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101,3,"2018-04-19 02:48:19","Allergies & Asthma",101,"2018-04-19 03:09:04","Medications Used to Treat Asthma in Children","Medications Used to Treat Asthma in Children Page Content Article BodyThe goals of treatment for asthma are to minimize symptoms and allow children to participate in normal physical activities with minimum side effects. It is also important to prevent emergency department visits and hospitalizations due to asthma attacks. Ideally, this means a child should not experience asthma symptoms more than once or twice per week, asthma symptoms should not wake a child at night more than twice per month, and a child should be able to participate in all play, sports, and physical education activities.Asthma medications come in a variety of forms, including the following: Metered-dose inhalers Dry powder inhalers Liquids that can be used in nebulizers Pills Injectable medications Note: Inhaled forms are preferred because they deliver the medication directly to the air passages with minimal side effects.Types of Asthma MedicationsAsthma is different in every patient, and symptoms can change over time. The child's doctor will determine which asthma medication is best based on the severity and frequency of symptoms and the child's age. Children with asthma s​ymptoms that occur only occasionally are given medications only for short periods. Children with asthma whose symptoms occur more often may need a controller medication based on the severity and frequency of symptoms and their age.Sometimes, it is necessary to take several medications at the same time to control and prevent symptoms. The child's doctor may give several medications at first, to get the asthma symptoms under control, and then decrease the medications as needed. They may also recommend a peak flow meter for a child to use at home to monitor lung function. This can help parents and caregivers make decisions about changing therapy or following the effects of changes made by the doctor.Asthma medications are divided into 2 groups: quick-relief medications and controller medications.Quick-Relief Medications Quick-relief medications are for short-term use to open up narrowed airways and help relieve the feeling of tightness in the chest, wheezing, and breathlessness. They can also be used to prevent exercise-induced asthma. These medications are taken only on an as-needed basis. The most common quick-relief medication is albuterol.Controller Medications Controller medications are used on a daily basis to control asthma and reduce the number of days or nights that your child has symptoms. Controller medications are not used for relief of symptoms. Children with symptoms more than twice per week or who wake up more than twice per month should be on controller medications. The number and severity of asthma attacks also determine whether a controller medication is needed. Controller medications include the following: Inhaled steroids Combination products that contain inhaled steroids and long-acting bronchodilators Leukotriene receptor antagonists (only available in pill form) Inhaled nonsteroids (e.g., cromolyn or nedocromil) Methylxanthines (e.g., theophylline) Omalizumab injection ​Inhaled corticosteroids are the preferred controller medication for all ages. When used in the recommended doses, they are safe for most children. However, the child's doctor may recommend another type of controller medication based on the specific needs of the child.Asthma Action PlanAll people with asthma should have an asthma action plan (or asthma management plan). The plan shows the child's treatment information, such as what kind of medicines to take and when to take them. It also describes how to control asthma long term and how to handle an asthma attack. Additionally, the plan explains when to call the child's doctor or go to the emergency room.All of the people who care a child should know about the child's asthma action plan. These include family members, child care providers, schools, camps, team coaches, and instructors. In an emergency, these people can help the child follow their asthma action plan. The Centers for Disease Control and Prevention (CDC) provides easy-to-use examples and forms. Click here to learn more. Additional Information Asthma Management at School Asthma Triggers and What to do About Them Asthma Inhalers Managing Asthma​​ Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2015)"
102,3,"2018-04-19 02:48:19","Allergies & Asthma",102,"2018-04-19 03:09:12","Mild, Moderate, Severe Asthma: What Do Grades Mean?","Mild, Moderate, Severe Asthma: What Do Grades Mean? Page Content Article BodyAfter confirming an asthma diagnosis, your pediatrician will grade the severity of your child’s condition. This grading takes into account the frequency and severity of past and current asthma symptoms and the physical examination, and may include measures of lung function including spirometry or peak flow measurements. This information enables your pediatrician to select the right medication and determine the proper dose to keep the condition in check. (See “What Really Matters Is Control, Not Severity” below.) In making a decision about a child’s asthma severity level, the first distinction to be made is whether your child has intermittent asthma (ie, just occasional problems) or persistent asthma (ie, more than occasional). Patients with persistent asthma can have mild, moderate, or severe asthma. Following are more details about the 4 asthma severity levels that arise by making this kind of distinction. What Really Matters Is Control, Not Severity It turns out that asthma severity categories are somewhat arbitrary and, in fact, were actually created more with adults in mind than children. They are just a general guide for the doctor seeing