Pediatrician Grades

Children with even mild or passing bouts of depression, anxiety and/or behavioral issues were more inclined to have serious problems that complicated their ability to lead successful lives as adults, according to research from Duke Medicine.

Reporting in the July 15 issue of JAMA Psychiatry, the Duke researchers found that children who had either a diagnosed psychiatric condition or a milder form that didn't meet the full diagnostic criteria were six times more likely than those who had no psychiatric issues to have difficulties in adulthood, including criminal charges, addictions, early pregnancies, education failures, residential instability and problems getting or keeping a job.

"When it comes to key psychiatric problems -- depression, anxiety, behavior disorders -- there are successful interventions and prevention programs," said lead author William Copeland, Ph.D., assistant clinical professor of Psychiatry and Behavioral Sciences at Duke. "So we do have the tools to address these, but they aren't implemented widely. The burden is then later seen in adulthood, when these problems become costly public health and social issues."

Copeland and colleagues analyzed data from the Great Smoky Mountains Study, which began nearly two decades ago and includes 1,420 participants from 11 North Carolina counties. The study is ongoing and has followed the participants from childhood through adulthood -- most are now in their 30s.

Among the study group, 26.2 percent met the criteria for depression, anxiety or a behavioral disorder in childhood; 31 percent had milder forms that were below the full threshold of a diagnosis; and 42.7 percent had no identified problems.

The researchers found that as these children grew into adults, even some of those who had no psychiatric diagnosis as children -- nearly one in five -- stumbled in adulthood, suggesting that difficulties were not limited to those with psychiatric diagnoses.

But having a psychiatric diagnosis or a close call dramatically raised the odds that adulthood would have rough patches. This was the case even if they did not continue to have psychiatric problems in adulthood.

Of those with the milder psychiatric indicators as kids, 41.9 percent had at least one of the problems in adulthood that complicates success, and 23.2 percent had more than one such issue. For those who met the full psychiatric diagnosis criteria, 59.5 percent had a serious challenge as adults, and 34.2 percent had multiple problems.

Copeland said specific psychiatric disorders were associated with specific adult problems, but the best predictor of having adult issues was having multiple psychiatric problems as kids.

"When we went into this, it was an open question: Are these psychiatric diagnoses in childhood impairing in the moment, but something people recover from and go on?" Copeland said. "We weren't expecting to find these protracted difficulties into adulthood."

Copeland said the findings reinforce the need to attack problems early with effective therapies. He said only about 40 percent of children get the treatment they need for psychiatric disorders, and even fewer who have borderline problems are treated.

"A big problem with mental health in the United States is that most children don't get treatment and those who do don't get what we would consider optimal care," Copeland said. "So the problems go on much longer than they need to and cost much more than they should in both money and damaged lives."

Source: News-medicine

Is your baby biting everything and everyone he/she sees? It might be possible that he/she is teething. 

Some babies bite not out of spite but because it soothes their irritated gums. If this is the case, try giving him/her a frozen bagel or cold teething ring to chew on.

But what If teething isn't the cause and your child doesn't seem particularly anxious about something? (which can sometimes be behind biting), 

Here are some other reasons why your child is biting: 

• Expressing emotion: Oddly enough, young toddlers can bite as a way of showing love. Toddlers have really intense feelings but don’t know how to show them. Biting can be a way of expressing their feelings. Mothers often don’t understand why it’s just them who get bitten.
• Experimenting: Toddlers are learning how their body works – they put things in their mouths, and sometimes bite. It’s impulsive and they don’t mean to hurt. Often, a baby bites someone when they’re teething. Sometimes toddlers bite when they’re over-excited.
• Defending: Young children learn to bite as a defense, especially if they can’t talk. Sometimes changes or upsets at home can bring on this type of biting.
• Controlling: Some children know biting is a way of getting other children – or their parents – to do what they want. They don’t always do this consciously. Sometimes the youngest child in the family bites to gain power.
• Frustrated or irritated: Your child wants a toy back. Or they want a cookie or adult attention, or can’t cope with a situation. They may not understand turn-taking and sharing. Or things may have changed at home or the child feels under stress. Your child doesn’t necessarily mean to cause harm, but just can’t find the words to express themselves.

