health_issue_article.id,health_issue_article.ts,health_issue_article.title,health_issue_article.content
1,"2018-04-19 02:59:41","Abdominal Pain in Children","Abdominal Pain in Children Page Content Article BodyConstipation often is blamed for abdominal pain, and while it’s rarely a problem in younger infants, it’s a common cause of pain in older children, especially in the lower part of the abdomen. When a child’s diet lacks plenty of fluids, fresh fruits and vegetables, and fiber rich in whole grains, bowel problems are more likely to occur. For more information, talk to your pediatrician. Urinary tract infections (UTI) are much more common in one- to five-year-old girls than in younger children. UTIs produce discomfort in the abdomen and the bladder area, as well as some pain and burning when urinating. These children also may urinate more frequently and possibly wet the bed. However, the infection usually does not produce a fever. If your child complains of these symptoms, take her to the pediatrician, who will examine her and check her urine. If an infection is present, an antibiotic will be prescribed, which will eliminate both the infection and the abdominal pain. Strep throat is a throat infection caused by bacteria called streptococci. It occurs frequently in children over three years of age. The symptoms and signs include a sore throat, fever, and abdominal pain. There may be some vomiting and headache as well. Your pediatrician will want to examine your child and swab her throat to check for strep bacteria. If the results are positive for strep, your child will need to be treated with an antibiotic. Appendicitis is very rare in children under age three and uncommon under the age of five. When it does occur, the first sign is often a complaint of constant stomachache in the center of the abdomen, and later the pain moves down and over to the right side. Lead poisoning most often occurs in toddlers living in an older house where lead-based paint has been used. Children in this age group may eat small chips of paint off the walls and woodwork. The lead is then stored in their bodies and can create many serious health problems. Parents also should be aware of toys or other products with unacceptable lead content. Symptoms of lead poisoning include not only abdominal pain, but also constipation, irritability (the child is fussy, crying, difficult to satisfy), lethargy (she is sleepy, doesn’t want to play, has a poor appetite), and convulsions. If your child is exposed to lead paint, has eaten paint chips or been exposed to toys with cracking, peeling, or chipping paint and has any of the above symptoms, call your pediatrician. She can order a blood test for lead and advise you as to what else needs to be done. Milk allergy is a reaction to the protein in milk, and can produce cramping abdominal pain, often accompanied by vomiting, diarrhea, and skin rash. Emotional upset in school-age children sometimes causes recurrent abdominal pain that has no other obvious cause. Although this pain rarely occurs before age five, it can happen to a younger child who is under unusual stress. The first clue is pain that tends to come and go over a period of more than a week, often associated with activity that is stressful or unpleasant. In addition, there are no other associated findings or complaints (fever, vomiting, diarrhea, coughing, lethargy or weakness, urinary tract symptoms, sore throat, or flulike symptoms). There also may be a family history of this type of illness. Finally, your child probably will act either quieter or noisier than usual and have trouble expressing her thoughts or feelings. If this type of behavior occurs with your child, find out if there’s something troubling her at home or school or with siblings, relatives, or friends. Has she recently lost a close friend or a pet? Has there been a death of a family member, or the divorce or separation of her parents? Your pediatrician can suggest ways to help your child talk about her troubles. For example, he may advise you to use toys or games to help the child act out her problems. If you need additional assistance, the pediatrician may refer you to a child therapist, psychologist, or psychiatrist. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
2,"2018-04-19 02:59:52","Abdominal Pains in Infants","Abdominal Pains in Infants Page Content Article BodyColic usually occurs in infants between the ages of ten days and three months of age. While no one knows exactly what causes it, colic seems to produce rapid and severe contractions of the intestine that probably are responsible for the baby’s pain. The discomfort often is more severe in the late afternoon and early evening, and may be accompanied by inconsolable crying, pulling up of the legs, frequent passage of gas, and general irritability. You can try a variety of approaches to colic, which might include rocking your baby, walking with her in a baby carrier, swaddling her in a blanket, or giving her a pacifier. Intussusception is a rare condition that may cause abdominal pain in young infants (usually between eight months and fourteen months of age). This problem occurs when one part of the intestine slides inside another portion of the intestine, creating a blockage that causes severe pain. The child will intermittently and abruptly cry and pull her legs toward her stomach. This will be followed by periods without stomach pain and often without any distress. These children also may vomit and have dark, mucousy, bloody stools that often look like blackberry jelly. It is important to recognize this cause of abdominal pain and to talk to your pediatrician immediately. She will want to see your child and perhaps order an X-ray called an air or barium enema. Sometimes doing this test not only enables the diagnosis but also unblocks the intestine. If the enema does not unblock the intestine, an emergency operation may be necessary to correct the problem. Viral or bacterial infections of the intestine (gastroenteritis) are usually associated with diarrhea and/or vomiting. On and off abdominal pain is often also present. Most cases are viral, require no treatment, and will resolve on their own over a week or so; the pain itself generally lasts one or two days and then disappears. One exception is an infection caused by the Giardia lamblia parasite. This infestation may produce periodic recurrent pain not localized to any one part of the abdomen. The pain may persist for a week or more and can lead to a marked loss of appetite and weight. Treatment with appropriate medication can cure this infestation and the abdominal pain that accompanies it. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
3,"2018-04-19 02:59:56","Appendicitis in Teens","Appendicitis in Teens Page Content Article BodyEarly adolescence is prime time for appendicitis, a potentially serious inflammation of the appendix. The small appendage, located on the right side of the lower abdomen, sticks out from the colon like a protruding tongue. Should it become inflamed and need to be surgically removed—the sole treatment for appendicitis—the appendix is hardly missed, for it has no known function. Symptoms that Suggest Appendicitis may Include: Persistent abdominal pain that migrates from the midsection to the right lower abdomen Nausea and vomiting Constipation Gas pain Diarrhea Low fever, beginning after other symptoms Tenderness in the right lower abdomen Abdominal swelling Elevated white blood cell count Appetite loss “Anybody who’s had appendicitis will tell you that pain is unlike any other kind of pain,” says Dr. Alan Lake, M.D. “In adolescents, it begins as a vague stomachache near the navel. Then patients feel it in the lower part of the right side of the abdomen.” He describes the sensation as a peculiar combination of pressure and fullness. The distinctive symptom should be heeded very seriously; should the appendix rupture, it may infect the double-layer peritoneal membrane that lines the abdominal cavity. The medical term for this is peritonitis. Notify your pediatrician at once or contact a local hospital emergency department. While you wait to see the doctor, instruct your teen to lie down and be still. Any kind of movement, including coughing or taking a deep breath, can exacerbate the pain. Don’t offer water, food, laxatives, aspirin or a heating pad. How Appendicitis Is Diagnosed Physical examination and thorough medical history, plus one or more of the following procedures: White blood cell count Urinalysis, to rule out a urinary-tract infection Ultrasound Lower GI series (barium enema) CT scan Exploratory laparoscopic surgery How Appendicitis Is Treated Surgery: Appendicitis can be difficult to diagnose definitely. Therefore, your physician may not schedule the appendectomy until the symptoms have progressed somewhat. Conventional “open” surgery usually requires a two day hospital stay, barring complications, and leaves youngsters with a small scar, but completely cured. Helping Teens To Help Themselves Youngsters should be encouraged to follow these basic guidelines for a healthy digestive tract: Eat at regular hours. Drink lots of water (at least eight cups of water or other liquid every day). Keep physically active. Chew food slowly and thoroughly before swallowing. Use aspirin and nonsteroidal anti-inflammatory medications sparingly; these drugs can irritate the fragile gastrointestinal lining. Don’t smoke; cigarettes, too, contribute to ulcers. Listen to your body! Don’t suppress the urge to move your bowels. Try not to strain during bowel movements. And most important, even with a busy schedule regular meals should be taken daily. Attempts should be made to have at least some of these meals sitting around a table preferably allowing time to talk, chew and digest. This will not only help your teens’ gut, but help the whole family stay connected. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
4,"2018-04-19 03:00:03","Bowel Function in Eating Disorders","Bowel Function in Eating Disorders Page Content Article BodyAdolescents with bulimia—the binge-purge syndrome—frequently abuse laxatives to provoke diarrhea and purge unwanted calories. Constipation, by contrast, is a recognized complication of anorexia. Apart from a diet that is woefully deficient in nutrients and bulk, an anorexic teenager has weakening of the intestinal muscles and an overall slowing of body metabolism, both of which are directly due to starvation. In addition, adolescents with this serious eating disorder typically drink very little for fear of becoming bloated. The weight of stool retained in the intestines can make it difficult to judge whether treatment is progressing. Finally, constipation may be worsened by medications used to treat anorexia. Specialists treating adolescents with anorexia manage constipation through a diet that includes adequate fiber and fluids. They also encourage moderate exercise and may recommend stool softeners and other medications if necessary. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
5,"2018-04-19 03:00:10","Campylobacter Infections","Campylobacter Infections Page Content Article BodyCampylobacter are a type of bacteria that produce infections in the GI tract. They are a major bacterial cause of diarrheal sickness among children in the United States. You may hear your pediatrician use the names Campylobacter jejuni or Campylobacter coli, which are the most common Campylobacter species associated with diarrhea. Common ways that a child can get the infection are from contaminated food, especially undercooked chicken; unpasteurized milk; and household pets, most often puppies, cats, hamsters and birds. Infection can also spread by person-to-person contact. The incubation period is usually 2 to 7 days. Signs and Symptoms Illness caused by Campylobacter infections includes diarrhea, stomach pain, and fever. Blood may be present in the stools. In young infants, bloody diarrhea may be the only sign that an infection is present. Severe diarrhea can cause dehydration, with symptoms such as excessive thirst and a decline in the frequency of urination. Campylobacter can also enter the blood stream and infect other organs, though this is not common. In rare cases, complications caused by the body’s immune system may develop. The antibodies made against Campylobacter can react against the child’s body, causing an uncommon form of arthritis called reactive arthritis, a skin sore called erythema nodosum, and a serious condition of the nerves called Guillain-Barré syndrome. With Guillain-Barré syndrome, the child develops weakness that usually starts in the legs and moves up the body. What You Can Do If your child has blood in his diarrhea or stools, you should call your pediatrician. Children with Campylobacter infections tend to get better on their own without any particular treatment. Until your child’s diarrhea goes away, make sure he drinks lots of fluids. Rehydration fluids are sold in stores, but can also be made at home. Talk to your pediatrician about how to include the proper amount of salt and sugar. How Is the Diagnosis Made? The blood and feces can be tested in the laboratory for the presence of Campylobacter bacteria. This will help your pediatrician give you an exact diagnosis of the cause of your child’s diarrhea. Treatment Sometimes, particularly when a Campylobacter infection is severe, antibiotics may be given. If taken early in the course of the illness, antibiotics such as erythromycin and azithromycin can eliminate the bacteria from the stool in 2 to 3 days and shorten the length of the illness. When your pediatrician gives these medicines, make sure your child takes them as instructed. Over the counter antidiarrheal medicines may make your child sicker and should not be taken if there is blood in the stools. What Is the Prognosis? If your child has a mild Campylobacter infection, the illness may last only for a day or two. In other cases, youngsters may recover within a week, although about 20% have a relapse or a prolonged or severe illness. Prevention Many cases of Campylobacter infections are connected with touching or eating undercooked poultry. Therefore, proper food handling and preparation are important. To prevent these infections in your family: Wash your hands thoroughly after handling raw poultry. Also, wash cutting boards and utensils with soap and water after they’ve been in contact with raw poultry. It is important to cook poultry thoroughly before eating. Drink only milk that has been pasteurized. Because pets can be carriers of Campylobacter bacteria, members of your family should wash their hands thoroughly after having contact with the feces of dogs, cats, hamsters, and birds. Wash your hands carefully after touching the underclothes or diapers of young children and infants with diarrhea. Children should always wash their hands before eating. If a child that attends child care has diarrhea, you should tell the caregivers right away. Preventing Gastroenteritis Wash your hands. Don’t share utensils. Wash and/or peel raw fruits and vegetables. Cook meats thoroughly. Avoid contaminating foods eaten raw (eg, fruit, salad) with foods that get cooked (eg, chicken, turkey, beef, pork). Last Updated 11/21/2015 Source Adapted from Immunizations and Infectious Diseases: An Informed Parents Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2011"
6,"2018-04-19 03:00:17","Celiac Disease in Children & Teens","Celiac Disease in Children & Teens Page Content​By: Anthony Porto, MD, MPH, FAAPPeople are thinking about celiac disease and the possibility of a gluten intolerance more often now than they have in the past. About 30% of people living in the United States are following some form of a gluten-free diet—either by choice or due to a medical condition. In this article, the American Academy of Pediatrics (AAP) answers common questions about celiac disease, gluten-related disorders, and following how children can follow a gluten-free diet.What is celiac disease?Celiac disease is a life-long condition affecting the small intestine. When a person with celiac disease eats, or is exposed to gluten (a protein found in food that contains rye, barley and wheat), his or her body destroys the intestinal villi—small, finger-like projections in the small intestine that absorb nutrients from food. Damage to the villi means that nutrients from food cannot be properly absorbed by the body and can lead to gastrointestinal symptoms, poor absorption of nutrients, and potentially to poor weight gain. No matter how much a person eats, he or she remains malnourished. When this happen to children, it can affect their growth and development. Once a child stops eating gluten, the villi heal and can absorb nutrients normally.Who is at risk for celiac disease?Approximately 35-40% of people carry one or both celiac genes—called HLA-DQ2 and DQ8. Those who carry one or both genes are considered to be ""at risk"" of developing celiac disease, although only a small percentage will actually develop the condition. In addition, children with certain conditions and/or syndromes may be more at risk for celiac disease. Children with one or more of the following are at an increased risk of developing celiac disease and should be considered for testing:First-degree relatives (children, siblings) of a person with celiac diseaseDown syndromeType 1 diabetesSelective IgA deficiencyTurner syndromeWilliams syndromeAutoimmune thyroiditisWhat are the symptoms of celiac disease?The symptoms of celiac disease vary widely and are influenced by age. Very young children may have poor growth, which begins at the time that they start eating any gluten-containing solid foods—about 6 months of age. Other classic symptoms in children this age are diarrhea and gas.  Older children and teens may have other symptoms such as abdominal pain, vomiting, and constipation. Non-gastrointestinal symptoms include delayed growth during puberty (short stature), skin rashes, iron deficiency anemia that does not respond to iron supplementation, elevated liver function tests, and bone problems (osteoporosis). Note that some children, particularly those in high-risk groups, will not show any symptoms and are typically found to have celiac disease through a blood test. What is the difference between celiac disease and gluten sensitivity?In addition to celiac disease, there are two other classes of gluten-related disorders: wheat allergy and non-celiac gluten sensitivity. Wheat allergy is an immediate, allergic response to wheat protein (IgE-mediated). It can lead to gastrointestinal symptoms and other symptoms seen with celiac disease. Non-celiac gluten sensitivity is not well defined, and some doctors believe it may only be caused by an intolerance to wheat and not to all gluten-containing grains. The type of intolerance seen in non-celiac gluten sensitivity does not lead to intestinal inflammation, as is seen in celiac disease.How do I know if my child has celiac disease or another gluten-related disorder?For celiac disease: Several tests are done to officially diagnose celiac disease. The first step is a blood test to look for certain antibodies—including tissue transglutaminase IgA. The level of these antibodies is usually high in people with celiac disease, but it is almost never increased in people without it. If the test is positive, a biopsy of the small intestine is recommended to confirm the diagnosis of celiac disease. The biopsy is usually collected during a test called an upper endoscopy—where a tube with a small camera on the tip is passed into the mouth and down the gastrointestinal tract and removes small pieces of the surface of the small intestine. The biopsy is not painful and is performed by a pediatric gastroenterologist while a child is sedated.  ​Other testing may include additional blood work for other antibodies such as deamidated gliadin IgG and endomysial IgA. Genetic testing may also be performed by taking a swab of the cheek; this is done in certain circumstances if the diagnosis of celiac disease is not certain. For a wheat allergy: Blood tests or skin- prick tests can be done to see if there is an elevated wheat IgE blood level or a skin reaction to the presence of wheat antigen on the skin. For non-celiac gluten sensitivity: There are no accurate tests available for evaluating. A child should continue to eat foods containing gluten until all testing is complete. Starting a gluten-free diet or avoiding gluten before testing may make it difficult to confirm the diagnosis. What is the treatment for celiac disease?The only available treatment for celiac disease is a strict life-long, gluten-free diet. It is important to limit cross-contamination—even crumbs containing gluten can lead to symptoms and intestinal inflammation. Additionally, gluten may be found in certain medications and in some non-food items such as shampoo and make-up—but these are not harmful unless they are eaten. Talking to a knowledgeable dietitian can help parents and children make the needed adjustments to a gluten-free lifestyle. Without treatment, children with celiac disease can go on to develop anemia, osteoporosis, and other complications.Is the gluten-free diet healthy?Just because a food is labeled ""gluten-free"" does not mean it is better for you. Therefore, reading labels may not always be the most efficient way to remain healthy and symptom-free. See Gluten-Free Food Labeling. ​Processed gluten-free foods are not vitamin fortified. For example, they may lack B vitamins and iron and be high in fat and sugar and low in protein. Eat naturally gluten-free and healthy foods. These include fruits, vegetables, meats and fish, as well as a variety of grains including amaranth, millet and quinoa. Some children with celiac disease may also need a daily multivitamin.What accommodations can be made for a child with celiac disease?Parents of children who are newly diagnosed with celiac disease will need to speak to their child's teacher or child care provider about the condition, what foods are safe, and what to do in case of inadvertent exposure to gluten.School lunches: Schools are required by law to provide substitutions to the school meals for children with celiac disease—if their needs are supported by a statement signed by a licensed doctor. The doctor's order may require certain products to be purchased for the child. Schools may not charge children with certified special dietary needs more than they charge other children for program meals or snacks. In other words, children who receive free lunches cannot incur any charges for their meals and children who pay full-price cannot be charged extra for the special foods the school must purchase.Classroom management: Children with a 504 plan or those who can document their condition are entitled not only to lunch, but to a plan for classroom management of their celiac disease. That might mean young children with celiac will not have access to glue or other gluten-containing art class items they might taste or put in their mouths. It might mean older children will not have field trips where they might encounter gluten, such as a tour of a bread factory. Additional Information & Resources: Common Food Allergies Diagnosing Food Allergies in ChildrenAsk the Pediatrician: My wife and I are on a gluten-free diet. Is it ok for our baby to also eat gluten-free?Ask the Pediatrician: When should I introduce wheat into my baby's diet?Celiac Disease FoundationGluten Intolerance Group of North America About Dr. Porto: Anthony Porto, MD, MPH, FAAP is a board-certified pediatrician and board-certified pediatric gastroenterologist. He is an Associate Professor of Pediatrics and Associate Clinical Chief of Pediatric Gastroenterology at Yale University and Director, Pediatric Gastroenterology at Greenwich Hospital in Greenwich, CT. He is also the medical director of the Yale Pediatric Celiac Program. Within the American Academy of Pediatrics, Dr. Porto sits on the PREP Gastroenterology Advisory Board and is a member of the Section on Gastroenterology, Hepatology and Nutrition. He is also a member of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition's Public Education Committee, a pediatric expert on nutrition for The Bump's Real Answers, and is the co-author of The Pediatrician's Guide to Feeding Babies and Toddlers. Follow him on Instagram @Pediatriciansguide. ​ Article Body Last Updated 7/24/2017 Source American Academy of Pediatrics (Copyright © 2017)"
7,"2018-04-19 03:00:22",Cholera,"Cholera Page Content Article BodyCholera is an infection of the intestines caused by bacteria called Vibrio cholerae. It causes a watery diarrhea that can range from mild to extremely severe. Cholera is rare in the United States but if you travel with your child to parts of the developing world, your child may contract cholera by drinking water or, less commonly, eating food such as raw or undercooked shellfish contaminated with V cholerae. Cholera has occurred in children who have visited Latin America or Asia or consumed food imported from that part of the world. Contaminated crabs, oysters, and other shellfish from the Gulf of Mexico have also caused cholera. It is probably not spread through person-to-person contact. There are some species of Vibrio that do not cause cholera, although they can produce diarrhea and may be responsible for blood and wound infections. They are associated with preparing or eating raw or undercooked seafood, particularly oysters, shrimp, and crabs. Signs and Symptoms In some cases of Vibrio infection, no symptoms are present. In most cases, however, there is mild to moderate diarrhea. In a relatively small number of cases, the watery diarrhea becomes severe and dehydration occurs. Vomiting, sometimes severe, is common. Early signs of dehydration include thirst, dry mouth, sunken eyes, and decreased urination. In the most severe cases, especially when lost fluids are not replaced, very serious complications can develop, including seizures, shock, and coma. In noncholera Vibrio infections, the most common symptom is diarrhea, with watery stools accompanied by abdominal cramps. Other symptoms may include headaches, chills, a low-grade fever, and vomiting. Diarrhea caused by these Vibrio infections can be bloody with mucus. Skin infections typically are very painful with redness and swelling. Fever is often present. Large blisters may form in more serious infections. When the bacteria gets into the bloodstream, the child will become very ill. There may be bleeding into the skin, low blood pressure, and sometimes shock. How Is the Diagnosis Made? Laboratory tests can detect the presence of Vibrio bacteria in the child’s feces, wounds, or blood. Treatment Children with dehydration due to cholera need to be rehydrated right away. This can usually be done with oral solutions made specifically for this purpose and available over the counter. For youngsters who are moderately to severely ill, intravenous fluids may be necessary. They also may be given antibiotics such as trimethoprim sulfamethoxazole, doxycycline, or tetracycline to get rid of the bacteria and shorten the duration of the diarrhea. Antidiarrheal medicines can make the illness worse, particularly in young children, and should not be used. Noncholera Vibrio infections causing diarrhea usually get better without treatment in 2 to 3 days, but it is important to make sure your child remains well hydrated. Antibiotics may be prescribed for severe infections. For skin infections, your child will need antibiotics. If the infection is mild, an oral antibiotic will be given. More serious skin infections and bacteria in the blood are treated in the hospital with intravenous antibiotics. In some cases, your child may require surgery to drain pus and damaged tissues. Prevention V cholerae can be killed by boiling, filtering, or treating water with chemicals such as chlorine or iodine. Adequately cooking food that may contain the organism will also destroy bacteria. Leftover cooked seafood should be refrigerated as soon as possible. When traveling abroad: Take precautions such as making sure your food is thoroughly cooked and the water is boiled. Avoid salads, raw vegetables, fruits that have already been peeled, and food from street vendors. Consume safe beverages such as carbonated drinks with no ice and tea and coffee prepared with boiled water. When taking measures like these, the risk of contracting cholera is low. Although 2 cholera vaccines have been made, they are of only limited effectiveness and not available in the United States. Last Updated 11/21/2015 Source Adapted from Immunizations and Infectious Diseases: An Informed Parents Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2011"
8,"2018-04-19 03:00:28","Clostridium difficile","Clostridium difficile Page Content Article BodyClostridium difficile is a cause of diarrhea in children. It is also responsible for producing a serious form of colitis (inflammation of the colon) called pseudomembranous colitis. These infections are often contracted in the hospital while a child is receiving antibiotic treatment, although illness may develop days or weeks after leaving the hospital. These anaerobic bacteria are often found normally in the gut of newborns and young children. The disease is caused when the bacteria produce a toxin (poison) that damages the lining of the gut. This happens most often when your child is taking antibiotics that kill other bacteria in the gut, permitting C difficile to multiply to very high numbers. The incubation period for this illness is not known. The bacteria can live in the gut for long periods without causing illness. Signs and Symptoms C difficile causes diarrhea with stomach cramps or tenderness, fever, and blood and mucus in the stools. How Is the Diagnosis Made? To make a proper diagnosis, your child’s stool can be tested for the presence of toxins produced by C difficile. Treatment Because antibiotic use and overuse is associated with C difficile infections, children on antibiotics should be taken off these medicines as soon as possible. In mild cases, children may get better once they stop taking the antibiotics. Some children, however, may need to be given particular medicines such as metronidazole or vancomycin that fight the bacteria. Most children make a full recovery. If a relapse of the illness occurs, which happens in up to 10% to 20% of patients, the same treatment is often repeated. Prevention It may be possible to prevent or reduce the risk of C difficile disease through proper hand washing, as well as the proper handling of dirty diapers and other waste matter. Also, the use of antibiotics should be limited to only those circumstances in which it is absolutely necessary. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
9,"2018-04-19 03:00:31","Communicating Hydrocele","Communicating Hydrocele Page Content Article BodyIf the opening between the abdominal cavity and the scrotum has not closed properly and completely, abdominal fluid will pass into the sac around the testis, causing a mass called a communicating hydrocele. As many as half of all newborn boys have this problem; however, it usually disappears within one year without any treatment. Although most common in newborns, hydroceles also can develop later in childhood, most often with a hernia. If your son has a hydrocele, he probably will not complain, but you or he will notice that one side of his scrotum is swollen. In an infant or young boy, this swelling decreases at night or when he is resting or lying down. When he gets more active or is crying, it increases, then subsides when he quiets again. Your pediatrician may make the final diagnosis by shining a bright light through the scrotum, to show the fluid surrounding the testicle. Your doctor also may request an ultrasound examination of the scrotum if it is very swollen or hard. If your baby is born with a hydrocele, your pediatrician will examine it at each regular checkup until around one year of age. During this time your child should not feel any discomfort in the scrotum or the surrounding area. But if it seems to be tender in this area or he has unexplained discomfort, nausea, or vomiting, call the doctor at once. These are signs that a piece of intestine may have entered the scrotal area along with abdominal fluid. If this occurs and the intestine gets trapped in the scrotum, your child may require immediate surgery to release the trapped intestine and close the opening between the abdominal wall and the scrotum. If the hydrocele persists beyond one year without causing pain, a similar surgical procedure may be recommended. In this operation, the excess fluid is removed and the opening into the abdominal cavity closed. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
10,"2018-04-19 03:00:39","Constipation in Children","Constipation in Children Page Content​​Bowel patterns vary from child to child just as they do in adults. What's normal for your child may be different from what's normal for another child. Most children have bowel movements 1 or 2 times a day. Other children may go 2 to 3 days or longer before passing a normal stool. For instance, if your child is healthy and has normal stools without discomfort or pain, ­having a bowel movement every 3 days may be her normal bowel pattern. Children with constipation may have stools that are hard, dry, and difficult or painful to pass. These stools may occur daily or be less frequent. Although constipation can cause discomfort and pain, it's ­usually temporary and can be treated.  Constipation is a common problem in children. It's one of the main reasons children are referred to a specialist, called a pediatric gastroenterologist. Here is information from the American Academy of Pediatrics (AAP) about constipation and its causes, symptoms, and treatments, as well as ways to prevent it.  What causes constipation?Constipation frequently occurs for a variety of ­reasons.  Diet. Changes in diet, or not enough fiber or fluid in your child's diet, can cause constipation. Illness. If your child is sick and loses his ­appetite, a change in his diet can throw off his system and cause him to be constipated. Constipation may be a side effect of some ­medicines. Constipation may result from certain medical conditions, such as hypothyroidism (underactive thyroid gland).Withholding. Your child may withhold his stool for different reasons. He may withhold to avoid pain from passing a hard stool, which can be even more painful if your child has a bad diaper rash. Or he may be dealing with issues about independence and control—this is common between the ages of 2 and 5 years. Your child may also withhold because he simply doesn't want to take a break from play. Your older child may withhold when he's away from home, at camp, or at school, because he's embarrassed or uncomfortable using a public toilet.Other changes. In general, any changes in your child's routine, such as traveling, hot weather, or stressful situations, may affect his overall health and how his bowels function.If constipation isn't treated, it may get worse. The longer the stool stays inside the lower intestinal tract, the larger, firmer, and drier it becomes. Then it becomes more difficult and painful to pass the stool. Your child may hold back his stool because of the pain. This creates a vicious cycle.  What are the symptoms of ­constipation?Symptoms of constipation may include:  Many days without normal bowel movementsHard stools that are difficult or painful to passAbdominal pain, such as stomachaches, ­cramping, or nauseaRectal bleeding from tears, called fissuresSoiling Poor appetiteCranky behaviorYou may also notice your child crossing her legs, making faces, stretching, clenching her buttocks, or twisting her body on the floor. It may look as if your child is trying to push the stool out, but instead she's trying to hold it in.  How is constipation treated?Constipation is treated in different ways. Your child's doctor will recommend what is best for your child's situation. In some cases, your child may need to have a medical test before your child's doctor can recommend treatment. For example, your child's doctor may need to look inside your child's body and x-rays may be used to create these images. In most cases, no tests are needed.  What is encopresis?If your child withholds her stools, she may ­produce such large stools that her rectum stretches. She may no longer feel the urge to pass a stool until it is too big to be passed without the help of an enema, laxative, or other treatment. Sometimes, only liquid can pass around the stool and leaks out onto your child's underwear. The liquid stool may look like diarrhea, confusing both parent and pediatrician, but it's not. This problem is called encopresis.Dietary changesBabies. Constipation is rarely a problem in younger infants. It may become a problem when your baby starts solid foods. Your child's doctor may suggest adding more water or juice to your child's diet.Older children. When a child or teen is con­stipated, it may be because his diet doesn't include enough high-fiber foods and water. Your child's doctor may suggest adding higher-fiber foods to your child's diet and may encourage him to drink more water. These changes in your child's diet will help get rid of abdominal pain from constipation.​MedicineIn some cases, your child's doctor may prescribe medicine to soften or remove the stool. Never give your child laxatives or enemas unless your child's doctor says it's OK; laxatives can be dangerous to children, if not used properly. After the stool is removed, your child's doctor may suggest ways you can help your child develop good bowel habits to prevent stools from backing up again.  How can constipation be prevented?Because each child's bowel patterns are different, become familiar with your child's normal bowel patterns. Make note of the usual size and consistency of her stools. This will help you and your child's doctor determine when constipation occurs and how best to treat it. If your child doesn't have normal bowel movements every few days or is uncomfortable when stools are passed, she may need help in developing proper bowel habits.  You can…  Encourage your child to drink plenty of water and eat higher-fiber foods.Help your child set up a regular toileting routine.Encourage your child to be physically active. Exercise along with a balanced diet provides the foundation for a healthy, active life.Getting enough fiber in your dietThe AAP recommends that people between the ages of 2 and 19 years eat a daily amount of fiber that equals their age plus 5 grams of fiber. For example, 7 grams of fiber are recommended if your child is 2 years of age (2 plus 5 grams).  Remember…If you are concerned about your child's bowel movements, talk with your child's doctor. A simple change in diet and exercise may be the answer. If not, your child's doctor can suggest a plan that works best for your child. Additional Information from HealthyChildren.org: Infant ConstipationAbdominal Pain in Children Stomachaches in Children & TeensKids Need Fiber: Here's Why and How​ Article Body Last Updated 2/28/2017 Source Constipation and Your Child (Copyright © 2005 American Academy of Pediatrics, Updated 10/2016)"
11,"2018-04-19 03:00:43",Diarrhea,"Diarrhea Page Content Article BodyWhat is the best way to treat diarrhea? Most children with mild diarrhea can continue to eat a normal diet including formula or milk. Breastfeeding can continue. If your baby seems bloated or gassy after drinking cow's milk or formula, call your pediatrician to discuss a temporary change in diet. Special fluids for mild illness are not usually necessary. Special fluids for moderate illness Children with moderate diarrhea may need special fluids. These fluids, called electrolyte solutions, have been designed to replace water and salts lost during diarrhea. They are extremely helpful for the home management of mild to moderately severe illness. Do not try to prepare these special fluids yourself. Use only commercially available fluids—brand-name and generic brands are equally effective. Your pediatrician or pharmacist can tell you what products are available. If your child is not vomiting, these fluids can be used in very generous amounts until the child starts making normal amounts of urine again. Reminder–Do's and Don'ts Do Watch for signs of dehydration which occur when a child loses too much fluid and becomes dried out. Symptoms of dehydration include a decrease in urination, no tears when baby cries, high fever, dry mouth, weight loss, extreme thirst, listlessness, and sunken eyes. Keep your pediatrician informed if there is any significant change in how your child is behaving. Report if your child has blood in his stool. Report if your child develops a high fever (more than 102°F or 39°C). Continue to feed your child if she is not vomiting. You may have to give your child smaller amounts of food than normal or give your child foods that do not further upset his or her stomach. Use diarrhea replacement fluids that are specifically made for diarrhea if your child is thirsty. Don't Try to make special salt and fluid combinations at home unless your pediatrician instructs you and you have the proper instruments. Prevent the child from eating if she is hungry. Use boiled milk or other salty broth and soups. Use ""anti-diarrhea"" medicines unless prescribed by your pediatrician. Last Updated 11/21/2015 Source Diarrhea and Dehydration (Copyright © 1996 American Academy of Pediatrics, Updated 7/2004)"
12,"2018-04-19 03:00:50","Drinks to Prevent Dehydration in a Vomiting Child","Drinks to Prevent Dehydration in a Vomiting Child Page Content Article BodyFor vomiting children, the main risk is water loss, or dehydration, especially if fever causes them to sweat more or they are also losing fluid through diarrhea. When vomiting is severe or prolonged, a child may lose sodium, potassium, and chloride. These minerals have a crucial role in the transmission of nerve impulses and the contraction of muscles, and in regulating the body’s fluid balance. While missing a meal or two will cause no harm to an otherwise healthy child, it’s important that a sick child continue to drink water to take care of normal daily needs, plus extra to make up for fluid loss and prevent dehydration. Young children are especially susceptible to dehydration because they are less efficient at conserving water than older children and adults. In addition, small body size means that it takes less fluid loss to lead to dehydration. Offer frequent sips of water or, if your child doesn’t feel like drinking, ice chips to suck on. Build up to 1 oz an hour, then 2 oz an hour until the child is able to drink normally. Your pediatrician may recommend a commercial rehydration solution to help replace lost sodium and potassium in a young child. These come in liquid and Popsicle-like forms to make them more appealing to children. It also makes certain that the liquid is taken slowly. Older children may ask for commercial sports drinks, but these should be used with care. They replace salts, but they also contain large amounts of sugar, which can make diarrhea worse. A child who wants a change from plain water may enjoy sips of fruit juice diluted half-and-half with water or flat soda. If your child is too sick to drink or listless, or shows signs of progressive dehydration such as dry mouth, fewer tears, or urinates less frequently, seek urgent medical attention. Contact your pediatrician immediately. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
13,"2018-04-19 03:00:57","Food Poisoning","Food Poisoning Page Content Article BodyEach year more than 30 million Americans suffer from food poisoning, which can be especially hazardous for babies and young children. If two or more members of your family experience cramps, nausea, vomiting, or diarrhea after eating the same food, food poisoning is the likely cause. To reduce the chance of food poisoning, wash hands with hot water and soap both before and while preparing meals, wash dish towels and sponges, and refrigerate all food immediately after a meal. Click here to listen Last Updated 1/23/2016 Source A Minute for Kids"