your child; your doctor realizes that asthma severity levels, particularly in children, can change over time, so reassessments need to take place on an ongoing basis to verify an individual child’s present asthma severity. Furthermore, the 2007 National Heart, Lung, and Blood Institute “National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma” make a strong point that the overall control of your child’s asthma is really what is most important, not what the severity level happens to be at any time. Adjustments of treatment are based mainly on how well-controlled your child’s asthma is when assessed at follow-up visits. Intermittent Asthma A child who has symptoms of wheezing and coughing no more than 2 days a week is con-sidered to have intermittent asthma; nighttime flare-ups occur twice a month at most. Outside of these few episodes, a child with intermittent asthma is free of asthma symptoms. Any child with asthma symptoms more often than 2 days a week or 2 nights per month, on average, is felt to no longer have intermittent asthma but persistent asthma. Persistent asthma has 3 levels of severity. Mild Persistent Asthma In mild persistent asthma, symptoms occur more than twice a week but less than once a day, and flare-ups may affect activity. Nighttime flare-ups occur more often than twice a month but less than once a week. Lung function is 80% of normal or greater. Moderate Persistent Asthma Asthma is classified as moderate persistent if symptoms occur daily. Flare-ups occur and usually last several days. Coughing and wheezing may disrupt the child’s normal activities and make it difficult to sleep. Nighttime flare-ups may occur more than once a week. In moderate persistent asthma, lung function is roughly between 60% and 80% of normal, without treatment. Severe Persistent Asthma With severe persistent asthma, symptoms occur daily and often. They also frequently curtail the child’s activities or disrupt his sleep. Lung function is less than 60% of the normal level without treatment. Severe is the least-common asthma level. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
103,3,"2018-04-19 02:48:19","Allergies & Asthma",103,"2018-04-19 03:09:20","Nickel Allergy: Electronic Devices & Food Can Cause Rash","Nickel Allergy: Electronic Devices & Food Can Cause Rash Page ContentIf your child complains of an itchy rash after wearing a belt with a buckle or jeans with a metal button, she might be allergic to nickel. The metal is used in clothes and jewelry and also can be found in cellphones, tablets, and even food. Regardless of whether your child wears an item made with nickel or eats food containing nickel, the allergic reaction is the same. Symptoms include an itchy rash on the skin with redness, scaling and possibly a crusty appearance. Called nickel-allergic contact dermatitis, the allergy affects about 11 million children. Symptoms appear hours to days after exposure to a product containing nickel. A rash can appear on the area of the skin exposed to nickel, or it can be more widespread, according to a study from the American Academy of Pediatrics' journal Pediatrics. Contact your pediatrician if you suspect your child has an allergy to nickel. Your doctor might suggest using an ointment or antihistamine.If your child has a nickel allergy, take these precautions to avoid future reactions: Look for belts, watches and jewelry that are labeled ""nickel-free,"" or buy items that are hypoallergenic or made from surgical-grade stainless steel, gold, silver, or platinum.Use clear nail polish to coat the metal on parts that touch the skin. Buy a case for your tablet or phone that covers the parts made of metal.Avoid foods containing nickel, including chocolate and cocoa powder, nuts, soy products, black tea, seeds, and commercial salad dressings. Avoid eating canned food, and avoid cooking acidic foods like tomato, vinegar, or lemon in stainless steel cookware. Run tap water for a few seconds before washing, drinking, and cooking to help flush out any nickel that leaches from pipes and fixtures. Additional Information: Rashes and Skin ConditionsAllergy Medicine for ChildrenAllergy Causes in Children: What Parents Can Do​ Article Body Last Updated 2/29/2016 Source AAP News (Copyright © 2016 American Academy of Pediatrics)"
104,3,"2018-04-19 02:48:19","Allergies & Asthma",104,"2018-04-19 03:09:27","Peak Flow Meter","Peak Flow Meter Page Content Article BodyA peak flow meter (or, rarely, a small electronic portable spirometer) is sometimes recommended as part of a treatment plan. These handheld devices measure how fast a person can blow air out of the lungs. Asthma causes patients to not be able to blow air out fast because their airways are narrowed, so a low measurement with this device suggests problems are occurring with your child’s asthma. These measurements can help warn a patient or parent that extra medication is needed to fend off more severe asthma symptoms. The results can also be useful for the patient who does not adequately perceive worsening airway obstruction or who has difficulty distinguishing anxiety or hyperventilation attacks from asthma. When your child is having asthma problems, a peak flow reading puts a number on how she is doing, much as a thermometer shows how high a temperature is. Your pediatrician or asthma specialist will show you how to record your child’s baseline measurements at a time when she is doing well with her asthma. This is referred to as her “personal best.” When your child’s asthma is not doing well or is at risk of flaring up (eg, during a “cold”), a peak flow reading can be obtained and the value compared to the child’s personal best. Using a simple range of color zones—green, yellow, and red, like traffic lights—specific recommendations can be spelled out as to what needs to be done to prevent a