Larissa Hirsch, MD

Hypercholesterolemia, atherosclerosis, and coronary artery disease are ever-growing problems in our society. While these “adult” medical issues rarely concerned pediatricians in the past, it is now well recognized that these troublesome processes begin in childhood.

The importance of vaccination has been well proved over the years for both individuals and the community as a whole. According to the 2004 to 2006 National Immunization Survey sponsored by the CDC, about 80% of children in the United States are up-to-date (UTD) with their immunizations, a rate that although respectable still leaves room for improvement.

The frequent visits that pediatricians have with infants are bittersweet. While they are wonderful opportunities to form lasting relationships with families, they are also times when babies suffer through the necessary pain of multiple immunizations.

New data underscore importance of discussing sex, STIs sooner rather than later.

To determine which children who had sustained head injuries would not benefit from CT scans, Kuppermann and colleagues3 conducted a prospective cohort study of more than 42,000 children from 25 North American emergency departments (EDs).

For years, pediatricians have discussed with parents the important role that reading to their children plays in the development of language skills. We have encouraged talking to children about things around them, describing objects and events, and telling stories.

Although it has been more than 40 years since Kawasaki disease was first described, it is still something of a medical mystery.

The most common chronic medical problem that we pediatricians treat is asthma. We do our best to manage our patients’ asthma by prescribing controller medications, providing asthma action plans, and guiding families through acute exacerbations. We often ask about possible environmental triggers, such as tobacco smoke and cockroaches, and we advise patients to reduce their exposure to those triggers.

The most common chronic medical problem that we pediatricians treat is asthma. We do our best to manage our patients' asthma by prescribing controller medications, providing asthma action plans, and guiding families through acute exacerbations. We often ask about possible environmental triggers, such as tobacco smoke and cockroaches, and we advise patients to reduce their exposure to those triggers.

As parents prepare to leave hospitals and physicians' offices with their children, clinicians explain how medications should be administered. Studies have shown that, despite these explanations, medication errors are common in children treated at home. These errors include inaccurate dosing and failure to complete prescribed courses.1

In the newborn nursery, pediatricians commonly encounter infants born to mothers who were receiving selective serotonin reuptake inhibitors (SSRIs) for depression during pregnancy. Earlier studies suggested a number of potential effects of maternal SSRI use on the newborn; these included jitteriness, agitation, diarrhea, hypoglycemia, vomiting, hypothermia, respiratory distress, seizures, feeding difficulties, increased or decreased tone, low birth weight, and small size for gestational age.1

Hemangiomas are the most common tumors seen in infants. Despite their rapid growth early in life, often the only action required of the physician is to reassure the parents that such tumors usually involute spontaneously during childhood.

For years, babies born between 32 and 36 weeks'gestation have been thought to have developmentaland neurological outcomes similar to those offull-term infants. Although studies have shownthat these infants are at greater risk for short-termmorbidities, such as respiratory distress, hyperbilirubinemia,hypoglycemia, and feeding problems,1 little researchhad been done regarding school outcomes for moderatepreterm(32 to 33 weeks) and late-preterm (34 to 36weeks) infants. Now a study in The Journal of Pediatricsby Chyi and colleagues2 has shown that these infantsmay also be at greater risk for difficulties in school laterin life.

Pertussis has long been known to cause severedisease and death in infants, especially in thosewho are unvaccinated or who are too young tobe immunized. With the number of pertussiscases in the United States increasing,1 those ofus who care for susceptible infants are looking for solutionsto this dangerous problem.

According to the National Center for HealthStatistics,1 almost one-fifth of American childrenaged 6 to 11 years are overweight-a proportion that has been increasing inrecent years. Overweight children are morelikely to become overweight adults, following a pathwaytoward such health complications as heart disease, diabetes,and sleep apnea.2 As pediatricians, we are constantlylooking for new ways to battle the obesity epidemic,and wonder what else we can do to slow theprogression of the trend.