14,"2018-04-19 03:01:02","Food Poisoning and Food Contamination","Food Poisoning and Food Contamination Page Content Article BodyFood poisoning occurs after eating food contaminated by bacteria. The symptoms of food poisoning are basically the same as those of stomach flu: abdominal cramps, nausea, vomiting, diarrhea, and fever. But if your child and other people who have eaten the same food all have the same symptoms, the problem is more likely to be food poisoning than stomach flu. The bacteria that cause food poisoning cannot be seen, smelled, or tasted, so your child won’t know when she is eating them. These organisms include: Staphylococcus Aureus (Staph) Staph contamination is the leading cause of food poisoning. These bacteria ordinarily cause skin infections, such as pimples or boils, and are transferred when foods are handled by an infected person. When food is left at a specific temperature (100 degrees Fahrenheit [37.8 Celsius])—generally one that is lower than the temperature needed to keep food hot—the staph bacteria multiply and produce a poison (toxin) that ordinary cooking will not destroy. The symptoms begin one to six hours after eating the contaminated food, and the discomfort usually lasts about one day. Salmonella Salmonella bacteria (there are many types) are another major cause of food poisoning in the United States. The most commonly contaminated foods are raw meat (including chicken), raw or undercooked eggs, and unpasteurized milk. Fortunately, salmonella are killed when the food is cooked thoroughly. Symptoms caused by salmonella poisoning start sixteen to forty-eight hours after eating, and may last two to seven days. E. Coli Escherichia coli (or E. coli) is a group of bacteria that normally live in the intestines of children and adults. A few strains of these bacteria can cause food-related illnesses. Undercooked ground beef is a common source of E. coli, although raw produce and contaminated water have caused some outbreaks. Symptoms of an infection typically include diarrhea (which can range from mild to severe) to abdominal pain, and in some cases nausea and vomiting. Some E. coli outbreaks have been quite severe and have even caused deaths in rare instances. The optimal treatment for an E. coli–related illness is rest and fluids (to counteract dehydration). But if symptoms are more severe, you should have a discussion with your pediatrician. Clostridium Perfringens Clostridium perfringens (C. perfringens) is a bacterium frequently found in soil, sewage, and the intestines of humans and animals. It usually is transferred by the food handler to the food itself, where it multiplies and produces its toxin. C. perfringens often is found in school cafeterias because it thrives in food that is served in quantity and left out for long periods at room temperature or on a steam table. The foods most often involved are cooked beef, poultry, gravy, fish, casseroles, stews, and bean burritos. The symptoms of this type of poisoning start eight to twenty-four hours after eating, and can last from one to several days. Shigellosis Shigella infections, or shigellosis, are intestinal infections caused by one of many types of shigella bacteria. These bacteria can be transmitted through contaminated food and drinking water, as well as via poor hygiene (in child care centers, for example). The organisms invade the lining of the intestine, and can lead to symptoms such as diarrhea, fever, and cramps. Shigellosis and its symptoms usually subside after about five to seven days. In the meantime, your child should consume extra fluids and (if your pediatrician recommends it) a rehydrating solution. In severe cases, your doctor may prescribe antibiotics, which can shorten the duration and intensity of the infection. Campylobacter One form of infectious food poisoning is caused by the bacteria Campylobacter, which a child may ingest when he eats raw or undercooked chicken, or drinks unpasteurized milk or contaminated water. This infection typically leads to symptoms such as watery (and sometimes bloody) diarrhea, cramps, and fever, about two to five days after the germs are consumed in food. To diagnose a Campylobacter infection, your doctor will have a culture of a stool specimen analyzed in the laboratory. Fortunately, most cases of this infection run their course without any formal treatment, other than making sure that your child drinks plenty of fluids in order to replace the fluids lost from diarrhea. When symptoms are severe, however, your pediatrician may prescribe antibiotics. In most cases, your child will be back to normal in about two to five days. Botulism This is the deadly food poisoning caused by Clostridium botulinum. Although these bacteria normally can be found in soil and water, illness from them is extremely rare because they need very special conditions in order to multiply and produce poison. Clostridium botulinum grows best without oxygen and in certain chemical conditions, which explains why improperly canned food is most often contaminated and the low-acid vegetables, such as green beans, corn, beets, and peas, are most often involved. Honey also can be contaminated and frequently causes severe illness, particularly in children under one year of age. This is the reason why honey should never be given to an infant under the age of one year. Botulism attacks the nervous system and causes double vision, droopy eyelids, decreased muscle tone, and difficulty in swallowing and breathing. It also can cause vomiting, diarrhea, and abdominal pain. The symptoms develop in eighteen to thirty-six hours and can last weeks to months. Without treatment, botulism can cause death. Even with treatment, it can cause nerve damage. Cryptosporidiosis In very uncommon situations, watery diarrhea, low-grade fever, and abdominal pain may be caused by an infection known as cryptosporidium. This infection is of special concern in children who do not have a normal immune system. Other sources of food poisoning include poisonous mushrooms, contaminated fish products, and foods with special seasonings. Young children do not care for most of these foods and so will eat very little of them. However, it still is very important to be aware of the risk. If your child has unusual gastrointestinal symptoms, and there is any chance she might have eaten contaminated or poisonous foods, call your pediatrician. Treatment In most cases of food-borne illnesses, all that’s necessary is to limit your child’s eating and drinking for a while. The problem will then usually resolve itself. Infants can tolerate three to four hours without food or liquids; older children, six to eight. If your child is still vomiting or her diarrhea has not decreased significantly during this time, call your pediatrician. Also notify the doctor if your child: Shows signs of dehydration Has bloody diarrhea Has continuous diarrhea with a large volume of water in the stool, or diarrhea alternating with constipation May have been poisoned by mushrooms Suddenly becomes weak, numb, confused, or restless, and feels tingling, acts drunkenly, or has hallucinations or difficulty breathing Tell the doctor the symptoms your child is having, what foods she has eaten recently, and where they were obtained. The treatment your pediatrician gives will depend on your child’s condition and the type of food poisoning. If she is dehydrated, fluid replacement will be prescribed. Sometimes antibiotics are helpful, but only if the bacteria are known. Antihistamines help if the illness is due to an allergic reaction to a food, toxin, or seasoning. If your child has botulism, she will require hospitalization and intensive care. Prevention Most food-borne illness is preventable if you observe the following guidelines. Cleanliness Be especially careful when preparing raw meats and poultry. After you have rinsed the meat thoroughly, wash your hands and all surfaces that have come in contact with the raw meat and poultry, with hot, sudsy water before continuing your preparation. Always wash your hands before preparing meals and after going to the bathroom or changing your child’s diaper. If you have open cuts or sores on your hands, wear gloves while preparing food. Do not prepare food when you are sick, particularly if you have nausea, vomiting, abdominal cramps, or diarrhea. Food Selection Carefully examine any canned food (especially home-canned goods) for signs of bacterial contamination. Look for milky liquid surrounding vegetables (it should be clear), cracked jars, loose lids, and swollen cans or lids. Don’t use canned or jarred goods showing any of these signs. Do not even taste them. Throw them away so that nobody else will eat them. (Wrap them first in plastic and then in a heavy paper bag.) Buy all meats and seafood from reputable suppliers. Do not use raw (unpasteurized) milk or cheese made from raw milk. Do not eat raw meat. Do not give honey to a baby under one year of age. Food Preparation and Serving Do not let prepared foods (particularly starchy ones), cooked and cured meats, cheese, or anything with mayonnaise stay at room temperature for more than two hours. Do not interrupt the cooking of meat or poultry to finish the cooking later. Do not prepare food one day for the next unless it will be frozen or refrigerated right away. (Always put hot food right into the refrigerator. Do not wait for it to cool first.) Make sure all foods are cooked thoroughly. Use a meat thermometer for large items like roasts or turkeys, and cut into other pieces of meat to check if they are done. When reheating meals, cover them and reheat them thoroughly.   Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
15,"2018-04-19 03:01:06","Gastroesophageal Reflux & Gastroesophageal Reflux Disease: Parent FAQs","Gastroesophageal Reflux & Gastroesophageal Reflux Disease: Parent FAQs Page Content​​​​By: Anthony Porto, MD, MPH, FAAPAll babies spit up— and it often seems like everything they just ate comes right back up! So, how do you know if your spitty baby's symptoms are normal or part of a larger problem?To help you sort it all out, the American Academy of Pediatrics (AAP) answers common questions about typical digestive functioning and explains the differences between gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD).What are the differences between GER and GERD? Without getting too technical, spit-up (also called reflux, gastroesophageal reflux, or GER) is the movement of stomach contents into the esophagus, and sometimes through the mouth and nose. When reflux is associated with other symptoms, or if it persists beyond infancy, it is considered a disease and is known as gastroesophageal reflux disease or GERD. GER in infants is not considered a disease and does not include a ""D."" In fact, GER is considered normal. These infants are known as ""happy spitters,"" because they are not cranky and do not appear to be in a great deal of pain when spitting up. In fact, your baby may feel better after a good spit-up. Other symptoms of GER include mild feeding problems, such as occasional prolonged feeds or interrupted feeds.When is spit-up or GER normal?GER usually begins at approximately 2 to 3 weeks of life and peaks between 4 to 5 months. Most babies who are born at full term will have complete resolution of symptoms by the time they are 9 to 12 months old. In most babies, GER disappears as the upper digestive tract functionally matures. In addition, normal development, including improved head control and being able to sit up, as well as the introduction of solid food, will help improve GER symptoms.What are the causes of GER?If your baby's stomach is full or his or her position is changed abruptly, especially after a feeding, the stomach contents—food mixed with stomach acid—press against the valve at the top of the stomach. This is called the lower esophageal sphincter. This ring of muscle normally relaxes to let food pass from the esophagus into the stomach and then tightens again to keep the food there. When it is not fully developed or it opens at the wrong time, the stomach contents move back or reflux into the esophagus. See Why Babies Spit Up for more information on this. In older children, diet can play more of a role. Large meals and highly acidic or spicy meals, as well as carbonated or caffeinated beverages, can lead to increased GER symptoms. In addition, GER is more common in children who are overweight or obese. How do I know if my child has GERD? Unlike GER, GERD is associated with complications from acid reflux. Call your pediatrician if your child exhibits any of the following signs or symptoms: Refusal to feedCrying and/or arching the back during feeds (i.e., seems to be in pain) Blood or greenish color in the spit-up Increase in frequency or intensity of the spit-up (i.e., forceful)Belly is swollen or distended or feels hard Respiratory symptoms—including wheezing and coughingIn addition, let your pediatrician know if you notice that your baby doesn't seem to be gaining weight or is having fewer wet and dirty diapers, as these may be signs that not enough of what he or she eats is staying down.How will my pediatrician evaluate my baby for GER?The AAP believes it is important for all pediatric health care providers to be able to properly identify and treat children with reflux symptoms, and to distinguish GER from more worrisome disorders to avoid unnecessary costs and treatments.Your child's pediatrician will review your child's symptoms and feeding patterns and assess your child's growth by plotting his or her weight and height on a growth chart. This information will help them determine whether your child is a ""happy spitter"" or has symptoms of GERD. How is GER or GERD treated?While we wish we had a ""quick fix"" for babies who spit up, the truth is that for a good many spitty babies, it is mostly a matter of time. Lifestyle changes—including feeding and/or position changes—are recommended as first-line therapy for both GER and GERD. If GERD is severe, treatment may include medication or surgery. The surgery to correct reflux is called fundoplication.Treatment options during infancy: Burp at natural pauses in feeding and keeping your child upright for up to thirty minutes after feeding. If your bottle-fed baby spits up unusually often, your pediatrician may recommend thickening his or her formula with a very small amount of baby cereal. Never add solids to the bottle unless your pediatrician advises it. See Oatmeal: The Safer Alternative for Infants & Children Who Need Thicker Food for more information on this line of treatment. Consider smaller and more frequent feedings, but be sure your baby is taking in enough to keep up typical growth and development. Consider keeping your baby in an upright position—in a stroller or carrier—for the first half hour or so after feeding. Always closely supervise your baby during this time.Regardless of whether or not your baby warrants watchful waiting or medical intervention, the AAP does have additional and simple feeding suggestions that can help you deal with the situation at hand. See Remedies for Spitty Babies for more treatment tips. Treatment options for an older child: Avoid fried and fatty foods; they slow down the rate of the stomach emptying and promote reflux. Peppermint, caffeine, and certain asthma medications can make the lower esophageal sphincter relax and allow stomach contents to reflux back into the esophagus. Some experts believe that tomato-based products have a similar effect. If any food seems to produce reflux or heartburn, keep it out of the diet for a week or two and then reintroduce it. If symptoms reoccur, avoid that food until your pediatrician recommends to reintroduce it into the diet.Sometimes your pediatrician may recommend medications that neutralize or decrease the acid in your child's stomach to treat symptoms associated with GERD. When might my pediatrician refer my child to a pediatric gastroenterologist? Your pediatrician may refer your child to see a pediatric gastroenterologist, a pediatrician who has specialized training in problems of the gastrointestinal tract—including GERD—for a variety of reasons including:Poor weight gainFeeding problemsNo response to medical therapyA pediatric gastroenterologist will review your child's history, examine your child and review his or her diet history and growth charts. Sometimes, it can be helpful for a pediatric gastroenterologist to observe your child being fed or self-feeding. Based on the visit, he or she will decide whether your child may benefit from additional testing or from the addition of or a change in medications. Additional Information & Resources: Infant VomitingCommon Feeding ProblemsGastroesophageal Reflux: Management Guidance for the Pediatrician (AAP Clinical Report)  About Dr. Porto:Anthony Porto, MD, MPH, FAAP is a board certified pediatrician and board certified pediatric gastroenterologist. He is an Associate Professor of Pediatrics and Associate Clinical Chief of Pediatric Gastroenterology at Yale University and Director, Pediatric Gastroenterology at Greenwich Hospital in Greenwich, CT. He is also the medical director of the Yale Pediatric Celiac Program. Within the American Academy of Pediatrics, Dr. Porto sits on the PREP Gastroenterology Advisory Board and is a member of the Section on Gastroenterology, Hepatology and Nutrition. He is also a member of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition's Public Education Committee, a pediatric expert on nutrition for The Bump's Real Answers, and is the co-author of The Pediatrician's Guide to Feeding Babies and Toddlers. Follow him on Instagram @Pediatriciansguide. ​ Article Body Last Updated 3/27/2017 Source American Academy of Pediatrics (Copyright © 2017)"
16,"2018-04-19 03:01:10","Giardia Intestinalis Infections","Giardia Intestinalis Infections Page Content Article BodyGiardiasis is the name doctors give to infections caused by a microscopic parasite called Giardia Intestinalis. This organism may be found in the stools of an infected person. It can be transmitted by person-to-person contact in places like child care centers and among family members who have not properly washed their hands after using the bathroom or changing diapers. Giardia may also be present in contaminated food and water and is a risk for campers drinking untreated water from mountain streams, which can be contaminated by stool from infected animals and campers.Signs and Symptoms Most children with a Giardia infection have no symptoms at all. A few have abdominal pain and watery, foul-smelling diarrhea that can lead to dehydration. They may also have excessive gas and bloating and could have a poor appetite, leading to weight loss. Fever is uncommon. Most often, symptoms begin 7 to 14 days after exposure to the Giardia parasite and can last, without treatment, for about 4 to 6 weeks. How Is the Diagnosis Made?A stool sample from your child will be examined for the presence of Giardia Intestinalis.Treatment To keep your child well hydrated, she should drink plenty of liquids recommended by your pediatrician, such as over-the-counter or homemade oral rehydrating solutions. Your doctor may also prescribe prescription medicines (most commonly, metronidazole, furazolidone, or nitazoxanide) that cure most cases after 5 to 7 days of treatment. ​If your child has Giardia organisms in the stool but does not have symptoms, no treatment is needed.Prevention When a child attends a child care center, parents should make sure the staff members practice good hygiene and encourage children to wash their hands frequently with soap and water.  Toys that a child puts in her mouth should be washed and disinfected before another youngster plays with them. It is a good idea to wash and peel raw fruits and vegetables before they are eaten. Children should avoid drinking untreated water from streams, lakes, rivers, and ponds.  Take bottled water on camping trips or boil, filter, and treat your drinking water with chemical tablets before drinking it.​ Last Updated 4/18/2016 Source Adapted from Immunizations and Infectious Diseases: An Informed Parents Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2011"
17,"2018-04-19 03:01:14","Healthy Children Radio: Tummy Troubles","Healthy Children Radio: Tummy Troubles Page Content Article Body​​​When your child is complains of a stomachache​, how do you know whether it's something you can address at home, or an illness requiring urgent medical care ​Pediatric emergency medicine physicianElizabeth Murray, DO, FAAP, joins the Healthy Children show on RadioMD to offer guidance on assessing your child's symptoms, treating at home and making the decision to call the doctor or head to the emergency department. Segment 1: Fever, Vomiting, Stomach Ache: When Is This an Emergency? Additional Information: Stomachaches in Children & Teens Surviving the Stomach Bug: Truths & Tips for Parents When to Call the Pediatrician: Fever When Your Child Needs Emergency Medical Services Last Updated 1/23/2016 Source American Academy of Pediatrics (Copyright © 2014)"
18,"2018-04-19 03:01:25","Helicobacter Pylori Infections","Helicobacter Pylori Infections Page Content Article BodyMost people, including doctors, used to believe that ulcers (sores) in the stomach or duodenum (the first section of the small intestine) were caused by stress, alcohol, or spicy foods. Now we know that this isn’t the case. In fact, these ulcers, called peptic ulcers, are most often (although not always) caused by bacteria—specifically, an organism called Helicobacter pylori. H pylori infections occur at a low rate in children in the United States, but may infect more than 75% of children in developing countries. Although infections increase in frequency as people get older, most children and adults with H pylori will never develop an infection. No one is certain how H pylori is contracted, but person-to-person contact could play a role, as could transmission through contaminated food and water. The incubation period is also unknown. Signs and Symptoms When H pylori causes an ulcer, the intensity of the symptoms can vary. In some cases, there will be no symptoms at all. Ulcers can cause a burning or gnawing pain in the stomach that may come and go, often happening a few hours after eating, as well as during the night, and then actually subsiding while eating food and drinking water. Other symptoms may include: Bloating Burping Nausea and vomiting Loss of appetite Weight loss Bloody vomit and dark stools from bleeding in the stomach or duodenum What You Can Do In the past, doctors treated peptic ulcers by recommending a bland diet as well as bed rest. But today, these lifestyle strategies appear to be inappropriate approaches to managing ulcers. When to Call Your Pediatrician Contact your pediatrician if your child Has burning stomach pain that is worse between meals and in the early morning hours and feels better when he eats Has persistent abdominal pain, vomiting, loss of appetite, or weight loss Has bloody stools or bloody vomit How Is the Diagnosis Made? Your pediatrician will take a medical history of your child and may perform some simple tests. Your pediatrician may sometimes refer your child to a specialist to conduct the more complicated and invasive tests needed to make the diagnosis of an H pylori infection. These tests include analyzing a small piece of tissue (a biopsy) obtained through a device called an endoscope, which is threaded down the throat to the stomach. The tissue is then examined under the microscope and tested for evidence of H pylori infection. Your pediatrician can also look at the esophagus, stomach, and duodenum with x-ray film (an upper GI series). There are noninvasive tests that can determine whether bacteria are present by analyzing a child’s blood, stool, or breath. The breath test can detect carbon dioxide released by a product made by H pylori. Treatment Doctors only prescribe treatment for H pylori infections if they have progressed to an actual ulcer. Combinations of antibiotics such as amoxicillin, clarithromycin, and metronidazole can be taken by your child to kill the bacteria. Make sure he takes the full course of these antibiotics as directed by your pediatrician. They are usually prescribed in combination with drugs called proton pump inhibitors or histamine receptor blockers that interfere with the production of acid in the stomach. What Is the Prognosis? An H pylori infection increases the risk of developing stomach cancer later in life. Prevention There is no known way to prevent H pylori infections. However, a vaccine that could someday prevent the infection is currently being researched. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
19,"2018-04-19 03:01:31",Hepatitis,"Hepatitis Page Content Article BodyHepatitis means “inflammation of the liver.” This inflammation can be caused by a wide variety of toxins, drugs, and metabolic diseases, as well as infection. There are at least 5 hepatitis viruses. Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has close contact with a person who is infected with the virus. Hepatitis A is present in the stool as early as 1 to 2 weeks before a person develops the illness. The infection can be spread in child care settings when caregivers do not wash their hands after changing the diaper of an infected baby or from infant to infant because most very young infants do not wash their hands or have their hands washed for them. This virus also can be spread during male homosexual activity. The incubation period is 2 to 6 weeks. Hepatitis B is spread through the blood and body fluids of an infected person, including through saliva or semen. (Because of the routine screening of donated blood, it is very unlikely that your child will get hepatitis B via a blood transfusion.) The virus can be spread through intimate sexual contact with an infected person or by using nonsterilized needles or syringes for drug use, tattoos, or body piercing. An infected pregnant woman can give the virus to her newborn during the delivery. Person-to-person transmission is uncommon and generally limited to long-term close contact with people with chronic hepatitis B infection. The incubation period is 2 to 5 months. Hepatitis C infections are most often acquired from transfusions of contaminated blood, although your child’s risk of contracting the virus by this route is very low because of routine testing of donated blood. Sexual transmission and transmission among family members through close contact is uncommon. When hepatitis C infections occur in children and teenagers, doctors frequently can’t determine how the virus was acquired. The incubation period is 2 weeks to 6 months. Hepatitis D can be contracted in ways similar to hepatitis B, including through blood, sexual contact, and the use of non-sterilized needles or syringes. Unlike the hepatitis B virus, transmission of hepatitis D from mother to newborn is uncommon. The hepatitis D virus causes hepatitis only in people who already have a hepatitis B infection. Hepatitis E is rare in the United States. When it has occurred abroad, it has been associated with drinking contaminated water. Hepatitis Viruses Type Transmission Prognosis A Fecal-oral (stool to mouth), contaminated food and water Expect full recovery. B Blood, needles, sexual 10% of older children develop chronic infection.90% of newborns develop chronic infection. C Blood, needles; often unclear Expect chronic infection. D Blood, needles, sexual Makes hepatitis B infection more severe. E Traveler: fecal-oral, contaminated food and water Expect recovery, although pregnant women are at risk for severe disease. Others A variety of viruses can affect the liver Signs and Symptoms Hepatitis symptoms tend to be similar from one virus type to another. Many of these symptoms are flu like, such as fever, nausea, vomiting, loss of appetite, and tiredness, sometimes with pain or tenderness of the liver in the right upper abdomen. A hepatitis infection is also associated with jaundice, a yellow discoloration of the skin and a yellowish color to the whites of the eyes. This is caused by inflammation and swelling of the liver with blockage and backup of bile (bilirubin) into the blood. This backup also usually causes the urine to turn dark orange and stools light yellow or clay colored. However, many children infected with the hepatitis virus have few if any symptoms, meaning you might not even know that your child is sick. In fact, the younger the child, the more likely she is to be symptom free. For example, among children infected with hepatitis A, only about 30% younger than 6 years have symptoms, and most of them are mild. Symptoms are more common in older children with hepatitis A, and they tend to last for several weeks. Children infected with the hepatitis B and C viruses are often free of symptoms or have only a very mild illness. When to Call Your Pediatrician If your youngster has developed any of the symptoms associated with hepatitis, including jaundice, or if she has had contact with someone who has hepatitis (eg, in a child care center), call your pediatrician. How Is the Diagnosis Made? If your pediatrician suspects that your child has hepatitis, your pediatrician will conduct a physical examination and take a thorough medical history to determine whether your child may be at risk of getting the infection. Your doctor may also order a simple blood test that can determine whether your child is infected with the hepatitis virus and if so, which type. Treatment In most cases, no specific therapy is given for acute hepatitis. The child’s own immune system will fight and overcome the infecting virus. Your pediatrician will recommend supportive care for your child, which can include rest, a well-balanced diet, and lots of fluids. Do not give your child acetaminophen without talking to your pediatrician first—there is a risk of toxicity because her liver may not be fully functioning. Your pediatrician may also want to reevaluate the dosages of any other medicines your child is taking. They may have to be adjusted because of changes in the liver’s ability to manage the current dosages. If a child develops chronic hepatitis B or C, your pediatrician will probably send her to a specialist in gastroenterology or, in some instances, a liver specialist (hepatologist). Medicines such as interferon and ribavirin are used in adults with chronic hepatitis, but there are limited studies of these drugs in children. Your doctor may recommend enrolling your child in a study using these medicines or others. What Is the Prognosis? Most children with hepatitis fully recover. The mild symptoms of hepatitis A, for example, tend to resolve on their own within a month or less, and your child will be back to normal. Chronic infections are extremely rare. Some children with acute hepatitis B, particularly those who have contracted it before 5 years of age, develop a chronic infection. These children can become lifetime carriers of the virus. In certain cases, the chronic liver infection causes progressive damage, leading to scarring (cirrhosis) and liver cancer. Hepatitis C infections become long lasting in at least half of the children who develop this infection. In adults, chronic hepatitis leads to cirrhosis in 60% to 70% of patients, while in children this is unusual (less than 5%). Prevention Vaccines are available to protect children from hepatitis A and B. The hepatitis A vaccine is approved only for youngsters 2 years and older. The hepatitis A vaccines, however, are not recommended for everyone, but should be given to children living in US communities with consistently high hepatitis A rates. Other groups considered high risk, including certain travelers, should also be vaccinated for hepatitis A. When immediate protection is needed following close contact with a person with hepatitis A, your doctor may recommend an injection of immune (gamma) globulin. The hepatitis B vaccine is part of the recommended series of immunizations given to children beginning at birth. Your child should receive a total of 3 doses of the hepatitis B vaccine. Although there is no vaccine specifically for hepatitis D, the hepatitis B vaccine should protect against hepatitis D. Hepatitis D cannot develop unless a hepatitis B infection is already present. To further lower your youngster’s risk of hepatitis, she should practice good hygiene and avoid contaminated food and water. Encourage your child to wash her hands before eating and after going to the bathroom. If she spends time in a child care setting, make sure the staff practices good hand washing behaviors, especially after changing diapers and when preparing and serving food to children. Before traveling with your child to foreign countries, ask your pediatrician about the risk of exposure to hepatitis and any precautions that your family needs to take. In some cases, your pediatrician may recommend that your child receive the hepatitis A vaccine or an injection of gamma globulin, or both, before traveling abroad. General food precautions for travelers should be observed. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
20,"2018-04-19 03:01:36","Hepatitis C","Hepatitis C Page Content Article BodyWhat is Hepatitis C and why should I be concerned about it? Hepatitis C virus is a virus that can cause liver disease. Although most people recover from the initial phase of HCV infection, up to 80% of them may develop evidence of chronic liver infection that may lead to much more serious liver problems and possibly death. Hepatitis C virus is the cause of approximately 10,000 deaths each year in the United States. Symptoms of HCV Infection with HCV usually begins as nothing more than a mild flulike illness (although many babies and children show no symptoms). Some people may experience one or more of the following: Flulike symptoms (body aches, fever, diarrhea, or nausea) Extreme tiredness Lack of appetite or weight loss Dark yellow urine Light, clay-colored bowel movements Stomach pain, especially in the upper right side of the abdomen Jaundice (a yellowing of the eyes and skin) Infants with HCV infection also may have an enlarged liver or spleen, grow more slowly, or fail to gain weight. If your child has some of the symptoms of HCV infection, contact your pediatrician. Be sure to tell your pediatrician if your child has been exposed to anyone with HCV. To diagnose HCV infection, your pediatrician will examine your child and test your child's blood for the virus. How HCV is Spread Hepatitis C virus cannot be spread by touching, hugging, or kissing. Therefore, children with HCV infection can participate in all normal childhood activities and should not be excluded from child care centers or schools. However, because it can be spread through contact with blood, parents of children with HCV infection should make sure household items such as toothbrushes, razors, nail clippers, or other items that may contain small amounts of blood, are not shared. Hepatitis C virus also can be spread through sexual contact. Infected teens and young adults should be strongly advised to avoid having sex. If they are going to have sex, they need to use latex condoms to prevent the spread of HCV. Drinking alcohol also should be avoided by anyone with HCV infection because alcohol can speed up liver damage. Long-Term Effects of HCV Infection In some children, HCV infection can lead to persistent liver disease in the form of cirrhosis or scarring of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The liver eventually stops working and can no longer remove wastes from the body. Infants who develop cirrhosis of the liver because of chronic HCV infection may require a liver transplant to survive. Children infected with HCV also are at risk for developing other serious liver diseases, including liver cancer. Hopes for a Cure While at the present time there is no vaccine to prevent hepatitis C, hope for treatment is on the horizon. Recent medical advances may result in the testing of several new drugs for HCV infection within the next few years. Last Updated 11/21/2015 Source Hepatitis C (Copyright © 2003 American Academy of Pediatrics)"
21,"2018-04-19 03:01:39","Hirschsprung Disease","Hirschsprung Disease Page Content Article BodyIf your new baby has only rare bowel movements, his stools are hard, and his abdomen appears bloated, your pediatrician will examine him to determine whether retained stool is swelling the abdomen while the rectum is empty. This group of symptoms can indicate Hirschsprung disease, a rare condition in which the baby lacks the nerves needed for having bowel movements. Hirschsprung disease is treated with surgery. Left untreated, it can lead to life-threatening complications, so be sure to bring early constipation that occurs just after birth or in early infancy to your pediatrician’s attention. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
22,"2018-04-19 03:01:42","Infant Vomiting","Infant Vomiting Page Content Article BodyMy baby vomits a lot. Is this a sign of a problem? Because many common childhood illnesses can cause vomiting, you should expect your child to have this problem several times during these early years. Usually it ends quickly without treatment, but this doesn’t make it any easier for you to watch. That feeling of helplessness combined with the fear that something serious might be wrong and the desire to do something to make it better may make you tense and anxious. To help put your mind at ease, learn as much as you can about the causes of vomiting and what you can do to treat your child when it occurs. Vomiting vs Spitting Up First of all, there’s a difference between real vomiting and just spitting up. Vomiting is the forceful throwing up of stomach contents through the mouth. Spitting up (most commonly seen in infants under one year of age) is the easy flow of stomach contents out of the mouth, frequently with a burp. Vomiting occurs when the abdominal muscles and diaphragm contract vigorously while the stomach is relaxed. This reflex action is triggered by the “vomiting center” in the brain after it has been stimulated by: Nerves from the stomach and intestine when the gastrointestinal tract is either irritated or swollen by an infection or blockage Chemicals in the blood (e.g., drugs) Psychological stimuli from disturbing sights or smells Stimuli from the middle ear (as in vomiting caused by motion sickness) Causes of Vomiting The common causes of spitting up or vomiting vary according to age. During the first few months, for instance, most infants will spit up small amounts of formula or breastmilk, usually within the first hour after being fed. This “cheesing,” as it is often called, is simply the occasional movement of food from the stomach, through the tube (esophagus) leading to it, and out of the mouth. It will occur less often if a child is burped frequently and if active play is limited right after meals. This spitting up tends to decrease as the baby becomes older, but may persist in a mild form until ten to twelve months of age. Spitting up is not serious and doesn’t interfere with normal weight gain. Occasional vomiting may occur during the first month. If it appears repeatedly or is unusually forceful, call your pediatrician. It may be just a mild feeding difficulty, but it also could be a sign of something more serious. Persistent Vomiting Between two weeks and four months of age, persistent forceful vomiting may be caused by a thickening of the muscle at the stomach exit. Known as hypertrophic pyloric stenosis, this thickening prevents food from passing into the intestines. It requires immediate medical attention. Surgery usually is required to open the narrowed area. The important sign of this condition is forceful vomiting occurring approximately fifteen to thirty minutes or less after every feeding. Anytime you notice this, call your pediatrician as soon as possible. GERD Occasionally the spitting up in the first few weeks to months of life gets worse instead of better—that is, even though it’s not forceful, it occurs all the time. This happens when the muscles at the lower end of the esophagus become overly relaxed and allow the stomach contents to back up. This condition is known as gastroesophageal reflux disease, or GERD. This condition usually can be controlled by doing the following: Thicken the milk with small amounts of baby cereal as directed by your pediatrician. Avoid overfeeding or give smaller feeds more frequently. Burp the baby frequently. Leave the infant in a safe, quiet, upright position for at least thirty minutes following feeding. If these steps are not successful, your pediatrician may refer you to a gastrointestinal (GI) specialist. Infection After the first few months of life, the most common cause of vomiting is a stomach or intestinal infection. Viruses are by far the most frequent infecting agents, but occasionally bacteria and even parasites may be the cause. The infection also may produce fever, diarrhea, and sometimes nausea and abdominal pain. The infection is usually contagious; if your child has it, chances are good that some of her playmates also will be affected. Rotaviruses are a leading cause of vomiting in infants and young children, with symptoms often progressing to diarrhea and fever. These viruses are very contagious, but are becoming less common than in the past, due to the availability of a vaccine that can prevent the disease. The rotavirus is one of the viral causes of gastroenteritis, but other types of viruses—such as noroviruses, enteroviruses, and adenoviruses—can cause it as well. Occasionally infections outside the gastrointestinal tract will cause vomiting. These include infections of the respiratory system, infections of the urinary tract otitis media, meningitis , and appendicitis. Some of these conditions require immediate medical treatment, so be alert for the following trouble signs, whatever your child’s age, and call your pediatrician if they occur. Blood or bile (a green-colored material) in the vomit Severe abdominal pain Strenuous, repeated vomiting Swollen or enlarged abdomen Lethargy or severe irritability Convulsions Signs or symptoms of dehydration, including dry mouth, absent tears, depression of the ""soft spot"", and decreased urination Inability to drink adequate amounts of fluid Vomiting continuing beyond twenty-four hours Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
23,"2018-04-19 03:01:47","Inguinal Hernia","Inguinal Hernia Page Content Article BodyIf you notice a small lump or bulge in your child’s groin area or an enlargement of the scrotum, you may have discovered an inguinal hernia. This condition, which is present in up to five of every hundred children (most commonly in boys), occurs when an opening in the lower abdominal wall allows the child’s intestine to squeeze through. This inguinal hernia is frequently confused with a more benign condition, a communicating hydrocele. The testicles of the developing male fetus grow inside his abdominal cavity, moving down through a tube (the inguinal canal) into the scrotum as birth nears. When this movement takes place, the lining of the abdominal wall (peritoneum) is pulled along with the testes to form a sac connecting the testicle with the abdominal cavity. A hernia in a child is due to a failure of this normal protrusion from the abdominal cavity to close properly before birth, leaving a space for a small portion of the bowel to later push through into the groin or scrotum. Most hernias do not cause any discomfort, and you or the pediatrician will discover them only by seeing the bulge. Although this kind of hernia must be treated, it is not an emergency condition. You should, however, notify your doctor, who may instruct you to have the child lie down and elevate his legs. Sometimes this will cause the bulge to disappear. However, your doctor will still want to examine the area as soon as possible. Rarely, a piece of the intestine gets trapped in the hernia, causing swelling and pain. (If you touch the area, it will be tender.) Your son may have nausea and vomiting as well. This condition is called an incarcerated (trapped) hernia and does require immediate medical attention. Call your pediatrician immediately if you suspect an incarcerated hernia. Treatment Even if the hernia is not incarcerated, it still should be surgically repaired as soon as possible. The surgeon also may check the other side of the abdomen to see if it, too, needs to be corrected, since it is very common for the same defect to be present there. If the hernia is causing pain, it may indicate that a piece of intestine has become trapped or incarcerated. In that case, consult with your pediatrician immediately. He may try to move the trapped piece of intestine out of the sac. Even if this can be done, the hernia still needs to be surgically repaired soon thereafter. If the intestine remains trapped despite your doctor’s efforts, emergency surgery must be performed to prevent permanent damage to the intestine. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