full-blown asthma attack based on what color zone the patient falls into with her peak flow measurement. How to Use a Peak Flow Meter Your child’s peak flow–based asthma treatment plan uses his own personal best peak flow reading because every child is unique. Your child’s peak flow may be higher or lower than that of another child even though their age, sex, and height are identical. To find your child’s personal best, your pediatrician will instruct him to use the peak flow meter at the same time every day for 2 to 3 weeks during a period when he doesn’t have any symptoms and asthma is under good control. To obtain a peak flow measurement, have your child do the following: Stand up. Place the peak flow device indicator at 0. Take a deep breath, then place the device well in to the mouth. Close his lips around the mouthpiece and keep his tongue clear of the opening. Blow once as hard and fast as he can. Note the reading. Repeat steps 2 through 5 twice more and write down the highest score. After your child has established his personal best your doctor may ask him to use the meter for readings when he is beginning to have symptoms, or when he has a “cold” (a time when asthma commonly gets worse). The doctor may also ask you to monitor his peak flow when adjustments have been made to his medication program, whether it be up or down, to detect any change in asthma control. Starting at about age 4 or 5 years, your child can learn how to use a peak flow meter. The following color zone system is commonly used with peak flow monitoring: Green means that the airflow score is at 80% to 100% of your child’s personal best peak flow (the targeted peak flow value determined by your child’s pediatrician); his medications don’t need to be adjusted and he may continue full activity. Yellow means caution, just as it does on the road with a traffic light; airflow is between 50% and 80% of your child’s personal best and certain additional asthma medications should be started or increased to ward off symptoms. Red means danger; your child’s score is less than 50% of his peak flow. Have your child take his quick-relief medications (usually a bronchodilator at a high dose to open up the airways and steroid pills or liquid to calm inflammation) if it is part of the asthma action plan worked out between you and your pediatrician or asthma specialist. Call or see your physician soon, or go for emergency care, if the peak flow reading stays below 50% despite the treatment. The peak flow meter provides one way to measure asthma objectively, but it’s critical that the child and everyone else in the family not rely on just a peak flow number for assessment of how a child’s asthma is doing. Symptoms are as important, probably even more important, than a peak flow reading. It is not uncommon for symptoms to detect a flare-up of asthma even before peak flow measurements do. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
105,3,"2018-04-19 02:48:19","Allergies & Asthma",105,"2018-04-19 03:09:32","Peanut Allergies: What You Should Know About the Latest Research & Guidelines","Peanut Allergies: What You Should Know About the Latest Research & Guidelines Page Content​​By: Claire McCarthy, MD, FAAP​When I was growing up, peanut butter and jelly sandwiches were really common in the school lunchroom. These days, most parents wouldn't even think of sending one. We've moved from peanut-free lunch tables to peanut-free schools—and many camps and afterschool programs have banned anything peanut too.They do it to save lives. Not only has the prevalence of peanut allergy doubled in Western countries over the past 10 years, it is the leading cause of food allergy related death in the United States.Finally we may have an answer, and it is the simplest answer of all: eating peanuts. Not actual peanuts—they are a serious choking hazard—but things made from peanuts, like peanut butter.  Previous Recommendations:For many years, experts thought that the best way to fight peanut allergy was to avoid peanut products in the first years of life—that's why in 2000 the American Academy of Pediatrics (AAP) recommended that any child at high risk of peanut allergy (like those with a family history of it, or with other food allergies, or eczema) not eat any before they turned 3. But that didn't help, which is why in 2008 the AAP stopped recommending it.New Research on Peanut Allergies: Around this time, researchers in the UK noticed something interesting: peanut allergy in Jewish children living in the UK was about 10 times more common than it was in Jewish children living in Israel. Since these children shared a similar ancestry, the difference had to be something that they were doing.It turned out there was a big diet difference. Children in the UK rarely ate peanut products in the first year or so of life—whereas children in Israel commonly ate a snack called Bamba, a corn puff made with peanut butter. The researchers wondered: Could this be the important difference—that the Israeli children ate peanut products from an early age?So they tested it. They did a study on about 600 babies who had severe eczema or egg allergy, which are known to increase the risk of peanut allergies. They divided them up into two groups: one was given Bamba to eat regularly (if they didn't like Bamba, they could eat smooth peanut butter), and the other was told to stay away from foods containing peanuts. They did this until the children were 5 years old.At 5 years, only 3 percent of the kids who ate peanut products were allergic to them—compared with 17 percent of those who didn't eat peanuts. This included children who tested positive for a peanut allergy as infants (those with strong positive tests, however, were not included in the study).This is huge, amazing news.New Guidelines on the Introduction of Peanut Products​Since this