How to stop it

• Intervene: Open your eyes – look at how intense, how frequent bites are and what the triggers are. One of the best ways is to act before your child has a chance to sink their teeth into anyone. Sometimes, parents are slow to do this – but it’s one of the best ways. Don’t put them into large groups if that’s where it happens. Plan in advance for their behavior. Children often clench their teeth before they bite – an unmistakable sign. Take the child somewhere quiet to calm down. If a teething child is trying out his or her teeth, find toys to chew and chomp on.
• Teach them it’s wrong: When your child bites, use simple but firm words. Try, “that’s biting, that’s wrong” or a firm “no”. If you’re in a group, remove them from the situation. Explain that it hurts others and why you don’t like them doing it.
• Teach them to express themselves: When things have calmed down, try to help your child find a less painful way to express their feelings. This works well with children who are biting to try to show their affection, says Mr. Flower. “If your child’s expressing love, teach them to hug rather than bite whenever they feel strong emotions.” Likewise, if your child bites out of defense, show them how to tell somebody they don’t want him or her too close – to make the “stop” sign (a hand held up) – or even gently to push the other child’s shoulder – which won’t hurt but gives a clear message. Or teach them to come and find you instead if they’re angry.

• Reduce the effectiveness: When children bite to gain attention, dealing with it is trickier. After the first big talking to, don’t try to continue to reason or explain. Give a firm “no”. Put your body between victim and biter and turn your back on the biter. Give the victim sympathy and the biter a clear message this is an unproductive way of getting attention.
• If time-out is one of your methods, now’s the time to use it. If the bite was over a toy or treat, remove it for a short while. If a child tries to control his or her mom by biting, try physically putting a part of their body in the way as they go to bite – an arm or a leg, which will stop them in their tracks.
• Praise them for good behavior: Catch your child behaving well – not biting siblings, playing well in groups, not biting to get his or her way – and be generous with praise. Be specific – “good boy” becomes like water off a ducks back to them. Instead try: “how well you’re playing” or “aren’t you kind and gentle to your little brother?”

Additional Tips: 

Some children learn at different speeds and won’t pick up on things right away – you might need to be more persistent. When nothing works try these additional tips:

• Stick with it: Keeping to a plan of action is more difficult than it seems. You need attention, energy, consistency and support These methods aren’t rocket science, but need planning and determination. Make sure your family is on the same page – young children find it hard when they receive mixed messages.
• Give clear commands and be positive: Young children can’t understand negatives, so avoid “don’ts”. Try “we keep our mouths to ourselves” instead. Try not to raise your voice and speak in a firm voice. Don’t overdo explanations: One of the biggest mistakes is to give the warning all over again. If they continue to bite, don’t go into why it’s wrong; just say ‘that’s biting, that’s wrong’.

Be sure that no one laughs when your child bites and that no one, including older siblings, treats biting as a game or ever gives your baby a "love bite." Also never use your child's biting as an excuse to give in to his demands. Make sure that daycare providers understand your approach and are willing to follow it.

When to ask for help: Don’t rush to a therapist; seek help or advice first from friends and other parents, or teachers and nurseries who can also point you in the right direction if you want to take it further.

Source: BabyCenter, Supernanny.

Definition

Type 1 diabetes in children is a condition in which your child's pancreas no longer produces the insulin your child needs to survive, and you'll need to replace the missing insulin. Type 1 diabetes in children used to be known as juvenile diabetes or insulin-dependent diabetes.