24,"2018-04-19 03:01:54","Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD)","Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) Page Content Article BodyIrritable bowel syndrome (IBS) is often referred to inaccurately as “colitis” and “mucous colitis.” But the suffix “itis” in a medical condition’s name denotes inflammation, which is not a hallmark of IBS. Rather than inflaming the colon, IBS sensitizes the nerves responsible for the contractions (called peristalsis) that propel partially digested food through the organ. As a result, the muscular inner wall overreacts to mild stimuli like milk products and emotional stress, and goes into spasm. Irritable bowel syndrome produces cramplike pains and bouts of diarrhea and/or constipation. The more serious disorders, Crohn’s disease and ulcerative colitis, are both forms of inflammatory bowel disease. IBD damages the tissue of the small bowel and the large bowel, respectively, through the process of inflammation. As the body’s response to injury, inflammation is characterized by blood-carrying, infection-fighting white blood cells that rush to the site of the injury. Their presence accounts for the painful swelling, warmth and redness associated with an inflammatory reaction. Among children, Crohn’s is two times more prevalent than ulcerative colitis. Whereas ulcerative colitis affects only the inner lining of the intestine and is confined to one section, “Crohn’s disease can penetrate the full thickness of the bowel and tends to occur in more than one area,” explains Dr. Alan Lake, a pediatrician and pediatric gastroenterologist at Baltimore’s Johns Hopkins University School of Medicine. In colitis, however, ulcers form where inflammation has destroyed the tissue. The open sores ooze blood, mucus and pus. The cause of inflammatory bowel disease has yet to be discovered, although theories abound. Heredity is a factor: 15 to 30 percent of IBD sufferers have a relative with either disorder. Symptoms that Suggest Irritable Bowel Syndrome may include: Cramplike pain and spasms in the lower abdomen Nausea Bloating and gas Headache Rectal pain Backache Appetite loss Alternating bouts of diarrhea and constipation Fatigue Depression Anxiety Difficulty concentrating Symptoms that Suggest Inflammatory Bowel Disease may include: Crohn’s Disease Cramping abdominal pain and tenderness, particularly after meals Nausea Diarrhea General ill feeling Fever Appetite loss possibly leading to weight loss Bloody stool Swelling, pain, stiffness in the knees and ankles Cankerlike sores in the mouth Eye inflammation Irritation or swelling around the rectum Fatigue Depression Anxiety Difficulty concentrating Delayed growth and sexual development in younger teens, due to lack of nutrition Ulcerative Colitis Pain and cramping in the left side of the abdomen Intermittent episodes of bloody, mucus-like stool Swelling, pain, stiffness in the knees and ankles Canker-like sores in the mouth Fatigue Depression Anxiety Difficulty concentrating Growth retardation in younger teens, due to lack of nutrition Acute attacks may include: Up to twenty bloody, loose bowel movements a day Urgent need to move bowels Severe cramps and rectal pain Profuse sweating Dehydration Nausea Appetite loss Weight loss Abdominal bloating Fever up to 104 degrees F You can see that many of the symptoms overlap, making diagnosis complicated at times. In general, says Dr. Lake, “the patient with ulcerative colitis has more bloody bowel movements, and the patient with Crohn’s disease experiences more pain.” He goes on to say that while ulcerative colitis is usually picked up quickly, “with Crohn’s disease, many months can pass between the onset of symptoms and the time of diagnosis. Not only are the symptoms subtle, but they can be minimized by cutting back on eating. So it can be difficult for parents to recognize that something is the matter. “Frequently, kids are diagnosed because they develop inflammation elsewhere, like the eyes, the mouth and the rectum. If your child has irritation or swelling around the rectum,” he advises, “never assume that it is hemorrhoids, which is all but unheard of in children. The concern should be that he or she has Crohn’s disease.” How Irritable Bowel Syndrome is Diagnosed: Physical examination and thorough medical history, plus one or more of the following procedures: Urinalysis Urine culture Complete blood count Erythrocyte sedimentation rate (sed rate) blood test Stool blood test Sigmoidoscopy How Inflammatory Bowel Disease is Diagnosed: Physical examination and thorough medical history, plus one or more of the following procedures: Complete blood count Prothrombin time blood test Erythrocyte sedimentation rate (sed rate) blood test Stool blood test Urinalysis Sigmoidoscopy or colonoscopy Upper gastrointestinal (GI) series (also known as a barium swallow) Still other laboratory tests may be ordered. How Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are Treated All of these chronic conditions are incurable but treatable, meaning that steps can be taken on several fronts to reduce the frequency and severity of symptoms. Changes in diet: Boys and girls with IBS or IBD are able to eat relatively normally when the disease is in remission, which is much of the time. During flareups, though, they need to be conscientious about avoiding certain foods. Your pediatrician will work with a nutritionist or a GI specialist to tailor an eating plan for your youngster.In irritable bowel syndrome, adding roughage to the diet may be all that’s necessary to ease cramping and soften hardened stool or eliminate diarrhea. However, high-fiber foods induce the opposite effect in a teen with Crohn’s disease or ulcerative colitis, who should stick to easy-to-digest low-residue items like broth, gelatin, skinless poultry, fish, rice, eggs and pasta. Fried foods and dairy are also taboo when the disease is active.Memo to Mom and Dad: Help spare your son or daughter some of the unwelcome consequences of IBD by serving five or six small meals a day instead of the customary big three. Drug therapy: If diet alone doesn’t bring relief from an irritable bowel, occasionally a pediatrician will prescribe an antispasmodic agent to slow down its activity. Medication is usually indicated in Crohn’s disease or ulcerative colitis, where the favored drugs include corticosteroids such as prednisone (“the cornerstone of treatment,” according to Dr. Lake), and the 5-ASA agents sulfasalazine, olsalazine and mesalamine. Should these fail to stem the inflammation, your pediatrician might prescribe one of the following immunomodulators: azathioprine, cyclosporine, methotrexate or 6-mercaptopurine. They work by altering the body’s immune response. An IBD patient’s medicine cabinet often contains antibiotics and antidiarrheal medicines as well. Dietary supplements: From a child's perspective, one of the most upsetting effects of inflammatory bowel disease is its suppression of growth and sexual maturity. Large doses of prednisone can decelerate physical development; accordingly, pediatricians lower the dose or gradually take young people off the drug once it has controlled the inflammation.The main cause of poor growth, however, is insufficient nutrition. Adolescents with IBD sometimes fall into the habit of skimping on breakfast and lunch in order to avoid repeated trips to the bathroom while at school. As a result, they may be lacking in calories, nutrients, vitamins and minerals. Protein is especially crucial for growth.Your pediatrician will monitor your child’s eating patterns. Most nutritional deficiencies can be corrected by tinkering with the diet. If necessary, though, she can prescribe oral supplements and/or high-calorie liquid formulas. Surgery: Cases of inflammatory bowel disease that resist drug therapy or develop complications may require an operation to remove part or all of the colon. This route is rarely taken during the teen years. Mental health care: Emotional stress does not cause IBS or IBD, but it can aggravate either condition. Therefore, patients may benefit a great deal from seeing a mental health professional who can teach them stress-reduction techniques such as progressive muscle relaxation and progressive guided imagery. As with other chronic ailments, inflammatory bowel disease can be frustrating for teenagers. Flareups often leave them more dependent on their parents than they want to be and make them feel different from their friends. They may feel as though their body has betrayed them. If you suspect that your son or daughter is having a hard time coping, ask your pediatrician for a referral to a suitable counselor. Last Updated 11/21/2015 Source Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
25,"2018-04-19 03:02:01",Malabsorption,"Malabsorption Page Content Article BodySometimes children who eat a balanced diet suffer from malnutrition. The reason for this may be malabsorption, the body’s inability to absorb nutrients from the digestive system into the bloodstream. Normally the digestive process converts nutrients from the diet into small units that pass through the wall of the intestine and into the bloodstream, where they are carried to other cells in the body. If the intestinal wall is damaged by a virus, bacterial infection, or parasites, its surface may change so that digested substances cannot pass through. When this happens, the nutrients will be eliminated through the stool. Malabsorption commonly occurs in a normal child for a day or two during severe cases of stomach or intestinal flu. It rarely lasts much longer since the surface of the intestine heals quickly without significant damage. In these cases, malabsorption is no cause for concern. However, chronic malabsorption may develop, and if two or more of the following signs or symptoms persist, notify your pediatrician. Signs and Symptoms Possible signs and symptoms of chronic malabsorption include the following: Persistent abdominal pain and vomiting Frequent, loose, bulky, foul- smelling stools Increased susceptibility to infection Weight loss with the loss of fat and muscle Increase in bruises Bone fractures Dry, scaly skin rashes Personality changes Slowing of growth and weight gain (may not be noticeable for several months) Treatment When a child suffers from malnutrition, malabsorption is just one of the possible causes. She might be undernourished because she’s not getting enough of the right types of food, or she has digestive problems that prevent her body from digesting them. She also might have a combination of these problems. Before prescribing a treatment, the pediatrician must determine the cause. This can be done in one or more of the following ways. You may be asked to list the amount and type of food your child eats. The pediatrician may test the child’s ability to digest and absorb specific nutrients. For example, the doctor might have her drink a solution of milk sugar (lactose) and then measure the level of hydrogen in her breath afterward. This is known as a lactose hydrogen breath test. The pediatrician may collect and analyze stool samples. In healthy people, only a small amount of the fat consumed each day is lost through the stool. If too much is found in the stool, it is an indication of malabsorption. Collection of sweat from the skin, called a sweat test, may be performed to see if cystic fibrosis is present. In this disease, the body produces insufficient amounts of certain enzymes necessary for proper digestion and an abnormality in the sweat. In some cases the pediatrician might request that a pediatric gastroenterologist obtain a biopsy from the wall of the small intestine, and have it examined under the microscope for signs of infection, inflammation, or other injury. Ordinarily, these tests are performed before any treatment is begun, although a seriously sick child might be hospitalized in order to receive special feedings while her problem is being evaluated. Once the physician is sure the problem is malabsorption, she will try to identify a specific reason for its presence. When the reason is infection, the treatment usually will include antibiotics. If malabsorption occurs because the intestine is too active, certain medications may be used to counteract this, so that there’s time for the nutrients to be absorbed. Sometimes there’s no clear cause for the problem. In this case, the diet may be changed to include foods or special nutritional formulas that are more easily tolerated and absorbed. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
26,"2018-04-19 03:02:06","Oatmeal: The Safer Alternative for Infants & Children Who Need Thicker Food","Oatmeal: The Safer Alternative for Infants & Children Who Need Thicker Food Page Content​​Certain diet textures are often prescribed to help infants and children with special needs eat more safely and easily. Children with dysphagia or gastroesophageal reflux, for example, may need their food to be thicker in order to swallow safely or reduce reflux.In response to concerns over arsenic in rice, the American Academy of Pediatrics (AAP) now recommends parents of children with these conditions use oatmeal instead of rice cereal.  Why Oatmeal?Children with these conditions were exposed to more rice cereal (and, therefore, more arsenic) for a longer period of time. For infants, this increased exposure also comes at a time when they are developing most rapidly and may be at the greatest risk for side effects of arsenic. Therefore, a safer alternative was needed.Oatmeal is not a member of the wheat family (i.e. oatmeal is gluten-free), so it's also safe for kids with celiac disease.Tips for Parents: Talk with your child's pediatrician or feeding specialist about the different types of oatmeal cereals on the market and how to arrive at a just-right consistency. The amount of oatmeal to add to the liquid (formula, breast milk, etc.) is dependent on your child's condition. It is important to follow the recommendations of your pediatrician or feeding therapist.If you are mixing oatmeal cereal in pumped breast milk: It is best to do it right before your infant will feed. If you mix it too early, the enzymes in the breast milk will break down the oatmeal—making it ineffective.If you are mixing oatmeal cereal in formula: It is most effective if done no more than 20 to 30 minutes before your infant will feed. If your child is drinking it from a bottle, you may need to go up to a larger nipple size in order for the oatmeal to flow. Most feeding specialists now recommend either a faster flow nipple or commercially precut, cross-cut nipples provided by the hospital.Be certain that your child is sitting in an appropriate position, as it can affect his or her ease and enjoyment with the meal. Make sure you are not over feeding your child. If he or she is gaining weight rapidly, but spitting up a lot, try decreasing the amount at each feeding. Infants with reflux, for example, tend to do better with smaller, more frequent meals. The commercial thickening agent, Simply Thick, should not be used in any infant. It increases the risk of developing a life-threatening condition called necrotizing enterocolitis.Additional Information on HealthyChildren.org:GERD/RefluxTips to Reduce Arsenic in Your Baby's Diet Working Together: Breastfeeding and Solid FoodsStarting Solid Foods Article Body Last Updated 4/18/2016 Source American Academy of Pediatrics (Copyright © 2016)"
27,"2018-04-19 03:02:10",Peptic-Ulcers,"Peptic-Ulcers Page Content Article BodyThe highly acidic digestive juices in the stomach and bowel can erode the delicate lining of the gastrointestinal tract, causing sores known as ulcers. The most common site is the duodenum: the portion of the small intestine that receives the soupy mixture of semidigested food from the stomach. Both duodenal ulcers and gastric (stomach) ulcers are referred to as “peptic” ulcers. The name alludes to pepsin, the digestive enzyme responsible for breaking down the protein in food. Doctors used to believe that all ulcers were caused by diet and stress. We now know that a bacterium known as Helicobacter pylori is behind many adult ulcers. The percentage of adolescent ulcer patients infected with H. pylori may be in the neighborhood of 25 percent. Scientists believe that this common microorganism enters our bodies via food and water, and possibly through kissing. Half of all men and women over sixty carry the bacteria. Why the majority of them never develop peptic ulcer disease is a question still in search of an answer. Symptoms that Suggest Peptic Ulcers may Include: Sharp, burning or gnawing pain in the upper abdomen that lasts anywhere from thirty minutes to three hours and comes and goes Appetite loss Weight loss Weight gain Nausea and vomiting Blood-tinged vomit Bloody stool Bloating Belching Anemia How Ulcers Are Diagnosed Physical examination and thorough medical history, plus one or more of the following procedures: Endoscopic exam of the stomach (gastroscopy) or the upper bowel (esophagogastroduodenoscopy), including tissue biopsy, to detect H. pylori bacteria To locate the source of gastrointestinal bleeding, the doctor may order one or more of the following: Stool blood test Complete blood count Prothrombin time blood test Angiogram Sigmoidoscopy or colonoscopy Scintigraphic studies CAT (CT) scan Magnetic resonance imaging (MRI) scan How Ulcers Are Treated Drug therapy: “When I started in gastroenterology in the 1970s,” says Dr. Alan Lake, a pediatrician and pediatric gastroenterologist at Baltimore’s Johns Hopkins University School of Medicine, “I was subjecting six to eight patients a year to partial removal of their stomachs to treat chronic peptic ulcer disease. But since the mid 1980s, I haven’t sent a single patient to surgery. The medication options that are now available have virtually eliminated the need for an operation.” Several types of drugs are typically incorporated into treatment: Nonprescription antacids, taken intermittently to neutralize excess stomach acid and relieve abdominal pain. H2 blockers (cimetidine, rantidine, famotidine), which reduce acid production in the digestive tract. Antibiotics, if diagnostic tests reveal the presence of H. pylori. Acid pump inhibitors (omeprazole). Mucosal protective agents (sucralfate, misoprostol). Youngsters taking H2 blockers should begin to feel significantly better after several weeks. The medication can then be discontinued. Your child can also resume eating normally; the bland diet of old has not been found to help treat or prevent ulcers. Should the disease recur—as happens in half to four-fifths of all cases—most pediatricians would recommend staying on the drug for six months to two years. Last Updated 11/21/2015 Source Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
28,"2018-04-19 03:02:17","Rare Infections: Yersinia Enterocolitica and Yersinia Pseudotuberculosis","Rare Infections: Yersinia Enterocolitica and Yersinia Pseudotuberculosis Page Content Article BodyYersinia enterocolitica and Yersinia pseudotuberculosis are bacterial infections that are uncommon, but can cause problems when they occur. Y enterocolitica causes a condition called enterocolitis, which is an inflammation of the small intestine and colon that occurs, and often recurs, mostly in young children. These infections appear to be acquired by eating contaminated food, particularly raw or inadequately cooked pork products, and drinking unpasteurized milk. They might also be contracted by touching an infected animal, drinking contaminated well water, or on rare occasions, from contaminated transfusions. The infections are increasing in frequency among children whose immune system is weakened. The incubation period is around 4 to 6 days. Signs and Symptoms When a Y enterocolitica infection is present, it not only causes an inflamed small intestine and colon, but also symptoms such as diarrhea and a fever. A child with this infection may have stools that contain blood and mucus. These symptoms may last for 1 to 3 weeks, sometimes longer. Along with these more common symptoms, very young children who have too much iron stored in their bodies, such as those who receive blood transfusions, or whose immune system is already suppressed or weakened because of another illness, may be susceptible to bacteremia (the spread of bacteria to the blood). Older youngsters may also have symptoms that mimic appendicitis (a pseudoappendicitis syndrome), with right-sided abdominal pain and tenderness. On rare occasions, this infection may be associated with conditions such as a sore throat, eye inflammation, meningitis, and pneumonia. In older youngsters, joint pain or a red skin lump (erythema nodosum) on the lower legs may develop after the infection itself has gone away. Children with Y pseudotuberculosis will likely develop a fever, a rash, and abdominal pain, including the pseudoappendicitis syndrome. Some children may also have diarrhea, a rash, and excess fluid in the chest region or spaces around the joints. When to Call Your Pediatrician Contact your pediatrician if your child’s stool is streaked with blood. Look for signs of dehydration that could be caused by your youngster’s diarrhea, including dry mouth, unusual thirst, and a decline in the frequency of urination. How Is the Diagnosis Made? Your pediatrician can order tests to detect the presence of Yersinia organisms in your child’s stool. Evidence of the infection may also be seen by taking throat swabs and evaluating them in the laboratory, examining the urine, or testing the blood for antibodies to the bacteria. Because these are relatively rare infections, most laboratories do not routinely perform tests looking for Yersinia organisms in feces. Treatment In most children, the infection will go away on its own. In some cases, Yersinia infections need to be treated with antibiotics. As with all cases of diarrhea, fluids are given to prevent or treat dehydration. Prevention Make sure your child does not consume raw or undercooked pork, unpasteurized milk, and contaminated water.Wash your hands thoroughly with soap and water after handling raw pork intestines (chitterlings). No vaccine is available to prevent Yersinia infections. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
29,"2018-04-19 03:02:24","Reye Syndrome","Reye Syndrome Page Content Article BodyReye syndrome (often referred to as Reye’s syndrome) is a rare but very serious illness that usually occurs in children younger than fifteen years of age. It can affect all organs of the body, but most often injures the brain and the liver. Reye syndrome is preceded by a viral infection, most commonly chickenpox or influenza. Although no one knows precisely what causes Reye syndrome, it affects only a small number of children, and is strongly associated with aspirin or aspirin-containing medication during the viral infection. Signs and Symptoms Whenever your child has a viral illness, be alert for the following pattern typical of Reye syndrome: Your child may develop a viral infection, such as influenza, an upper respiratory illness, or chickenpox, and then seem to be improving. However, then he abruptly starts to vomit repeatedly and frequently every one or two hours over a twenty-four to thirty-six-hour period, becoming lethargic or sleepy, which then turns into agitation, delirium, or anger. Then he may become confused or even become unresponsive. If the disease progresses, there is a strong chance he will have seizures and go into a deep coma. Call your pediatrician as soon as you suspect that your child’s illness is following this pattern. If your doctor is not available, take your child to the nearest emergency department. It is very important to diagnose this illness as early as possible. Prevention Since the medical community issued a public warning against the use of aspirin during viral illnesses, the number of cases of Reye syndrome has decreased greatly. Therefore, we strongly recommend that you do not give aspirin or any medications containing aspirin to your child or teenager when he has any viral illness, particularly chickenpox or influenza. If he needs medication for mild fever or discomfort, give him acetaminophen or ibuprofen. Ibuprofen is approved for use in children six months of age or older; however, it should never be given to children who are dehydrated or who are vomiting continuously. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
30,"2018-04-19 03:02:31","Shigella Infections","Shigella Infections Page Content Article BodyShigella bacteria cause a diarrheal illness that can occur in children. Four species of Shigella bacteria (S boydii, S dysenteriae, S flexneri, and S sonnei) have been identified as infecting the lining of the intestines. These bacterial illnesses are highly contagious. They are spread through the feces of people with the infection, particularly in close contact environments such as within families and in child care centers. They can also be contracted by consuming contaminated food or water or by touching an object on which the bacteria may be present. Children aged 2 to 4 years are particularly vulnerable to developing the disease. The incubation period is usually 2 to 4 days. Signs and Symptoms A Shigella infection can cause mild watery or loose stools with no other symptoms, or it can be more serious, with fever, abdominal cramps or tenderness, crampy rectal pain (tenesmus), and mucous-filled and sometimes bloody stools. When to Call Your Pediatrician Call your pediatrician if you notice blood in your child’s stool, there’s no improvement in her diarrhea, or she is showing signs of dehydration. How Is the Diagnosis Made? A pediatrician may order laboratory tests in which a culture of the child’s feces is examined for evidence of Shigella bacteria. Treatment If your child’s symptoms are mild, your pediatrician may decide that it’s not necessary to prescribe medicine to treat the infection. These children generally get better rapidly without any medicine. However, antibiotics such as cefixime, ampicillin, or trimethoprim sulfamethoxazole may be prescribed in more severe cases. These drugs can kill Shigella bacteria in the child’s stools, shorten the duration of the diarrhea, and lower the chances of spreading the illness. If your child is having lots of watery diarrhea, be sure to give her extra fluids to avoid dehydration. It is important that the fluids contain salt because salts are lost in the diarrhea. Rehydration fluids are sold over the counter, but you can also make these at home. Talk to your pediatrician to be sure you have the correct amount of salt and water. In severe cases, intravenous fluids may be required. Do not self-prescribe antidiarrheal medicines, which can actually make your child worse. What Is the Prognosis? In most cases, Shigella infections run their course in 2 to 3 days. Occasionally, complications may develop, including bacteremia (bacteria in the blood), hemolytic uremic syndrome (a disorder characterized by kidney failure and anemia), and Reiter syndrome (painful urination, joint achiness). Prevention If your child attends a child care facility, make sure staff members practice good hygiene, including frequent hand washing, particularly before food preparation and after diaper changes, and regularly disinfect toys. At home as well as at these child care settings, food should be stored, handled, and prepared according to good sanitation guidelines. People with a diarrheal illness should not be involved in preparing food for others. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
31,"2018-04-19 03:02:39","Stomachaches in Children & Teens","Stomachaches in Children & Teens Page Content Article Body​Children complain of stomachaches for all sorts of reasons—not uncommonly, to stall at bedtime. Or perhaps they’re trying to avoid school. Or maybe their “eyes were bigger than their stomach” and they ate too much for dinner. Recurrent abdominal pain (often simply called stomachache) is common but luckily usually not serious in children. In some cases, no physical cause can be found, and the pain is termed functional or nonspecific pain, possibly related to emotional stress. At times, spasms in the digestive tract may cause pain. A crying child may swallow gas, which can cause abdominal discomfort. What’s essential to remember is that the pain can be real, even though there is no obvious cause. Other Causes of Stomachaches Include the Following: Constipation, although rarely a problem in younger babies, is more common in older children. Urinary tract infections are more common in 1- to 5-year-old girls than in younger children and cause discomfort in the abdomen and bladder area. Strep throat is a throat infection caused by bacteria (streptococci), with symptoms that include a sore throat, fever, and abdominal pain. Appendicitis is very uncommon in children younger than 5 years; the first sign is a complaint of constant stomachache in the center of the abdomen, which later moves down and over to the right side. Milk allergy, a reaction to the protein in milk, produces cramping abdominal pain. Lactose intolerance is when the body lacks the enzyme needed to break down lactose in milk and other milk products. Lactose intolerance is different from a milk allergy and is more common in African American and Asian children. Symptoms of lactose intolerance include diarrhea or constipation, increased gassiness, and cramping abdominal pain. Emotional upset, particularly in school-aged children, may cause recurrent abdominal pain that seems to have no other cause. When to Call Your Pediatrician: Abdominal pain that comes on suddenly or persists may require prompt attention, especially if your child has additional symptoms, such as a change in his bowel pattern, vomiting, fever (temperature of 100.4°F or higher), sore throat, or headache. Even when no physical cause can be found, the child’s distress is genuine and should receive appropriate attention. Call your pediatrician promptly if your baby is younger than 1 year and shows signs of stomach pain (for example, legs pulled up toward the abdomen, unusual crying); if your child aged 4 years or younger has recurrent stomachache; or if abdominal pain awakes him or stops him from getting to sleep. Last Updated 11/21/2015 Source Sleep: What Every Parent Needs to Know (Copyright © 2013 American Academy of Pediatrics)"
32,"2018-04-19 03:02:45","Surviving the Stomach Bug: Truths & Tips for Parents","Surviving the Stomach Bug: Truths & Tips for Parents Page Content Article BodyStomach bugs tend to be the nastiest illnesses our children bring home from school. 7 Truths & Tips for Survival of Stomach Bugs When They Hit Your Home Hand washing and keeping things clean are your best defenses from getting ill with a stomach bug. Not surprisingly, this is particularly true after touching or supporting your child and when preparing food and eating. Some viruses will survive on surfaces for days. And some viruses like Norovirus can even survive hand sanitizer. You have to use soap and water to kill it. But even with ridiculous, meticulous attention to hygiene, every parent knows that when the vomit is flying, it’s hard to lasso every single errant particle. So simply commit to do your best. Change the sheets and clean up areas of vomit immediately after supporting your child. Soapy warm water is your friend. Wash surfaces immediately, use hot water for the wash, and use high heat in the dryer. 24 hours (or so): In general, most pediatricians will tell you that vomiting doesn’t exceed 24 hours with typical gastroenteritis. Occasionally it can. Many kids don’t follow the rules. Once a virus that causes gastroenteritis takes hold of a child, vomiting starts. Children tend to vomit more than adults. Part may be an easy gag reflex. With most viruses that cause the “stomach flu,” as the infection moves through the stomach and intestines, vomiting stops after about 24 hours. But not always. If you advance liquids too quickly or children eat more solids than they are ready for, even after the first meal 1 to 2 days into eating again, they may have a vomit encore. If you have one of those, start back where you started (sips of clear liquids) and go very slow advancing their diet. If vomiting is accelerating at 24 hours, it is time to check in with your child’s doctor. Disgusting and terrifying: It’s creepy-eepy to take care of a child with vomiting. Not only is it entirely gnarly and disgusting to remove and clean chunks from vomit-laden carpet, sheets, and clothing, it’s also terrifying to provide support to a vomiting child because you can get equally uneasy about catching the virus. You’re not alone in this. It’s absolutely nauseating to see your own child ill, unwell, and retching. And it’s awful to imagine having to provide care while getting miserably sick. Do your best to keep your hands washed and keep the love going. As all of us know, when you find yourself picking out vomit bits from the carpet at 3:00 am, it really can only get better from there. Medication: Children rarely need medication when recovering from gastroenteritis. Although some antinausea drugs are available for use in children, most children don’t need prescription medications. Talk with your child’s pediatrician if you feel you child is vomiting longer than 24 hours or becoming dehydrated. Remember that vomiting is a protection reaction of your child’s body to clear infection. Soap, water, and bleach: William Osler said, “Soap and water and common sense are the best disinfectants.” Cleaning your home to avoid spreading infection is a must. You don’t need expensive products, just vigilance. With some highly infectious viruses that cause vomiting, even 10 viral particles can cause illness. So in addition to soap and water, consider using a dilute bleach solution to clean hard surfaces. Detective work: Sometimes you’ll simply never know where it all came from. But it won’t stop you from playing the role of infectious detective. The only issue: this is simply wasted time. Yummy, clingy love: There is an occasional perk to a terrible stomach bug. And we have to find one to maintain a sense of optimism. When our children are ill, they really turn over and show us they want us over anything else on earth. Then there is resilience. Children do very well recovering from typical viral gastroenteritis, although diarrhea can last for days. Even so, our children’s resilience will long astonish us. Additional Information: Stomachaches in Children & Teens Food-Borne Illnesses Prevention Treating Vomiting Diarrhea Drinks to Prevent Dehydration in a Vomiting Child Cleaners, Sanitizers & Disinfectants Preventing the Spread of Illness in Child Care or School Hand Washing: A Powerful Antidote to Illness Author Wendy Sue Swanson, MD, MBE, FAAP Last Updated 11/21/2015 Source Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance (Copyright © 2014 Wendy Sue Swanson)"
33,"2018-04-19 03:02:52","Treating Dehydration with Electrolyte Solution","Treating Dehydration with Electrolyte Solution Page Content Article BodyFor severe dehydration, hospitalization is sometimes necessary so that your child can be rehydrated intravenously. In milder cases, all that may be necessary is to give your child an electrolyte replacement solution according to your pediatrician’s directions. The table below indicates the approximate amount of this solution to be used. *Note: This is the smallest amount of fluid that a normal child requires. Most children drink more than this. Body Weight (lbs) Minimum Daily Fluid Requirements (oz)* Electrolyte Solution Requirements for Mild Diarrhea (oz/24 hrs) 6-7 10 16 11 15 23 22 25 40 26 28 44 33 32 51 40 38 61 Exclusively breastfed babies are less likely to develop severe diarrhea. If a breastfed infant does develop diarrhea, generally you can continue breastfeeding, giving additional electrolyte solution only if your doctor feels this is necessary. Many breastfed babies can continue to stay hydrated with frequent breastfeeding alone. Once your child has been on an electrolyte solution for twelve to twenty-four hours and the diarrhea is decreasing, you gradually may expand the diet to include foods such as applesauce, pears, bananas, and flavored gelatin, with a goal of returning to his usual diet over the next few days as he tolerates. In children over age one, milk can be withheld for one to two days until the diarrhea begins improving. In infants on formula, you can mix the formula with twice as much water as usual to make half-strength formula for a few feeds until the diarrhea seems to be improving and then you can mix it as usual. (Add an equal volume of water to your child’s usual full-strength formula.) As the vomiting and diarrhea improve, an older child may be able to eat small quantities of bland foods such as rice, toast, potatoes, and cereal, and should be moved to an age-appropriate diet as soon as possible. You can continue to give the electrolyte replacement solution if your child likes it or they are not taking usual amounts of their regular fluids. It is usually unnecessary to withhold food for longer than twenty-four hours, as your child will need some normal nutrition to start to regain lost strength. After you have started giving him food again, his stools may remain loose, but that does not necessarily mean that things are not going well. Look for increased activity, better appetite, more frequent urination, and the disappearance of any of the signs of dehydration. When you see these, you will know your child is getting better. Diarrhea that lasts longer than two weeks (chronic diarrhea) may signify a more serious type of intestinal problem. When diarrhea persists this long, your pediatrician will want to do further tests to determine the cause and to make sure your child is not becoming malnourished. If malnutrition is becoming a problem, the pediatrician may recommend a special diet or special type of formula. If your child drinks too much fluid, especially too much juice or sweetened beverages as mentioned earlier, a condition commonly referred to as toddler’s diarrhea could develop. This causes ongoing loose stools but shouldn’t affect appetite or growth or cause dehydration. Although toddler’s diarrhea is not a dangerous condition, the pediatrician may suggest that you limit the amounts of juice and sweetened fluids your child drinks (limiting fruit juice is always a good idea). You can give plain water to children whose thirst does not seem to be satisfied by their normal dietary and milk intake. When diarrhea occurs in combination with other symptoms, it could mean that there is a more serious medical problem. Notify your pediatrician immediately if the diarrhea is accompanied by any of the following: Fever that lasts longer than twenty-four to forty-eight hours Bloody stools Vomiting that lasts more than twelve to twenty-four hours Vomited material that is green-colored, blood-tinged, or like coffee grounds in appearance A distended (swollen-appearing) abdomen Refusal to eat or drink Severe abdominal pain Rash or jaundice (yellow color of skin and eyes) If your child has another medical condition or is taking medication routinely, it is best to tell your pediatrician about any diarrheal illness that lasts more than twenty-four hours without improvement, or anything else that really worries you. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
34,"2018-04-19 03:02:55","Treating Vomiting","Treating Vomiting Page Content Article BodyWhat's the best way to treat vomiting? In most cases, vomiting will stop without specific medical treatment. The majority of cases are caused by a virus and will get better on their own. You should never use over-the-counter or prescription remedies unless they've been specifically prescribed by your pediatrician for your child and for this particular illness. When your infant or young child is vomiting, keep her lying on her stomach or side as much as possible. Doing this will minimize the chances of her inhaling vomit into her upper airway and lungs. Watch for Dehydration When there is continued vomiting, you need to make certain that dehydration doesn't occur. Dehydration is a term used when the body loses so much water that it can no longer function efficiently. If allowed to reach a severe degree, it can be serious and life-threatening. To prevent this from happening, make sure your child consumes enough extra fluids to restore what has been lost through throwing up. If she vomits these fluids, notify your pediatrician. Modify Your Child's Diet For the first twenty-four hours or so of any illness that causes vomiting, keep your child off solid foods, and encourage her to suck or drink small amounts of electrolyte solution (ask your pediatrician which one), clear fluids such as water, sugar water (1/2 teaspoon [2.5 ml] sugar in 4 ounces [120 ml] of water), Popsicles, gelatin water (1 teaspoon [5 ml] of flavored gelatin in 4 ounces of water) instead of eating. Liquids not only help to prevent dehydration, but also are less likely than solid foods to stimulate further vomiting. Be sure to follow your pediatrician's guidelines for giving your child fluids. Your doctor will adhere to requirements like those descibed below. Estimated Oral Fluid and Electrolyte Requirements by Body Weight   Body Weight (in pounds)  Minimum Daily Fluid Requirements (in ounces)* Electrolyte Solution Requirements for Mild Diarrhea (in ounces for 24 hours)  6–7  10  16  11  15  23 22  25  40  26  28  44  33  32  51  40  38  61  1 pound = 0.45 kilograms1 ounce = 30 ml*NOTE: This is the smallest amount of fluid that a normal child requires. Most children drink more than this.  In most cases, your child will just need to stay at home and receive a liquid diet for twelve to twenty-four hours. Your pediatrician usually won’t prescribe a drug to treat the vomiting, but some doctors will prescribe antinausea medications to children. If your child also has diarrhea, ask your pediatrician for instructions on giving liquids and restoring solids to her diet. When to Call the Pediatrician If she can’t retain any clear liquids or if the symptoms become more severe, notify your pediatrician. She will examine your child and may order blood and urine tests or X-rays to make a diagnosis. Occasionally hospital care may be necessary. Until your child feels better, remember to keep her hydrated, and call your pediatrician right away if she shows signs of dehydration. If your child looks sick, the symptoms aren’t improving with time, or your pediatrician suspects a bacterial infection, he may perform a culture of the stool, and treat appropriately. Last Updated 8/1/2017 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
35,"2018-04-19 03:02:58","ADHD Medication Daily Routines","ADHD Medication Daily Routines Page Content Article BodyAs the parent of a child with ADHD, you may already be aware of certain times of day that are more difficult than others. If your child has begun taking a stimulant medication, you may notice fluctuations in her attention and behavioral control throughout the day as each dose of medication begins to take effect, works well, and then wears off. With stimulant medications, effects such as behavioral rebound (a short period of irritability or moodiness as the medication is wearing off in about 4, 8, or 12 hours) may lead to difficulties at around dinnertime or bedtime that had not generally occurred before. You can help your child adjust to these changes by observing how and when her emotions and behavior tend to fluctuate each day and arranging her schedule as much as possible to accommodate these ups and downs. If you know, for example, that she is usually somewhat unsettled and irritable for a half hour after her arrival home from school, schedule her homework for after that time. If her medication suppresses her appetite at certain times during the day, schedule meals to avoid these periods. Take special care to prepare her for transitions between activities because these are likely to be especially difficult times for her. Another issue to consider is the way a specific length of time can sometimes feel to your child with ADHD. For a child who struggles with managing her behavior or retaining focus for more than a few minutes at a time, tedious, repetitive, or boring activities can seem exceedingly long and soon become absolutely unbearable. Forcing your child to participate in such an activity (requiring her to sit still for long periods while you chat with a friend, introducing her to clubs or groups that involve little physical action and too much down time, expecting her to pick up all the toys at once in a disorderly room) will probably only lead to failure and the probability of subsequent punishment. Even fun activities can be strenuous in the same way. For example, baseball, which includes long periods of inactivity while on the field, may not be as good an activity for children with ADHD as soccer, which has a much faster and continuous pace. By avoiding such situations or breaking up activities (including homework) into short chunks of time, you can help your child experience success as she struggles to manage her responses. It may also help to let your child know ahead of time how long a particular activity will last, and even to place a timer in view to help her awareness of how much time has passed. If she knows she has already been working on her homework or practicing the piano for more than half the allotted time, she may be able (with your support and coaching) to continue to the end. Last Updated 11/21/2015 Source ADHD: A Complete and Authoritative Guide (Copyright © 2004 American Academy of Pediatrics)"
36,"2018-04-19 03:03:01","ADHD and Homework","ADHD and Homework Page Content Article BodyOur eleven-year-old daughter, who has been diagnosed with inattentive-type ADHD, has been doing better since she began treatment with stimulant medication. However, we still have trouble getting her organized around homework. We have tried setting up an office in her room, taking away all the distractions, keeping the area quiet, and not allowing the television to go on until all her homework is done. We don’t seem to be making much progress and, in fact, we are all getting even more frustrated because nothing seems to work. Her teachers still complain that work is not getting turned in, and her grades are still suffering in spite of her teacher always telling us how bright she is. There is no one-size-fits-all solution to the ideal homework setting. Some children with ADHD work inefficiently in an isolated, quiet setting like their room, and do better in the midst of some action, like at the kitchen table with a radio playing. You might need to try a few different settings until you find the most efficient one. In addition, you might need to figure out if any other factors are making homework difficult. Think about all the steps involved. Does your child know what all the assignments are? Does she bring the materials home that are necessary for doing the work? Does she have a nightly work plan that fits with her learning style? (She might need to schedule breaks between math and English, or between outlining the report and writing the first 3 paragraphs.) Does she have a system to check on whether all the nightly work is done? Is there a system for checking that her completed work gets turned in on the due date? How does she or you know that work is late? Have you or her teacher set up rewards for progress or consequences for late work? Is there a system for her teacher to communicate with you about late work? Once you have gone through this type of systematic list of questions, you can begin to solve the problem in an organized way—and you might discover some simple and obvious solutions. If she is taking stimulant medication and she does her homework primarily at a time after it has worn off, you could consider a short-acting extended dose of medication for the early evening. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