news, the National Institute of Allergy and Infectious Diseases has come out with guidelines to help pediatricians and parents understand and use this news—and do it safely. The guidelines divide babies into three groups: those with severe eczema (persistent or recurrent eczema who need prescription creams frequently) and/or egg allergy, those with mild to moderate eczema, and those who don't have any eczema or food allergy. For the first group, those with severe eczema and/or egg allergy, testing for peanut allergy is recommended—and parents should talk with their doctors about how and when to give peanut products. If testing shows an allergy, it may be a good idea to do that first taste of peanut product in the doctor's office. Parents of babies in this group should talk to their doctor early, like at the 2 or 4-month checkup, because the recommendation is that these babies should get peanut products between 4 and 6 months. There is no testing needed for babies with mild to moderate eczema, although they should still talk with their doctors about their child's situation and needs. These babies should try peanut products at around 6 months of age. The babies who don't have any eczema or food allergy can have peanut products along with other foods based on their family's preferences and cultural practices. It's not so important to do it early, but it's fine if parents do. It's very important that parents not give babies whole peanuts or chunks of them (or chunky peanut butter) because babies could choke. Smooth peanut butter mixed into a puree is better, as are snacks or foods made with peanut butter. We don't know if this will work for other food allergies, so if there are other allergies you are looking to prevent, talk to your doctor. ​​Additional Information & Resources: Ask the Pediatrician: When can I start giving my baby peanut butter? ​Diagnosing Food Allergies in ChildrenAvoid a Food Allergy Scare on HalloweenManagement of Food Allergy in the School Setting (AAP Clinical Report)​Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectio​us Diseases-Sponsored Expert Panel (AAP-Endorsed Guidelines)​​About Dr. McCarthy:Claire McCarthy, MD, FAAP is a primary care pediatrician at Boston Children's Hospital, an Assistant Professor of Pediatrics at Harvard Medical School, a senior editor for Harvard Health Publications, and an official spokesperson for the American Academy of Pediatrics. Along with serving on the HealthyChildren.org Editorial Advisory Board, she writes about health and parenting for Boston.com and Huffington Post. ​ Article Body Author Claire McCarthy, MD, FAAP​ Last Updated 2/6/2017 Source American Academy of Pediatrics (Copyright © 2015)"
106,3,"2018-04-19 02:48:19","Allergies & Asthma",106,"2018-04-19 03:09:37","Seasonal Allergies in Children","Seasonal Allergies in Children Page Content Article BodyEvery fall, 5-year-old Timmy develops a runny nose, itchy, puffy eyes, and attacks of sneezing. His mother shares the problem, which she dismisses as mild hay fever, and something her son has to learn to live with. Lately, however, Timmy has also suffered attacks of wheezing and shortness of breath when he visits his grandmother and plays with her cats. Timmy’s pediatrician suspects allergic asthma, and wants him to undergo some tests. Timmy’s symptoms are by no means rare among children across the United States. Allergies and asthma often start in childhood and continue throughout life. Although neither can be cured, with proper care they can usually be kept under control. Allergies are caused by the body’s reaction to substances called “allergens,” which trigger the immune system to react to harmless substances as though they were attacking the body. When to Suspect an Allergy Some allergies are easy to identify by the pattern of symptoms that follows exposure to a particular substance. But others are subtler, and may masquerade as other conditions. Here are some common clues that could lead you to suspect your child may have an allergy. Repeated or chronic cold-like symptoms that last more than a week or two, or that develop at about the same time every year. These could include: Runny nose Nasal stuffiness Sneezing Throat clearing Nose rubbing Sniffling Snorting Sneezing Itchy, runny eyes Itching or tingling sensations in the mouth and throat. Itchiness is not usually a complaint with a cold, but it is the hallmark of an allergy problem. Coughing, wheezing, difficulty breathing, and other respiratory symptoms. Recurrent red, itchy, dry, sometime scaly rashes in the creases of the skin, wrists, and ankles also may indicate an allergy. Eczema When it comes to rashes, the most common chronic inflammatory skin condition in children is eczema, also called atopic dermatitis. Although not strictly an allergic disorder, eczema in young children has many of the hallmarks of allergies and is often a sign that hay fever and asthma may develop. The rate of eczema, like that of asthma, is increasing throughout the world. Where asthma is rare, the rate of eczema is also low. When to Suspect Asthma Although allergies and asthma often go together, they are actually two different conditions.  