Category Archives: Pediatrics

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Generation Next Dr. Lisa Costello, 37, Assistant Professor of Pediatrics, WVU - WV News

Pediatrics

Local pediatricians tips on keeping kids active and eating healthy this summer – WTOP

June 27, 2024 medical

A local pediatrician has tips on how to keep your children healthy and active this summer now that school's out.

Now that school is out for summer, parents should think about keeping kids active and eating healthy in the weeks ahead.

At the start of summer its a mad dash for us to figure out how were going to keep kids active and keep them off their devices. In general, we always recommend that you try to limit screen time to less than two hours a day, said Dr. Tekeema Dixon, chief of pediatrics for the Baltimore area of Mid-Atlantic Kaiser Permanente group.

This is super challenging in the summer, unless were filling their time with other things. So its important to find activities, she added.

Away from classrooms and without homework, theres a risk kids could be in front of their computer screens playing video games or on their smartphones engaging with social media for hours on end.

Unfortunately, we do know and we are seeing some implications or side effects of all of the screen time that our kids are having. It impacts your eyes and your visual health, and also is one of the main contributors to the obesity pandemic that were seeing, Dixon said.

When kids spend too much time on screens theyre spending less time getting active and moving. And sometimes too much screen time is also associated with a lot of snacking, she added. It also has impacts on sleep as well.

To get kids moving, present the activity as play instead of exercise and find activities that can be done as a family.

Dixon recommended swimming lessons or spending time at a pool, taking biking trips, hiking, doing things together as a family, while making sure that kids are having fun.

Summertime is also a good time to work on healthy eating habits together as a family. On the warm and hot days of summer, kids should properly hydrate.

Its important for parents to make sure that theyre emphasizing the importance of choosing water over any sugary drinks. So making sure kids are hydrating with water, and limiting any sugary drinks to four to six ounces a day is really important, she said.

She also recommended creating a kitchen schedule, or a policy on when its eating time and when the kitchen if off limits: Make it the rule that meals and snacks are to happen on a routine schedule. It helps to curb the snacking throughout the day.

Its also important to make sure that families are eating together. Having family mealtime without devices and screens serves as an opportunity to model healthy eating habits and also offers a time to connect, Dixon said.

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Local pediatricians tips on keeping kids active and eating healthy this summer - WTOP

Pediatrics

Discussing health care sustainability, climate change, and WHO’s One Health goal – Contemporary Pediatrics

June 27, 2024 medical

"Health care sustainability means taking into account how the health care system, our hospitals and clinics, have impacted greenhouse gas emissions," said Shreya Doshi, MBBS, FAAP, in this Contemporary Pediatrics video interview.

Doshi is a board-certified pediatrician and an infectious disease fellow at Children's National Hospital in Washington, DC. Doshi joined Contemporary Pediatrics to explain what health care sustainability is and how various health institutions are contributing to climate change.

"At this time, we're seeing so many events around the world that are related to extreme weather or climate change," said Doshi. "Children tend to be some of the most vulnerable people because [they] are growing and they need a good, healthy environment and healthy food in order to grow. So, for our children to be healthy, it's very important for their environment and their planet to be healthy."

Doshi explains the World Health Organization's (WHO) One Health plan, which according to WHO, is an "integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems."1

Doshi explained that health care systems in the United States make up 8.5% of the country's total greenhouse gas emissions. Of the health care system that contributes to overall greenhouse has emissions, 35% come from the hospital setting.2

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Discussing health care sustainability, climate change, and WHO's One Health goal - Contemporary Pediatrics

Pediatrics

Pediatric chiropractic boosta physical, emotional well-being – The Times of Northwest Indiana

June 27, 2024 medical

Carrie Steinweg Times correspondent

Dr. Michael Kehoe of Health from Within in Orland Park explains how chiropractic adjustments can help children with autism, ADHD and other special needs.

Pediatric chiropractic treatment is a specialized form of chiropractic care that focuses on assessing and adjusting the spine and nervous system of children. It involves gentle, safe adjustments performed by a specially trained pediatric chiropractor who understands the unique anatomy of children, said Dr. Matt Hammett, who with his wife, Dr. Trish Hammett, operates the New Family Life Chiropractic Center in Merrillville. The couple are also co-authors of the book "Inspire Chiropractic."

Dr. Michael Kehoe has been practicing at Health From Within in Orland Park for more than 5 years, the last twodedicating "ourselves to seeing more pediatrics and specializing in taking care of kids.

More specifically, we really specialize in taking care of what we call Perfect Storm' kidsautism, sensory processing disorder, ADHD, behavioral struggles, he said. Other common reasons parents seek out our help are for colic, sleep issues, constipation, diarrhea, immune struggles, chronic ear infections, asthma, headaches and allergies.