37,"2018-04-19 03:03:07","ADHD and Substance Abuse: The Link Parents Need to Know","ADHD and Substance Abuse: The Link Parents Need to Know Page ContentChildren and teens with attention deficit/hyperactivity disorder (ADHD) are more likely ​than other kids to smoke, drink, or use drugs. They experiment with all three at younger ages than those children without ADHD. They are also at a greater risk for developing a substance use disorder. However, just because a child has ADHD does not guarantee he or she will have alcohol or drug issues as a teen. The key for parents is to be aware of the link between the two, step-up prevention efforts at home, and seek professional help if a drug problem is suspected. Why Are People With ADHD More Likely to Abuse Drugs and Alcohol?There are several theories as to why ADHD increases the risk for substance use:Impulsivity, poor judgment and school troubles that can go along with ADHD may increase the risk for initiating substance use. There could be a genetic link between ADHD and the vulnerability for developing a substance use disorder. Individuals with ADHD may try to use psychoactive drugs to self-medicate.  Early Treatment of ADHD May Decrease the Risk of Substance AbuseThe timing of treatment matters. Children treated at a younger age for ADHD may be less likely to develop substance use disorders compared to those who begin treatment later. Treatment may delay the onset of substance use. Treating mental health disorders that often co-exist with ADHD, such as anxiety and depression, is also important​ and also increase the risk for substance use​.    Are Stimulant Drugs for ADHD Addictive? Stimulant medi​ations are considered ""first line"" treatment for ADHD. No study has ever found that stimulant treatment increases rates of substance use disorders, however stimulant medications can be misused, abused, or given to others. Close monitoring is recommended to prevent misuse. Your doctor may question you closely if your child loses pills or runs out early as those can be signs of misuse.   Some types of ADHD medication are more likely to be misused compared to others. For example, short acting stimulant medications are abused more often than longer acting or non-stimulant medications. Talk to your child's doctor for more information about the risks and benefits of different types of medication used to treat ADHD. Does Your Teen Have ADHD, a Drug Problem, or Both?Alcohol and drug use can cause symptoms that are similar to ADHD, including:Attention problemsDifficulty completing tasksDisorganizationTrouble sleepingPoor appetite Reluctance to socialize with othersLoss of interest in school Discuss any new symptoms or a sudden change in ADHD symptoms during adolescence with your child's doctor. One of the big differences is ADHD starts in early elementary school while most substance use disorders begin in middle school and not first grade.What Parents Can Do:Pay close attention to any change in behavior, even if you think it could be attributed to your child's ADHD. Communicate with your teen about safe and acceptable behavior.​​ Set an example by not misusing alcohol, tobacco, or illegal drugs yourself.Pay attention to your child's friends. If your child is hanging out with someone who is into drugs, it is very highly likely that your child may be exposed to drugs as well.Talk with your child about the importance of using all medications, including stimulants, exactly as prescribed. Discuss side effects and other concerns with your child's doctor. Sharing, selling, or distributing prescription stimulants is always illegal and is dangerous. Keep a close eye on your teens' ADHD medication, as prescription drug abuse among teens is on the rise. Make sure your child understands that he should never give his medication to anyone. Do not keep the medication in a public place such as in the bathroom or the kitchen or anywhere else people can see it. Make sure it's locked up or put away and monitored. Teach your kids to be responsible for their medication, too. Help her learn to ​manage her ADHD and to own her condition, and be aware that she is at higher risk for certain problems.Additional Inform​​ation on HealthyChildren.org: Is Your Child Vulnerable to Substance Abuse? What You Need to Know About Stimulant Medication Drug Abuse Prevention Starts with Parents​ ​​ Article Body Last Updated 6/21/2016 Source American Academy of Pediatrics (Copyright © 2014)"
38,"2018-04-19 03:03:12","Adapting a Style of Communication with Your Child with ADHD","Adapting a Style of Communication with Your Child with ADHD Page Content Article BodyChildren with ADHD frequently experience difficulty participating in elements of sustained and focused day-to-day conversation. But adapting your own style of communication to your child’s needs can help him maintain a connection. When necessary, pause to get your child’s attention (call his name before giving a command), maintain eye contact, and perhaps have him repeat back or explain what you have told him to be sure he has heard and understands. This approach works well not only when issuing commands but also when beginning any sort of conversation with your child. If he tends to interrupt, help him out by keeping your sentences brief and focusing only on what needs to be said. Avoid interrupting him frequently because he may not be able to stay engaged in this type of interaction. If you sense that his attention is wandering, touch his arm, take his hand, or otherwise make physical contact. Some parents find that conversation flows more smoothly if they are also involved in a physical activity with their child, such as washing dishes or making dinner. Finally, if you are telling your child something that you want him to remember, write it down in simple terms or encourage him to write it down himself. Introducing concepts such as “consequences,” “rewards,” and “positive and negative behavior” into the family vocabulary can go a long way toward clarifying communications. Where you might have previously instructed your child to “Go to your room!” following an unacceptable behavior, you can now inform him that his behavior has led to a “time-out”—and by the time you give this command, he will know the exact rules that apply to this term. Specific behavior therapy language strategies, such as when/then statements (“When you finish your homework, then you can go play baseball.”) may also prove useful when interacting with all of your children and can improve communication and morale in the family as a whole. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
39,"2018-04-19 03:03:18","Allergies and Hyperactivity","Allergies and Hyperactivity Page Content Article BodyParents often blame candies and other high-sugar foods when children get unruly. Some insist that sugar triggers hyperactivity. However, when put to the test, the sugar-behavior link does not hold up. In a carefully controlled study of preschool and school-aged children, researchers found no effect on behavior or ability to concentrate when sugar intake was far above normal, even among those whom parents identified as “sugar sensitive.” Another study found that sugar had the opposite effect to what was expected—when boys whose parents believed them to be sugar reactive were each given a large dose of sugar, they were actually less active than before. Finally, several studies comparing blood glucose levels have found that children with attention-deficit/hyperactivity disorder (ADHD) have exactly the same response to sugar consumption as do children without ADHD. There is no scientific basis for claims that sugar and other sweeteners influence behavior or cause ADHD, even at levels many times higher than in a normal diet. The overactivity children show after a birthday party or Halloween may be due more to the stimulation of the event than the sugar. Special Diets Special diets for hyperactivity are based on the belief that allergies or reactions to foods cause undesirable behavior. The diets typically target artificial additives, sugar, or the commonly allergenic foods (ie, corn, nuts, chocolate, shellfish, and wheat). However, there is no evidence that links foods and behavior. Some studies show that chemical preservatives or dyes, presumably through a drug rather than allergic mechanism, might contribute to these problems, but the evidence is weak and not widely accepted by experts. Therefore, the American Academy of Pediatrics does not recommend special diets for treating hyperactivity. If your child behaves oddly or has unusual symptoms after eating a particular food, it will do no harm to avoid it, provided his diet includes other choices from the same food group. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
40,"2018-04-19 03:03:22","Applied Kinesiology and ADHD","Applied Kinesiology and ADHD Page Content Article BodyAdvocates of this approach, also known as neural organization technique, believe that learning disabilities are caused by the misalignment of 2 specific bones in the skull—a misalignment that creates unequal pressure on different areas of the brain and leads to brain malfunction. This misalignment is also said to create “ocular lock,” an eye movement malfunction that contributes to reading problems. Treatment consists of restoring the cranial bones to the proper position through specific body manipulations. This theory is not consistent with either current knowledge about the causes of learning disabilities or knowledge of human anatomy. (Standard medical textbooks inform us that cranial bones do not move.) No research has been done to support the effectiveness of this form of treatment. Because it is based on false assumptions concerning the causes of learning disabilities, it is not recommended as a treatment for these disabilities, nor for ADHD. Last Updated 11/21/2015 Source ADHD: A Complete and Authoritative Guide (Copyright © 2004 American Academy of Pediatrics)"
41,"2018-04-19 03:03:28","Attention Deficit Hyperactivity Disorder","Attention Deficit Hyperactivity Disorder Page Content Article BodyAttention deficit hyperactivity disorder (ADHD) is a developmental disorder that affects the behavior, attention, and learning of children. If it is unrecog­nized, these children can face excessive criticism, failure, and disappointment, while their parents struggle with what to do. ADHD youngsters are easily distracted and have trouble concentrating. They may be impulsive and seem to act without think­ing, touching objects that are off limits or running into the street to chase a ball with­out apparent regard for their own safety. In calm moments, they might know better. They may not cope well with frustration and can have dramatic mood swings. At school they may be fidgety and brimming with energy, finding it difficult to sit still, jumping out of their seat constantly, as if unable to control their perpetual motion. They often have difficulty with sequencing and organizational skills. Others who can­not concentrate may sit quietly, daydream­ing and appearing ""spaced out."" Because of their behavior they may be rejected by other children and disliked by teachers; in the process, their report cards may be dis­appointing and their self-esteem may suffer, despite the fact that they are often as bright as their peers. Over the years a variety of labels—mini­mal brain dysfunction, hyperkinetic/impulsive disorder, hyperkinesis, hyperactivity, and attention deficit disorder with or with­out hyperactivity—have been used to de­scribe children with some or all of these behavioral problems. Now, most experts are using the term attention deficit hyperac­tivity disorder as a diagnosis for children whose behavior tends to be characteristi­cally impulsive, inattentive, or a combination of both. Since all children have these traits some of the time, the diagnosis usu­ally requires that the symptoms be present for at least six months by age seven, be ev­ident in various situations, and be more in­tense than usually seen in other children of the same age and gender. More than 6 percent of school-age chil­dren have ADHD. Boys outnumber girls. Re­searchers are examining multiple causes of the disorder, including heredity, brain chemistry, and social factors. Some re­searchers believe that children with ADHD have abnormally low levels and imbalances of certain neurotransmitters, the chemi­cals that convey messages between brain cells. Recent studies suggest that various parts of the brain may be functioning dif­ferently than in the majority of children. Many ADHD children also have reading disabilities and other specific learning problems, which further interfere with their success at school. (Most children who have specific learning problems do not have ADHD.) Children with difficulties with language and memory have problems with schoolwork that are compounded when ADHD characteristics like distractibility and impulsiveness are present. A child with ADHD can affect his family in many ways. Normal family routines may be hard to maintain because the child's be­havior has been so disorganized and unpredictable, often for a number of years. Parents may not be able to comfortably plan outings or other family events, not knowing what their child's behavior or ac­tivity level is likely to be. Children with ADHD frequently become ""overexcited"" and out of control in stimulating environ­ments. They may also exhibit angry and resistant behavior toward their parents or have low self-esteem. This may be the re­sult of the child's exasperation at failing to meet their parents' expectations or to manage day-to-day tasks due to ADHD symp­toms. School performance also suffers, and teachers complain to parents, who also must struggle with their child's difficulties with peers—conflicts, inappropriate behav­ior, and having few friends. The condition may produce enormous stress for families, who often search for physicians and others able to provide the care they need.       Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
42,"2018-04-19 03:03:34","Behavior Therapy for Children with ADHD","Behavior Therapy for Children with ADHD Page ContentMost experts recommend using both medication and behavior therapy to treat ADHD. This is known as a multimodal treatment approach. There are many forms of behavior therapy, but all have a common goal—to change the child's physical and social environments to help the child improve his behavior. Under this approach, parents, teachers, and other caregivers learn better ways to work with and relate to the child with ADHD. You will learn how to set and enforce rules, help your child understand what he needs to do, use discipline effectively, and encourage good behavior. Your child will learn better ways to control his behavior as a result. You will learn how to be more consistent. The table below shows specific behavior therapy techniques that can be effective with children with ADHD. Behavior therapy recognizes the limits that having ADHD puts on a child. It focuses on how the important people and places in the child's life can adapt to encourage good behavior and discourage unwanted behavior. It is different from play therapy or other therapies that focus mainly on the child and his emotions.  How can I help my child control her behavior?As the child's primary caregivers, parents play a major role in behavior ­therapy. Parent training is available to help you learn more about ADHD and specific, positive ways to respond to ADHD-type behaviors. This will help your child improve. In many cases parenting classes with other parents will be sufficient, but with more challenging children, individual work with a counselor/coach may be needed. Taking care of yourself also will help your child. Being the parent of a child with ADHD can be tiring and trying. It can test the limits of even the best parents. Parent training and support groups made up of other families who are dealing with ADHD can be a great source of help. Learn stress-­management techniques to help you respond calmly to your child. Seek counseling if you feel overwhelmed or hopeless. Ask your pediatrician to help you find parent training, counseling, and support groups in your community. Additional resources are listed at the end of this article.  Tips for helping your child control his behavior:Keep your child on a daily schedule. Try to keep the time that your child wakes up, eats, bathes, leaves for school, and goes to sleep the same each day.Cut down on distractions. Loud music, computer games, and TV can be overstimulating to your child. Make it a rule to keep the TV or music off during mealtime and while your child is doing homework. Don't place a TV in your child's bedroom. Whenever possible, avoid taking your child to places that may be too stimulating, such as busy shopping malls.Organize your house. If your child has specific and logical places to keep his schoolwork, toys, and clothes, he is less likely to lose them. Save a spot near the front door for his school backpack so he can grab it on the way out the door.Reward positive behavior. Offer kind words, hugs, or small prizes for reaching goals in a timely manner or good behavior. Praise and reward your child's efforts to pay attention.Set small, reachable goals. Aim for slow progress rather than instant results. Be sure that your child understands that he can take small steps toward learning to control himself.Help your child stay ""on task."" Use charts and checklists to track progress with homework or chores. Keep instructions brief. Offer ­frequent, friendly reminders.Limit choices. Help your child learn to make good decisions by ­giving him only 2 or 3 options at a time.Find activities at which your child can succeed. All children need to experience success to feel good about themselves.Use calm discipline. Use consequences such as time-out, removing the child from the situation, or distraction. Sometimes it is best to simply ignore the behavior. Physical punishment, such as spanking or slapping, is not helpful. Discuss your child's behavior with him when both of you are calm.Develop a good communication system with your child's teacher so that you can coordinate your efforts and monitor your child's progress.Additional Information on HealthyChildren.org:Understanding ADHD: Information for ParentsCommon ADHD Medications & Treatments for ChildrenHow Schools Can Help Children with ADHDCommon Coexisting Conditions in Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738)  Article Body Last Updated 1/9/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
43,"2018-04-19 03:03:40","Causes of ADHD: What We Know Today","Causes of ADHD: What We Know Today Page Content​Attention-deficit/hyperactivity disorder (ADHD) is one of the most studied conditions of childhood, but ADHD may be caused by a number of things. Research to date has shown: ADHD is a neurobiologic condition whose symptoms are also dependent on the child's environment.A lower level of activity in the parts of the brain that control attention and activity level may be associated with ADHD.ADHD frequently runs in families. Sometimes ADHD is diagnosed in a parent at the same time it is diagnosed in the child.In very rare cases, toxins in the environment may lead to ADHD. For instance, lead in the body can affect child development and behavior. Lead may be found in many places, including homes built before 1978 when lead was added to paint.Significant head injuries may cause ADHD in some cases.Prematurity increases the risk of developing ADHD.Prenatal exposures, such as alcohol or nicotine from smoking, increase the risk of developing ADHD.There is little evidence that ADHD is caused by: Eating too much sugarFood additivesAllergiesImmunizationsWhy do so many children have ADHD?The number of children getting treatment for ADHD has risen. It is not clear whether more children have ADHD or more children are receiving a diag­nosis of ADHD. Also, more children with ADHD are getting treatment for a longer period. ADHD is now one of the most common and most studied conditions of childhood. Because of more awareness and better ways of diagnosing and treating this disorder, more children are being helped. It may also be the case that school performance has become more important because of the higher ­technical demand of many jobs, and ADHD frequently interferes with school functioning. Additional Information on HealthyChildren.org:Inheriting Mental DisordersUnderstanding ADHD: Information for ParentsTreatment & Target Outcomes for Children with ADHDCommon ADHD Medications & Treatments for ChildrenAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738) ​ Article Body Last Updated 1/9/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
44,"2018-04-19 03:03:47","College Support Services and Accommodations for Adolescents with ADHD","College Support Services and Accommodations for Adolescents with ADHD Page Content Article BodyBefore he can choose an appropriate college, your teenager will need to consider—ideally with you and his guidance counselor, teachers, pediatrician, and/or psychologist—which services or accommodations he may need in his new life as an undergraduate. Services and accommodations for college students with ADHD may include Special orientation programs to introduce students to the institution’s academic structure and available services Specialized academic advisors or counselors to help students identify the classes, professors, class load, and even the major best suited to their interests and needs Priority scheduling to allow students to sign up for the most appropriate classes at the most appropriate times of day Reduced course loads, which prevents students with ADHD from becoming overwhelmed (A reduced course load may mean that the student will have to make up credits during summer school or a fifth year.) A private dormitory room for students who may find the presence of a roommate too distracting or disruptive Math laboratories, writing workshops, computer laboratories, and reading courses to supplement and improve basic academic skills Specialized tutoring for students with ADHD—emphasizing organizational and planning skills and effective study techniques, as well as help with specific coursework and examination preparation A “personal coach” to check in with the student each day, reviewing his schedule for the day and the work she expects to accomplish Classroom technology, such as laptop computers, tape recorders, videos, and other recording aids, to facilitate students’ ability to retain and review the information in classroom lectures Academic aides, including in-class note-takers and homework editors Special testing arrangements, such as untimed examinations or testing in a separate, quiet room Advocates to help communicate a student’s diagnosis and needs to professors when appropriate and to help him obtain needed services Support groups or contact with other students with ADHD who can provide companionship, emotional support, and information Career guidance and mentoring for students with ADHD Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
45,"2018-04-19 03:03:52","Common ADHD Medications & Treatments for Children","Common ADHD Medications & Treatments for Children Page Content​For most children, stimulant medications are a safe and effective way to relieve ADHD symptoms. As glasses help people focus their eyes to see, these medications help children with ADHD focus their thoughts better and ignore distractions. This makes them more able to pay attention and control their behavior.  Stimulants may be used alone or combined with behavior therapy. Studies show that about 80% of children with ADHD who are treated with stimulants improve a great deal once the right medication and dose are determined. Two forms of stimulants are available: immediate-release (short-acting) and extended-release (intermediate-acting and long-acting). Immediate-release medications usually are taken every 4 hours, when ­needed. They are the cheapest of the medications. Extended-release medi­cations usually are taken once in the morning.  Children who use extended-release forms of stimulants can avoid taking ­medication at school or after school. It is important not to chew or crush extended-release capsules or tablets. However, extended-release capsules that are made up of beads can be opened and sprinkled onto food for children who have difficulties swallowing tablets or capsules. Non-stimulants can be tried when stimulant medications don't work or cause bothersome side effects. Which medication is best for my child?It may take some time to find the best medication, dosage, and ­schedule for your child. Your child may need to try different types of stimulants or other ­medication. Some children respond to one type of stimulant but not another.  The amount of medication (dosage) that your child needs also may need to be adjusted. The dosage is not based solely on his weight. Your pediatrician will vary the dosage over time to get the best results and control possible side effects. The medication schedule also may be adjusted depending on the target ­outcome. For example, if the goal is to get relief from symptoms mostly at school, your child may take the medication only on school days. It is important for your child to have regular medical checkups to ­monitor how well the medication is working and check for possible side effects. What side effects can stimulants cause?Side effects occur sometimes. These tend to happen early in treatment and are usually mild and short-lived, but in rare cases they can be prolonged or more severe.  The most common side effects include: Decreased appetite/weight lossSleep problemsSocial withdrawalSome less common side effects include: Rebound effect (increased activity or a bad mood as the medication wears off)Transient muscle movements or sounds called ticsMinor growth delayVery rare side effects include Significant increase in blood pressure or heart rateBizarre behaviorsThe same sleep problems do not exist for atomoxetine, but initially it may make your child sleepy or upset her stomach. There have been very rare cases of atomoxetine needing to be stopped because it was causing liver ­damage. Rarely atomoxetine increased thoughts of suicide. Guanfacine can cause drowsiness, fatigue, or a decrease in blood pressure. More than half of children who have tic disorders, such as Tourette syndrome, also have ADHD. Tourette syndrome is an inherited condition associated with frequent tics and unusual vocal sounds. The effect of stimulants on tics is not predictable, although most studies indicate that stimulants are safe for children with ADHD and tic disorders in most cases. It is also possible to use atomoxetine or guanfacine for ­children with ADHD and Tourette syndrome. Most side effects can be relieved by: Changing the medication dosageAdjusting the schedule of medicationUsing a different stimulant or trying a non-stimulant Close contact with your pediatrician is required until you find the best ­medication and dose for your child. After that, periodic monitoring by your doctor is important to maintain the best effects. To monitor the effects of the medication, your pediatrician will probably have you and your child's teacher(s) fill out behavior rating scales, observe changes in your child's ­target goals, notice any side effects, and monitor your child's height, weight, pulse, and blood pressure. Stimulants, atomoxetine, and guanfacine may not be an option for children who are taking certain other medications or who have some medical conditions, such as congenital heart disease. Are children getting high on stimulant medications?When taken as directed by a doctor, there is no evidence that children are getting high on stimulant drugs such as methylphenidate and amphetamine. At therapeutic doses, these drugs also do not sedate or tranquilize children and do not increase the risk of addiction. Stimulants are classified as Schedule II drugs by the US Drug Enforcement Administration because there is abuse potential of this class of medication. If your child is on medication, it is always best to supervise the use of the medication closely. Atomoxetine and ­guanfacine are not Schedule II drugs because they don't have abuse potential, even in adults. Are stimulant medications gateway drugs leading to illegal drug or alcohol abuse?People with ADHD are naturally impulsive and tend to take risks. But patients with ADHD who are taking stimulants are not at a greater risk and actually may be at a lower risk of using other drugs. Children and teenagers who have ADHD and also have coexisting conditions may be at ­higher risk for drug and alcohol abuse, regardless of the medication used. See ADHD and Substance Abuse: The Link Parents Need to Know for more information.Unproven treatments:You may have heard media reports or seen advertisements for ""miracle cures"" for ADHD. Carefully research any such claims. Consider whether the source of the information is valid. At this time, there is no scientifically proven cure for this condition. The following methods need more scientific evidence to prove that they work: Megavitamins and mineral supplementsAnti–motion-sickness medication (to treat the inner ear)Treatment for candida yeast infectionEEG biofeedback (training to increase brain-wave activity)Applied kinesiology (realigning bones in the skull)Reducing sugar consumptionOptometric vision training (asserts that faulty eye movement and sensitivities cause the behavior problems)Additional Information on HealthyChildren.org:Understanding ADHD: Information for ParentsADHD and Substance Abuse: The Link Parents Need to KnowTreatment & Target Outcomes for Children with ADHDBehavior Therapy for Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD All About ADHD Medication (Understood.org) ​Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738)  Article Body Last Updated 1/10/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
46,"2018-04-19 03:03:55","Common Coexisting Conditions in Children with ADHD","Common Coexisting Conditions in Children with ADHD Page ContentAs part of the diagnosis, your ­pediatrician will look for other conditions that show the same types of ­symptoms as attention-deficit/hyperactivity disorder (ADHD). Your child may simply have a different condition or ADHD and another condition. Most children with a diagnosis of ADHD have at least one coexisting ­condition. Common coexisting conditions of ADHD: Learning disabilities—Learning disabilities are conditions that make it ­difficult for a child to master specific skills such as reading or math. ADHD is not a learning disability. However, ADHD can make it hard for a child to do well in school. Diagnosing learning disabilities requires evaluations, such as IQ and academic achievement tests, and it requires ­educational interventions.Oppositional defiant disorder or conduct disorder—Up to 35% of ­children with ADHD also have oppositional defiant disorder or conduct disorder. Children with oppositional defiant disorder tend to lose their temper easily and annoy people on purpose, and they are defiant and hostile toward authority figures. Children with conduct disorder break rules, destroy property, get suspended or expelled from school, and violate the rights of other people. Children with coexisting conduct disorder are at much higher risk for getting into trouble with the law or having substance abuse problems than children who have only ADHD. Studies show that this type of coexisting condition is more common among children with the primarily hyperactive/impulsive and combination types of ADHD. Your pediatrician may recommend behavioral therapy for your child if she has this condition.Mood disorders/depression—About 18% of children with ADHD also have mood disorders such as depression or bipolar disorder (formerly called manic depression). There is frequently a family ­history of these types of disorders. Coexisting mood dis­orders may put children at higher risk for suicide, especially during the teenage years. These disorders are more common among children with ­inattentive and combined types of ADHD. Children with mood disorders or depression often require additional inter­ventions or a different type of medication than those normally used to treat ADHD.Anxiety disorders—These affect about 25% of children with ADHD. Children with anxiety disorders have extreme feelings of fear, worry, or panic that make it difficult to function. These disorders can produce ­physical symptoms such as racing pulse, sweating, diarrhea, and nausea. Counseling and/or different medication may be needed to treat these coexisting conditions.Language disorders—Children with ADHD may have difficulty with how they use language. It is referred to as a pragmatic language disorder. It may not show up with standard tests of language. A speech and language clinician can detect it by observing how a child uses language in her day-to-day activities.Additional Information on HealthyChildren.org:Understanding ADHD: Information for Parents Causes of ADHD: What We Know TodayTreatment & Target Outcomes for Children with ADHDHow Schools Can Help Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738) ​ Article Body Last Updated 1/9/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
47,"2018-04-19 03:04:00","Common Symptoms of Hyperactivity/Impulsivity","Common Symptoms of Hyperactivity/Impulsivity Page Content Article BodyEarly Childhood (preschool and early school years) Behavior within normal range: The child runs in circles, does not stop to rest, may bang into objects or people, and asks questions constantly. Behavior signaling a hyperactivity/impulsivity problem: The child frequently runs into people or knocks things down during play, gets injured frequently, and does not want to sit for stories or games. Behavior signaling the possible presence of ADHD, hyperactive-impulsive type: The child runs through the house, jumps and climbs excessively on furniture, will not sit still to eat or be read to, and is often into things. Middle Childhood (later primary grades through preteen years) Behavior within normal range: The child plays active games for long periods. The child may occasionally do things impulsively, particularly when excited. Behavior signaling a hyperactivity/impulsivity problem: The child may butt into other children’s games, interrupt frequently, and have problems completing chores. Behavior signaling the possible presence of ADHD, hyperactive-impulsive type: The child is often talking and interrupting, cannot sit still at mealtimes, is often fidgeting when watching television, makes noise that is disruptive, and grabs toys or other objects from others. Adolescence Behavior within normal range: The adolescent engages in active social activities (eg, dancing) for long periods, and may engage in risky behaviors with peers. Behavior signaling a hyperactivity/impulsivity problem: The adolescent engages in “fooling around” that begins to annoy others, and he fidgets in class or while watching television. Behavior signaling the possible presence of ADHD, hyperactive-impulsive type: The adolescent is restless and fidgety while doing any and all quiet activities, interrupts and “bugs” other people, and gets into trouble frequently. Hyperactive symptoms decrease or are replaced with a sense of restlessness.  Last Updated 1/25/2016 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
48,"2018-04-19 03:04:07","Diagnosing ADHD in Children: Guidelines & Information for Parents","Diagnosing ADHD in Children: Guidelines & Information for Parents Page Content​Your pediatrician will determine whether your child has ADHD using standard guidelines developed by the American Academy of Pediatrics. These diagnosis guidelines are specifically for children 4 to 18 years of age. It is difficult to diagnose ADHD in children younger than 4 years. This is because younger children change very rapidly. It is also more difficult to ­diagnose ADHD once a child becomes a teenager. There is no single test for ADHD. The process requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child's school, and other caregivers should be involved in assessing your child's behavior.  Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. See the behaviors listed in the table below.  Your pediatrician will look at how your child's behavior compares to that of other children her own age, based on the information reported about your child by you, her teacher, and any other caregivers who spend time with your child, such as coaches or child care workers. The following guidelines are used to confirm a diagnosis of ADHD: Symptoms occur in 2 or more settings, such as home, school, and social situations, and cause some impairment.In a child 4 to 17 years of age, 6 or more symptoms must be identified.In a child 17 years and older, 5 or more symptoms must be identified.Symptoms significantly impair your child's ability to function in some of the activities of daily life, such as schoolwork, relationships with you and siblings, relationships with friends, or the ability to function in groups such as sports teams.Symptoms start before the child reaches 12 years of age. However, these may not be recognized as ADHD symptoms until a child is older.Symptoms have continued for more than 6 months.In addition to looking at your child's behavior, your pediatrician will do a physical and neurologic examination. A full medical history will be needed to put your child's behavior in context and screen for other conditions that may affect her behavior. Your pediatrician also will talk with your child about how your child acts and feels.  Your pediatrician may refer your child to a pediatric subspecialist or mental health clinician if there are concerns in one of the following areas:  Intellectual disability (formerly called mental retardation)Developmental disorder such as speech problems, motor problems, or a learning disabilityChronic illness being treated with a medication that may interfere with learningTrouble seeing and/or hearingHistory of abuseMajor anxiety or major depressionSevere aggressionPossible seizure disorderPossible sleep disorderHow can parents help with the diagnosis?As a parent, you will provide crucial information about your child's behavior and how it affects her life at home, in school, and in other social settings. Your pediatrician will want to know what symptoms your child is showing, how long the symptoms have occurred, and how the behavior affects your child and your family. You may need to fill in checklists or rating scales about your child's behavior.  In addition, sharing your family history can offer important clues about your child's condition. Keep safety in mind:If your child shows any symptoms of ADHD, it is very important that you pay close attention to safety. A child with ADHD may not always be aware of dangers and can get hurt easily. Be ­especially careful around:Traffic FirearmsSwimming poolsTools such as lawn mowersPoisonous chemicals, cleaning supplies, or medicinesHow will my child's school be involved?For an accurate diagnosis, your pediatrician will need to get information about your child directly from your child's classroom teacher or another school professional. Children at least 4 years and older spend many of their waking hours at preschool or school. Teachers provide valuable insights. Your child's teacher may write a report or discuss the following ­topics with your pediatrician: Your child's behavior in the classroomYour child's learning patternsHow long the symptoms have been a problemHow the symptoms are affecting your child's progress at schoolWays the classroom program is being adapted to help your childWhether other conditions may be affecting the symptomsIn addition, your pediatrician may want to see report cards, standardized tests, and ­samples of your child's schoolwork. How will others who care for my child be involved?Other caregivers may also provide important information about your child's behavior. Former teachers, religious and scout leaders, or ­coaches may have valuable input. If your child is homeschooled, it is especially important to assess his behavior in settings outside of the home.  Your child may not behave the same way at home as he does in other ­settings. Direct information about the way your child acts in more than one setting is required. It is important to consider other possible causes of your child's symptoms in these settings.  In some cases, other mental health care professionals may also need to be involved in gathering information for the diagnosis. Are there other tests for ADHD?You may have heard theories about other tests for ADHD. There are no other proven tests for ADHD at this time.  Many theories have been presented, but studies have shown that the following tests have little value in diagnosing an individual child: Screening for high lead levels in the bloodScreening for thyroid problemsComputerized continuous performance testsBrain imaging studies such as CAT scans and MRIsElectroencephalogram (EEG) or brain-wave testWhile these tests are not helpful in diagnosing ADHD, your pediatrician may see other signs or symptoms in your child that warrant blood tests, brain imaging studies, or an EEG.  Additional Information on HealthyChildren.org: Understanding ADHD: Information for Parents Causes of ADHD: What We Know Today Treatment & Target Outcomes for Children with ADHD Common ADHD Medications & Treatments for Children How Schools Can Help Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community.  National Resource Center on AD/HD  How Is ADHD Diagnosed? Video (Understood.org)​​ Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050 Attention Deficit Disorder Association or 856/439-9099 Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464 Tourette Association of America or 888/4-TOURET (486-8738)  Article Body Last Updated 1/9/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
49,"2018-04-19 03:04:14","Early Warning Signs of ADHD","Early Warning Signs of ADHD Page Content Article BodyMost experts agree that the tendency to develop ADHD is present from birth, yet ADHD behaviors are often not noticed until children enter elementary school. One reason for this delay is the fact that nearly all preschool-aged children frequently exhibit the core behaviors or symptoms of ADHD—inattention, impulsivity, and hyperactivity—as part of their normal development. As other children gradually begin to grow out of such behaviors, children with ADHD do not, and this difference becomes increasingly clear as the years pass. School settings can highlight a child’s problems relating to inattention, impulsivity, and hyperactivity because classroom activities demand an increased amount of focus, patience, and self-control. These types of demands are not as prevalent at home or in playgroups, so in those settings, the child may have had fewer problems. Usually by the time a child with ADHD reaches age 7 years, his parents have already become aware that their child’s inattentiveness, level of activity, or impulsiveness is greater than is typical. You may have noticed that your child finds it nearly impossible to focus on a workbook for even a very short period, even when you are there to assist him. Or you may still feel as worn out at the end of a day with your overly active 8-year-old as you did when he was 2. Your child may ask adults questions so often that you have begun to suspect it is not “normal.” Or, you may have noticed that he does not seem to be picking up the nuances of social interaction (respecting others’ personal space, letting other people have a turn to talk) that his playmates are beginning to adopt. Yet it is difficult for a parent to tell whether such behaviors are just part of the normal process of growing up (“Plenty of six-year-olds get bored with workbooks!”), whether they are more frequently problematic because of parenting difficulties (“Maybe I’ve been too inconsistent with setting limits.”), or whether this child’s temperament puts him far to one end of the spectrum (“He’s always been a handful.”), but not so far as to represent a disorder such as ADHD. This is why, for a child to be diagnosed with the disorder, the AAP advises pediatricians to gather information about the child’s behavior in at least one other major setting besides his home—including a review of any reports provided by teachers and school professionals. By comparing the child’s behavior across 2 or more settings, the pediatrician can begin to differentiate among such varied reasons for attentional problems as a “difficult” but normal temperament, ineffective parenting practices, inappropriate academic setting, and other challenges. She can also clarify whether the child’s behavior is preventing him from functioning adequately in more than one setting—another requirement for diagnosis. What Parents Notice When ADHD Behaviors Emerge It is sometimes hard to match the behavior we observe in our children with the formal terms used by pediatricians and other medical professionals. We rarely think of our children as having “hyperactive-impulsive problems.” Instead, we think, “Why can’t he ever settle down?” To confuse matters, the terms that doctors use for these behaviors have changed in recent years. The term “ADD” (attention deficit disorder) was once commonly used, and referred primarily to the form of ADHD with “inattentive only” symptoms. These children are not overly active, and their symptoms may even go unnoticed by many adults because their behavior is not disruptive. But more recently, the umbrella term “ADHD” is typically used when describing all types of ADHD. When reviewing the list that follows of typical remarks made about children with ADHD, ask yourself how many times per day or week you say or think the same things yourself. It is true that all parents make such comments now and then, but parents of children with ADHD continue to see the same behaviors on a daily basis, and for extended periods—long after other children have progressed. Parents of Children With Predominantly Inattentive-Type ADHD Say “He seems like he’s always daydreaming. He never answers when I talk to him. I wonder if he hears me.” “He loses everything. I’ve had to buy four new lunchboxes since school started.” “I’ll ask him to go up to his room and get dressed, and ten minutes later I find him playing with his toys with only his shirt on.” “He can’t remember what he learns because he misses instructions and explanations in school. Even though we work so hard on his schoolwork at night, by the next day he’s forgotten everything.” “One teacher called him her ‘space cadet,’ and another her ‘random student.’ ” Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
50,"2018-04-19 03:04:21","Educating Your Child's Siblings about ADHD","Educating Your Child's Siblings about ADHD Page Content Article BodyMy nine-year-old son was recently diagnosed with ADHD. He seems to be responding well to treatment and discussions of what ADHD is and how he can work to manage his problems. However, his older sister, who is thirteen, has responded to the news much more negatively. She resists going anywhere with the family where she might be seen by classmates in the company of her brother. At home, she calls him “weird” and yells at him to stay away from her and her friends. I understand that it can be difficult for an adolescent to deal with anything “different” about her family, but her behavior is rude and is damaging to my son’s self-esteem, hard as we are working to build it up. What can we do to persuade our daughter to be more supportive of her brother?   It may help to look at a situation like this as more of an opportunity than a problem because it gives you an opening to work with your daughter on general issues relating to sensitivity to others, respect for family members’ rights and feelings, and acceptance of the challenges that each person must face, as well as issues directly related to ADHD. As you are already doing with your son, your daughter needs to be educated regarding what ADHD is and is not, which of your son’s behaviors are typical of children with ADHD and which are just part of normal sibling conflicts, and how her responses can help him achieve better self-control and improve general family functioning. If you have not already spoken directly with your daughter about these issues, be sure to do so—you might do some of this in the context of a “family meeting.” Your family may also benefit from one or more sessions with a family therapist or from a support group for families of children with ADHD that may help your daughter understand that the problems that she faces with her brother are common, and provide her with positive approaches for interacting with her brother. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