Asthma is a chronic condition that starts in the lungs. Allergies are reactions that start in the immune system. Not everybody with allergies has asthma, but most people with asthma have allergies. Asthma Attacks The airways of the typical child with asthma are infl amed or swollen, which makes them oversensitive. When they come in contact with an asthma “trigger” — something that causes an asthma attack — the airways, called bronchial tubes, overreact by constricting (getting narrower). Many different substances and events can “trigger” an asthma attack: Exercise Cold air Viruses Air pollution Certain fumes Other allergens In fact, about 80 percent of children with asthma also have allergies and, for them, allergens are often the most common asthma triggers. Common Allergens in Home and School In the fall, many indoor allergens cause problems for children because they are inside of home and school for longer periods. Dust: contains dust mites and finely ground particles from other allergens, such as pollen, mold, and animal dander Fungi: including molds too small to be seen with the naked eye Furry animals: cats, dogs, guinea pigs, gerbils, rabbits, and other pets Clothing and toys: made, trimmed, or stuffed with animal hair Latex: household and school articles, such as rubber gloves, toys, balloons; elastic in socks, underwear, and other clothing; airborne particles Bacterial enzymes: used to manufacture enzyme bleaches and cleaning products Certain foods Controlling Allergy Symptoms It’s helpful to use air conditioners, where possible, to reduce exposure to pollen in both your home and your car. Molds are present in the spring and late summer, particularly around areas of decaying vegetation. Children with mold allergies should avoid playing in piles of dead leaves in the fall. Dust mites congregate in places where food for them (e.g , flakes of human skin) is plentiful. That means they are most commonly found in upholstered furniture, bedding, and rugs. 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. Wash linens weekly, and other bedding such as blankets, every 2 to 3 weeks in hot water to kill the dust mite. Pillows should be replaced every 2 to 3 years. Working With Your Child’s Pediatrician Your child’s allergy and/or asthma treatment should start with your pediatrician. If needed, your pediatrician may refer you to a pediatric allergy specialist for additional evaluations and treatments, depending on how severe the child’s symptoms are. Although there are many over-the-counter antihistamines, decongestants, and nasal sprays, it is very important that you work with a pediatrician over the years to make sure that your child’s allergy and asthma are correctly diagnosed and the symptoms properly treated. Last Updated 11/21/2015 Source Healthy Children Magazine, Allergy/Asthma 2007"
107,3,"2018-04-19 02:48:19","Allergies & Asthma",107,"2018-04-19 03:09:42","Skin Tests - The Mainstay of Allergy Testing","Skin Tests - The Mainstay of Allergy Testing Page Content Article BodySkin tests, first developed almost a century ago, are still the mainstay of allergy testing. They are easy and safe to do, give fast results, and are relatively inexpensive, which makes them the best way to start looking for specific allergies. In performing scratch skin tests, drops of allergen extracts (eg, pollens, dust mites, molds, animal danders, foods) are allowed to seep through shallow scratches made in the patient’s skin. The tests can also be performed by the deeper, intradermal technique, in which extracts are injected under the skin. There are pros and cons to both testing methods. Scratch tests are painless and very easy to do. They are somewhat less sensitive than intradermal tests; they are also less likely to cause a severe reaction in someone who is highly allergic. The intradermal tests, which let the allergen extracts penetrate deeper into the skin, are highlysensitive, but they can occasionally result in false-positive reactions, indicating allergies where none exist. Your physician may decide to start with scratch tests, then go on to intradermal testing if further information is needed. Before testing, your doctor will ask you not to give your child any antihistamines for 3 to 5 days, as they will interfere with the results of the tests. If your child has formed specific IgE antibodies through earlier exposure to one of the substances being tested, the skin test area will redden and swell into a disk that looks like a mosquito bite around the puncture site. This skin reaction usually peaks within 15 to 20 minutes after the test extracts are applied, and then gradually clears up. The skin where the tests were done may feel itchy for a few hours. Skin Tests Must Be Done by an Experienced Physician Although a positive result to scratch or intradermal skin testing strongly suggests that your child has formed lgE antibodies against a specific allergen, it does not follow that your child will definitely develop allergy symptoms when exposed to that particular allergen in the environment. As a rule, the bigger the skin test reaction, the higher the chances are that your child is allergic and will sneeze, itch, or break out in a rash. However, in some cases the skin reaction is trivial while the symptoms are overwhelming, and vice versa. Further, even though your child may have diminished symptoms as he gets older, the skin test result can remain positive. It is important that tests be conducted and results interpreted by someone trained and experienced in allergy skin testing. This Is Only a Test Many parents and children are afraid of having allergy skin testing because they’ve heard false reports that it is painful and upsetting. Scratch tests, the form of testing most often used in children, are mostly painless because they are done on the surface of the skin, where there aren’t any nerve endings to register pain. Furthermore, new test devices are available that can do up to 8 tests at a time and allow scratch testing to be done quickly and without injury. The intradermal technique uses a very fine needle to penetrate the surface of the skin. It is “felt” a little more than scratch testing but is still not very painful. Many people also falsely believe that children have to reach a certain age before they can be tested. In fact, age is no barrier to skin testing; positive results can be obtained at any age. For example, in infants and toddlers who have eczema and suspected food allergy, skin tests often reveal sensitivity to milk or egg. Once parents have this information, they can keep those foods out of their child’s diet to control allergy symptoms. Finally, experienced doctors and nurses perform allergy testing on a daily basis. They know how to take away fears and put children—and parents—at ease. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