As pediatricians, we have been encouragingcar seat and seat belt use by our patients formany years-checking them off our list ofanticipatory guidance to be given at healthmaintenance visits. If we are not runningshort on time, we may even remember to remind preteensthat they should not get in the car with anyonewho has been drinking or using drugs. But are thereother issues we should be mentioning related to gettinginto cars that pose a risk to our patients?

In today's hectic world, where parents and children alike are rushing fromone activity to the next, it is difficult to get meals organized-let alone tofind time to eat together as a family. While this only gets more complicatedas children reach their adolescent years, recent studies have stressedthe importance of these joint meals, especially for teenagers.

Parents often come to the pediatrician with concerns about their preschooler's temper tantrums. Should we reassure them that tantrums are normal, or should we refer the child for further evaluation? What clues suggest that tantrums might be a sign of future problems?

Parents often come to the pediatrician with concernsabout their preschooler's temper tantrums.Should we reassure them that tantrums arenormal, or should we refer the child for furtherevaluation? What clues suggest that tantrumsmight be a sign of future problems?

With the banning of peanut butter and jelly from some school cafeterias, peanut allergies have become a popular topic in the media and the public. Discussions often include references to an increasing prevalence of allergies, as well as to an earlier emergence of those allergies in children.

With the banning of peanut butter and jelly from someschool cafeterias, peanut allergies have become a populartopic in the media and the public. Discussions ofteninclude references to an increasing prevalence ofallergies, as well as to an earlier emergence of thoseallergies in children.

In addition to term infants (born after at least 37 weeks' gestation), many hospitals currently consider late-preterm infants (born between 34 and 36 weeks' gestation) mature enough to be admitted to the well-baby nursery. Several studies, including one recently published by Young and colleagues1 from Utah, have shown an increased mortality among these late-preterm (also known as near-term) infants.

When preparing a nursery, most parents buy bumper pads to soften the sides of the crib and to add a decorative touch. Traditional thinking has been that bumpers protect infants' heads from the hard sides of the crib and prevent arms and legs from becoming stuck between crib rails. The AAP recommends that if bumpers are used, they should be thin and firm.1 They advise parents to avoid pillow-like bumpersand to remove them when the child is pulling to stand.2 However, a study recently published in The Journal of Pediatrics may lead us to rethink what we tell parents about the dangers of decorative bedding.

There are frequently stories in the news and talk among the public of the over-diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in today's hypervigilant society. However, a study recently published in Archives of Pediatrics and Adolescent Medicine may serve to debunk this common belief.1

For years we have been prescribing prophylactic antibiotic therapy for children with a first-time urinary tract infection (UTI) before obtaining imaging studies-as is recommended in the 1999 American Academy of Pediatrics' practice parameter1-and for those with vesiculoureteral reflux (VUR). Although many pediatricians have raised questions about the efficacy and safety of this practice, the risks and benefits of antibiotic prophylaxis have not been well studied.

Transient tachypnea of the newborn (TTN) has traditionally been seen as a benign, self-limited disorder that occurs within a few hours of birth and resolves within 72 hours. For years, we have been telling parents that this innocent condition has no long-lasting effects and is nothing to be concerned about. According to a recent study in The Journal of Pediatrics, however, we may need to rethink that advice.

Heelys

According to the American Academy of Pediatrics (AAP), the average child watches 4 hours of television per day.1 By the time a child finishes elementary school, he or she will have seen 8000 murders on TV.1 By high school graduation, that child will have spent more time in front of the TV than in school.2

With the introduction of Gardasil--the vaccine that protects against infection with human papillomavirus (HPV) types 6, 11, 16, and 18--pediatricians are fielding an increasing number of questions from parents about this disease. Parents want to know how prevalent HPV infection actually is and how much of an impact the vaccine will have.

Each year in this country, UTI is diagnosed and treated in numerouschildren younger than 18 years; some are hospitalized as a result.Affected children have positive urine cultures and are treated withantibiotics.