Kehoe said pediatric chiropractic focuses on optimizing the function of the central nervous system and the autonomic nervous system.

The nervous system (brain, spinal cord and peripheral nerves) perceives our environment and then coordinates every action in the body, he explained. If our body and nervous system are holding on to too much stress and tension, that diminishes the body's capacity to adapt. And when we aren't adapting as well as we can, that's when symptoms start to appear.

Hammett noted that pediatric chiropractic can be beneficial for infants through adolescents. It can address a wide range of conditions, including musculoskeletal issues, developmental delays, sensory processing issues, ADHD, asthma, allergies, cranial asymmetries (flat head), tongue tie and more.

We see kids as young as days old, and every age above that. We see infants due to the fact that a high percentage of infants are born with physical strain to their spine, particularly the upper neck, said Kehoe. This is what can set the stage for a host of issues down the line.

And not all benefits are physical.

It can also contribute to a child's overall well-being and help them reach their full potential, said Hammett. It is vital for parents to do their own research and feel confident in their decision to pursue chiropractic care for their child.

Kristina Pop of Valparaiso has been a patient of the Hammetts for several years, who have treated every member of the family including four children ages 10, 8, 6 and 3.

Our four children look forward to their adjustments and know that Dr. Matt helps keep their bodies aligned, happy and healthy as they play and grow through childhood, said Pop.

Pop began seeing Hammett during her third pregnancy and then sought treatment for her daughter whod had an occasional twitch in her leg from being cramped in utero. She also brought her fourth child, a girl born with cephalohematoma, a usually harmless birth injury that causes blood to pool at the scalp.

We were told it would take up to three months to heal. She also had some difficulty breastfeeding. I brought her in to Dr. Matt at about a week old, and I wish I hadnt waited so long, said Pop. With his gentle care and regular visits, she was able to nurse comfortably and with ease immediately after her first adjustment and the cephalohematoma had completely resolved within a month.

Andrea Florer, a Valparaiso mother of four (ages 4, 9, 12 and 14), also has been a patient at New Life Family Chiropractic.

All of my children receive chiropractic care for overall health and wellness. Weve seen benefits for all my children even when they were small babies, she said. Chiropractic has helped with projectile vomiting when my son was under a year old. My 12-year-old was found to have his hip out of place from a hockey injury. My 14-year-old had adjustments after receiving a concussion from an ice skating fall, and my 9-year-old had adjustments to help alleviate neck pain from using his school laptop/tablet on a regular basis. They all enjoy the chiropractic adjustments and look forward to their visits.

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Pediatric chiropractic boosta physical, emotional well-being - The Times of Northwest Indiana

Pediatrics

Ask the Pediatrician: How firearm safety begins at home – Union Democrat

June 27, 2024 medical

Firearm violence has become the leading killer of children and young adults under 24, surpassing deaths from vehicle collisions since 2017. And while daily headlines emphasize news of mass shootings, most firearms-related deaths and injuries are preventable and occur in a familiar place -- at home.

June is National Gun Violence Awareness Month and the American Academy of Pediatrics is not only calling attention to the sobering statistics, but is also offering tools and tips for families, communities and governmental entities to help prevent gun violence. Parents can learn more at HealthyChildren.org.

About 80% of firearm-related suicides take place in the home of a youth or a relative, with the firearm belonging to either the youth or parent or caregiver in 90% of cases. Approximately 40% of U.S. households with children have firearms, of which 15% stored at least one firearm loaded and unlocked, the storage method with the highest risk.

Between 2015 and 2022, there were at least 2,802 unintentional shootings by children 17 years old and younger. These resulted in 1,083 deaths and 1,815 nonfatal firearm injuries, nearly all among other kids. And at least 895 preschoolers and toddlers managed to find a firearm and unintentionally shoot themselves or someone else during this time.

Firearms are pervasive in America but we do have reason for hope. Research has shown us there are effective ways to prevent or reduce the risks of harm, just as our country did to improve motor vehicle safety. This is a public health epidemic that we can do something about, through a combination of regulation, legislation, product design, education and individual steps like securely storing firearms in the home.

Pediatric practitioners are encouraged to counsel families, offer mental health screenings and promote secure firearm storage as part of routine patient visits. As with other consumer products, the AAP supports regulating firearms for safety and notes that national requirements could be established for safe storage, training, licensing, insurance coverage and registration of individuals purchasing firearms.

Extreme risk protection order (ERPO) laws, also known as "red flag laws," which prohibit individuals at risk of harming themselves or others from purchasing or owning a firearm by a court order, are also becoming more common among states.