108,3,"2018-04-19 02:48:19","Allergies & Asthma",108,"2018-04-19 03:09:49","Tests Used to Diagnose Allergies","Tests Used to Diagnose Allergies Page Content Article BodyInstead of skin tests, your pediatrician or allergy specialist may order a blood test that has various names, including specific IgE blood test, in vitro IgE test, and radioallergosorbent test (RAST). (When the test was first invented years ago, it was called RAST, based on the specific way the test was done in the laboratory. Even though that technique is no longer used, the name RAST has kind of hung on.) The specific IgE blood test is especially useful if skin tests cannot be done because, for instance, a child has eczema over much of his body or cannot be taken off medication that interferes with skin testing. This blood test shows specific sensitivities, as skin tests do, but does so by detecting the presence of allergy antibodies circulating in the blood. If antibodies are in the blood, it usually means the same antibodies are also in other tissues. The method is not quite as versatile as skin testing because certain extracts are not available for measuring specific IgE using this technique. For example, a specific IgE blood test cannot be used to detect sensitivity to medications and is rarely used to detect insect venom allergy. However, the specific IgE blood test, in general, is adaptable and sensitive enough to detect a wide range of allergies. The procedure costs more per test than skin testing. It requires only a few minutes of the patient’s time to draw a blood sample and there is no risk of any allergic reaction. The results take from 1 to 5 days, whereas skin test results are available immediately. Radiographs and Imaging Tests While sometimes useful, radiographs (x-ray films) are not essential for diagnosing asthma or allergies. In fact, people with asthma usually have normal chest radiographs. However, chest radiographs are sometimes done to make sure children do not have other conditions that can mimic asthma. Sinus infection can produce symptoms similar to those of respiratory allergies, and children who have respiratory allergies are prone to sinus infections. Your pediatrician may order an imaging test to see if your child simply has a prolonged or recurrent infection, or whether a sinus infection is complicating his allergies. An imaging test can be done the old-fashioned way, with a radiograph of the head, or it can be performed by computed tomography (CT). A CT scan is more sensitive than a radiograph and shows finer details of the anatomy of the sinuses, which can help your pediatrician decide on the best way to treat your child’s sinus problem. Finally, imaging tests can sometimes help your pediatrician identify the reason your child snores or has a permanently stuffed-up nose. A radiograph of the upper neck area can show if the stuffiness is caused by enlargement of the adenoid tissue, which sits in the upper throat just behind the nose. Lung Function Tests If your child has symptoms indicating possible asthma, your pediatrician or asthma specialist may perform tests to evaluate his lung function. Lung function tests are performed in your pediatrician’s office or a pulmonary function laboratory where special equipment is available. An instrument called a spirometer is used to measure how much air your child can breathe out, as well as how fast the air flows. The technician will place a clip over your child’s nose to prevent air escaping from the nostrils. The technician will then ask your child to perform breathing maneuvers into a mouthpiece attached to a pulmonary function monitor. The maneuvers aren’t difficult or painful. All your child has to do is take a deep breath, then breathe out forcefully through the mouthpiece. Instead of using a spirometer, the doctor may ask your child to blow into a simpler device called a peak flow meter. Your pediatrician usually has your child perform the lung function test at least 3 times at a sitting to make sure results are consistent. If lung function testing shows that your child cannot blow air out fast enough, your pediatrician may perform further tests for asthma. Your pediatrician may give your child a dose of bronchodilator medication to see if there is a change in airflow. If airflow is normal or improved after the medication, the result strongly suggests that asthma is present. Sweat Test Cystic fibrosis is an inherited disorder that involves many body systems. It causes symptoms in the respiratory and digestive tracts that can mimic those of asthma and allergies. A child with cystic fibrosis may have asthma or allergies, as well. Your pediatrician may order tests to measure the levels of certain minerals in your child’s sweat (commonly called a sweat test). If the results indicate cystic fibrosis, further tests will be done to confirm the diagnosis. Last Updated 11/21/2015 Source Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)"
109,3,"2018-04-19 02:48:19","Allergies & Asthma",109,"2018-04-19 03:09:55","Understanding UV and Pollen Indexes","Understanding UV and Pollen Indexes Page Content Article BodyIn the warmer months, if you have allergies, asthma, or another respiratory condition, it is recommended that you check the pollen and mold counts for the day. And if you plan to be ouside, protect your skin by checking to see the intensity of the UV rays. Click here to listen Last Updated 1/23/2016 Source A Minute for Kids"