51,"2018-04-19 03:04:27","Employment and the Workplace for a Young Adult with ADHD","Employment and the Workplace for a Young Adult with ADHD Page Content Article BodyLife in the workplace can be formidable for a young adult with ADHD. Not only is he exposed to the same social and emotional pressures as his peers on college campuses, but he must also perform in a work environment that typically provides few or no supportive services and where no one may know he has ADHD. He may find it more stressful than he had expected to arrive at work exactly on time, manage paperwork or other detail-oriented work, attend frequent meetings, meet deadlines, and otherwise conform to what can often be a noisy, stressful and, in some cases, physically inactive environment. While teenagers with ADHD can often perform as well as their peers, adults with ADHD who are employed full-time tend to switch jobs more frequently and earn less money than their colleagues. A young adult with ADHD will be more likely to start off on the right foot if he spends time during high school considering what types of jobs might best suit someone with his particular strengths and weaknesses and working on developing his time-management and selfcare skills. Career counseling services are often available through the high school guidance office, and may be mandated under IDEA. Any job can be made more “ADHD-friendly” if the employee with ADHD knows how to alter his environment to better suit his needs and to advocate effectively for appropriate accommodations. Coping With the Workplace A teenager or young adult with ADHD who joins the workforce but finds a job too difficult should get some help in analyzing where the job-related challenges lie. Is he overwhelmed by paperwork? Does he get in trouble for arriving late on too many days? Does he put off tasks and thus fail to complete them? Does he forget his employer’s instructions? Does he find it impossible to concentrate with all the noise around him? Is it hard for him to get along with coworkers or his boss? Once he has identified his problem areas, he can brainstorm on his own or with coworkers, a job coach, a counselor or a psychologist, a family member, or members of his treatment team about ways to address them. He may decide to use a daily planner or computer software to manage daily tasks and appointments. A watch with alarms or a timer can help him keep track of work arrival time or deadlines, and any number of handheld devices can be used to record tasks to be accomplished. He may choose to carpool with a coworker to help him get to work on time, and to take regular, brief “exercise breaks” to work off excess energy. Asking Your Employer for Help If these self-help techniques prove insufficient, and if a young adult feels comfortable disclosing that he has some functional issues related to ADHD, he should consider asking his employer about accommodations that might be provided that could help him work at his best level. Accommodations might include a less distracting office or workspace, a daily review each morning of work to be done, help with breaking complex jobs into smaller tasks, or even flex-time or a transfer from a heavily detail-oriented, time-pressured job to one that better matches his strengths. It may be difficult for him to work up the courage to ask for such help at first, but chances are that his employer will make at least some effort to cooperate. His problems at work may have puzzled or displeased his supervisor if she did not previously understand their cause, and she will probably appreciate and respect her employee’s effort to improve his performance. As is the case in any aspect of his life, he is likely to meet with greater success on the job as he focuses on his strengths rather than his weaknesses. Adults with ADHD are often among the most creative, imaginative, energetic members of society. The more successfully he can understand and communicate to his employer his talents, strengths, and needs, the harder he or she may work to help him. It is important to remember, however, that ADHD symptoms are an explanation of why he is experiencing difficulty and not an excuse for them. The greater his understanding of how ADHD affects him and the better his self-esteem coming out of high school, the more likely he will feel empowered to effectively advocate for himself in a present or future job. An adolescent may be entitled to continue counseling services and assessment under an IDEA-mandated Individual Written Rehabilitation Plan. If this is not the case, however, he will need to be extra-vigilant regarding any ADHD-related concerns that are beginning to get out of hand, because routine accommodations are rarely provided by an employer. Make sure that your teenager has the names and phone numbers of physicians, job counselors, therapists, and other community resources who can help him with a variety of potential difficulties. The most helpful role as a parent may include providing nonjudgmental help or “reality checks” if he approaches you about these issues. Parents should remember that their role is to empower and not to enable or provide excuses for their adult child. If he is offered a health insurance plan by his employer, he should review it along with his job-related benefits to learn in advance what counseling or other support services he can obtain. He may also consider the possible benefits of using a coach to help with some of these transitions from adolescence to adult life. Again, a thorough understanding of his ADHD-related strengths and weaknesses, coupled with a determination to monitor and manage his symptoms, is the best way for your growing adolescent to join the ranks of other young adults with ADHD who enjoy stimulating, fulfilling, and successful careers. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
52,"2018-04-19 03:04:33","Encouraging Independence in Teenagers with ADHD","Encouraging Independence in Teenagers with ADHD Page Content​The teenage years can be a special challenge. Academic and social demands increase. In some cases, symptoms may be better controlled as the child grows older; however, frequently the demands for performance also increase so that in most cases, ADHD symptoms persist and continue to interfere with the child's ability to function adequately. According to the National Institute of Mental Health, about 80% of those who required medication for ADHD as children still need it as teenagers.Parents play an important role in helping teenagers become independent. Encourage your teenager to help herself with strategies:Using a daily planner for assignments and appointmentsMaking listsKeeping a routineSetting aside a quiet time and place to do homeworkOrganizing storage for items such as school supplies, clothes, CDs, and sports equipmentBeing safety conscious (e.g., always wearing seat belts, using protective gear for sports)Talking about problems with someone she trustsGetting enough sleepUnderstanding her increased risk of abusing substances such as tobacco and alcoholActivities such as sports, drama, and debate teams can be good places to channel excess energy and develop friendships. Find what your teenager does well and support her efforts to ""go for it.""Milestones such as learning to drive and dating offer new freedom and risks. Parents must stay involved and set limits for safety. Your child's ADHD increases her risk of incurring traffic violations and accidents.It remains important for parents of teenagers to keep in touch with teachers and make sure that their teenager's schoolwork is going well.Talk with your pediatrician if your teenager shows signs of severe problems such as depression, drug abuse, or gang-related activities.Addit​ional Information on HealthyChildren.org:ADHD and Substance Abuse: The Link Parents Need to KnowTreatment & Target Outcomes for Children with ADHDBehavior Therapy for Children with ADHDCommon ADHD Medications & Treatments for ChildrenHow Schools Can Help Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738)  Article Body Last Updated 1/10/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
53,"2018-04-19 03:04:40","Girls and ADHD","Girls and ADHD Page Content Article BodyThe fact that many more boys than girls are diagnosed with ADHD—at a ratio of approximately 2 to 1 or 3 to 1—has led to the mistaken belief among many parents and teachers that ADHD is a “boys’ disorder” that rarely occurs in girls. In fact, more girls than boys qualify for the diagnosis of ADHD, but more girls remain undiagnosed because they have the inattentive type of ADHD, and tend to be overlooked entirely or do not attract attention until they are older. This means that girls are less likely to be referred for evaluation and to receive the help they need. Even when diagnosis and treatment have been obtained, girls with ADHD are further disadvantaged by the fact that most ADHD research to date has focused on boys. Little is known about potential differences between the genders in the development of the condition over time or response to medication and other forms of treatment. Compared with other girls, girls with ADHD experience more depression, anxiety, distress, poor teacher relationships, stress, external locus of control (the feeling that “the winds of fate” control their destiny instead of themselves), and impaired academics. Compared with boys with ADHD, girls with ADHD experience more difficulties from feeling anxious, distressed, or depressed, and less of a feeling that they can take control in solving problems that they face. If your daughter has been referred for evaluation for ADHD, or if you suspect that she may have the condition, it is important not to discount the possibility just because she is female. Teachers tend to under-refer girls for evaluation, even when their symptoms are the same as boys’, and girls are less likely than boys to receive sufficient medical treatment once they have been diagnosed. Be aware that some sociocultural beliefs about girls (that they tend to daydream, that they just are not interested in academics) may mask a real problem in your child’s ability to function. If your daughter is diagnosed with ADHD, ask the pediatrician to keep you updated on ongoing research about the development of ADHD in girls, the particular challenges girls with ADHD are likely to meet, and the different ways in which they may respond to various forms of treatment Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
54,"2018-04-19 03:04:50","Health and Safety of Children with ADHD","Health and Safety of Children with ADHD Page Content Article BodyA growing number of studies have shown that adults with ADHD may be at greater risk for health- and safety-related problems than their peers without ADHD. Their greater risktaking behaviors and frequently erratic driving practices (inability to follow driving rules, inconsistent operation of vehicles) increase the chances of injuries. During adolescence and young adulthood, they may also have more unprotected sex with a greater number of partners than those without ADHD, and are therefore at greater risk for acquired immunodeficiency syndrome (AIDS) and other sexually transmitted infections. It is important that your child be informed as early as the preteen and early teen years about these areas of increased risk. A healthy and proactive stance for a young adult with ADHD includes monitoring his risk-taking behaviors closely. In general, the more fully he understands that his health and safety are his own responsibility, and that monitoring his risktaking behavior will always be an important part of his life, the better prepared he will be to meet these challenges. Switching to long-acting stimulant preparations or making sure symptoms are under control when driving or well into the evening hours may also help with critical decision-making and problem-solving skills affected by uncontrolled ADHD symptoms. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
55,"2018-04-19 03:04:58","Healthy Children Radio: ADHD","Healthy Children Radio: ADHD Page Content Article Body​Developmental pediatrician Andrew Adesman, MD, FAAP, comes on the Healthy Children radio show to discuss the diagnosis and treatment of ADHD. Segment 1: The Often Devastating Effects of ADHD Segment 2: Helping Your Child Understand Their ADHD Medication Therapy Segment 3: Your Child's Diet: A Cause and a Cure of ADHD?   Last Updated 1/23/2016 Source American Academy of Pediatrics (Copyright © 2012)"
56,"2018-04-19 03:05:01","Homeopathic Treatments for ADHD","Homeopathic Treatments for ADHD Page Content Article Body Homeopathy, a therapeutic approach developed in the 1800s that is especially popular in Europe, springs from the concept that illness results from a disorder of “vital energies,” and that these energies must be restored if a patient is to recover. Vital energies can be restored through the use of diluted animal, plant, or mineral extracts designed to treat specific symptoms. These treatments have been shown to be more effective than placebos in reliable scientific studies, though the reason for this is not yet known. Homeopathic treatment for ADHD, increasingly widespread in the United States as individual accounts of success have spread, has been demonstrated effective in one initial study in improving ADHD-type behavior, although the study failed to use a fully double-blind design. Though the mechanisms underlying this treatment are still not scientifically defined, the success of the study merits further investigation of homeopathy as a treatment for ADHD, but it cannot be recommended as a proven therapy at this time. If you do become interested in using this approach, be sure to discuss your plans first with your child’s physician. Some extracts can interact negatively with medications your child may be taking. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
57,"2018-04-19 03:05:08","How ADHD Treatments Are Proven Effective","How ADHD Treatments Are Proven Effective Page Content Article BodyYou may have noticed that the media seem to report on a new treatment for ADHD frequently. If so, you may wonder why so many alternative treatments exist for ADHD, and why they so easily gain credibility with the general public. One reason is that, as opposed to such medical conditions as diabetes, the results of a given treatment for ADHD are difficult to measure objectively—that is, there is no blood, urine, or other laboratory test that can prove conclusively that the treatment has worked. Instead, as you will see, the effectiveness of treatments for ADHD are judged through rigorous studies of groups undergoing the treatment compared with those who are not. Because effects of these treatments are determined through relatively subjective methods, such as changes in teachers’ and parents’ observations, and ratings of behaviors over time—not by objective blood, urine, or magnetic resonance imaging studies—it is often more difficult, even with careful statistical analysis, to clearly establish that any proposed standard or alternative treatment for ADHD is wellfounded. If a treatment cannot quickly and objectively be proven effective, it is easier for its proponents to just claim that it works. Thus claims for a particular approach can be greatly exaggerated and widely disseminated long before it has been sufficiently studied. Yet there is a standard, reliable process for deciding whether a new treatment is effective. This process is called the scientific method, and through it investigators can subject any treatment approach to a reliable series of tests or studies to evaluate its effectiveness. There is a great deal written these days about “evidence-based medicine,” which is a set of procedures, resources, and information tools for appraising the strength of the scientific evidence to assist practitioners in applying research findings to the care of individual patients. The medical community now expects treatments strongly recommended for the treatment of ADHD to meet these standards of evidence-based medicine. Studies of treatments for ADHD conducted according to the scientific method make use of research tools, including structured observations, rating scales, and objective tests of the child’s functioning, whenever possible. They are structured so that extraneous factors that might influence results are taken into account and designed so that they can be reproduced by other researchers to make sure similar results are achieved. According to the scientific method and evidence-based medicine, we can only rely on the results of studies relating to a particular treatment if the researchers have Formulated a clear hypothesis. The researcher must state what she wants to determine through the study. For instance, she might state the hypothesis, “Because diet and nutrition are known to affect brain development, a diet fortified with extra vitamins will have a positive effect on ADHD symptoms.” This then will be proved or disproved by a wellconducted study. Created a detailed plan to test the hypothesis. The researcher must then define the nature of the treatment (for example, state which vitamins will be administered, at what dose, and how frequently), how it will be administered (by parents, by a physician, by the children themselves), how it will be monitored (by counting the number of pills left in the bottle at the end of the study), and how the effects will be measured (through a daily dosage checklist, parents’ reports, physicians’ records, teacher observations, etc). In this way, the study results can be systematically explained (perhaps it did not work because the children reported taking the vitamins but did not always do so, for example), and other researchers can confirm the results by using the same methods with different sets of children. Defined the group to be tested. This is an important and sometimes difficult part of creating a reliable study. Can a child be allowed to participate in the study solely on the basis of whether he looks hyperactive to the researchers? Must he have been diagnosed by his pediatrician? Or have the researchers made their own diagnosis according to rigorous research criteria? The group under study must also be large enough for the treatment results to apply to the population as a whole—1, 6, or even 100 children may not be enough, depending on the research question. The group receiving the treatment must be compared with a group not receiving the treatment, and/or another group or groups receiving a different type of treatment for ADHD. The members of the groups under study should otherwise be as similar as possible, and children who might be affected by extraneous influences, such as coexisting disorders, high or low extremes in intelligence, and unusual family circumstances, are sometimes screened out. Depending on the question to be answered, the researcher must limit as many other variables as possible, aside from the treatment under study. Eliminated the power of suggestion. One way to test whether a treatment is effective is to compare the proposed treatment with a placebo treatment. People often tend to respond to placebos—inactive medications or treatments they believe may work— whether or not the treatment is actually effective in the long run. A person with a headache who is given a “sugar pill,” believing it is pain medication, may report that the headache is gone a short time later. In many studies placebos can be shown to be somewhat or very effective. One way to test whether a treatment for ADHD is effective, for example, is to make sure that the subjects do not know whether they are really receiving the proposed treatment or a placebo treatment. In the vitamin treatment example, then, half of the subjects in the study might receive actual megavitamins and the other half would receive an inactive, neutral, but identical-looking pill. Depending on the type of investigation, the study design may work even better if used in a “double-blind” experiment—that is, if the subject, his family, his teacher, and the researcher do not know whether the actual pill or a placebo was used in a particular patient until the study has ended. That way there is no danger that the researcher has inadvertently communicated this information to the subject, his family, or teacher, or that he misinterpreted the results because of what he knew. Of course, if the treatment has specific effects, such as an unusual taste difficult to mimic in the placebo, it may be impossible to keep everyone in the dark about which person got the experimental treatment. Placebo treatments are more difficult to create when the treatment involves a procedure, such as psychotherapy, rather than a pill. Still, researchers must make every effort to make the real treatment and the placebo treatment equally convincing to the subject. Having independent evaluators who are unaware of the treatment being used, called blinded, to whether the treatment is the megavitamin or the placebo preparation improves the accuracy of the study. Provided a valid means of evaluating the results. Some treatment results are easier to evaluate than others. As you’ve already read, in the case of ADHD, results can be difficult to judge because they cannot be measured through precise laboratory tests or other fully objective measures. Still, researchers can standardize test results through such techniques as quantifying behaviors (having teachers report how many times per day a child interrupted a conversation, got out of his seat without permission, or failed to hear someone talking to him), using standard rating scales, comparing the study subjects’ performance to that of the other groups in the study who received different treatments, and measuring changes in the behaviors being studied at predetermined intervals throughout the course of the investigation. Treatments can be evaluated by standardized tests (such as performance on standardized math tests), as well as in terms of the child’s performance in the real world (measures of classroom behavior or improvements in family relationships). Rigorous statistical techniques are then used to find any significant differences in results among the groups in the study. The methods and results of any study are then reviewed by other experts in the field. This process, called peer review, is required before the study is published in a reputable scientific journal. If a treatment proves successful, it is also helpful to follow up with the children on the treatment for longer than the period that was studied to make sure that the beneficial results continue and do not cause any serious long-term side effects. Which Treatments Have Been Shown to Work? The treatments for ADHD supported by the strongest evidence are stimulant medications and behavior therapy techniques, often used together. These forms of treatment have been the most studied and validated by the types of rigorous scientific research described previously. For this reason, pediatricians can feel secure in recommending these approaches as proven, safe, and effective, evidence-based, first-line treatments for ADHD. Many other forms of treatment for ADHD have been tested in studies using the scientific method. Some, such as traditional psychotherapy and cognitive therapy, have been shown through convincing research not to demonstrate positive results in treating the condition’s core symptoms. Another group of potential treatments for ADHD has been tested to some extent, but the studies have been too few in number or were conducted with some flaws in study designs, or the results were too ambiguous to prove that the treatment works. Evidence of a treatment’s effectiveness may be insufficient if the Studies involve too few subjects, so that results cannot be generalized to the ADHD population at large “Proof” relies on anecdotal evidence, such as parents’ testimonies or one physician’s experience with his own patients, rather than on a large group that has been part of a well-designed scientific study Study results have not been subjected to the scrutiny of experts who would have reviewed the study prior to publication to identify any possible flaws in the study design or the results Last Updated 1/1/2004 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
58,"2018-04-19 03:05:14","How Schools Can Help Children with ADHD","How Schools Can Help Children with ADHD Page Content​Your child's school is a key partner in providing effective behavior ­therapy for your child. In fact, these principles work well in the classroom for most students. Classroom management techniques may include: Keeping a set routine and schedule for activitiesUsing a system of clear rewards and consequences, such as a point system or token economy Sending daily or weekly report cards or behavior charts to parents to inform them about the child's progressSeating the child near the teacherUsing small groups for activitiesEncouraging students to pause a moment before answering questionsKeeping assignments short or breaking them into sectionsClose supervision with frequent, positive cues to stay on taskChanges to where and how tests are given so students can succeed (e.g., allowing students to take tests in a less distracting environment or allowing more time to complete tests)Federal laws to help children with ADHD:Your child's school should work with you and your pediatrician to develop strategies to assist your child in the classroom. When a child has ADHD that is severe enough to interfere with her ability to learn, 2 federal laws offer help. These laws require public schools to cover costs of evaluating the ­educational needs of the affected child and providing the needed services.  The Individuals with Disabilities Education Act, Part B (IDEA) requires public schools to cover costs of evaluating the educational needs of the affected child and providing the needed special education services if your child qualifies because her learning is impaired by her ADHD.Section 504 of the Rehabilitation Act of 1973 does not have strict ­qualification criteria but is limited to changes in the classroom, modifi­cations in homework assignments, and taking tests in a less distracting environ­ment or allowing more time to complete tests.If your child has ADHD and a coexisting condition, she may need additional special services such as a classroom aide, private tutoring, special classroom settings, or, in rare cases, a special school.  It is important to remember that once ADHD is diagnosed and treated, children with it are more likely to achieve their goals in school.  Additional Information on HealthyChildren.org:Treatment & Target Outcomes for Children with ADHDBehavior Therapy for Children with ADHDCommon Coexisting Conditions in Children with ADHDCommon ADHD Medications & Treatments for ChildrenAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738)  Article Body Last Updated 1/10/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
59,"2018-04-19 03:05:19","Integrating ADHD Management Into Your Family Life","Integrating ADHD Management Into Your Family Life Page Content Article BodySuccessfully managing ADHD takes a great deal of time and effort on your part as well as your child’s. If you, your partner, or any of your other children also have ADHD (not unlikely because the condition can run in families), the amount of time and effort spent is further compounded. Family members without ADHD may resent the time and attention that they feel are taken from them to meet the needs and address the issues of those who have it. It is no surprise, then, that the pressure to satisfy everyone’s demands sometimes becomes overwhelming. One way around this is to formally schedule regular personal time with each child and with your spouse as well. These periods do not have to be lengthy—half an hour at a time may do—but they should be frequent and as predictable (daily, for example) as possible, and you should make sure they actually happen. When you are spending time with one of your children or your spouse, make it a policy not to bring up divisive issues. Try to keep your time positive and focused on the present relationship so that both of you will have more emotional energy for the rest of the family later on. If you are the parent taking most of the responsibility for dealing with issues related to ADHD, it is also a good idea to try to delegate other daily chores as much as possible. Allow your partner, older children, or other relatives to take over duties that free up your time and, when possible, take advantage of time-saving services such as online banking, drive through services, and so on. Every minute you save from these errands is a valuable minute you can give to your child with ADHD, other family members and, just as important, yourself. Partnering in Your Child’s Care Management Becoming your child’s care manager means serving as the vital link connecting all aspects of his treatment plan at home, at school, and in the community. This requires a great deal of thought, organization, and support, and can make an enormous contribution to your child’s progress and your family’s welfare. Organization needs to extend beyond some of the aspects already discussed, such as calendars and time management. For example, a child with ADHD accumulates a lot of records—from teachers, physicians, mental health professionals, medical insurance companies, and so on. Keep these papers neatly filed and available when you need them. By organizing reports and treatment decisions chronologically, you can create an excellent database for future discussions with treatment providers and school personnel about how your child is progressing. Always keep a pen and pad of paper or your handheld device available as well to record any information you feel might be useful at the next treatment review meeting with your child’s pediatrician. Because concrete, quantitative information is so valuable in evaluating his progress, you will want specific notes on your child’s behavior rather than general, half-remembered impressions. Once you have instituted these organizing principles, you will likely find that you have more complete records than any of your child’s physicians, psychologists, or teachers, and that you have indeed become the true care manager. Whenever possible, partner with the care manager in your medical home. In caring for your child with ADHD, the American Academy of Pediatrics recommends creating a “medical home."" This term and concept is gaining increasing attention among pediatricians and parents. Despite the name, a medical home is not a building, nor is it a house. Instead, it is an approach to providing your child with high-quality, comprehensive care. It is an ongoing partnership between your family and your pediatrician and other members of your treatment team, and is based on the needs of the whole child and his family. It is defined as care that is coordinated, accessible, continuous, comprehensive, family-centered, compassionate, and culturally effective. Educating Family Members While you, your child with ADHD, and other adults involved in his care have probably focused a great deal of attention on learning about the nature of his condition, it is important to keep in mind that your other children and relatives are likely to understand much less. They will need your help in learning how to respond to your child’s behavior and to support his efforts to function successfully. If family members seem to resent or blame your child for his actions, take the time to talk privately with them about the challenges he faces. Discuss treatment decisions with everyone in your family, explaining the reasons for your choices. If you are implementing behavior therapy techniques in your home, other family caregivers will need to learn to implement them as well. (Fortunately, all the tools and techniques you will learn through parent training apply equally well to other children in the family and can be equally helpful.) Teach other family members to frame ADHD-related challenges positively and to work with your child to solve problems. You might ask them to write down any issues they have (such as, “Frances interrupts me all the time!”) and then think about how to rephrase them in ways that will help solve the problem (“I need for Frances to wait until I’m finished talking before she talks.”). Once this is done, family members can discuss possible solutions, try one out and evaluate it, and move on to another solution if that one does not work. Sometimes family members refuse to cooperate, express chronic resentment, or seem unable to act in positive ways. These are common issues; you might consider locating an ADHD support group in your area and/or seeking family therapy to help everyone adjust. In the meantime, let your child communicate directly to his other family members whenever possible instead of always “defending him” yourself. Such conversations can be quite effective in smoothing relationships and helping your child become a respected part of the family. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
60,"2018-04-19 03:05:22","Learning, Motor Skills, and Communication Disorders","Learning, Motor Skills, and Communication Disorders Page Content Article BodyLearning Disorders Reading Disorders Reading disorders, the most common and best studied of the learning disabilities, account for 80% of all children diagnosed as learning disabled. Children with reading disorders are able to visualize letters and words but have difficulty recognizing that letters and combinations of letters represent different sounds. Most reading disorders involve difficulties with recognizing single words rather than with reading comprehension. The cause often lies in the area of the child’s “phonologic awareness”—difficulty perceiving how sounds make up words. Reading disorders—even including letter reversals—have little to do with vision. These problems make it quite difficult for children to add new words to their reading repertoire and become good readers. While their listening and speaking skills may be adequate, they may have trouble naming objects (such as quickly coming up with the word for “computer” or “backpack”) and/or remembering verbal sequences (such as “The boy saw the man who was driving the red car.”). A smaller group of children also have reading disabilities that involve comprehension, and these children tend to have poor receptive language skills—that is, difficulty understanding language even when it is spoken to them. A reading disorder, depending on how it is defined, is not necessarily a lifelong condition, but these problems do persist into adulthood in at least 40% of children. Like all other learning disabilities, reading disorders cannot be detected through neurologic tests, such as special examinations, electroencephalograms (EEGs: brain wave tests), or brain scans like computed tomography and magnetic resonance imaging. They are identified when a child’s reading level or language achievement scores are significantly lower than those of his classmates. In assessing reading disabilities, it is important to identify each component of your child’s problem so that specific treatment measures can be applied. It is also important to address the attentional and behavioral aspects of the ADHD so that your child can make optimal progress at school. Mathematics Disorder Mathematics disorder can be thought of as a type of learning disability in which spoken language is not affected, but computational math is. Children with mathematics disorder also may have difficulties with motor and spatial, organizational, and social skills. Children with coexisting ADHD, or even ADHD alone, can have additional problems in math—such as delays in committing math facts to memory, the making of careless math errors, rushing through problems and impulsively putting down the wrong answers or not showing their work, and making errors because they misaligned columns during addition or long division. Although math disabilities are about as common as reading disabilities, they are not well studied. It is not known whether math skills stem from the innate abilities of children to understand the concepts of magnitude or quantities and compare numbers, or whether they arise in brain areas that are responsible for language, visual-spatial, or attention and memory systems. It is generally agreed that children with mathematics disability have a deficit in recalling math facts. Accurate and fluent recall of single digit math facts is felt to be important in freeing up higher brain areas for learning and applying more complex tasks. Children with both reading and math disabilities struggle particularly with word problem-solving. Written Expression Disorder Children with written expression disorder can have difficulty composing sentences and paragraphs; organizing paragraphs; using correct grammar, punctuation, and spelling in their written work; and writing legibly. Children with spoken-language problems can develop problems with written language as well as math. Children with ADHD can also have difficulty with taking the mental time to plan their writing, and their handwriting can be immature and sometimes unreadable without necessarily having a written expression disorder. When handwriting problems are more a function of ADHD than a written expression or motor skills disorder, they sometimes improve rapidly and dramatically with appropriate stimulant medication treatment. Nonverbal Learning Disability Nonverbal learning disability is a condition that is not yet formally categorized as a disorder but that has been the subject of increasing interest. It is particularly important to consider in children with ADHD because it relates to attentional functioning. It is often difficult to decide whether a child with ADHD has a coexisting NLD or whether he just has an NLD that mimics ADHD—especially the inattentive symptoms. Nonverbal learning disability accounts for about 5% to 10% of children with learning disabilities. It consists of a cluster of deficits, including poor visuospatial skills, problems with social skills, and impaired math ability. Problems with disorganization, inconsistent school performance, and social problems may lead to an evaluation for ADHD. In some cases this makes children with NLD difficult to differentiate from children with Asperger disorder. General functioning in children with NLD younger than 4 years can be relatively typical or only involve mild deficits. Following this period, children can develop disruptive behavior and may develop hyperactivity and inattention. They are frequently thought of as acting out and hyperactive, and are commonly identified by their teachers as overtalkative, trouble makers, or behavior problems. As they grow older, their high activity level can disappear. By older childhood and early adolescence, problems can tend to be more internal, characterized by withdrawal, anxiety, depression, unusual behaviors, and social skills problems. Interactions with other children may become more difficult, and their faces can seem unexpressive. These behaviors can be accompanied by deficits in how they judge social situations, judgment, and interaction skills. Children with NLD are particularly prone to emotional problems over the course of their development, as opposed to children with other learning disabilities. Nonverbal learning disabilities are less prevalent than languagebased learning disorders. Where it is estimated that about 4% to 20% of the general population have identifiable learning disabilities, it is thought that only 1% to 10% of those individuals would be found to have NLD. Children with NLD are often not identified until late elementary school or middle school, when the peer problems increase and academic tasks become more complicated. They frequently develop symptoms of depression and anxiety. Academic Problems As was pointed out earlier in this chapter, children with ADHD frequently experience significant challenges at school and elsewhere that cannot be formally categorized as disabilities or formal disorders. Forty percent of children with ADHD, for example, who do not qualify for a diagnosis of learning disability still experience learning problems that lead to underachievement at school. These learning problems may include Inattention and distractibility Lack of persistence and inconsistent performance A tendency to become easily bored or to rush through or not complete work Impulsive responses and careless errors Difficulty self-correcting mistakes A limited ability to sit still and listen Difficulty with time-limited tasks and test taking Problems with planning, homework flow, and work completion Difficulty taking notes or performing other forms of multitasking Difficulty memorizing facts Difficulty organizing and producing written work Immature and slow handwriting that can also create obstacles in expressive writing Difficulty with reading comprehension Stimulant medications that decrease your child’s ADHD symptoms are likely to help her address many of these problems. Behavior therapy techniques aimed at increasing or decreasing specific behaviors at home and in school can also prove beneficial. Specific behavioral goals, such as improving completion of assignments, can be addressed by understanding your child’s individual strengths and weaknesses and collaborating with school staff in using positive reinforcement, appropriate behavioral techniques, daily report cards, and ongoing monitoring. Motor Skills Disorder Motor skills disorder, also known as developmental coordination disorder, is diagnosed when motor skills problems significantly interfere with academic achievement or activities of daily living. It is frequently overlooked in children with ADHD due to its nonspecific cluster of symptoms—yet it can affect children’s lives by interfering with writing and other academic activities or preventing children from participating at their classmates’ level in sports and play. Children with ADHD and other learning disabilities frequently have motor skills disorder as well. Motor skills disorder involves a developmental delay of movement and posture that leaves children with coordination substantially below that of others of their age and intelligence level. These children seem so clumsy and awkward they are rarely picked for teams at school. As the years pass, they tend to fall further behind in terms of motor skills, and their confidence diminishes as a result. By adolescence, most children with motor skills disorder not only perform poorly in physical education classes, but may also have a poor physical self-image and perform below expectations academically. Motor skills disorder may be first identified when a preschooler or kindergartner is unable to perform age-appropriate skills, such as buttoning buttons and catching a ball, or when an elementary school child struggles with writing or sports activities. A child with motor skills disorder may have difficulty with the mechanics of writing, with planning motor actions, or with memorizing motor patterns. While many young children with ADHD but no motor skills disorder may seem clumsy in their younger years, their awkwardness is related more to inattentiveness or impulsivity than to poor motor control and it is frequently outgrown. However, a child with ADHD and coexisting motor skills disorder may not outgrow his clumsiness. If your child is diagnosed with developmental coordination disorder, he may be referred to a pediatric occupational therapist for individualized therapy and, particularly if his deficits negatively affect his academic performance or daily skills, be recommended for special gym activities at school to promote hand-eye coordination and motor development and improve specific skills. Communication Disorders Communication disorders—conditions that interfere with communications with others in everyday life—involve not only the ability to appreciate language sounds (phonologic awareness) but also to acquire, recall, and use vocabulary (semantics) and to deal with word order and appropriately form or comprehend sentences (syntax). Subcategories of these disorders have been identified, including expressive language disorder, mixed receptive-expressive disorder, phonologic disorder, articulation (word pronunciation) disorder, and stuttering. Because there is such a close association between communication and social relationships, these language deficits are often accompanied by social skills difficulties. Children with ADHD without a language disorder may also have difficulties in using language, particularly in social situations. You may notice that your child has problems with excessive talking, frequent interruption, not listening to what is said, blurting out answers before questions are finished, and having disorganized conversations. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