The diagnosis of type 1 diabetes in children can be overwhelming at first. Suddenly you and your child — depending on his or her age — must learn how to give injections, count carbohydrates and monitor blood sugar. Although type 1 diabetes in children requires consistent care, advances in blood sugar monitoring and insulin delivery have improved the daily management of type 1 diabetes in children.

Symptoms

• Increased thirst and frequent urination. As excess sugar builds up in your child's bloodstream, fluid is pulled from the tissues. This may leave your child thirsty. As a result, your child may drink — and urinate — more than usual.
• Extreme hunger. Without enough insulin to move sugar into your child's cells, your child's muscles and organs become energy-depleted. This triggers intense hunger.
• Weight loss. Despite eating more than usual to relieve hunger, your child may lose weight — sometimes rapidly. Without the energy sugar supplies, muscle tissues and fat stores simply shrink. Unexplained weight loss is often the first sign to be noticed.
• Fatigue. If your child's cells are deprived of sugar, he or she may become tired and lethargic.
• Irritability or unusual behavior. Children with undiagnosed type 1 diabetes may suddenly seem moody or irritable.
• Blurred vision. If your child's blood sugar is too high, fluid may be pulled from the lenses of your child's eyes. This may affect your child's ability to focus clearly.
• Yeast infection. Girls with type 1 diabetes may have a genital yeast infection, and babies can develop diaper rash caused by yeast.

Causes

The exact cause of type 1 diabetes is unknown. Scientists do know that in most people with type 1 diabetes the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet) cells in the pancreas. Genetics may play a role in this process, and exposure to certain viruses may trigger the disease.

Source: MayoClinic

A baby who had heart surgery at St. Mary's Medical Center in Florida died Tuesday, at least the ninth infant to pass away after such a procedure since the program opened at the end of 2011.

A CNN investigation calculates that from 2011 to 2013, the program had a 12.5% mortality rate for open heart surgeries, which is more than three times the national average.

"Why won't they stop?" asked Nneka Campbell, whose baby daughter, Amelia, died after heart surgery at the hospital.

The same day the latest baby died, St. Mary's CEO Davide Carbone wrote a letter to employees about the CNN investigation, which aired Monday night, expressing support for the program and its heart surgeon, Dr. Michael Black.

"The patients we serve are afflicted with severe life-threatening conditions, and it is impossible to eliminate the risk of mortality," he wrote.

The hospital, which is owned by Tenet Healthcare, says CNN did not get the mortality rate right, but won't say what the hospital believes the correct rate is.

Surgical death rates for babies kept secret from parents

"We are deeply saddened when a lack of institutional transparency may have contributed to potentially unnecessary risk and serious harm," said Amy Basken, a spokeswoman for the Pediatric Congenital Heart Association, a national advocacy group.

Last year in April, the Florida Department of Health sent a team of expert heart doctors to St. Mary's to review the children's heart surgery program. The head of the panel, Dr. Jeffrey Jacobs, a professor of cardiac surgery at Johns Hopkins, suggested they stop doing heart surgeries on babies younger than 6 months.

The baby who died Tuesday, Davi Ricardo Brandao, was only a few weeks old when he had surgery in March for a severe heart defect called truncus arteriosus, according to his mother, Pautilia Gomes. She said her son needed a second surgery later that month.

In April, in response to an inquiry from CNN, St. Mary's spokeswoman Shelly Weiss said a patient with truncus arteriosus at St. Mary's was "recovering well and the prognosis is good."

Davi never left the hospital and was not quite 2 months old when he died. Gomes posted a picture on her Facebook page of an eye filled with tears and the word "LUTO," which is Portuguese for "mourning."

According to St. Mary's, the hospital received the experts' final reviews last year in June. In his letter to employees, Carbone said that since that time, "our mortality rate has been consistent with the national average, and does not significantly exceed the mortality rate of other programs as the CNN story alleges."

He did not say what the hospital's mortality rate was, or whether it included Davi's death. An email from CNN to Weiss went unanswered Wednesday.