110,3,"2018-04-19 02:48:19","Allergies & Asthma",110,"2018-04-19 03:10:01","What is Asthma?","What is Asthma? Page Content Article BodyAsthma is a chronic disease of the tubes that carry air to the lungs. These airways become narrow and their linings become swollen, irritated, and inflamed. In patients with asthma, the airways are always irritated and inflamed, even though symptoms are not always present. The degree and severity of airway inflammation varies over time. Children with asthma can have symptoms start or worsen when they are exposed to many indoor substances such as Dust and dust mites Cockroaches Animals such as cats and dogs Molds Secondhand cigarette smoke Children with asthma may also be sensitive to colds and other viral infections, cold air, and particles or chemicals in the air. Ongoing exposures to these substances will not only worsen asthma symptoms, but also continue to aggravate airway inflammation. Inflammation of the airways causes them to be oversensitive and “twitchy,” often called “hyperreactive.” When the airways are hyperreactive, they can go into spasms, causing blockage and symptoms of wheezing, chest tightness, and shortness of breath. Who Gets Asthma? Asthma is a common condition in childhood. In the United States, 10% to 15% of children in grade school have or have had asthma. It can cause a lot of sickness and result in hospital stays and even death. The number of children with asthma is increasing, and the amount of illness due to asthma may also be increasing in some parts of the country. The reasons for these increases are not exactly known; however, outdoor air pollution and increased exposure to allergens are not likely causes. Recent studies suggest that how often and how early a child is exposed to certain infections and animals can influence the development of asthma. For example, children who come from large families, live with pets, or spend a considerable amount of time in child care in the first year of life are less likely to develop asthma. This early exposure to common allergens may actually protect against the development of asthma. Studies have also shown that a child’s exposure to infections early in life can determine whether he develops allergies or asthma. Some infections seem to decrease the risk of developing asthma, whereas one infection, respiratory syncytial virus, increases the risk. How Is Asthma Treated? Any child who has asthma symptoms more than twice per week should be treated. One of the most important treatments of asthma is to control the underlying inflammation of the airways. This can be done with medications or by avoiding environmental factors that cause or aggravate airway inflammation. Knowing the causes and triggers for asthma can allow families to reduce or avoid these triggers and reduce ongoing airway inflammation and hyperreactivity. This can reduce the severity and frequency of asthma symptoms and, hopefully, the need for as much asthma medication. Last Updated 11/21/2015 Source AAP Section on Allergy and Immunology (Copyright © 2003)"
111,3,"2018-04-19 02:48:19","Allergies & Asthma",111,"2018-04-19 03:10:06","When Pets Are the Problem","When Pets Are the Problem Page Content Article BodyFurry pets are among the most common and potent causes of allergy symptoms. However, fur usually is not the only animal allergen. Even shorthaired, “non-shedding” animals leave a trail of dander and saliva. Cats are commonly more allergenic than dogs. Although certain breeds of dogs are said to be less allergenic than others, studies don’t support the claim. Comparisons of dogs also show wide differences in levels of allergen-creation between individual dogs of the same breed. Reptiles, fish, and amphibians are not generally causes of allergy. Making Adjustments For families with a member allergic to an animal that are deeply attached to their animals, the notion of finding another home for a pet is hard to accept. Many prefer to keep the animal and battle on against allergy symptoms. If you can’t part with your pet, at least keep it out of your allergic child’s bedroom, and sweep, dust, and vacuum frequently. Another solution may be to keep your cat or dog permanently outdoors with adequate shelter. Weekly bathing in tepid water has also been shown to lower a pet’s potential allergens, including animals that never venture out of doors, but doing this regularly and consistently is often not realistic. Long after an animal has left the family home, animal allergens can persist due to hair and dander left behind. Before You Consider a New Pet … It is unwise to bring home a furry pet if you have a strong family history of allergies and, consequently, a high risk that infants and young children in your home could develop allergies. Better to wait a few years and, then, if there are no signs of trouble and your child’s allergy tests are clear, you may want to look into pet ownership. Try to expose your child to the pet a few times before bringing the pet home, just to see if there are any allergic symptoms that would indicate this is not the right move for your child. A household pet may be unjustly blamed for causing allergy symptoms. Don’t automatically banish Fido to the doghouse unless your child’s been tested and the results suggest that your child has an animal allergy. Occasionally, symptoms that seem to be caused by an animal may be, in fact, due to other allergies, such as to pollen or mold. What happens is that Fido and Felix explore outdoors, then come back into the house with a load of pollen granules and mold spores in their coats. Every time the hay fever sufferer pats the pets, he stirs up an invisible cloud of allergens that triggers symptoms. Tips for Handling Pet Allergies More than 70 percent of U.S. households have a dog or cat, according to the American College of Allergy, Asthma, and Immunology (ACAAI). People