61,"2018-04-19 03:05:29","Mood Disorders & ADHD","Mood Disorders & ADHD Page Content Article Body The mood disorders most likely to be experienced by children with ADHD include dysthymic disorder, major depressive disorder (MDD), and bipolar disorder. Dysthymic disorder can be characterized as a chronic low-grade depression, persistent irritability, and a state of demoralization, often with low self-esteem. Major depressive disorder is a more extreme form of depression that can occur in children with ADHD and even more frequently among adults with ADHD. Dysthymic disorder and MDD typically develop several years after a child is diagnosed with ADHD and, if left untreated, may worsen over time. Bipolar disorder is a severe mood disorder that has only recently been recognized as occurring in children. Unlike adults who experience distinct periods of elation and significant depression, children with bipolar disorder present a more complex disturbance of extreme emotional instability, behavioral difficulties, and social problems. There is significant overlap with symptoms of ADHD, and many children with bipolar disorder also qualify for a diagnosis of ADHD. What to Look For Every child feels discouraged or acts irritable once in a while. Children with ADHD, who so often must deal with extra challenges at school and with peers, may exhibit these behaviors more than most. If your child claims to be depressed, however, or seems irritable or sad a large portion of each day, more days than not, she may have a coexisting dysthymic disorder. To be diagnosed with dysthymic disorder, a child must also have at least 2 of the following symptoms: Poor appetite or overeating  Insomnia or excessive sleeping  Low energy or fatigue  Low self-esteem  Poor concentration or difficulty making decisions  Feelings of hopelessness Before dysthymic disorder can be diagnosed, children must have had these symptoms for a year or longer, although symptoms may have subsided for up to 2 months at a time within that year. The symptoms also must not be caused by another mood disorder, such as MDD or bipolar disorder, a medical condition, substance abuse, or just related to ADHD itself (low self-esteem stemming from poor functioning in school, for example). Finally, the symptoms must be shown to significantly impair your child’s social, academic, or other areas of functioning in daily life. Major depressive disorder is marked by a nearly constant depressed or irritable mood or a marked loss of interest or pleasure in all or nearly all daily activities. In addition to the symptoms listed previously for dysthymic disorder, a child with MDD may cry daily; withdraw from others; become extremely self-critical; talk about dying; or even think about, plan, or carry out a suicide attempt. Unlike the brief outbursts of temper exhibited by a child with ODD who does not get her way, a depressed child’s irritability may be nearly constant and not linked to any clear cause. Her inability to concentrate differs from ADHD-type inattention in that it is accompanied by other symptoms of depression, such as loss of appetite or loss of interest in favorite activities. Finally, the depression itself stems from no apparent cause—as opposed to being demoralized as a result of specific obstacles posed by ADHD or becoming depressed in response to parental divorce or any other stressful situation. (In fact, research has shown that the intactness of a child’s family and its socioeconomic status have little or no effect on whether a child develops MDD.) While children with ADHD/CD alone are not at higher than normal risk for attempting suicide, children with ADHD/CD who also have an MDD and are involved in substance abuse are more likely to make such an attempt and should be carefully watched. Talk of suicide (even if you are not sure whether it is serious), a suicide attempt, self-injury, any violent behavior, or severe withdrawal should be considered an emergency that requires the immediate attention of your child’s pediatrician, psychologist, or local hospital. A depressed child may admit to feeling guilty or sad, or she may deny having any problems. It is important to keep in mind the fact that many depressed children refuse to admit to their feelings, and parents often overlook the subtle behaviors that signal a mood disorder. By keeping in close contact with her teacher, bringing your child to each of her treatment reviews with her pediatrician, and including her in all discussions of her treatment as appropriate to her age, you can improve the chances that her pediatrician or mental health professional will detect any signs of developing depression, and that she will have someone to talk to about her feelings. A child with bipolar disorder and ADHD is prone to explosive outbursts, extreme mood swings (high, low, or mixed mood), and severe behavioral problems. Such a child is often highly impulsive and aggressive, with prolonged outbursts typically “coming out of nowhere” or in response to trivial frustrations. She may have a history of anxiety. She may also have an extremely high energy level and may experience racing thoughts and inflated self-esteem or grandiosity, extreme talkativeness, physical and emotional agitation, overly sexual behavior, and/or a reduced need for sleep. These symptoms can alternate with periods of depression or irritability, during which her behavior resembles that of a child with MDD. A child with ADHD/ bipolar disorder typically has poor social skills. Family relationships are often strained because of the child’s extremely unpredictable, aggressive, or defiant behavior. Early on the symptoms may only occur at home, but often begin to occur in other settings as the child gets older. Bipolar disorder is a serious psychiatric disorder that can sometimes include psychotic symptoms (delusions/hallucinations) or self-injurious behavior such as cutting, suicidal thoughts/impulses, and substance abuse. Many children with bipolar disorder have a family history of bipolar disorder, mood disorder, ADHD, and/or substance abuse. Children with ADHD and bipolar disorder are at higher risk than those with ADHD alone for substance abuse and other serious problems during adolescence. If your child has ADHD with coexisting bipolar disorder, her pediatrician will generally refer her to a child psychiatrist for further assessment, diagnosis, and recommendations for treatment. Treatment As with ADHD with anxiety disorders, treatment of ADHD with depression usually involves a broad approach. Treatment approaches may include a combination of cognitive-behavioral therapy, interpersonal therapy (focusing on areas of grief, interpersonal relationships, disputes, life transitions, and personal difficulties), traditional psychotherapy (to help with self-understanding, identification of feelings, improving self-esteem, changing patterns of behavior, interpersonal interactions, and coping with conflicts), as well as family therapy when needed. Medication management approaches, as with ADHD and other coexisting conditions, include treating the most disabling condition first. If your child’s ADHD-related symptoms are causing most of her functioning problems, or the signs of depression are not completely clear, your child’s pediatrician is likely to start with stimulant medication to treat the ADHD. In cases when the depressive symptoms turn out to stem from poor functioning due to ADHD and not to a depressive disorder, they may diminish as the ADHD symptoms improve. If the ADHD and depressive symptoms improve, your child’s pediatrician will probably maintain stimulant treatment alone. If her ADHD symptoms improve but her depression remains the same, even after a reasonable trial of the type of broad psychotherapeutic approach described previously, her pediatrician may add another medication, most commonly an SSRI—a class of medications including Prozac, Zoloft, Paxil, Luvox, and Celexa. Selective serotonin reuptake inhibitors can make the symptoms of bipolar disorder worse, so a careful evaluation must be completed before starting medication. If this approach is unsuccessful, you may be referred to a developmental/behavioral pediatrician or a psychiatrist, who may try other classes of medications. Last Updated 11/21/2015 Source ADHD: A Complete and Authoritative Guide (Copyright © 2004 American Academy of Pediatrics)"
62,"2018-04-19 03:05:35","Myths and Misconceptions about ADHD","Myths and Misconceptions about ADHD Page Content Article BodyMuch misinformation has circulated about ADHD and its causes, diagnosis, and treatment over recent decades. Following are a number of untrue assumptions about the disorder, along with explanations aimed at clarifying the issues. “My preschooler is too young to have ADHD.” Many parents believe that ADHD is a problem of school-aged children. But, in fact, the symptoms of ADHD, and the diagnosis of the condition, can occur as early as the preschool years. At times, even doctors have difficulty differentiating “normal” behavior from those suggesting ADHD in a preschooler. Although a young child may normally have characteristics like impulsive or hyperactive behavior, these can be symptoms of ADHD as well. A pediatrician will evaluate the intensity of these behaviors in a preschooler to help in making the diagnosis. Attention-deficit/hyperactivity disorder is diagnosed when these problems get to the point where they are significantly and consistently interfering with a preschooler’s life, development, self-esteem and general functioning. “He’s just lazy and unmotivated.” This assumption is a common response to the behavior exhibited by a child who is struggling with ADHD. A child who finds it nearly impossible to stay focused in class, or to complete a lengthy task such as writing a long essay, may try to save face by acting as though he does not want to do it or is too lazy to finish. This behavior may look like laziness or lack of motivation, but it stems from real difficulty in functioning. All children want to succeed and get praised for their good work. If such tasks were easy for children with ADHD to accomplish, and provided rewarding feedback, those children would seem just as “motivated” as anyone else. “He’s a handful—or, she’s a daydreamer—but that’s normal. They just don’t let kids be kids these days.” It is true that all children are impulsive, active, and inattentive at times, sometimes to the extreme. A child with ADHD, however, is more than just a “handful” for his parents and teachers, or a “daydreamer” who tends to lose herself in thought. His or her hyperactivity and/or inattentiveness constitute a real day-to-day functional disability. That is, it seriously and consistently impedes the ability to succeed at school, fit into family routines, follow household rules, maintain friendships, interact positively with family members, avoid injury, or otherwise manage in his or her environment. As you will learn in Chapter 2, this clear functional disability is what pediatricians look for when diagnosing ADHD and recommending treatment. “Treatment for ADHD will cure it. The goal is to get off medication as soon as possible.” Attention-deficit/hyperactivity disorder is a chronic condition that often does not entirely go away, but instead changes form over time. Many older adolescents and adults are able to organize their lives and use techniques that allow them to forego medical treatment, although a significant number continue various forms of treatment and support throughout their life spans. Depending on the circumstances and demands as a person matures, this may or may not include continuing with medication or other treatments for ADHD at different times, even through adult life. The true goal is to function well at each stage of childhood and adolescence, and as an adult, rather than to stop any or all treatments as soon as possible. “He focuses on his video games for hours. He can’t have ADHD.” For the most part ADHD poses problems with tasks that require focused attention over long periods, not so much for activities that are highly engaging or stimulating. School can be especially challenging for a person with ADHD because the typical classroom lecture, compared with a video game, can be relatively unstimulating in terms of visuals, sound, and physical activity. Assignments can be long and require sustained, organized thought and effort, and the daily routine can be less structured and predictable than a child with ADHD might require. Most children with ADHD are diagnosed during their school years precisely because the academic, social, and behavioral demands during these years are so difficult for them. The difficulties that such children experience may make it seem that school is the problem (and, certainly, that possibility should be considered), but it is more likely to be a result of the child’s struggle to manage in this environment. Other situations that can be problematic for children with ADHD include social interactions, with their constant, subtle exchange of emotional and social information; sports that require a high degree of focus or concentration; and extracurricular activities that require them to sit still, listen, or wait their turn for long periods. “ADHD is caused by poor parental discipline.” Attention-deficit/hyperactivity disorder is not a result of poor discipline—although behaviors that stem from ADHD can challenge otherwise effective parenting styles. Inconsistent limit-setting and other ineffective parenting practices can, however, worsen its expression. You will find a number of proven parenting techniques that can help children with ADHD manage their behavior. “If, after a careful evaluation, a child doesn’t receive the ADHD diagnosis, she doesn’t need help.” Attention-deficit/hyperactivity disorder is diagnosed on a continuum, which means that a child can exhibit a number of ADHD-type behaviors yet not to the extent that she is diagnosed with ADHD. This does not mean she needs no help coping with the problems that she does have. The family of a child who does not meet the criteria for ADHD but has similar problems may be offered pediatric counseling, education about the range of normal developmental behaviors, home behavior management tools, school behavior management recommendations, social skills interventions, and help with managing homework flow and with organization and planning. “Children with ADHD outgrow this condition.” Parents and many doctors once believed that as children with ADHD enter adolescence and then move into adulthood, their ADHD will no longer be an issue. But recent studies have shown that some aspects of ADHD can persist well into adult life for as many as 85% of these children. Some adults can still benefit from the use of ADHD medication for the rest of their lives. Others have demonstrated enough improvement that this medication becomes unneeded depending on what occupation they choose and their ability to succeed in relationships and other social activities. No matter what the circumstances of particular adults may be, however, they can make adjustments in their environment, take full advantage of their own strengths, and lead very productive adult lives, even when aspects of ADHD still persist. Last Updated 1/1/2004 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
63,"2018-04-19 03:05:39","Neurofeedback, Hypnotherapy, and Guided Imagery","Neurofeedback, Hypnotherapy, and Guided Imagery Page Content Article BodyA number of proposed treatments for ADHD—including hypnotherapy, self-hypnosis, guided imagery, neurofeedback, and relaxation training—are aimed at helping a child begin to regulate his own behavior and psychological state. The fact that these techniques can be used quite successfully for children in other areas of self-regulation (headache management, teaching bowel control, etc) increases their appeal as a form of treatment. Hypnotherapy has not been shown to significantly improve the core symptoms of ADHD, though it may improve such accompanying problems as sleep problems and tics when used as part of an integrated treatment approach. One difference between the use of hypnotherapy for headaches versus ADHD is that children learn to institute the self-hypnosis at the early signs of a headache. There is no comparable “trigger” with ADHD, and children cannot do self-hypnosis all day long. Neurofeedback treatment involves placing electrodes on a child’s head to monitor brain activity. Children are asked, for example, to change the aspects of a video game (for example “making the sun set with your mind”), which happens when their brainwaves are of a desired frequency. The theory is that learning to do this increases their arousal levels, improves their attention, and results in reductions in hyperactive-impulsive behaviors. This is based on findings that many children with ADHD show low levels of arousal in frontal brain areas, with excess of theta (daydreamy) waves and deficit of beta waves (indicators of a highly focused mind), thereby reducing ADHD. The studies on the use of neurofeedback to date have been criticized for lacking the appropriate controls or the random assignment of test subjects to the treatment or sham treatment groups. It should also be pointed out that neurofeedback treatment is an expensive approach to treating ADHD. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
64,"2018-04-19 03:05:44","Non-Stimulant Medications Available for ADHD Treatment","Non-Stimulant Medications Available for ADHD Treatment Page Content​Some non-stimulant medications may be appropriate for children who have been diagnosed with Attention Deficient Hyperactivity Disorder (ADHD) and certain coexisting conditions—such as ADHD with accompanying tic disorders (such as Tourette Syndrome)—because they can in some cases treat both conditions simultaneously. Proven alternate choices to stimulant medications include Atomoxetine, Guanfacine XR, Clonidine XR, and Bupropion. Note: The first three are newer FDA approved medications that have not been ​used as long as stimulants. Bupropion is not FDA approved but has had several small trials for ADHD. Atomoxetine, guanfacine XR and clonidine XR are considered second-line (second-choice) treatments. Bupropion is a third line agent.AtomoxetineAtomoxetine (Strattera) is a non-stimulant approved by the FDA for the treatment of ADHD. It is in the class of medications known as selective norepinephrine reuptake inhibitors. Because atomoxetine does not have a potential for abuse, it is not classified as a controlled substance. Atomoxetine is a newer medication and the evidence supporting its use is more limited than for stimulants. Atomoxetine, unlike stimulants, is active around the clock. However, atomoxetine has been found to be only about two-thirds as effective as stimulant medications. After starting atomoxetine it may take up to 6 weeks before it reaches its maximum effectiveness. Possible side effectsAtomoxetine has a warning on it that it may, in a very small number of cases, have some potential for causing suicidal thoughts in the first few weeks of treatment. Atomoxetine may be helpful in the treatment of children who have both ADHD and anxiety, since stimulants may worsen anxiety symptoms. Side effects are generally mild but can include decreased appetite, upset stomach, nausea or vomiting, tiredness, problems sleeping, and dizziness. Jaundice (turning yellow) is mentioned in a warning on the medication, but is extremely rare. Taking atomoxetine with food can help avoid nausea and stomachaches. Atomoxetine should be used in lower doses in children also taking certain antidepressants like fluoxetine (Prozac) or paroxetine (Paxil), because they can raise the atomoxetine levels in the bloodstream.Atomoxetine is now considered an option for first-line therapy for ADHD, and is the first non-stimulant to fall into the first-line category. Parents concerned about the possibility that stimulants may be used for substance abuse may choose atomoxetine as the first-line agent for their child. It is often used for children who have had unsuccessful trials of stimulants.Long-Acting Guanfacine Long-acting guanfacine (Intuniv) is in the group of medications known as alpha agonists. These medications were developed for the treatment of high blood pressure but have also been used to treat children with ADHD who have tics, sleep problems, and/or aggression. It has recently been approved by the FDA for the treatment of children with ADHD. Long-acting guanfacine is a pill, but it cannot be crushed, chewed, or broken and must be swallowed whole. Like atomoxetine, it is not a controlled substance. Possible side effectsIt does not cause much appetite suppression, so may be a good choice for children who lost a significant amount of weight when taking a stimulant. Side effects can include sleepiness, headaches, fatigue, stomachaches, nausea, lethargy, dizziness, irritability, decreased blood pressure, and decreased appetite. Although sleepiness occurs in a large number of children when children start taking long-acting guanfacine, it seems to get better as they continue to take it. It may take 3 to 4 weeks to see medication benefit. Long-Acting ClonidineLong-acting clonidine (Kapvay) is also FDA approved for the treatment of ADHD. It is taken twice a day while long acting guanfacine is once a day.  Both long acting alpha agonists have been studied for use alone or as an add-on to stimulants when the stimulant alone does not eliminate all the symptoms of ADHD. Two other shorter-acting alpha agonists are available for use, but not approved by the FDA for ADHD. These are clonidine (Catapres) and short-acting guanfacine (Tenex). These can be used as adjunctive medications, or if FDA-approved medications are not helpful. If no FDA-approved medication has been found helpful for your child, you should also consider whether ADHD is the correct diagnosis, and whether additional coexisting conditions might be present. BupropionBupropion is a unique type of antidepressant that has been less frequently studied as a treatment for ADHD. It is also not FDA approved for ADHD or as an antidepressant in people under the age of 18. Some research indicates that bupropion is effective in reducing ADHD symptoms in some children, but it seems to have less effect than stimulants or atomoxetine. Its use in ADHD is not widespread. Possible side effectsThe side effects, though usually minimal, can include irritability, decreased appetite, insomnia, and a worsening of existing tics. It is important to note that at higher doses, bupropion may make some individuals more prone to seizures and cause hallucinations, so it should be used cautiously in children who have seizure disorders.Additional Information from HealthyChildren.org: How ADHD Treatments Are Proven Effective Common ADHD Medications & Treatments for ChildrenADHD and Substance Abuse: The Link Parents Need to KnowFDA's Role in the Drug Approval ProcessGeneric Drugs: What Parents Need to Know Article Body Last Updated 6/17/2016 Source American Academy of Pediatrics (Copyright © 2016)"
65,"2018-04-19 03:05:50","Parenting Teenagers with ADHD","Parenting Teenagers with ADHD Page Content​Achieving independence is a primary developmental goal of adolescence. Your teenager will experience this urge as strongly as his peers without ADHD, but his or her impulsivity, inattention, and aspects of delayed maturity may mean moving slower toward this goal.  Specifically, you may need to:Remove loss of privileges in response to a broken rule. Know that long-standing loss of privileges, however, harbors resentment and has little teaching value.Work at consciously modeling responsible behavior. Watch the video Offering Boundaries & Being Role Models for more information and tips.Break down tasks and responsibilities into smaller steps. Reward your teen for accomplishing them.Develop a plan for transferring responsibilities over to your teenager as he or she works toward independence.Addressing Your Concerns Directly It's easy to imagine that a teenager would resent a 10:00 pm curfew, if his or her friends are, for example, were allowed to stay out until midnight. Talk with your teen about the reasons if you worry about his staying out later. You may be concerned that parties tend to get wilder after about 10:00 pm, a time where you have observed that his or her impulsivity usually increases, or that driving is potentially riskier late at night because his medication will have worn off by then. If your teen feels he or she is ready to take responsibility for staying out later, and you have made the necessary adjustments to ensure success (such as possibly changing his or her medication routine to enhance attention while driving), then extend the curfew for 1 hour. If he or she arrives home on time with no evidence of high-risk activity, give praise. Reward your teen with a continued 11:00 pm curfew. Moving in these small steps allows you to continue to build a mutual trust and respect—vital for your teen's self- esteem.Providing Structure & SupportDuring your child's earlier years, you were encouraged to actively monitor his or her behavior in the classroom and at home. Now that your teenager is growing more independent, you may feel it is time to stop this type of monitoring. However, many teens with ADHD continue to need more parental monitoring and structure.While it is best for parents of many other 15-year-olds to back off and let their child manage his or her own homework, for example, a teen with ADHD may need continued monitoring to see that he or she is completing work and turning it in on time. While other parents may grow laxer about knowing where their older teenagers are every minute, you may have reason to continue monitoring where your teenager is, with whom, what he or she is doing, and when he or she will be home, particularly when you sense that he or she might be in a high-risk situation that may be difficult to manage. While monitoring is necessary, it must be done in a way that is also respectful of your teenager and his or her developmental needs.Establishing & Enforcing RulesAny teen might have an argumentative style, and your teen's resistance to your continued monitoring may lead to a great deal of boundary testing, negotiating, and possibly outright rebellion. When warranted, you may feel better— and will be able to save some energy—if you identify 4 or 5 nonnegotiable rules based on the issues you consider essential for your family. You may decide, for example, that use of illegal drugs of any kind—including marijuana, alcohol, and cigarettes—will not be tolerated in your house, or that driving can only be done at times when stimulant medication still has an active effect. These strict, nonnegotiable rules should be reserved for critical issues of safety or family functioning.When you have arrived at the 4 or 5 basic rules, write them down and discuss them with your teenager. Explain that the trust built through compliance with these rules can open the door to negotiating the other freedoms he or she craves. Discuss the rewards for compliance (i.e. extended privileges in other areas) and the consequences (i.e. increased restrictions) for breaking these rules. Enforce these consequences consistently. Catch your teen doing something good. Remember, rewards are much more powerful than negative consequences.Negotiating with Your TeenOnce your teenager has shown he or she is able to follow these few essential rules, you are likely to feel more at ease when negotiating other issues. Negotiation is based on the assumption that, as a teen matures, he or she will take a more active role in creating the rules by which he or she lives. It is important to establish the fact that as the parent, right now you assume the final responsibility for rules and consequences. A good way to negotiate rules or solutions to family conflicts is to use a technique called problem-solving training. This technique consists of the following steps:Define the problem and its effect.Come up with a variety of possible solutions.Choose the best solution.Plan how to implement the solution.Renegotiate a new solution if necessary.When first attempting to solve problems in this way, it is best to start with issues that are important but not emotionally intense for your teenager or for you. Eventually you may become so adept at this rational form of problem solving that you and your teenager will be able to resolve arguments on the spot, in most cases, using informal versions of this technique.Providing Appropriate ConsequencesYou will need to ""stick to your guns"" in enforcing the rules and procedures on which you have all already agreed. Provide rewards and consequences consistently, and as soon as possible after the behavior has occurred. Pre–agreed-on losses of privileges, for example, may be temporarily losing car key rights for coming home late. The tighter the link between the behavior and the consequences the better. Try to let these negotiated consequences take the place of argument, recrimination, yelling, or nitpicking. Keep the conflicts and emotions out of it. Simply provide the appropriate response to keep family life relatively pleasant and upbeat.Fostering a Positive Attitude & Giving Each Other BreaksResearch suggests that the presence of one fully supportive adult in the life of a child with ADHD is one of the key factors in determining that child's future success. Be sure to invest plenty of quality time in your teenager—and make it fun and rewarding for both of you. Sometimes, when things get too tough at home, it is a good idea to take a break from one another. A weekend that you spend away can restore your awareness that your problems at home can be solved, and can give all of you the space you need to maintain a healthy relationship. Parents need support too!As any teenager explores newly accessible choices, he or she will inevitably make some good and bad decisions. This is a normal and an important part of becoming a responsible adult. Additional Information from HealthyChildren.org: How to Help New High School Grads Transition into AdulthoodEncouraging Teens to Take Responsibility for Their Own HealthParent-Teen Driving Agreement ADHD and Substance Abuse: The Link Parents Need to KnowBehavior Therapy for Children with ADHD Article Body Last Updated 5/13/2016 Source Mental Health Leadership Work Group (Copyright © 2016 American Academy of Pediatrics)"
66,"2018-04-19 03:05:53","Resisting to Take ADHD Medication","Resisting to Take ADHD Medication Page Content Article BodyMy 14-year-old daughter began taking stimulants for her ADHD 6 months ago. Though we were all hesitant at first to try medication, the results were so clearly positive when she did try it that we had no problem continuing. Lately, though, my daughter has begun “forgetting” to take her pill in the morning. The more we remind her, the more resistant she gets. Her typical response is, “OK, Mom, I’ll take it! Do you think I forgot for a minute that I have ADHD?” So far, she hasn’t missed her medication more than one or two days in a row, but we fear these lapses may grow more frequent if we don’t figure out why they’re happening. Is this kind of resistance common with most kids with ADHD? Medication continues to carry with it a stigma that many children with ADHD—particularly early adolescents—feel acutely as they try to fit in with their peer group in the neighborhood and at school. In addition, adolescents with ADHD must negotiate the same process of seeking independence from parents that all teenagers do. Your daughter’s resistance to taking medication despite its obvious benefits is not unusual, though it is an issue that needs to be addressed. While there is no one-size-fits-all solution to your situation, you should work with your daughter and the rest of your treatment team toward a positive approach. This may involve allowing her more control of the medication process—letting her make decisions about when and where she takes the medication— as well as control over the dosage schedule. Because she is first starting medication in her teenage years, it is important that she had buy-in to the initial trial of medication and that it was carried out in a manner that clearly demonstrated to her that the medication had a clear, positive effect. It is also important that she remain as informed as possible about the medication and all aspects of her medication management. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
67,"2018-04-19 03:05:59","Simplifying, Organizing, and Structuring the Home Environment: For Parents of Children with ADHD","Simplifying, Organizing, and Structuring the Home Environment: For Parents of Children with ADHD Page Content Article BodyYou will find that your child’s ability to progress in nearly all areas of self-management and social interaction increases when his environment is organized and structured to meet his unique needs. If your child is physically impulsive or accident-prone, take the time to unclutter and safety-proof your home. Some children with ADHD may benefit from an orderly physical environment with a place for each object, while keeping the environment (eg, your child’s room) organized may be a hopeless task for others. Try helping your child organize his room at a level he can manage. Daily routines are an absolute necessity for many children with ADHD. Consistent limitsetting with predictable consequences, along with limited choices (not “What do you want to eat?” but “Do you want an apple or a boiled egg?”), also make your child’s world more manageable and help him meet his goals. Written lists of chores or other daily tasks are especially useful in helping your child keep track of what he needs to do, and is an excellent habit for him to carry into adolescence and adulthood. When considering how to structure your child’s day-to-day experiences, it may help to picture your growing child as a construction project in progress. The limits, lists, routines, and other measures you are putting in place today are like scaffolding that will provide the necessary support as he develops fully. As he turns these routines into daily habits and becomes more self-directed, some of these supports can be gradually removed while his underlying functioning remains well in place. (You may no longer have to create homework checklists with him, for example, because he has learned to make them himself.) Far from “babying” your child, helping to structure and organize his world allows him to add to his competencies and experience many more small triumphs, increasing his self-esteem. Just as you have observed that your child may feel less overwhelmed when his home life is well organized, so you may find that organizing your own family life as thoroughly as possible will help you feel calmer and more in control. (This is even more likely to be the case, of course, if you have ADHD.) With the number of medical visits, teachers’ conferences, and treatment reviews necessary to maintain your child’s well-being and continued progress, a family calendar including all scheduled activities can be an essential for many families. Daily lists of tasks to perform and errands to run will help you stay organized just as they help your child. Many parents find it worthwhile to devote a private 10 minutes to half an hour before the kids get up in the morning to “regroup”—thinking about everything that must be accomplished that day and arranging tasks in order of priority. Make sure that any plan is realistic and not overwhelming. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
68,"2018-04-19 03:06:06","Special Education Services and Federal Laws","Special Education Services and Federal Laws Page Content Article BodyFor most children with ADHD, staying in a regular classroom with an excellent teacher, trained in and adept at behavior management, is the preferred situation. This is especially true if any necessary accommodations for your child can be put into place in that setting. Children with ADHD whose academic or behavior struggles cannot be managed effectively in a regular classroom using typical strategies may require special education services. These services may be delivered in a variety of settings, including the regular classroom and separate classrooms for part or all of a school day. The setting is determined by the needs of the eligible child. The federal law Individuals with Disabilities Education Act (IDEA) guarantees your child’s right to be evaluated for and receive such services if eligible, free of charge. IDEA The IDEA was designed to guarantee the provision of special services for children whose disabilities severely affect their educational performance. A child can receive services under IDEA if she is learning disabled, emotionally disturbed, or “other health impaired.” Your child may qualify for IDEA coverage if she has been diagnosed with ADHD and her condition has been shown to severely and adversely affect school performance. Note that both conditions must be met: an ADHD diagnosis alone does not guarantee coverage for your child unless it or another disorder is adversely affecting her educational performance. In most cases, it is a child’s coexisting learning, disruptive behavior, anxiety, or other functional problem—not the ADHD itself—that qualifies her for IDEA coverage. The IDEA is based on providing services for categories of disability. It includes 13 categories that require coverage “without undue delay.” Under this law, schools are responsible for identifying and evaluating children who are suspected of having disabilities and who may need special education services. Depending on her diagnoses and assessment, your child’s disability may be categorized as “specific learning disability,” “serious emotional disturbance,” or “other health impairment.” After these needs are evaluated, documented, and eligibility determined, an IEP can be created to detail the special education services that are necessary. Specific Learning Disabilities The IDEA criteria for specific learning disabilities can vary from state to state. Children qualify for learning disabilities under this law if they have significant needs in the areas of Oral expression Listening comprehension Written expression Basic reading skills Reading comprehension Mathematics calculation Mathematics reasoning Testing for learning disabilities generally includes assessment by the school psychologist. In addition to learning disabilities, children with ADHD and significant emotional problems can also receive services through IDEA. To receive these services, a child’s educational performance needs to be adversely affected by emotional and behavioral concerns: An inability to learn that can be best explained on a behavioral basis An inability to build or maintain relationships with peers and teachers Inappropriate types of behavior or feelings A persistent mood of unhappiness or depression A tendency to develop physical symptoms or fears associated with personal or schoolproblems A comprehensive evaluation that meets federal and state guidelines needs to be completed before children can qualify for services as emotionally disturbed. A note from your child’s pediatrician that your child has ADHD or is depressed or anxious will not be enough to qualify her for services. All children, including those with ADHD, are also eligible for services if they have the disabilities below and can be shown to need special education in order to benefit from their educational program. Intellectual or cognitive disabilities Hearing impairment, including deafness Speech or language impairment Visual impairment, including blindness Serious emotional disturbance Orthopedic impairment Autism spectrum disorders Traumatic brain injury Other health impairment, including ADHD and Tourette disorder Specific learning disabilities Developmental delay (used in some states for children aged 3–9 who have problems with development of their physical, cognitive, communication, social/emotional, or adaptive skills [everyday life skills]). Additional considerations for eligibility include (1) schools cannot be overidentifying children in terms of race or ethnicity; (2) a child is not eligible for special education solely because of lack of instruction in academic areas; and (3) in newer IDEA legislation, children no longer need to demonstrate a severe discrepancy between their ability (IQ) and their achievement. An alternative way to assess a child’s need for special services, as mentioned previously, is RTI, an approach where a student with academic delays is given one or more research-validated interventions. The student’s academic progress is monitored frequently to see if those interventions are sufficient to help the student catch up with his or her peers. If the student fails to show significantly improved academic skills despite several well-designed and implemented interventions, this failure to “respond to intervention” can be viewed as evidence of an underlying learning disability. One advantage of RTI in the diagnosis of educational disabilities is that it allows schools to intervene early to meet the needs of struggling learners and not require them to fail before anything is done. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
69,"2018-04-19 03:06:12","Treatment & Target Outcomes for Children with ADHD","Treatment & Target Outcomes for Children with ADHD Page ContentOnce the diagnosis is confirmed, the outlook for most children who receive treatment for ADHD is encouraging. There is no specific cure for ADHD, but there are many treatment options available.  Each child's treatment must be tailored to meet his individual needs. In most cases, treatment for ADHD should include: A long-term management plan withTarget outcomes for behaviorFollow-up activitiesMonitoringEducation about ADHDTeamwork among doctors, parents, teachers, caregivers, other health care professionals, and the childMedicationBehavior therapy including parent trainingIndividual and family counselingTreatment for ADHD uses the same principles that are used to treat other chronic conditions like asthma or diabetes. Long-term planning is needed because these conditions are not cured. Families must manage them on an ongoing basis. In the case of ADHD, schools and other caregivers must also be involved in managing the condition.  Educating the people involved about ADHD is a key part of treating your child. As a parent, you will need to learn about ADHD. Read about the condition and talk with people who understand it. This will help you manage the ways ADHD affects your child and your family on a day-to-day basis. It will also help your child learn to help himself. Setting target outcomesAt the beginning of treatment, your pediatrician should help you set around 3 target outcomes (goals) for your child's behavior. These ­target outcomes will guide the treatment plan. Your child's target ­outcomes should focus on helping her function as well as possible at home, at school, and in your ­community. You need to identify what behaviors are most preventing your child from success. Here are examples of target outcomes: Improved relationships with parents, siblings, teachers, and friends (e.g., fewer arguments with brothers or sisters or being invited more ­frequently to friends' houses or parties)Better schoolwork (e.g., completing class work or homework ­assignments)More independence in self-care or homework (e.g., getting ready for school in the morning without supervision)Improved self-esteem (e.g., increase in feeling that she can get her work done)Fewer disruptive behaviors (e.g., decrease in the number of times she ­refuses to obey rules)Safer behavior in the community (e.g., when crossing streets)The target outcomes should be:  RealisticSomething your child will be able to doBehaviors that you can observe and count (e.g., with rating scales)Your child's treatment plan will be set up to help her achieve these goals. Keeping the treatment plan on track:Ongoing monitoring of your child's behavior and medications is required to find out if the treatment plan is working. Office visits, phone conversations, behavior checklists, written reports from teachers, and behavior report cards are common tools for following the child's progress. Treatment plans for ADHD usually require long-term efforts on the part of families and schools. Medication schedules may be complex. Behavior ­therapies require education and patience. Sometimes it can be hard for everyone to stick with it. Your efforts play an important part in building a healthy future for your child.  Ask your pediatrician to help you find ways to keep your child's ­treatment plan on track.  What if my child does not reach his target ­outcomes?Most school-aged children with ADHD respond well when their ­treatment plan includes both medication and behavior therapy. If your child is not achieving his goals, your pediatrician will assess the following factors: Were the target outcomes realistic?Is more information needed about the child's behavior?Is the diagnosis correct?Is another condition hindering treatment?Is the treatment plan being followed?Has the treatment failed?While treatment for ADHD should improve your child's behavior, it may not completely eliminate the symptoms of inattention, hyperactivity, and impulsivity. Children who are being treated successfully may still have trouble with their friends or schoolwork. However, if your child clearly is not meeting his specific target outcomes, your pediatrician will need to reassess the treatment plan. Unproven treatments:You may have heard media reports or seen advertisements for ""miracle cures"" for ADHD. Carefully research any such claims. Consider whether the source of the information is valid. At this time, there is no scientifically proven cure for this condition. The following methods need more scientific evidence to prove that they work: Megavitamins and mineral supplementsAnti–motion-sickness medication (to treat the inner ear)Treatment for candida yeast infectionEEG biofeedback (training to increase brain-wave activity)Applied kinesiology (realigning bones in the skull)Reducing sugar consumptionOptometric vision training (asserts that faulty eye movement and sensitivities cause the behavior problems)Always tell your pediatrician about any alternative therapies, supplements, or medications that your child is using. These may interact with prescribed medications and harm your child. Will there be a cure for ADHD soon?While there are no signs of a cure at this time, research is ongoing to learn more about the role of the brain in ADHD and the best ways to treat the ­disorder. Additional research is looking at the long-term outcomes for people with ADHD. Will my child outgrow ADHD?ADHD continues into adulthood in most cases. However, by developing their strengths, structuring their environments, and using medication when needed, adults with ADHD can lead very productive lives. In some careers, having a high-energy behavior pattern can be an asset.  Additional Information on HealthyChildren.org:Understanding ADHD: Information for Parents​Common ADHD Medications & Treatments for ChildrenBehavior Therapy for Children with ADHDHow Schools Can Help Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738) ​​ Article Body Last Updated 1/9/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