If there are firearms in the home, evidence shows that the risk of injury or deathboth unintentional as well as from an intentional shooting-- is greatly reduced when they are securely stored. This means storing the firearm unloaded and locked away from children, with the ammunition locked in a separate place that youth cant access. For households who store their firearms loaded, firearm lockboxes and safes can be used so curious children or teenagers at risk for suicide or homicide, cant access them without an adult. When there are individuals at risks of suicide or homicide in the household, storing firearms outside of the home (e.g. shooting range, firearm seller) is another option.

One study demonstrated that if 20% of parents who currently store their firearms unlocked instead stored their firearm and ammunition locked away separately, there would be an estimated decrease of up to 122 pediatric firearm-related fatalities and 201 injuries annually nationwide.

Even when they've been trained not to touch firearms, we know that young children are curious and will often pick up a firearmand even pull the triggerif they find it. Make sure, wherever your child is going this summer for playdates and vacationincluding the homes of relativesthat you ask about how firearms are secured in the home.

You can frame this as a safety conversation and first talk about food allergies and car seats. And then ask about how any firearms in the home are stored. But also think about your other options if you have concerns about how firearms are stored in the homeperhaps offer to meet at a park or museum or at your house instead.

Ultimately, we will need a multipronged approach to substantially decrease firearm injuries and deaths to U.S. youth. This is a public health epidemic that requires urgent, deliberative action. We must do better our children deserve it.

____

Lois Lee, MD, MPH, FAAP, Chair of the American Academy of Pediatrics Council on Injury, Violence and Poison Prevention, is a pediatric emergency medicine physician at Boston Childrens Hospital and Associate Professor of Pediatrics and Emergency Medicine at Harvard Medical School. Dr. Lee has published seminal research on pediatric emergency medicine, health disparities and injury prevention, including related to firearms. Dr. Lees expertise was recognized with her election to the National Academy of Medicine in 2023.

2024 Tribune Content Agency, LLC.

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Ask the Pediatrician: How firearm safety begins at home - Union Democrat

Pediatrics

Expert consensus and guidance for integrating discussions of racism in pediatric care – News-Medical.Net

June 27, 2024 medical

Extensive research shows the link between exposure to racism during childhood and adolescence and increased risks of depression and metabolic health issues, such as obesity, diabetes and heart disease. Conversely, racial socialization, described as behaviors and practices that teach children about race and ethnic identity, has shown potential in mitigating these negative effects, and discussions like these could be effective in pediatric clinics, according to the first expert consensus guidance on this topic published in Pediatrics.

Over the years, numerous calls to action have been made to address racism in medicine. However, there's been little guidance on how to have these conversations within clinical settings. Pediatric clinicians, in particular, have a unique opportunity to incorporate crucial conversations about race and racism into clinical visits, as these interactions occur during key developmental stages of a child's life."

Nia Heard-Garris, MD, MBA, MSc, senior author,researcher and pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine

Dr. Shawnese Clark, lead study author, and research team conducted the consensus study. It involved a panel of pediatric clinicians and psychologists with expertise in racism and child health, as well as parents and adolescents with lived experience of racism. They identified overarching themes to consider before, during, and after discussions with patients, as well as barriers that clinicians may encounter.

Consensus was reached on the necessity for pediatric clinicians to have a thorough understanding of the systemic nature of racism and the importance of both learning from patients and addressing intersectionality during these conversations. Panelists agreed on the short- and long-term benefits these conversations could bring to patient appointments, including building greater trust and affirmation.

"Racism is a strong determinant of health and longevity of life so talking about it, feeling affirmed and perhaps even receiving support will go a long way to social, mental, and emotional wellbeing of patients and care providers too," said one panelist.

Panelists also emphasized the potential negative consequences if clinicians lack adequate training.

"As research in this field continues to evolve, it is imperative to maintain ongoing dialogue about the key principles guiding conversations about race and racism, and to equip clinicians with the necessary tools to provide care that fully considers the impact of race on the patient population," said Dr. Heard-Garris.

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Expert consensus and guidance for integrating discussions of racism in pediatric care - News-Medical.Net

Pediatrics

JAMA Pediatrics Published Study Rise in Infant Deaths in Texas to Abortion Ban – ASEAN NOW

June 27, 2024 medical

A recent study published in JAMA Pediatrics links a significant rise in infant deaths in Texas to the state's stringent abortion ban enacted in 2021. The study, conducted by analysts from Johns Hopkins University and Michigan State University, investigated infant mortality rates following the implementation of the Texas heartbeat law, which effectively banned abortions around 5 to 6 weeks into pregnancy. This law, passed in September 2021, was one of the most restrictive in the nation at the time, prohibiting abortions after the detection of a fetal heartbeat, typically around six weeks of gestation.