Source: CNN

"Cocoa Butter prevents stretch marks."

• False: As tempting as it might be to slather your growing belly with a lotion that smells like chocolate, the last thing it does is prevent stretch marks. In fact, it might even make skin more sensitive. Try a solution with vitamin E, which has been proven to smooth skin. But be aware, nothing prevents stretch marks. 

"Walking brings on labor."

• False: While its a healthy way to stay active that's easy on pregnant joints, walking hasn't been proven to bring on labor. Walking will, however, help move along labor that is already in progress. 

"No Sushi while pregnant."

• False:  You might have a few concessions, but you don't have to give it up altogether! To ensure safety, avoid raw fish and seafood during pregnancy. You can have rolls with cooked fish like salmon, which is high in omega-3 fatty acids and very good for brain development, but take it easy on the tuna (which is high in mercury)- keep it under 12. oz (about two rolls) per week.

"Sleep only on your left side while pregnant."

• False: Unless there are serious complications in the pregnancy like high blood pressure, feel free to sleep any old way you like. After all, the chances of getting a full night's sleep is going to be kind of slim when the baby arrives. 

Pregnancy heartburn = hairy baby.

• False: As much as your heartburn might make you envision a velvety- skinned baby with loads of lustrous locks, its just not true. Though a study at Johns Hopkins in 2007 seemed to support rather than disprove the old wives' tale, many women who had heartburn ended up with babies who had little to no hair. Listen, your organs are pretty crowded, especially as your baby nears birth, and your reflux is due directly to your stomach having nowhere to expand, forcing acid up the esophagus. 

"Don't fly in your first or las trimesters."

• False: The truth is that flying is completely safe in any month of pregnancy. Most airlines hesitate to fly women in advanced stages of pregnancy (think emergency landing liability), and your own healthcare provider might want you to stick around as your due date looms.

"Raising you hands above your head is dangerous."

• False: Mom's upward salute pose definitely won't be at fault if baby emerges with the umbilical cord around his neck. There's a little prenatal acrobat in there, and its not the length of the cord and his movement -not yours- that determines if the cord will be wrapped around his neck. 

"No coffee while pregnant."

• False: Luckily for pregnant moms, and everyone around them, its perfectly safe to drink one cup a day. But don't overdo it- more than 200 mg of caffeine a day might put you at risk for preterm labor or miscarriage. 

"Your face looks soo different, it must be a girl."

• False: This about tops the worst things you can say to a pregnant mom. No one wants to be told that her face looks "different" (fat, spotty, blotchy), even if it means it's your answer to her unsolicited informal survey of what you think she's having. Your best bet is to smile and buy a gender neutral gift, because your chances of being right are 50/50 anyway.

"Don't go on a really bumpy car ride."

• False: Its a valid concern, especially while commuting down the post-winter pothole-ridden streets, but a regular car ride isn't dangerous for a pregnant mom. Your baby has plenty cushioning between the amniotic fluid and the uterus, so just buckle up and enjoy the ride. 

"Severe morning sickness means its definitely a girl."

• False: Even among those with the worst morning sickness, the male and female offspring were nearly 50-50 and whether this applies to milder cases is unknown. 

Source: huffingtonpost 

Pediatrics (also spelled paediatrics) is the branch of medicine that deals with the medical care of infants, children and adolescents, and the range limit usually ranges from the time of birth up to 18 years of age ( in some places until completion of secondary education, and until the age of 21 in the United States. A medical practitioner who specializes in this area is known as a Pediatrician or Paediatrician. Pediatrics work both in hospitals, particularly those working in its specialized subfields such as neonatology, and as primary care physicians who specialize in children.

Role of a Pediatrician:

• Treat Illness
• Monitor Chronic diseases
• Tracks Growth and Development
• Encourages Healthy Lifestyle
• Communicates with patients and parents
  

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The PediatricianGrades.com team