70,"2018-04-19 03:06:18","Understanding ADHD: Information for Parents","Understanding ADHD: Information for Parents Page Content​Almost all children have times when their behavior veers out of control. They may speed about in constant motion, make noise nonstop, refuse to wait their turn, and crash into everything around them. At other times they may drift as if in a daydream, unable to pay attention or finish what they start. However, for some children, these kinds of behaviors are more than an occasional problem. Children with attention-deficit/hyperactivity disorder (ADHD) have behavior problems that are so frequent and severe that they interfere with their ability to live normal lives.  These children often have trouble getting along with siblings and other children at school, at home, and in other settings. Those who have trouble paying attention usually have trouble learning. An impulsive nature may put them in actual physical danger. Because children with ADHD have difficulty controlling this behavior, they may be labeled ""bad kids"" or ""space cadets."" Left untreated, ADHD in some children will continue to cause ­serious, lifelong ­problems, such as poor grades in school, run-ins with the law, failed relationships, and the inability to keep a job. Effective treatment is available. If your child has ADHD, your pedia­trician can offer a long-term treatment plan to help your child lead a happy and healthy life. As a parent, you have a very important role in this treatment.  What is ADHD?ADHD is a condition of the brain that makes it difficult for children to control their behavior. It is one of the most common chronic con­ditions of childhood. It affects 4% to 12% of school-aged children. ADHD is diagnosed in about 3 times more boys than girls.  The condition affects behavior in specific ways.  What are the symptoms of ADHD?ADHD includes 3 groups of behavior symptoms: inattention, hyperactivity, and impulsivity. The table below explains these symptoms. Are there different types of ADHD?Not all children with ADHD have all the symptoms. They may have one or more of the symptom groups listed in the table above. The symptoms usually are ­classified as the following types of ADHD: Inattentive only (formerly known as attention-deficit disorder [ADD])—Children with this form of ADHD are not overly active. Because they do not disrupt the classroom or other activities, their symptoms may not be noticed. Among girls with ADHD, this form is more common.Hyperactive/impulsive—Children with this type of ADHD show both hyperactive and impulsive behavior, but they can pay attention. They are the least common group and are frequently younger.Combined inattentive/hyperactive/impulsive—Children with this type of ADHD show a number of symptoms in all 3 dimensions. It is the type that most people think of when they think of ADHD.How can I tell if my child has ADHD?Remember, it is normal for all children to show some of these symptoms from time to time. Your child may be reacting to stress at school or home. She may be bored or going through a difficult stage of life. It does not mean she has ADHD. Sometimes a teacher is the first to notice inattention, hyperactivity, and/or impulsivity and bring these symptoms to the parents' attention.  Perhaps questions from your pediatrician raised the issue. At routine visits, pediatricians often ask questions such as: How is your child doing in school?Are there any problems with learning that you or your child's ­teachers have seen?Is your child happy in school?Is your child having problems completing class work or homework?Are you concerned with any behavior problems in school, at home, or when your child is playing with friends?Your answers to these questions may lead to further evaluation for ADHD. If your child has shown symptoms of ADHD on a regular basis for more than 6 months, discuss this with your pediatrician.  Additional Information on HealthyChildren.org:Causes of ADHD: What We Know TodayTreatment & Target Outcomes for Children with ADHDCommon ADHD Medications & Treatments for ChildrenHow Schools Can Help Children with ADHDAdditional Resources:The following is a list of support groups and additional resources for further information about ADHD. Check with your pediatrician for resources in your community. National Resource Center on AD/HD Understanding ADHD​ (Understood.org) Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) or 800/233-4050Attention Deficit Disorder Association or 856/439-9099Center for Parent Information and Resources National Institute of Mental Health or 866/615-6464Tourette Association of America or 888/4-TOURET (486-8738)  Article Body Last Updated 1/9/2017 Source Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder (Copyright © 2007 American Academy of Pediatrics, Updated 6/2016)"
71,"2018-04-19 03:06:22","Vision, Inner-Ear, Auditory Integration, and Sensory Integration Problems","Vision, Inner-Ear, Auditory Integration, and Sensory Integration Problems Page Content Article BodyAn entire class of theories about the causes of ADHD and effective treatments for it centers on the workings of the senses. Problems relating to sight, hearing, balance controlled by the inner ear, sensory integration, and so on have been proposed as underlying conditions that lead to ADHD and accompanying problems and disorders. Each theory is linked to a treatment approach, and each form of treatment is supported by a large number of vocal enthusiasts. Again, none of these theories or methods has yet been proven valid in diminishing or eliminating the behaviors related to ADHD. Optometric Training Optometric training, a kind of eye training for children with learning disabilities, is based on the theory that faulty eye movements and problems in visual perception can cause dyslexia, language disorders, and other learning problems that frequently accompany ADHD. Named behavioral optometry by the optometrists who developed and support this form of therapy, the treatment consists of teaching children specific visual skills as a way of improving learning. These skills include tracking moving objects, fixating on or locating objects quickly and accurately, encouraging both eyes to work together successfully, and changing focus efficiently. The skills are taught through the use of eye exercises and special colored or prismatic lenses. Optometric training is often supplemented with training in academic skills, nutrition, and personal relationships. This treatment is frequently quite expensive. However, little research has supported the theory that dyslexia or other learning disabilities are caused by vision defects or problems, and thus vision training is an ineffective approach to reading and learning disabilities. In 1984 the American Academy of Pediatrics (AAP), along with the American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Ophthalmology, issued a policy statement affirming that no known scientific evidence “supports the claims for improving the academic abilities of dyslexic or learning-disabled children with treatment based on visual training, including muscle exercises, ocular pursuit or tracking exercises, or glasses (with or without bifocals or prisms).” Because vision training is not only ineffective but may delay more effective treatment for coexisting learning disabilities, it is not recommended. Motion-Sickness Medication Dr Harold Levinson, a New York physician, is responsible for the popular theory that inner-ear problems can cause problems with balance, coordination, and energy regulation, which in turn can lead to ADHD and learning disabilities—as well as dyslexia, obsessive-compulsive disorder, panic disorder, and many other difficulties. In his book, Total Concentration, Levinson states that ADHD symptoms are often related to a kind of dizziness or motion sickness resulting from inner-ear problems. He recommends treatment with anti–motion-sickness medications, often in combination with antihistamines, tricyclic antidepressants, the antipsychotic drug thioridazine (Mellaril), vitamin B complex, gingerroot, or stimulants. To date no studies have revealed a link between ADHD and inner-ear deficiencies, and Levinson’s theory conflicts with much that is currently known about ADHD. His claims rest almost entirely on anecdotal information, and the published reports of his work consist of individual case studies rather than scientific research. Because insufficient research has been conducted to prove this treatment effective, and because it contradicts many of the known facts about the causes of ADHD, it is not recommended as a treatment option. Sound Treatment Difficulties with auditory integration—that is, organizing, attending to, and making sense out of information while listening—have also been suspected as a cause of ADHD. The Tomatis Method, devised by the French physician Alfred Tomatis, is perhaps the best-known treatment approach aimed at this proposed deficiency. A large number of individual accounts testify to the effectiveness of Tomatis’ auditory-stimulation sessions—in which children listen to high-frequency modifications of the human voice, classical music, and Gregorian chant through special headphones called “electronic ears,” and are given listening training to improve focus and attention. The effects of music and sound on brain function have been insufficiently studied to date, however. While one study did show that boys with ADHD were better able to solve arithmetic problems when listening to their favorite music—implying that auditory stimulation may help to improve performance on specific tasks—no scientifically controlled studies have yet supported the claim that the Tomatis Method improves ADHD. Any improvement that has been reported by individuals may be due to the treatment’s emphasis on individual attention for each child, with at least 75 specially designed listening sessions and targeted training in social and academic skills. Sensory Integration Training Dr Jean Ayres, an occupational therapist, developed the theory that much of the hyperactivity in today’s children is the result of poor sensory integration—that is, the failure of the brain to organize and make use of information derived from such senses as vision, hearing, smell, taste, touch, motion, and temperature. According to this theory, sensory integration dysfunction makes it difficult to concentrate and sit still, and puts children at risk for learning disabilities, problems with coordination, social difficulties, and touch sensitivity. Ayres claimed that sensory integration dysfunction is usually genetically inherited or acquired prenatally, during birth, or from environmental toxins. Recommended treatment includes exercises or experiences that provide the child with extrasensory stimulation and feedback—such as brushing and rubbing of the skin, deeppressure exercises, vibration, stretching, and so on. While this approach has some intuitive appeal, feels good to children, can be calming, and is said to address the poor coordination and social difficulties that many children with ADHD experience, no convincing evidence has surfaced to prove that deficits in sensory integration are a cause of related disorders. Studies have not shown that sensory integrative training succeeds as a treatment for children with ADHD or learning or behavior problems. While not known to be harmful in any way, the expense and time demands are such that this approach cannot be recommended as a treatment for ADHD. Last Updated 11/21/2015 Source ADHD: A Complete and Authoritative Guide (Copyright © 2004 American Academy of Pediatrics)"
72,"2018-04-19 03:06:26","When Children with ADHD are Labeled","When Children with ADHD are Labeled Page Content Article BodyMy son who is in fourth grade has just been diagnosed with ADHD. Both his teacher and doctor agree. I also agree that he is overactive and has trouble focusing. He is starting to have problems with his schoolwork and friendships even though he is a very bright and loving child. I can see that he needs some help, but I am also very concerned about his getting “labeled” and what negative effects this might have on him. You share a common concern of many parents whose child has just received the diagnosis of ADHD. In a sense, the diagnosis just tells you what you already know—that the problem behaviors you described during your child’s evaluation match the diagnostic criteria for ADHD, and that they are causing your child significant problems on a daily basis. The diagnosis may serve as an entrance point for receiving different levels of help at school, and for knowledgeable teachers as a means to better understand and help your child. However, the diagnosis can be misunderstood by underinformed teachers or other adults who interact regularly with your child—but there is now a good deal of effort going into training teachers about ADHD and related disorders. You and your child’s pediatrician can also contribute a great deal to this effort with your child’s own teacher in many positive ways. Community support groups like CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) can provide you with a forum for discussing this and a place to meet parents who have already had experience with many of these challenges. Last Updated 11/21/2015 Source ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)"
73,"2018-04-19 03:06:31",Allergies,"Allergies Page Content Article BodyAllergies and asthma, which typically start in childhood, are by far the most common chronic diseases among children in the United States. Consider the following statistics: Some 50 million Americans have allergies (about 1 in 5 people in this country). The most common type of allergy is hay fever (allergic rhinitis); the medical cost of treating it, when direct and indirect costs are added up, now exceeds $7 billion a year. More than 17 million Americans have asthma, and about one-fourth of these are younger than 18 years. Asthma accounts for about 4,000 deaths a year. Seventy to 80% of school-aged children with asthma also have allergies, which are among the most common triggers for asthma, closely tied with viral respiratory infections. If one parent has allergies, there’s a 25% chance that a child will also be allergic. The risk is more than doubled to 60% to 70% if both parents have allergies. Many aspects of allergies, eczema, and asthma still are not fully understood. But advances in the diagnosis and treatment of these disorders are helping millions of sufferers. What Are Allergies? Many people mistakenly use the word allergy to refer to a disease or almost any unpleasant or adverse reaction. We often hear someone say, “I have allergies,” “He’s allergic to hard work,” or “She’s allergic to anything that’s green.” In reality, allergies are reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema. Your immune system is made up of a number of different cells that come from organs throughout the body—principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose). Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens. Who Is at Risk? Although allergies can develop at any age, they most commonly show up during childhood or early adulthood. A search of family medical histories of a child with allergies will usually turn up a close relative who also has allergies. If one parent, brother, or sister has allergies, there is a 25% chance that a child will also have allergies. The risk is much higher if both parents are allergic. But the child will not necessarily be allergic to the same substances as the parents or always show the same type of allergic disease (eg, hay fever, asthma, eczema). Symptoms Associated With Allergies Eyes, Ears, Nose, Mouth Red, teary, or itchy eyes Puffiness around the eyes Sneezing Runny nose Itchy nose, nose rubbing Postnasal drip Nasal swelling and congestion Itchy ear canals Itching of the mouth and throat Lungs Hacking dry cough or cough that produces clear mucus Wheezing (noisy breathing) Feeling of tightness in the chest Low exercise tolerance Rapid breathing; shortness of breath Skin Eczema (patches of itchy, red skin rash) Hives (welts) Intestines Cramps and intestinal discomfort Diarrhea Nausea or vomiting Miscellaneous Headache Feelings of restlessness, irritability Excessive fatigue When to Suspect an Allergy Allergies can result in various types of conditions. Some are easy to identify by the pattern of symptoms that invariably follows exposure to a particular substance; others are more subtle and may masquerade as other conditions. Here are some common clues that should lead you to suspect your child may have an allergy. Patches of bumps or itchy, red skin that won’t go away Development of hives—intensely itchy skin eruptions that usually last for a few hours and move from one part of the body to another Repeated or chronic cold-like symptoms, such as a runny nose, nasal stuffiness, sneezing, and throat clearing, that last more than a week or two, or develop at about the same time every year Nose rubbing, sniffling, snorting, sneezing, or drippy nose Itchy, runny eyes Itching or tingling sensations in the mouth and throat Coughing, wheezing, difficulty breathing, and other respiratory symptoms Unexplained bouts of diarrhea, abdominal cramps, and other intestinal symptoms. Where Does Asthma Fit In? Although allergies can trigger asthma and asthma is often associated with allergies, they are actually 2 different things. In simple terms, asthma is a chronic condition originating in the lungs, whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs. Many different substances and circumstances can trigger an asthma attack—exercise, exposure to cold air, a viral infection, air pollution, noxious fumes, tobacco smoke, and for many asthma sufferers, a host of allergens. In fact, about 80% of children with asthma also have allergies. Although allergies are important in triggering asthma, severe asthma exacerbations are often set off by the good old common cold virus, totally unrelated to allergy. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
74,"2018-04-19 03:06:36","Allergy Causes in Children: What Parents Can Do","Allergy Causes in Children: What Parents Can Do Page Content Article BodyWhat Causes Allergies?​ Children get allergies from coming into contact with allergens. Allergens can be inhaled, eaten, or injected (from stings or medicine) or they can come into contact with the skin. Some of the more common allergens are: Pollens from trees, grasses, and weeds Molds, both indoor and outdoor Dust mites that live in bedding, carpeting, and other items that hold moisture Animal dander from furred animals such as cats, dogs, horses, and rabbits Some foods and medicines Venom from insect stings Allergies tend to run in families. If a parent has an allergy, there is a higher chance that his or her child also will have allergies. This risk increases if both parents are allergic. How Can I Help My Child? Identifying and avoiding the things your child is allergic to is best. If your child has an allergic condition, try the following: Keep windows closed during the pollen season, especially on dry, windy days when pollen counts are highest. Keep the house clean and dry to reduce mold and dust mites. Avoid having pets and indoor plants. Avoid those things that you know cause allergic reactions in your child. Prevent anyone from smoking anywhere near your child, especially in your home and car. See your pediatrician for safe and effective medicine that can be used to help alleviate or prevent allergy symptoms. Common Allergic Conditions Condition​ ​Triggers ​Symptoms ​Anaphylaxis ​Foods, medicines, insect stings, latex, and others ​Skin, gut, and breathing symptoms that may get worse quickly. Severe symptoms could include trouble breathing and poor blood circulation. ​Asthma ​Cigarette smoke, viral infections, pollen, dust mites, furry animals, cold air, changing weather conditions, exercise, airborne mold spores, and stress ​Coughing, wheezing, trouble breathing (especially during activities or exercise); chest tightness ​Contact dermatitis ​Skin contact with poison ivy or oak, latex, household detergents and cleansers, or chemicals in some cosmetics, shampoos, skin medicines, perfumes, and jewelry ​Itchy, red, raised patches that may blister if severe. Most patches are found at the areas of direct contact with the allergen. ​Eczema (atopic dermatitis) ​Sometimes made worse by food allergies or coming in contact with allergens such as pollen, dust mites, and furry animals. May also be triggered by irritants, infections, or sweating. ​A patchy, dry, red, itchy rash in the creases of the arms, legs, and neck. In infants it often starts on the cheeks, behind the ears, and on the chest, arms, and legs. ​Food allergies ​Any foods, but the most common are eggs, peanuts, milk, nuts, soy, fish, wheat, peas, and shellfish ​Vomiting, diarrhea, hives, eczema, trouble breathing, and possibly a drop in blood pressure (shock) ​Hay fever ​Pollen from trees, grasses, or weeds ​Stuffy nose, sneezing, runny nose; breathing through the mouth because of stuffy nose; rubbing or wrinkling the nose and face to relieve nasal itch; watery, itchy eyes; redness or swelling in and under the eyes ​Hives ​Food allergies, viral infections, and medicines such as aspirin or penicillin. Sometimes the cause is unknown. ​Itchy skin patches, bumps (large and small) commonly known as welts that are more red or pale than the surrounding skin. Hives may be found on different parts of the body and do not stay at the same spot for more than a few hours. ​Insect sting allergy ​Primarily aggressive stinging insects such as yellow jackets, wasps, and fire ants Anaphylaxis​ ​Medication allergy ​Various types of medicines or vaccines ​Itchy skin rashes, anaphylaxis   Last Updated 11/21/2015 Source Allergies in Children (Copyright ? 1997 American Academy of Pediatrics, Updated 4/2013)"
75,"2018-04-19 03:06:39","Allergy Medicine for Children","Allergy Medicine for Children Page Content Article BodySeveral effective, easy-to-use medications are available to treat allergy symptoms. Some are available by prescription; others, over-the-counter. As with any medications, over-the-counter products should be used only with the advice of your child's doctor.AntihistaminesAntihistamines, the longest-established allergy medications, dampen the allergic reaction mainly by suppressing the effects of histamine (itching, swelling, and mucus production) in the tissues. For mild allergy symptoms, your child's doctor may recommend one of the antihistamines widely available over-the-counter. Children who don't like to swallow tablets may prefer the medication in syrup, chewable, or melt-away form. Antihistamines can be useful for controlling the itchiness that accompanies hay fever, eczema, and hives. Your pediatrician may advise your child to take them regularly or just as needed. Antihistamine nasal sprays are also available for hay fever. They work locally in the nose to reduce symptoms. Some kids shy away from nose sprays and prefer using the antihistamines taken by mouthSome over-the-counter antihistamines, in particular the ""old-generation"" type, can cause drowsiness. For this reason, it's best to give the dose in the evening. Some new generation antihistamines may cause mild drowsiness especially after the first dose. Ask your child's doctor whether these non-sedating antihistamines are appropriate for your child.DecongestantsFor hay fever sufferers, antihistamines help stop runny nose, itching, and sneezing, but they have little effect on nasal congestion or stuffiness. To cover the range of symptoms, an antihistamine is often given together with a decongestant, sometimes combined in a single medication. In contrast to older antihistamines, which tend to make people sleepy, decongestants taken by mouth can cause stimulation. Children taking these medications may act hyper, feel anxious, have a racing heart, or find it difficult to get to sleep. Because of these possible side effects, it is best to avoid using long-term daily decongestants to control your child's nasal congestion, and instead, use another type of medication, such as a nasal corticosteroid spray.Decongestant treatment can be given topically with nose drops or sprays, but these medications have to be used carefully, and only for a short while, because prolonged use can lead to a rebound effect. The resulting stuffy nose is more difficult to treat than the original allergy symptoms.CromolynCromolyn sodium is sometimes recommended to prevent nasal allergy symptoms. This medication can be used every day for chronic problems or just for a limited period when a child is likely to encounter allergens. The medication is available without prescription as a nasal spray; it is taken 3 or 4 times a day. Nasal cromolyn has almost no side effects, but it's potency is not high, and because it requires frequent administration, it is hard to use on a regular basis in a consistent way.CorticosteroidsCorticosteroids, a category of medications also called steroids or cortisones, are highly effective for allergy treatment and are widely used to stop symptoms. They are available as skin medications (such as creams and ointments), nasal sprays, asthma inhalers, and pills or liquids. Steroid creams and ointments are a mainstay of treatment for children with eczema. They control eczema when applied once a day, or even once a day, depending on the severity of the rash or even once a day if the rash is not severe. Nasal sprays that contain a compound derived from cortisone have become the most effective form of treatment for patients with nasal allergy problems. Once-daily dosing is usually enough. These medications work best if used on a regular daily schedule, rather than with as-needed, interrupted dosing. No problems have emerged so far over many years in patients using cortisone nasal sprays over the long term.Allergy ImmunotherapyImmunotherapy, or allergy shots, may be recommended to reduce your child's sensitivity to airborne allergens. This form of treatment consists of giving a person material he is allergic to, by injection, with the goal of changing his immune system and making him less allergic to that material. Not every allergy problem can or needs to be treated with allergy shots, but treatment of respiratory allergies to pollen, dust mites, and outdoor molds is often successful. Currently, sub-lingual (under the tongue) immunotherapy is available for grass pollen and ragweed pollen only and is typically started a few months before the grass or ragweed pollen season. Immunotherapy for cat (and possibly dog) allergy can also be very effective, but allergy specialists advise that avoidance is the best way to manage animal allergies in children.Immunotherapy takes some time to work and demands patience and commitment. The treatment is given by injecting gradually stronger doses of allergen extract once or twice a week at first, then at longer intervals—for example, once every 2 weeks, then every 3 weeks, and eventually every 4 weeks. The effect of the extract reaches its maximum after 6 to 12 months of injections.After a number of months of immunotherapy, a child usually feels his allergy symptoms are better. Allergy injections are often continued for 3 to 5 years, and then a decision is made whether to stop them. Many children do fine after the shots are stopped and have little or no return of their symptoms.Additional InformationAllergy Causes in Children: What Parents Can DoAllergies and HyperactivityDiagnosing Allergies Seasonal Allergies in ChildrenWhen Pets Are the Problem Last Updated 11/21/2015 Source Adapted from Allergies and Asthma: What Every Parent Needs to Know (Copyright © 2010 American Academy of Pediatrics)"
76,"2018-04-19 03:06:44","Asthma Fables and Facts","Asthma Fables and Facts Page Content Article BodyAlthough our knowledge of asthma is expanding year by year, many people still cling to outdated beliefs about the disease. Following are some that are often repeated: Fable: Asthma comes and goes. Fact: Asthma is often an inflammatory condition that is always in the airways, even when the person is not having trouble breathing. Exposure to an asthma trigger can worsen symptoms, but the underlying condition never goes away, although it can be controlled with medications and environmental control measures. Fable: Asthma is an emotional disorder; it’s “all in the mind.” Fact: Asthma is a lung disease; it affects the airways, not the brain. It’s true that symptoms may get worse when a person is under emotional stress, but this is probably more marked in adults and less so in children. Changes in the airways in asthma occur through physiological mechanisms, not emotional ones. Fable: People with asthma should use medications only when they have attacks; otherwise, the medications lose their effect. Fact: Regularly using medications is the only way to calm the underlying airway inflammation and prevent asthma flare-ups. Used at the correct dosage, daily medications do not lose their effect or cause uncomfortable side effects. Effective antiasthma medications include inhaled beta-agonists such as albuterol to stop attacks, and inhaled steroids, long-acting beta-agonists, and leukotriene modifiers to prevent attacks from occurring at all. Fable: Asthma is just an annoying condition, not a real disease. Fact: Asthma can kill when people do not get treatment to control the underlying condition and stop severe attacks. If everybody who needed medications used the proper ones to control symptoms and prevent flare-ups, hospitalizations and deaths from asthma would be greatly reduced. Fable: Children grow out of asthma. Fact: Most people who have asthma are born with a tendency to the condition and keep it for life. It is true many children get much better with age, and their asthma appears to go away completely. However, many have it return in adulthood. Other children who still have asthma are less likely to lose their asthma as they go in to their adult years. Fable: Asthma clears up when you move to a warm, dry climate. Fact: If the proper environmental measures are taken and medications are regularly used, people with asthma can live comfortably in any climate they prefer. Very rarely do people ever have to move out of a city or other area because of their asthma. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
77,"2018-04-19 03:06:49","Asthma Gadgets: How to Use a Dry Powder Inhaler - Diskus","Asthma Gadgets: How to Use a Dry Powder Inhaler - Diskus Page Content Article BodyDry Powder Inhalers, or DPIs, work on the principle that the patient breathes in rapidly and deeply to deliver the medication. This is in contrast to how one breathes in with an MDI, which is slowly. This video demonstrates the proper use of the diskus technique. Watch video Last Updated 1/23/2016 Source PediaLink Essentials: Asthma Gadgets 2010 (Copyright © 2010 American Academy of Pediatrics)"
78,"2018-04-19 03:06:56","Asthma Gadgets: How to Use a Spacer with a Mask","Asthma Gadgets: How to Use a Spacer with a Mask Page Content Article BodyThere are 2 major techniques when using a tube spacer. The choice depends on whether the spacer is being used with a mask (for infants and toddlers) or without a mask. This video demonstrates the proper use of the spacer with a small mask. Watch video Last Updated 11/21/2015 Source PediaLink Essentials: Asthma Gadgets 2010 (Copyright © 2010 American Academy of Pediatrics)"
79,"2018-04-19 03:07:00","Asthma Gadgets: How to Use a Spacer without a Mask","Asthma Gadgets: How to Use a Spacer without a Mask Page Content Article BodyThere are 2 major techniques when using a tube spacer. The choice depends on whether the spacer is being used with a mask (for infants and toddlers) or without a mask. This video demonstrates the proper use of the spacer without a mask.  Watch video Last Updated 1/23/2016 Source PediaLink Essentials: Asthma Gadgets 2010 (Copyright © 2010 American Academy of Pediatrics)"
80,"2018-04-19 03:07:05","Asthma Gadgets: How to Use an MDI Closed-Mouth Inhaler","Asthma Gadgets: How to Use an MDI Closed-Mouth Inhaler Page Content Article BodyMetered Dose Inhalers, or MDIs, shoot medication through a nozzle to form a spray that comes out through the mouthpiece. MDIs deliver a high concentration of medicine directly to the lungs very quickly. There are 2 types of propellant-containing MDI devices: press-and-breathe and breath-actuated. This video demonstrates the proper use of the press-and-breathe inhaler using a closed-mouth technique. Watch video Last Updated 1/23/2016 Source PediaLink Essentials: Asthma Gadgets 2010 (Copyright © 2010 American Academy of Pediatrics)"
81,"2018-04-19 03:07:09","Asthma Inhalers","Asthma Inhalers Page Content Article BodyMany parents of children with asthma may already have heard of this alphabet soup of abbreviations — CFCs, MDIs, HFAs, and ODSs. They all have to do with a change in the type of metered dose inhalers (MDIs) being made to help reduce the release of chlorofluorocarbons (CFCs) into the atmosphere when taking certain asthma medications. Until recently, most MDIs in the United States, such as albuterol inhalers, contained CFCs — chemicals that propel the medicine in an inhaler into the lungs. But CFCs are ozone-depleting substances (ODSs) that hurt the environment. Manufacturers are now making CFC-free inhalers, also called hydrofluoroalkane (HFA) inhalers, that do not rob the atmosphere of ozone. “The FDA [Food and Drug Administration] and various manufacturers are reporting that the transition to HFA albuterol is occurring at a substantial pace,” says Pamela Wexler, an advisor to the U.S. Stakeholders Group on MDI Transition. This group is composed of nine leading medical societies and patient associations, including the American Academy of Pediatrics and the American Lung Association. “Estimates [near the start of 2007] indicate that as much as 50 percent of prescriptions are now being filled with HFA.” What Parents Need to Know What Is Happening? Metered-dose inhalers (MDIs) contain ozone-depleting substances, chlorofluorocarbons (CFCs), and are being phased out. All patients using a CFC-containing MDI will eventually need to transition to other products. FDA has set a phase-out date for CFC albuterol of December 31, 2009. CFC-free MDIs are safe and effective. Every other developed country is switching away from CFC MDIs without harm to patients. What Can Patients Do Now? Switch to CFC-free medications now that they are available. Use this transition as an opportunity to talk with your health care provider about your asthma management plan. Talk to your health care provider about CFC-free medications and non-MDI alternatives. Talk to your doctor, nurse, pharmacist, respiratory therapist, or other health care provider when you receive a new inhaler to make sure you and your child know how to use and maintain it properly. Check with your insurance provider to see whether the CFC-free inhaler is covered and if not, ask them to cover it. Investigate ways you may be able to receive free and discount drugs if you are unable to aff ord your medication. How Will the New Inhalers Work? CFC-free products may look, taste, and feel a little different, but the FDA has found the new products comparable in safety and effectiveness to current products. Non-CFC MDIs are used around the world, and have been found to be safe and effective, without any adverse effects to patients. What If I Cannot Afford My Medications? New CFC-free MDIs may be more expensive than the CFC-containing products they replace. Pharmaceutical companies are committed to ensuring that no patient is denied access to medication because of the transition away from CFC. There are numerous patient assistance programs to help people who cannot afford their medications. Some programs provide medicines free of charge, but have different eligibility requirements based on income. For patients who do not meet eligibility requirements for those free drugs but still need assistance, there are a number of programs that provide discounted drugs. This article was featured in Healthy Children Magazine. To view the full issue, click here. Last Updated 11/21/2015 Source Healthy Children Magazine, Allergy/Asthma 2007"
82,"2018-04-19 03:07:14","Asthma Management at School","Asthma Management at School Page Content Article BodyChildren spend a significant part of their day at school. That is why it is so important that asthma symptoms are well managed while they are there. It is also important that you are aware of your child’s symptoms and any problems with how your child’s asthma is managed in school. Effective Communication Good communication is essential to asthma care and management in school. The school needs to know about your child’s asthma, how severe it is, what medications your child takes, and what to do in an emergency. This communication can be helped by having your health care provider complete an asthma action plan for the school, as well as a medication permission form that includes whether your child should be allowed to carry and use her own inhaler. You should also sign a release at school and at your health care provider’s office to allow the exchange of medical information between you, the school, and your health care provider. Your child’s school needs to communicate to you its policies on how your child will get access to her medications and how they deal with emergencies, field trips, and after-school activities. The school should also inform you about any changes or problems with your child’s symptoms while she is at school. Peak Flow Meter Peak flow meters can be helpful for school staff in determining the severity of an asthma attack. If your child’s health care provider has recommended a peak flow meter, determine your child’s best peak flow (your health care provider should tell you how to do this). Then keep a peak flow meter at school. School Environment The environment at school is as important as the environment at home. Coping With Asthma at School Students with asthma face a number of problems related to school. Talk to your child about how well his asthma is being managed in school. Also talk to your child’s teachers, school nurse, coaches, and other school personnel to get their opinions on how well your child is coping with asthma in school and to see if asthma symptoms are causing any of the following problems: Missing school due to asthma symptoms or doctor visits. Avoiding school or school activities. Work with your health care provider and school personnel to encourage your child to participate in school activities. Not taking medication before exercise. Your child may avoid going to the school office or nurse’s office to use his inhaler before exercise. Schools that allow children to carry their inhalers with them can help avoid this problem. Side effects from medication. Some asthma medications may alter your child’s ability to perform in school. Teachers need to know if and when your child takes asthma medication so that you can be notified if there are any problems. Physical activity is important for your child’s physical and mental health. Children with asthma should be able, and encouraged, to participate completely in physical education, sports, and other activities in school. All students should have some knowledge of asthma basics and management. Encourage your school to offer asthma awareness education as part of the health education curriculum. Know Your Rights Learn about the federal laws that can help you with asthma management concerns at school. These include the following: Section 504 of the Civil Rights Act of 1973 Americans with Disabilities Act (ADA) Individuals with Disabilities Education Act (IDEA) Last Updated 11/21/2015 Source AAP Section on Allergy and Immunology (Copyright © 2003)"
83,"2018-04-19 03:07:21","Asthma Medicines: Long-term Control","Asthma Medicines: Long-term Control Page Content Article BodyCorticosteroids Synthetic versions of hormones produced in the adrenal glands, corticosteroids are the most powerful anti-inflammatory medications now available for treating asthma. In inhaled form, they are used exclusively for long-term control; they are not very effective for acute symptoms. Systemic corticosteroids taken by mouth as pills or liquid, or injected, are sometimes of value to get asthma quickly under control when a child is beginning long-term asthma therapy. Inhaled corticosteroids are the agents preferred and recommended as first-line treatment of chronic asthma by various asthma expert panels that publish guidelines on the proper treatment of asthma. They are available in various forms and different dosage forms, which make them convenient for patients to take, such as an aerosol in a metered-dose inhaler (MDI), a dry powder inhaler (DPI), and a liquid form that can be used in a nebulizer for small children. Leukotriene Modifiers These compounds act by decreasing the effects of an inflammatory chemical made by the body known as leukotrienes. The 2 leukotriene modifiers currently in use, montelukast and zafirlukast, are used as control medications. They have only mild to moderate beneficial effects at best but are very safe. They are taken in pill form; chewable and sprinkle forms are available for young children. Long-Acting Beta2-Agonists Medications in the beta2-agonist class work by relaxing the muscles that wrap around the bronchi of the lungs and tend to squeeze down and narrow the airways in those who have asthma. The short-acting forms of beta2-agonists, such as albuterol, are used as first-line agents for relief of asthma in all patients with asthma. Long-acting versions of beta2-agonists were made by making some chemical changes in the short-acting beta2-agonists. These long-acting beta2-agonists are almost always prescribed together with anti-inflammatory medications for long-term control, rarely if ever by themselves. They are usually added when a conventional dose of an inhaled steroid is not adequate for control of daily symptoms. There is evidence that rare patients experience loss of effect from their rapid-acting bronchodilator (eg, albuterol, levalbuterol) with taking long-acting bronchodilators. While this is quite uncommon, patients should be advised of this potential and instructed to notify their physician if the addition of a long-acting bronchodilator is associated with increased symptoms instead of the usual increased benefit. Theophylline Theophylline, usually taken by mouth as a timed-release pill, opens up the airways for an extended period. It can be used alone or together with inhaled corticosteroids. It can be particularly helpful in preventing nighttime symptoms in mild to moderate asthma. Although once used extensively, theophylline is currently infrequently prescribed for asthma, mainly because it requires careful monitoring of blood levels to avoid side effects and because other asthma medications often work as well or better. Cromolyn Sodium and Nedocromil These are very mildly effective anti-inflammatory medications rarely used anymore in long- term therapy of mild to moderate asthma in children. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
84,"2018-04-19 03:07:25","Asthma Medicines: Quick Relief","Asthma Medicines: Quick Relief Page Content Article BodyShort-Acting Beta2-Agonists These are used for the rapid relief of acute asthma symptoms and to prevent exercise-induced asthma in children. They are first-line treatment of acute asthma symptoms—all patients with asthma need to have available a short-acting beta2-agonist. Children may use them by MDI or nebulizer; either form is effective if used properly. The medication should be available at home, in school, and at the site of sports participation. This class of medication used to be called “rescue” medicine, but this term is no longer used because it implies that a patient must be in terrible shape to use it, which should not be the case. The new preferred term is quick relief. It turns out that almost all patients use albuterol (or a close cous-in called levalbuterol, which acts very similar to albuterol) for their quick-relief medication. Albuterol should be used for any asthma symptom, including wheeze, chest tightness, and cough, and not just reserved for asthma attacks. Anticholinergics Ipratropium bromide, a rapid-acting bronchodilator, may be used as an alternative to dilate the airways when inhaled beta2-agonists cannot be used, or given together with an inhaled beta2-agonist in severe asthma. Systemic Corticosteroids These are given by mouth or injection to reduce inflammation inside the airways and speed recovery when a youngster is having an asthma flare-up. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
85,"2018-04-19 03:07:29","Asthma Predictive Index","Asthma Predictive Index Page Content Article BodyMost wheezing during the first 3 years of life is related to viral respiratory infections. Respiratory viruses and symptoms of early asthma may be hard to tell apart, making diagnosis and treatment tricky. But doctors and parents now have a tool to help them predict with reasonable accuracy if the child will develop asthma or simply outgrow it. The asthma predictive index (API) is a guide to determining which small children will likely have asthma in later years. Children younger than 3 years who have had 4 or more significant wheezing episodes in the past year are much more likely to have persistent (ie, lifelong) asthma after 5 years if they have either of the following: One major decisive factor Parent with asthma Physician diagnosis of eczema (atopic dermatitis) Sensitivity to allergens in the air (as determined by physician through positive skin tests or blood tests to allergens such as trees, grasses, weeds, molds, or dust mites) OR Two minor decisive factors Food allergies Greater than 4% blood eosinophils (a type of white blood cell often seen in allergic disease) Wheezing apart from colds The API was developed after following almost 1,000 children through 13 years of age. It turned out that a wheezy child with a positive API at around 2 to 3 years of age meant there was about an 80% chance that child would have a definite diagnosis of asthma when entering first grade. Using the API, doctors and parents can watch more closely for symptoms of asthma as the child grows and if needed, start the right medications earlier. Earlier and better treatment can help keep children active and healthy, and their asthma in good control. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