The researchers found a troubling increase in infant deaths in Texas between 2021 and 2022. The number of infant deaths rose from 1,985 to 2,240, representing a 12.8 percent increase, compared to a 1.8 percent increase across the rest of the United States during the same period. This spike in Texas's infant mortality rate significantly outpaced the national average, which only saw a modest increase.

Prior to this law, Texas permitted abortions up to 22 weeks of pregnancy. The new restrictions, however, made no exceptions for cases of rape or incest, nor for congenital anomalies or birth defects. The study also highlighted a notable rise in congenital anomalies in Texas, which increased by 22.9 percent, contrasting sharply with a 3.1 percent decrease in such cases across the rest of the country.

The researchers noted that the Texas heartbeat law's implementation appeared to correlate with increased infant deaths, particularly due to congenital anomalies among infants who were in early gestation when the law took effect. This correlation suggests that the restrictive abortion policies may have unintended and severe consequences on infant health.

The study's findings were released on the two-year anniversary of the Supreme Court decision overturning Roe v. Wade, which had previously granted a constitutional right to abortion since 1973. This landmark ruling empowered states to impose their own abortion regulations, leading to a wave of restrictive abortion laws in several Republican-led states, including Texas.

Dr. Alison Gemmill, one of the study's lead authors, emphasized the relevance of these findings in light of the Supreme Court's ruling. She stated, "These findings suggest that restrictive abortion policies may have important unintended consequences in terms of infant health and the associated trauma to families and medical costs." This study underscores the broader implications of such policies, indicating that they may not only impact women's reproductive rights but also have far-reaching effects on infant mortality and family well-being.

Researchers employed statistical modeling and analyzed publicly available death-certificate data from January 2018 to December 2022 to arrive at these conclusions. Another research paper published last year corroborated these findings, linking nearly 10,000 additional live births in Texas to the state's abortion ban. The studys release and its alarming findings provide a crucial perspective on the real-world impacts of restrictive abortion legislation, highlighting the need for further examination and discussion on the implications for public health and policy.

Credit: Hill 2024-06-26

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Supreme Court Will Take Up State Bans on Gender Care for Minors: Here’s What to Know – Medpage Today

June 27, 2024 medical

The Supreme Court on Monday jumped into the fight over transgender rights, agreeing to hear an appeal from the Biden administration seeking to block state bans on gender-affirming care.

The justices' action comes as Republican-led states have enacted a variety of restrictions on healthcare for transgender people, school sports participation, bathroom usage, and drag shows. The administration and Democratic-led states have extended protections for transgender people, including a new federal regulation that seeks to protect transgender students.

The case before the high court involves a law in Tennessee that restricts puberty blockers and hormone therapy for transgender minors. The federal appeals court in Cincinnati allowed laws in Tennessee and Kentucky to take effect after they had been blocked by lower courts. (The high court did not act on a separate appeal from Kentucky.)

Arguments will take place in the fall.

The issue of gender-affirming care in minors has emerged as a big one in the past few years. While transgender people have gained more visibility and acceptance in many respects, half the states have pushed back with laws banning certain healthcare services for transgender kids.

Things to know about the issue:

What Is Gender-Affirming Care?

Gender-affirming care includes a range of medical and mental health services to support a person's gender identity, including when it's different from the sex they were assigned at birth.

The services are offered to treat gender dysphoria, the unease a person may have because their assigned gender and gender identity don't match. The condition has been linked to depression and suicidal thoughts.

Gender-affirming care encompasses counseling and treatment with medications that block puberty, and hormone therapy to produce physical changes. Those for transgender men cause periods to stop, increase facial and body hair, and deepen voices, among others. The hormones used by transgender women can have effects such as slowing growth of body and facial hair and increasing breast growth.

Gender-affirming care can also include surgery, including operations to transform genitals and chests. These surgeries are rarely offered to minors.

What Laws Are States Passing?

Over the past 3 years, 26 Republican-controlled states have passed laws restricting gender-affirming care for minors. Most of the laws ban puberty blockers, hormone treatment, and surgery for those under 18. Some include provisions that allow those already receiving treatment to continue.

The laws also make exceptions for gender-affirming treatments that are not part of a gender transition, such as medications to stop breast growth in boys and excessive facial hair in girls.

One of the laws -- in Arkansas -- was nixed by a federal court and is not being enforced.

Meanwhile, at least 14 Democratic-controlled states have adopted laws intended to protect access to gender-affirming care.

