with TBI pregnancy was matched with 3 non-TBI pregnancies, leading to 1176 matched pregnancies. Subgroup analysis measured effects based on the trimester of TBI.

A total 40,028 cases of TBI were recorded, 392 of which occurred during pregnancy. Concussion was the most common TBI reported, in 91.6% of patients, followed by diffuse traumatic brain injury in 2.8%, traumatic subdural hemorrhage in 1.8%, and unspecified intracranial injury in 1.5%.

Concussion was the only TBI reported in more than 5 cases. The incidence rate of TBI during pregnancy was 0.8 per 1000 pregnancies in 2016.

Compared to the reference group, women in the TBI group were younger, had increased smoking rates after the first trimester, lower rates of spontaneous vaginal birth, and higher rates of assisted vaginal, unplanned CS, and elected CS. The rate of emergency CS was 1.5% in the TBI group and 0.9% in the reference group.

When analyzing subgroups, pregnancies with TBI in the first trimester saw increased rates of induced labor compared to the reference group, while CS rates were higher in all TBI groups. The CS rate was especially higher in the TBI during third trimester group compared to the reference group.

Fetal outcomes did not occur between groups. For severe TBI, only 33 cases were recorded, with no difference in CS rate.

Overall, TBI was associated with increased odds of CS, especially during third trimester. Investigators recommended further studies on elective CS and reasons for unplanned CS among women with TBI during pregnancy.

Reference:

Vaajala M, Tarkiainen J, Liukkonen R, et al. Traumatic brain injury during pregnancy is associated with increased rate of cesarean section: a nationwide multi-register study in Finland. The Journal of Maternal-Fetal & Neonatal Medicine. 2023;36(1). doi:10.1080/14767058.2023.2203301

This article was initially published by our sister publication, Contemporary OB/GYN.

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Outcomes of traumatic brain injury during pregnancy - Contemporary Pediatrics

Pediatrics

Extraordinary Pediatric Nurse Recognized at LRMC | News … – Williamson Daily News

LOGAN Tobie Porter, RN of Logan Regional Medical Center was honored with the DAISY Award for Extraordinary Nurses in April.

This prestigious award is given to nurses who demonstrate exceptional patient care and compassion. Awarded to nurses at LRMC throughout the year, the DAISY Award is part of the DAISY Foundations programs to recognize the super-human efforts nurses perform every day.

Although Tobie has just been at LRMC for a year and a half, he has made an incredible impact on both patients and staff, the hospital said in a release. His dedication to his patients is unwavering, and his compassion for their well-being is evident in all that he does. Tobie goes above and beyond to make sure his patients feel comfortable and cared for during their stay at the hospital.

Porter has been recognized by home health representatives, co-workers and patients but one story that stood out was a shout-out from a patients mother.

The post read, My boy is no stranger to hospital stays, passing by the hospital he makes sure to let us know that he doesnt like staying at the doctor motel!! Today he met an awesome nurse, Tobie, that helped ease his little mind and had him looking at the fish in the river. He has a love for fishing and this really helped.

Tobie has been a wonderful asset to Logan Regional Medical Centers pediatric unit, said Megan OBrien, Director of Womens Services and Pediatrics. Tobie has a special way with connecting with our small patients and easing their fears. He treats our young patients with so much respect he not only takes care of them, but takes time out to speak to them, to play with them, and to comfort them. He truly is a wonderful nurse.

The not-for-profit DAISY Foundation is based in Glen Ellen, CA, and was established by family members in memory of J. Patrick Barnes. Patrick died at the age of 33 in late 199 form complications of Idiopathic Thrombocytopenic Purpura (ITP), a little known but not uncommon auto-immune disease. The care Patrick and his family received from nurses while he was ill inspired this unique means of thanking nurses for making a profound difference in the lives of their patients.

Nurses can be nominated by anyone who has been affected by their care patients, family members, other nurses, physicians, other clinicians, and staff anyone who has experience or observed extraordinary, compassionate care being provided by a nurse. Say thank you to a nurse and nominate for the DAISY Award by visitinghttps://www.loganregionalmedicalcenter.com/daisy-award.

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Extraordinary Pediatric Nurse Recognized at LRMC | News ... - Williamson Daily News