86,"2018-04-19 03:07:34","Asthma Triggers and What to do About Them","Asthma Triggers and What to do About Them Page Content Article BodyAsthma Triggers Certain things cause asthma “attacks” or make asthma worse. These are called triggers. Some common asthma triggers are Things your child might be allergic to. These are called allergens. (Most children with asthma have allergies, and allergies are a major cause of asthma symptoms.) House dust mites Animal dander Cockroaches Mold Pollens Infections of the airways Viral infections of the nose and throat Other infections, such as pneumonia or sinus infections Irritants in the environment (outside or indoor air you breathe) Cigarette and other smoke Air pollution Cold air, dry air Odors, fragrances, volatile organic compounds in sprays, and cleaning products Exercise (About 80% of people with asthma develop wheezing, coughing, and a tight feeling in the chest when they exercise.) Stress Be sure to check all of your child’s “environments,” such as school, child care, and relatives’ homes, for exposure to these same things. Help Your Child Avoid Triggers While it is impossible to make the place you live in completely allergenor irritant-free, there are things you can do to reduce your child’s exposure to triggers. The following tips may help. Do not smoke or let anyone else smoke in your home or car. Reduce exposure to dust mites. The most necessary and effective things to do are to cover your child’s mattress and pillows with special allergy-proof encasings, wash their bedding in hot water every 1 to 2 weeks, remove stuffed toys from the bedroom, and vacuum and dust regularly. Other avoidance measures, which are more difficult or expensive, include reducing the humidity in the house with a dehumidifier or removing carpeting in the bedroom. Bedrooms in basements should not be carpeted. If allergic to furry pets, the only truly effective means of reducing exposure to pet allergens is to remove them from the home. If this is not possible, keep them out of your child’s bedroom and consider putting a high-efficiency particulate air (HEPA) filter in their bedroom, removing carpeting, covering mattress and pillows with mite-proof encasings, and washing the animals regularly. Reduce cockroach infestation by regularly exterminating, setting roach traps, repairing holes in walls or other entry points, and avoiding leaving exposed food or garbage. Mold in homes is often due to excessive moisture indoors, which can result from water damage due to flooding, leaky roofs, leaking pipes, or excessive humidity. Repair any sources of water leakage. Control indoor humidity by using exhaust fans in the bathrooms and kitchen, and adding a dehumidifier in areas with naturally high humidity. Clean existing mold contamination with detergent and water. Sometimes porous materials such as wallboards with mold contamination have to be replaced. Pollen exposure can be reduced by using an air conditioner in your child’s bedroom, with the vent closed, and leaving doors and windows closed during high pollen times. (Times vary with allergens, ask your allergist.) Reduce indoor irritants by using unscented cleaning products and avoiding mothballs, room deodorizers, or scented candles. Check air quality reports in weather forecasts or on the Internet. When the air quality is poor, keep your child indoors and be sure he takes his asthma control medications. Decreasing your child’s exposure to triggers will help decrease symptoms as well as the need for asthma medications. Last Updated 11/21/2015 Source AAP Section on Allergy and Immunology (Copyright © 2003)"
87,"2018-04-19 03:07:41","Asthma and Food Allergies","Asthma and Food Allergies Page Content Article BodyA family history of any type of allergy increases the risk that a child may develop asthma. Children with asthma and food allergies are at increased risk for anaphylaxis, a severe allergic reaction, even when their asthma is well controlled. For children with known food allergies, especially those who also have asthma, parents should be thoroughly familiar with food ingredients. If their child has an anaphylactic reaction to foods, they should also carry an emergency dose of epinephrine at all times and make sure there is some with the child care provider and at school. Epinephrine, a drug that stops or slows down anaphylaxis, is available in spring-loaded self-injectable syringes. Though not a cure, a dose of epinephrine administered soon after symptoms begin should stall severe symptoms long enough to get necessary medical attention by calling emergency medical services (911). Sulfites, which are used to stop discoloration, overripening, and spoiling, are known to trigger asthma attacks. These additives are found in processed beverages and foods, including fruit juices, soft drinks, cider vinegar, potato chips, dried fruits and vegetables, maraschino cherries, and wines. Numerous reports of allergic reactions—mostly among people with asthma—and of deaths associated with sulfite ingestion have led the Food and Drug Administration to ban the use of sulfites in fresh fruits and vegetables. Sulfites may be used in certain processed foods, provided they are listed on labels in quantities higher than 10 parts per million, or when used at all in manufacturing. Processed potatoes and some canned foods may contain sulfites. If your child has asthma or is sensitive to sulfites, be cautious about any processed or prepared food. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
88,"2018-04-19 03:07:46",Corticosteroids,"Corticosteroids Page Content Article BodyWhat are corticosteroids? If your child has asthma or allergic rhinitis (hay fever), your pediatrician may prescribe a corticosteroid, also commonly referred to as a steroid. These medicines are the best available to decrease the swelling and irritation (inflammation) that occurs with persistent asthma or allergy. They are not the same as the anabolic steroids that are used illegally by some athletes to build muscles. The medicine works in 2 ways. Systemic corticosteroids must go through the body to treat the inflammation. Inhaled or intranasal corticosteroids go directly to where the inflammation is. In general, corticosteroids are safe and work well if the medicine is taken as recommended by your pediatrician. However, as with all medicines, you should know about the possible side effects. There are far fewer risks with inhaled or intranasal corticosteroids than with the side effects of systemic corticosteroids because much less medicine is given. The amount of medicine given in a systemic corticosteroid can be 10 to 100 times more. Systemic Corticosteroids May be given for a short period if your child has a bad asthma attack. In some cases, these medicines can save lives. Form. Your child may take a pill, tablet, or liquid. Medicine may also be given by a shot or through the vein (IV). Side effects can include behavior change, increased appetite, acne, thrush (a yeast infection in the mouth), stomach upset, or trouble sleeping. These all go away when the medicine is stopped. More serious side effects can happen if this medicine is used often or for 2 weeks or longer. They include cataracts (clouding of the lens of the eye), weight gain, worsening of diabetes, bone thinning, slowing of growth, reduced ability to fight off infections, stomach ulcers, and high blood pressure. Inhaled Corticosteroids May be given to prevent or control asthma symptoms. Inflammation inside the bronchial tubes of the lungs is felt to be an important cause of asthma. Inhaled corticosteroids work by decreasing this inflammation. Inhaled corticosteroids are the most effective long-term medicine for the control and prevention of asthma. They can reduce asthma symptoms, and your child may not need to take as many other medicines. Inhaled corticosteroids also can improve sleep and activity and prevent asthma attacks. Form. Medicine is breathed in through an inhaler. Side effects are much less common and less serious than those that occur from long-term systemic use. They may include a yeast infection in the mouth or hoarseness. The risk can be reduced using a spacer or holding chamber, rinsing the mouth after use, or using the lowest dose needed. Intranasal Corticosteroids May be given to prevent or control a runny nose and congestion from allergies. Intranasal corticosteroids work very well in treating allergy symptoms, and your child may not need to take as many other allergy medicines. Form. Medicine is sprayed into the nose. Side effects may include irritation of the nose, or feeling that something is ""running down the throat"" at the time the nose spray is used. Occasionally, a child can have nosebleeds from using the spray. If this occurs, stopping the nose spray for a few days often allows the child to be able to restart the medicine and continue using it. Your Child's Growth Recent studies have shown that inhaled corticosteroids for asthma may slow down growth in some children during the first year of treatment, but this is only temporary. These children ended up with their normal expected heights as adults. To reduce the risk of any side effects, your pediatrician will prescribe the lowest dose needed to control the symptoms. Your child's height will also be measured regularly during office visits. Last Updated 11/21/2015 Source Inhaled and Intranasal Corticosteroids and Your Child (Copyright © 2006 American Academy of Pediatrics)"
89,"2018-04-19 03:07:52","Create an Allergy and Anaphylaxis Emergency Plan: AAP Report Explained","Create an Allergy and Anaphylaxis Emergency Plan: AAP Report Explained Page Content​​​By: Michael Pistiner, MD, MMSc, FAAPSevere allergic reactions are unpredictable—they can happen anywhere, anytime. Symptoms can even go away with treatment and come back later. Parents of children with severe allergies to certain foods, insect stings, latex, and medication know this all too well.  What's the Plan?In an effort to appropriately treat anaphylaxis—a potentially life-threating, severe allergic reaction—the American Academy of Pediatrics (AAP) developed the clinical report, Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan. The report explains to pediatricians and other health care providers how to create and use the new AAP Allergy and Anaphylaxis Emergency Plan. This new emergency care plan (ECP) is based on the most up to date and appropriate treatment of anaphylaxis. It's also clearly written and easy to understand. See for yourself! Download the AAP Allergy and Anaphylaxis Emergency Plan (PDF) here.  The plan also emphasizes the important role of epinephrine and de-emphasizes the role of antihistamines (e.g., Benadryl). It lists symptoms and clearly tells the caregiver or child when to use the epinephrine auto-injector. Allergy and anaphylaxis emergency plans are especially important to provide to schools and child care facilities. Anaphylaxis emergency care plan overview:   Includes simple criteria to identify potential allergic emergencies for use by patients, families, school staff, and all caregiversIs accessible and understandable to anyone caring for your child Given to school, child care, after school programs, or any place where others care for your childTrains others using your child's specific ECPWhen creating an ECP, it is also important to customize it to the specific needs of your child, allergies, family, and your state and local regulations. (Some may have their own forms already in place; you can encourage them to use this new one.)If in Doubt, Give Epinephrine! The AAP report also includes more evidence for why epinephrine is so important and safe and that delaying the use of epinephrine and relying on antihistamines is a bad idea! Epinephrine is the first line treatment for anaphylaxis, because it works quickly by delivering a dose of medicine directly into a child's muscle. The auto-injectors are especially ​​designed for easy use in non-medical settings. Delays in giving epinephrine for anaphylaxis can increase the risk of death, long hospitalization, and a second anaphylactic reaction called a biphasic reaction.Things to know about epinephrine: First-line treatment of choiceActs where it is neededWill make you feel betterFast acting Delays in administration increase risk of deathErr on the side of caution and give if any doubtSafe medicineAnyone caring for a child with an allergy that can be life threatening must know how to recognize anaphylaxis and know when and how to give the lifesaving treatment for severe allergic reactions. The AAP Allergy and Anaphylaxis Emergency Plan and clinical report were designed to help with this—wherever your child is and whomever is caring for him or her.Be Better Prepared for an Allergic Emergency: Together, these new AAP resources will help pediatric teams give families the information and written plans needed to ensure that they are ready to deal with an allergic emergency in any setting—school, child care, sports practice, play dates, etc. In situations when you are not with your child, these written plans will also arm nurses, teachers, coaches, parents, relatives, babysitters, etc. with the tools they need in the event of an emergency.If you already have an ECP, discuss this newly available one with your pediatrician.If you don't have an ECP, pass along this new resource to your pediatrician.Additional Information & Resources: Peanut Allergies: What You Should Know About the Latest Research How to Use an Epinephrine Auto-InjectorHealthy Children Radio: Helping Children with Food Allergies (Audio)Healthy Children Radio: Food Allergies in the Community (Audio)  Management of Food Allergy in the School Setting (AAP Clinical Report)  About Dr. Pistiner: Michael Pistiner, MD, MMSc, FAAP is a Boston based pediatric allergist for Atrius Health. He is a member of the American Academy of Pediatrics Section on Allergy and Immunology Executive Committee and has a special interest in food allergy and anaphylaxis education and advocacy. Dr. Pistiner is also the father of a child with food allergy and cofounder and content creator of AllergyHome.org, a free food allergy and anaphylaxis educational resource.​ Article Body Last Updated 2/13/2017 Source American Academy of Pediatrics (Copyright © 2017)"
90,"2018-04-19 03:07:55","Diagnosing Allergies","Diagnosing Allergies Page Content Article BodyDiagnosis follows an orderly process that starts with a careful medical history. Your pediatrician or allergy specialist will ask a lot of questions about your child’s symptoms and medical background, and about your family’s medical history as well. Does your child cough, wheeze, or get extra short of breath when she’s running or playing hard? Does your child cough a lot? Is the coughing worse at night? Is she wheezing? Does she have trouble breathing? Does her chest feel tight sometimes? What happens when she laughs or becomes upset? Does your child sneeze frequently? Does she rub her nose often? Does she blow her nose or wipe it a lot? Is the nasal discharge clear and runny? (A clear discharge is typical of allergic rhinitis, also called hay fever, the most common form of allergy) Or is it thick and greenish or yellowish? (A yellow or green color suggests that your child may have an infection, separate or possibly in addition to allergy symptoms.) Are her eyes itchy and watery? Does she have more than her share of colds? Do they last longer than a week? Does she ever have a rash or itchy bumps on the skin? How often does she have symptoms? How long do they last? Do particular events or exposures seem to bring on symptoms, or make them better or worse? Have the symptoms ever gotten better after your child has taken medicine? What kind of medication helped? Your pediatrician will ask whether your child’s symptoms often appear during a particular season of the year, at a certain location, or when your child is around animals, such as cats. Your pediatrician will also ask whether symptoms come on after your child has eaten a particular food. Your pediatrician will ask whether other members of the family have hay fever, asthma, or eczema because allergy and asthma run in families. However, even if you can’t recall a single relative who sneezes and wheezes, your doctor will not discount allergy and asthma in your child because, like many disorders, they can appear with no prior family history. Parents sometimes try over-the-counter medications before asking their pediatricians about a persistent cough, a rash, or respiratory symptoms. Although it’s recommended that you talk with your pediatrician before giving medications to your child, it’s helpful to tell the doctor whether a medication had any effect because this can give clues about the possible cause of symptoms. For example, if a runny nose and itchiness bothered your child less and she stopped sneezing for a while after taking an antihistamine, chances are she has an allergy and not an infection. Conversely, if her coughing and wheezing did not change after she took a dose of an over-the-counter medication, your pediatrician may decide to test or even go ahead and treat for asthma before looking for other underlying conditions. Symptoms: All in the Timing Allergy symptoms that come and go with the seasons may be caused by seasonal plants such as trees, grasses, and weeds. Coughing, sneezing, or other chest and nose symptoms that get much better when your child is away from home may indicate that your child is sensitive to substances normally found indoors, such as pets. By contrast, symptoms that always clear up on weekends and school vacations suggest that there may be a problem with something in the environment at school. Coughing at night with hoarseness and frequent throat clearing may be caused by postnasal drip from allergic rhinitis or sinusitis. But coughing, wheezing, and related symptoms that get worse at night may also raise suspicions about asthma because asthma symptoms are often worse at night. Your pediatrician may suspect exercise-induced asthma if your child frequently coughs or wheezes when running or playing energetically. Allergies Tend to Run in Families Many types of allergy problems, including hay fever, asthma, and eczema, tend to run in families. If both parents have allergies, each child has about a 60% to 70% chance of being allergic. However, allergic responses to insect venom, medications, and latex are the exceptions to the rule. Having a parent with one of these allergies does not increase the chance a child will be allergic. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
91,"2018-04-19 03:08:02","Diagnosing Asthma","Diagnosing Asthma Page Content Article BodyIt is often difficult, especially in young children, to be entirely certain that asthma is the diagnosis. After a careful physical examination, your pediatrician will need to ask you specific questions about your child’s health. The information you give your pediatrician will help determine if your child has asthma. Your pediatrician will need information about Your child’s symptoms, such as wheezing, coughing, and shortness of breath What triggers the symptoms or when the symptoms get worse Medications that were tried and if they helped Any family history of allergies or asthma It is very important that your pediatrician test your child’s airway function. One way to do this is with a pulmonary function test using a device called a spirometer. This device measures the amount of air blown out of the lungs over time. Your pediatrician may also want to test your child’s pulmonary function after giving her some asthma medication. This helps confirm that the blockage in the air passages that shows up on pulmonary function tests goes away with treatment. Some children do not find relief from their symptoms even after using medications. If that is your child, your pediatrician may want to test your child for other conditions that can make asthma worse. These conditions include allergic rhinitis (hayfever), sinusitis (sinus infection), and gastroesophageal reflux disease (the process that causes heartburn). It is important to remember that asthma is a complicated disease to diagnose, and the results of airway function testing may be normal even if your child has asthma. Also keep in mind that not all children with repeated episodes of wheezing have asthma. Some children are born with small lungs, and their air passages may get blocked by infections. As their lungs grow they no longer wheeze after an infection. This type of wheezing usually occurs in children without a family history of asthma and in children whose mothers smoked during pregnancy. Last Updated 11/21/2015 Source AAP Section on Allergy and Immunology (Copyright © 2003)"
92,"2018-04-19 03:08:10","Diagnosing Asthma in Babies & Toddlers","Diagnosing Asthma in Babies & Toddlers Page Content Article BodyOne of the difficulties of diagnosing asthma in babies and toddlers is that it’s not very easy to measure lung function in small children. So in trying to make a diagnosis, your pediatrician will rely heavily on your child’s symptoms and other information. Wheezing, Coughing, or Fast Breathing Your pediatrician will ask whether your baby tends to wheeze, cough, or breathe fast when he has a “cold,” is near animals, or is in a place that’s dusty or tainted by smoke. Make sure you tell your pediatrician about any excessive coughing that your child has, particularly nighttime cough and prolonged cough after a “cold,” even if there is no wheezing, because asthma can be present with coughing being the only symptom. Your Family's Medical History Your pediatrician will also ask whether you or other family members have asthma, hay fever, or eczema, or if there’s anyone in the family with recurrent bronchitis or sinus problems.When Asthma is Not the CauseYour pediatrician will listen carefully to make sure that the sounds your baby is making are coming from the airways of the lungs, and not from the baby’s voice box higher up in the throat or the nose. Sometimes babies breathe noisily as a result of laryngotracheomalacia, a temporary weakness in the cartilage near the vocal cords. They grow out of this as the tissues become firmer. If your baby starts wheezing after breathing in a foreign object (eg, a bit of food, a small toy) that has become lodged in a bronchial tube, he needs urgentmedical attention. Unusual conditions related to airway development or prematurity can also cause wheezing in infants. In general, an unexplained frequent cough or daily cough in infants may mean serious disease and should be evaluated by your pediatrician or pediatric pulmonologist.Growth & Development Your pediatrician will check to make sure your baby is maintaining a satisfactory rate of growth and development. Most infants with asthma make good progress and are otherwise healthy. If your pediatrician is concerned that your baby may be growing too slowly or failing to thrive, tests for conditions other than asthma will be ordered. Certain tests, including a sweat test to rule out cystic fibrosis, may be necessary when your doctor wants to be sure your baby’s wheezing and chest symptoms are not caused by a condition with symptoms that are similar to asthma.Chest RadiographsChest radiographs may be ordered during your baby’s first wheezing bout to make sure that there isn’t a problem in the lungs. If asthma is diagnosed, repeated radiographs are rarely needed because the problem is in the bronchial tubes, which cannot be seen very well in radiographs. Allergy Testing Your pediatrician is not likely to recommend allergy testing right away for your baby unless you suspect that wheezing always occurs after your child has been around a certain item, like an animal, or consumed a certain food. However, keep in mind that food allergy is rarely a cause of asthma in infants and toddlers, although it may be a trigger for eczema.Asthma Medications & Treatment Sometimes the easiest and best way to diagnose asthma in a young child is to treat with asthma therapy and see if the child improves. This is because for the most part, medications for asthma only help asthma and not other conditions. If improvement is seen, asthma is the likely diagnosis. If this approach is taken with your child, help your pediatrician by monitoring your child’s symptoms carefully so you can give good feedback as to whether the medications have helped. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
93,"2018-04-19 03:08:16","Dust Mite Control: Tips for Parents","Dust Mite Control: Tips for Parents Page ContentWhen you know that dust mites are among the causes of your child’s allergic symptoms, you may want to reach for the vacuum cleaner every time you spy a trace of dust on the furniture. Why Vacuuming May Not Be the Solution:Use of a normally efficient vacuum cleaner stirs up clouds of fine dust that can hang about in the air for up to 8 hours and make sneezing, runny nose, and itchiness worse. It’s best to wait until your allergic child is out of the house—at school for the day, for example—before vacuuming. Or to avoid stirring up dust, invest in a vacuum cleaner with a high-efficiency particulate air (HEPA) filter. To keep household dust levels down:Clean all non-carpeted floors at least once a week with a damp mop.Use a damp cloth to wipe flat surfaces, louver blinds, window ledges, and picture frames.​Air-conditioning and keeping doors and windows closed are effective ways to keep your home free of allergens and irritants brought in by air from the outside. While it may be too costly to install air-conditioning throughout your home, you may find an economical way to install a unit in your allergic child’s bedroom. This could help your child sleep better at night and provide a low-allergen retreat on days when the pollen count is high. Air-conditioner filters should be checked and cleaned regularly, and sprayed with an anti-mildew aerosol to control the growth of molds.Families may find their allergic members have fewer symptoms when room air is filtered through a HEPA air cleaner. However, air filtration should complement, not replace, measures to control mites. In fact, air cleaners do not significantly reduce mite exposure and should not be recommended for dust mite control. A HEPA air cleaner can be installed centrally in a forced-air ventilation system, or used as a portable room unit and left on at night in your child’s bedroom (see below). When you run a room HEPA cleaning unit, make sure the windows of the room are shut and the bedroom door is closed.Dust Mites to Dust:Dust mites are the main source of allergens in house dust. It’s difficult for many people who are allergic to accept that these creatures, invisible except under a microscope, can be present in large numbers even in a thoroughly cleaned home. Some are convinced only when symptoms improve as a result of mite-containment measures.Dust mites are members of the same family as spiders. Too small to be seen with the naked eye, they find a home wherever humans live. Dust mites don’t ask for much in life. They feed on any protein that comes their way and find easy pickings in the dead skin scales that humans shed every day. Apart from this simple diet, they need only a moderately warm, moist atmosphere, with a temperature of 65°F or higher and humidity around 65%. Bedding is the ideal dust mite home; after all, bedding offers warmth, sufficient moisture, plenty of skin, and fibrous materials to which dust mites can cling with their barbed legs. They also thrive in upholstered furniture, clothing, soft toys, and carpets.The dust mite eats and excretes pellets of feces that are about the size of pollen grains, and finds other dust mites, with which it produces many offspring. Their fecal pellets enter the general household dust to become the main source of allergens. Eventually, as mites die off, their dried-out carcasses, composed of allergenic proteins, also join the dust. Over years, they can add many pounds to the weight of a mattress.Keep Humidity Low to Discourage Mites:Dust mites flourish when the humidity is around 75% to 80%. These tiny cousins of spiders need water to survive but have no means of conserving it in their tissues. When the surrounding humidity falls below 50%, mites soon shrivel up and die. Thus, reducing household humidity can drastically reduce the dust mite population. A dehumidifier is useful for drying out the air. Take care to empty the water pan daily and scour it to stop the growth of microscopic molds.Humidifier Use Can Promote Growth of Mites and Molds:Any increase in humidity, such as when a humidifier is used, will encourage mites and molds to grow in your child’s room. If your child has problems with croup or other breathing difficulties, ask your pediatrician’s advice about the best way to ensure that the air in the bedroom is moist enough to breathe comfortably but dry enough to discourage mites and molds.Additional Information from HealthyChildren.org:Hay Fever Triggers: Tips for ParentsAsthma Triggers and What to do About Them​Cleaners, Sanitizers & DisinfectantsEnvironmental HazardsMake Baby's Room Safe Article Body Last Updated 1/6/2011 Source Allergies and Asthma: What Every Parent Needs to Know (Copyright © 2010 American Academy of Pediatrics)"
94,"2018-04-19 03:08:19","Exercise and Asthma","Exercise and Asthma Page Content Article BodyAlmost every child (and adult) with asthma can benefit from sports and physical activity. Also, asthma should not prevent young athletes from enjoying a full athletic career. The following is information from the American Academy of Pediatrics about asthma and exercise. What is asthma Asthma is the most common chronic medical problem in children. Children with asthma can have different symptoms at different times. The most common problems are cough, wheeze, difficulty breathing, chest “tightness,” and chest pain. Almost all children with asthma will have one or more of these symptoms when they have a cold or with exercise.   Many symptoms are brought on with allergies or exposure to cigarette smoke, laughing, or crying. Most children with asthma have symptoms while they exercise or right after they exercise. Children with asthma symptoms only with exercise may have exercise-induced asthma. What causes asthma? The cause of asthma is unknown. Genetics may play a role—children are more likely to have asthma if other people in the family have asthma. However, many children with no family history of asthma have asthma. Asthma is also more common in children with allergies. However, some children with allergies do not have asthma and some children with asthma do not have allergies. Exposure to secondhand cigarette smoke or pollutants makes children more likely to develop asthma. How does exercise cause asthma symptoms? The symptoms of asthma are caused by narrowing of the small bronchial tubes in the lung. The narrowing is caused by inflammation and swelling within these tubes and by spasm of the muscles in the bronchial walls. It is unknown why exercise causes airways to narrow. In general, exercise-induced asthma is most likely to occur with endurance exercise in cool, dry air. However, there are exceptions, including exercising in warm humid air with a lot of pollutants or in swimming in a poorly ventilated space with strong chlorine fumes. How can you prevent exercise-induced asthma? The first thing to do to prevent asthma symptoms with exercise is to make sure that the asthma unrelated to exercise is well controlled. For many children this means the regular use of inhaled steroid medicines and use of medicines before exercise. Ask your child’s doctor about what medicine is best for your child and make sure your child learns the proper technique for using an inhaler. If the asthma is well controlled but your child still has problems during or after exercise, let your child’s doctor know. The following are other ways that may help prevent exercise-induced asthma: When exercising in the cold, wrap a scarf or mask around the face to warm up and humidify the air. Avoid exercise in the early morning or try exercising inside. Increase fitness level (exercise-induced asthma symptoms improve as fitness improves). Try a different sport or cross-training. Do a short warm-up exercise before the main exercise session. Warning: If a child still has symptoms even with treatment, the exercise bout should be stopped. Asthma can be life-threatening if the athlete tries to play through the symptoms. Once the symptoms are controlled, the child can return to exercise. What problems can “look like” asthma? Probably the most common situation that is mistaken for exercise-induced asthma is that a child is not in very good athletic shape. It is normal for all of us to breathe harder when we exercise, and this is especially true for someone who isn’t very active. Sometimes this normal heavy breathing can be mistaken for asthma. The good news is that it’s easy to “cure” this problem by doing more exercise! In athletes, another problem called vocal cord dysfunction (VCD) can occur, and seems a lot like exercise-induced asthma. The vocal cords are located in the throat, at the opening to our trachea (windpipe), not in our lungs. They help us form words by opening and closing to let different amounts of air out of the lungs. In VCD, the vocal cords close when they are supposed to open, making it harder to breathe in air. Signs of VCD include a high-pitched noise while breathing in, breathing too fast, and a “tight” feeling in the throat. It can be very difficult to distinguish VCD from asthma and may require referral to an asthma specialist or ear, nose, and throat specialist. Last Updated 11/21/2015 Source Care of the Young Athlete Patient Education Handouts (Copyright © 2011 American Academy of Pediatrics)"
95,"2018-04-19 03:08:25","Hay Fever Triggers: Tips for Parents","Hay Fever Triggers: Tips for Parents Page Content Article BodyPollens and Outdoor MoldsAs with other types of allergies, the ideal way to manage hay fever is to find out what your child is allergic to and then avoid it. It sounds simple, but this is much easier said than done. To start with, many children are allergic to pollens and molds, both of which are found everywhere outdoors and cannot be completely avoided. Children need to go outside to play, so pollen exposure when outdoors is unavoidable. What Parents Can Do: ​Exposure to outdoor pollen and mold that enters the house can be decreased by closing windows and using air conditioning, showering and changing clothes as soon as children come inside at the end of the day, and by making sure bedding is dried in a dryer, not outside on a clothes line.Dust Mites and Indoor MoldsIn addition to outdoor allergens, a child may be allergic to routinely encountered indoor substances such as dust mites or indoor molds. These everyday allergens can be kept at low levels when certain changes are made. Still, they are almost impossible to eliminate altogether, no matter how carefully you clean your home. Your child is also bound to run into indoor allergens and irritants when he ventures away from home and into other environments, such as school or friends’ homes.Dust had a reputation for causing sneezing and irritation long before allergies were called allergies. Not only does it irritate the nose, throat, and eyes, but it can also contain allergenic materials. A major cause of allergic symptoms lies beyond the dust itself. It has been traced to dust mites—tiny creatures that, like Dr Seuss’ Whos down in Whoville, make their homes among dust specks. But whereas the Whos asked only to be left in peace, there’s no getting away from dust mites. They live wherever humans live; in fact, they clean up after us. They can live on any organic debris, but their preferred diet is the half gram or so of worn-out skin cells that every human sheds daily. They a​lso thrive on tiny fungi—like the mites, too small to be seen with the naked eye—that flourish where the relative humidity is fairly high, at 70% or more. Spores from these fungi are a major cause of allergic symptoms in humans.Dust mites congregate where food is plentiful. They are especially numerous in beds, pillows, upholstered furniture, and rugs. Although vacuuming and dusting can help decrease dust levels inside the home, these measures don’t work very well against dust mites. As gross as it is, your child is actually allergic to a protein in dust mite feces. So steps are taken to kill dust mites and to use a containment approach to avoid mites’ feces. Padded furnishings such as mattresses, box springs, pillows, and cushions should be encased in allergen-proof, zip-up covers, which are available through catalogs and specialized retailers. Covers made of nonwoven synthetic fabrics are more comfortable than plastic covers and work at least as well. The microscopic dust mite fecal particles are too large to pass thorough allergy-proof covers.What Parents Can Do:  Choose blankets and pillows made of synthetic materials. Because dust mites can survive in warm soapy water, wash linens weekly and other bedding, such as blankets, every 2 to 3 weeks in hot water, then put them through the hottest cycle of a clothes dryer. Pillows should be replaced every 2 or 3 years. Dust mites also abound in cuddly stuffed toys. When possible, replace soft, plush-covered toys with others that have smooth plastic bodies and washable clothes. If your child has a favorite soft toy from which she can’t be parted, wash it every other day or so in hot water and dry it at the highest setting. Or seal soft toys in plastic bags and put them in the freezer for at least 5 hours or overnight once a week. Dust mites cannot survive longer than 5 hours at freezing temperature; you can then rinse the toys in warm water and put them in the dryer to get rid of the dead mites. These steps will not necessarily remove all of the allergenic dust mite feces, but they help! Keep bulky fabrics and dust-catching clutter out of your child’s room. Remove wall-to-wall carpeting, if possible. Floors should be wooden, tile, or vinyl—anything but carpet. Damp mopping and electrostatic floor mops are helpful for clean up. If you prefer rugs for comfort, use small cotton or synthetic throw rugs that can be washed weekly in hot water. Curtains should be easily washable. When it comes to the walls, the aim is to eliminate horizontal surfaces that trap dust. There should be no picture frames or shelves displaying books or ornaments, and all surfaces—on dressers, bedside tables, and other furniture—should be easy to wipe clean. Avoid humidifiers and vaporizers. Dust mites need humidity to live, and humidification will only further help the mite population grow. For the same reason, using a dehumidifier in certain moist geographical locations can be beneficial by helping to keep the humidity below the range that suits mites and molds. However, if you use a dehumidifier, it’s essential not only to empty the water pan but also to scour it daily to prevent the growth of invisiblesome airborne allergens but are not generally useful for dust mites. No matter how careful you may be, you can’t protect a child as if she were a hothouse plant. And even if you were to succeed in eliminating most environmental allergens in your home, children still get exposed at school and at playmates’ homes. Furthermore, it’s hard to avoid the normally harmless kinds of nonallergenic irritants that can set off symptoms in a nose already primed and twitchy from allergen exposure. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
96,"2018-04-19 03:08:32","Healthy Children Radio: Cold vs Allergies","Healthy Children Radio: Cold vs Allergies Page Content Article BodyIt's sometimes difficult to know whether the problem is allergies or a common cold. The diagnosis is often made when parents seek their pediatrician's advice for a lingering cold that their child can't shake. Pediatrician David Hill, MD, FAAP, comes on the Healthy Children radio to talk about a few, telling differences. Segment 1: Is It a Cold or Allergies Last Updated 1/22/2016 Source American Academy of Pediatrics (Copyright © 2013)"
97,"2018-04-19 03:08:37","HealthyChildren Radio: Asthma","HealthyChildren Radio: Asthma Page Content Article Body​In recent years, research into the diagnosis and treatment of childhood asthma has made a real difference in the control of asthma among children. Asthma is the most common lasting disorder in childhood, currently affecting around 6.2 million Americans under 18 years of age. Pediatrician Chitra Dinakar, MD, a specialist in asthma, allergies and immunology, comes on the Healthy Children Radio show on RadioMD to talk about diagnosis, severity, and treatments. Segment 1: Asthma 101: Grading the Severity of this Disease   Segment 2: Asthma Medications: Are They Safe For Your Child?   Segment 3: Exercise and Asthma: Are They Compatible? Last Updated 1/23/2016 Source American Academy of Pediatrics (Copyright © 2013)"
98,"2018-04-19 03:08:42","Indoor Allergies","Indoor Allergies Page Content Article Body1 in 6 kids suffers from indoor allergies, such as allergies to dust, mold, or animal dander. Replacing air duct filters once a month, sweeping and vacuuming regularly, and avoiding wall to wall carpeting can help reduce your child's reaction to these allergens. Click here to listen Last Updated 1/23/2016 Source A Minute for Kids"
99,"2018-04-19 03:08:49","Is It Allergies or a Cold? How to Tell the Difference","Is It Allergies or a Cold? How to Tell the Difference Page Content Article BodyIt’s sometimes difficult to know whether the problem is hay fever or a common cold (upper respiratory infection). The diagnosis is often made when parents seek their pediatrician’s advice for a lingering “cold” that their child can’t shake. While symptoms of allergies and colds often overlap, there are a few telling differences. The tip-offs for hay fever are A clear, watery nasal discharge Itching of the eyes, ears, nose, or mouth Spasmodic sneezing Fever is never from an allergy; it almost always suggests an infection. Antibiotics will not help allergies or a common cold from a virus. Colds or allergies can sometimes lead to ear or sinus infections; when this happens, antibiotics can be helpful. With a cold, nasal secretions are often thicker than in allergy and can be discolored (as compared with the clear, watery discharge of allergies). The child who has a cold may have a sore throat and a cough, and the child’s temperature is sometimes slightly raised but not always. Itchiness is not usually a complaint with a cold, but it is the hallmark of an allergy problem. A plain old cold usually doesn’t last much more than several days before it starts to get better and go away; allergy symptoms can go on for weeks to months. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
100,"2018-04-19 03:08:58","Managing Asthma","Managing Asthma Page Content Article BodyDevices to Help Deliver Asthma Medications Medications for asthma can be given to your child using a variety of devices including the following: Nebulizer—This is often used with younger children. This device uses an air compressor and cup to change liquid medication into a mist that can be inhaled through a mouthpiece or mask. Inhaled steroids and quick-relief medications can be given this way. Metered-dose inhaler (MDI)—This is the most commonly used device for asthma medications. However, your child will need to learn how to use it properly, which means pressing (or actuating) the device while taking a deep breath at the same time. The technique is reviewed on the following pages. Some MDIs are “breath actuated,” that is, they give out a puff of medication when you start to take a breath. These types of MDIs are much easier to use, but are only available for one type of quick-relief medication. Spacers can be used to help relieve some of the coordination problems in using MDIs and should always be used when using inhaled steroids. Dry powder inhaler (DPI)—This device is available for some medications. It is easier to use because you do not need to coordinate breathing with actuation. It also has less taste, and often has a built-in counter to help keep track of doses taken and doses left. Some asthma medications only come in pill form. However, inhaling the medication using one of the devices listed above is usually better because the medication passes straight into the airways. As a result, side effects are reduced or avoided altogether. Because there are several different inhalers on the market, your health care provider will suggest the one that is best for your child. There are important differences in the way they are used and in the amounts of medications they deliver to the airways. Your child will be taught how to use the inhaler, but her technique should be checked regularly to make sure she is getting the right dose of medication. Peak Flow Meter To help control asthma, your child may need to use a peak flow meter. This is a handheld device that measures how fast a person can blow air out of the lungs. Asthma treatment plans using peak flow meters use 3 zones—green, yellow, and red, like traffic lights—to help you determine if your child’s asthma is getting better or worse. Peak flow rates decrease (the numbers on the scale go down) when your child’s asthma is getting worse or is out of control. Peak flow rates increase (the numbers on the scale go up) when the asthma treatment is working and the airways are opening up. When to Use the Peak Flow Meter Check your child’s asthma using the peak flow meter at the following times: Every morning, before he takes any medications. If your child’s symptoms worsen or if he has an asthma attack. Check the peak flow rate before and after using medications for the attack. This will help you to see if the medications are working. Other times during the day, if your health care provider suggests. Keep in mind, there are differences in peak flow rate measurements at different times of the day. These differences are minimal when asthma is well controlled. Increasing differences may be an early sign of worsening asthma. Also, children of different sizes and ages have different peak flow rate measurements. Keep a record of your child’s peak flow numbers each day. This will help you and your health care provider see how your child’s asthma is doing. Bring this record with you when you visit the pediatrician. Last Updated 11/21/2015 Source AAP Section on Allergy and Immunology (Copyright © 2003)"