The gender-affirming care legislation is a major part of a broader set of laws and policies that has emerged in Republican-controlled states that rein in rights of transgender people. Other policies, adopted in the name of protecting women and girls, bar transgender people from school bathrooms and sports competitions that align with their gender.

What Have Courts Said So Far?

Most of the bans have faced court challenges, and most are not very far along in the legal pipeline yet.

The law in Arkansas is the only one to have been struck down entirely, but the state has asked a federal appeals court to reverse that ruling.

The 6th U.S. Circuit Court of Appeals, one step below the Supreme Court, last year ruled that Kentucky and Tennessee can continue to enforce their bans amid legal challenges. The high court has agreed to hear the Tennessee case in the term that starts later this year.

The U.S. Supreme Court in April ruled that Idaho can enforce its ban while litigation over it proceeds. A lower court had put it on hold.

What Does the Medical Community Think?

Every major U.S. medical group, including the American Academy of Pediatrics and the American Medical Association, has opposed the bans and said that gender-affirming treatments can be medically necessary and are supported by evidence.

But around the world, medical experts and government health officials are not in lockstep. Some European countries in recent years have warned about overdiagnosis of gender dysphoria.

In England, the state-funded National Health Service commissioned a review of gender identity services for children and adolescents, appointing retired pediatrician Hilary Cass, MD, to lead the effort. The final version of the Cass Review, published in April, found "no good evidence on the long-term outcomes of interventions to manage gender-related distress."

England's health service stopped prescribing puberty blockers to children with gender dysphoria outside of a research setting, following recommendations from Cass' interim report.

The World Professional Association for Transgender Health and its U.S. affiliate issued a statement in May saying they're deeply concerned about the process, content, and consequences of the review, saying it "deprives young trans and gender diverse people of the high-quality care they deserve and causes immense distress and harm to both young patients and their families."

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Supreme Court Will Take Up State Bans on Gender Care for Minors: Here's What to Know - Medpage Today

Pediatrics

Weekly review: Drowning prevention, coding updates, and more – Contemporary Pediatrics

June 9, 2024 medical

Thank you for visiting the Contemporary Pediatrics website. Take a look at some of our top stories from last week (Monday, June 3, to Friday, June 7, 2024), and click on each link to read and watch anything you may have missed.

1.) With drownings on the rise, prevention conversations with caregivers are crucial

Drowning is something that happens quickly, it happens usually insidiously, and [it is] really difficult to unwind the damage from drowning as time goes by, said James Barry, MD, a pediatric emergency medicine fellow in Rochester, New York. It is why the National Drowning Prevention Alliance (NDPA) and the American Academy of Pediatrics (AAP) held a joint virtual panel to discuss drowning prevention strategies this summer.

Click here for the full article.

2.) 2024 coding update

This article will detail how a recently activated code, G2211, will increase practice revenue and provider compensation. It may take some time, however, for insurance carriers to begin reimbursing for this add-on code, so pediatricians should be prepared to challenge rejected claims.

Click here for the full article from Andrew J. Schuman, MD.

3.) Now available: upadacitinib to treat JIA, psoriatic arthritis in patients 2 years and up

Upadacitinib (RINVOQ; AbbVie) is now available for patients aged 2 years and older with active polyarticular juvenile idiopathic arthritis (pJIA) and psoriatic arthritis (PsA) who have had an inadequate response or intolerance to 1 or more tumor necrosis factor (TNF) blockers, according to a press release from AbbVie.

Additionally, the company announced that a new, weight-based oral solution RINVOQ LQ, is now available as an option for the pediatric populations.

Click here for the full article.

4.) Use of monoclonal antibodies for idiopathic chronic eosinophilic pneumonia

Investigators of a study published in BMC Pulmonary Medicine aimed to describe the type of evidence and extent of research regarding the use of monoclonal antibodies for idiopathic chronic eosinophilic pneumonia (ICEP), to control the disease and limit secondary effects.

Click here for full study details.

5.) FDA approves increased amifampridine maximum daily dose to treat Lambert-Eaton myasthenic syndrome

With the federal agency's decision, the maximum daily dose increased from 80 mg to 100 mg, for adults and pediatric patients who weigh more than 45 kg, allowing for greater flexibility in treatment regimens for the management of LEMS.

Click here for full approval details.

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Weekly review: Drowning prevention, coding updates, and more - Contemporary Pediatrics

Pediatrics

A call to action for pediatrics: Caring for students with learning disabilities in custody and community settings | Pediatric … – Nature.com

June 9, 2024 medical

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A call to action for pediatrics: Caring for students with learning disabilities in custody and community settings | Pediatric ... - Nature.com