with allergies should be cautious in deciding what type of pet they can safely bring into their home. The ACAAI offers the following advice: Pet exposure may cause sneezing and wheezing. An estimated 10 percent of the population may be allergic to animals, and 20 to 30 percent of individuals with asthma have pet allergies. The best types of pets for an allergic patient are pets that don’t have hair or fur, shed dander, or produce excrement that creates allergic problems. Tropical fish are ideal, but very large aquariums could add to the humidity in a room, which could result in an increase of molds and house dust mites. Other hypoallergenic pets include reptiles and turtles, but be aware that turtles can spread salmonella, a highly contagious bacterial disease. If the family is unwilling to remove the pet, it should at least be kept out of the patient’s bedroom and, if possible, outdoors. Allergic individuals should not pet, hug, or kiss their pets because of the allergens on the animal’s fur or saliva. Indoor pets should be restricted to as few rooms in the home as possible. Isolating the pet to one room, however, will not entirely limit the allergens to that room. Air currents from forced-air heating and air-conditioning will spread the allergens throughout the house. Homes with forced-air heating and/or air-conditioning may be fitted with a central air cleaner. This may remove significant amounts of pet allergens from the home. The air cleaner should be used at least four hours per day. The use of heating and air-conditioning filters and HEPA (High Efficiency Particulate Arresting) filters as well as vacuuming carpets, cleaning walls and washing the pet with water are all ways of reducing exposure to the pet allergen. When it comes to diagnosing pet allergies, most are pretty obvious — symptoms occur soon after exposure. But sometimes the allergy is subtler. Skin tests or special allergy blood tests can be done, if necessary, to confirm a suspicion of an animal allergy. One way to confirm a pet’s significance as an allergen, is to remove the pet from the home for several weeks and do a thorough cleaning to remove the residual hair and dander. It is important to keep in mind that it can take weeks of thorough cleaning to remove all the animal hair and dander before a change in the allergic patient is noted. Allergy shots (immunotherapy) may be needed for cat or dog allergies, particularly when the animal cannot be avoided. They are typically given for at least three years and may decrease symptoms of asthma and allergy. They are not recommended as routine treatment for pet allergy in children, though. Avoidance and pet elimination are the preferred approach. 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"
112,4,"2018-04-19 02:48:19",Autism,112,"2018-04-19 03:10:11","Autism Spectrum Disorder","Autism Spectrum Disorder Page ContentWhat is Autism Spectrum Disorder?Autism spectrum disorder (ASD) is a neurologically-based disability that affects a child's social skills, communication, and behavior.Because most children with ASD will sit, crawl, and walk on time, you may not notice delays in social and communication skills right away. Looking back, many parents can recall early differences in interaction and communication. See What are the Early Signs of Autism?.ASD symptoms may change as children get older and with intervention. However, as many children with autism develop, they may likely have other developmental, learning, language, or behavioral issues or diagnoses. Others, while not very common, may improve so much that they might no longer be considered to have a diagnosis of ASD.How Common is ASD?ASD affects about 1 in 68 children. Boys are diagnosed with ASD about 5 times more often than girls.The number of children reported to have autism has increased since the early 1990s. The increase could be caused by many factors. Many families are more aware of ASD. Pediatricians are doing more screening for ASD, as recommended by the AAP, and children are identified earlier—which is a good thing.Also, there have been changes in how ASD is defined and diagnosed. In the past, only children with the most severe autism symptoms were diagnosed. Now children with milder symptoms are being identified and helped.The Benefits of Early IdentificationEach child with autism has different needs. The sooner autism is identified, the sooner an earl​y intervention program directed at the child's symptoms can begin.The American Academy of Pediatrics (AAP) recommends that all children be screened for ASD at their 18- and 24-month well-child checkups. Research shows that starting an intervention program as soon as possible can improve outcomes for many children with autism.See Where We Stand: Autism.Additional InformationWhat are the Early Signs of Autism?If Autism is Suspected, What's Next?What is Early Intervention?Where We Stand: AutismHow is Autism Diagnosed?How Doctors Screen for Autism Article Body Last Updated 8/4/2015 Source Adapted from Understanding Autism Spectrum Disorders (ASDs): An Introduction (Copyright © 2012 American Academy of Pediatrics)"
113,4,"2018-04-19 02:48:19",Autism,113,"2018-04-19 03:10:18","How Pediatricians Screen for Autism","How Pediatricians Screen for Autism Page Content​​​Pediatricians start screening your baby for signs of developmental or communication challenges like autism spectrum disorder (ASD) from his or her very first well-child visit. Your pediatrician observes how your baby giggles, looks to you for reassurance, tries to regain your attention during a conversation, points or waves, responds to his or her name, and cries. Those observations in combination with family history, health examinations, and parental perspectives remain extremely valuable in helping identify children at risk for ASD.Formalized Autism Screening Recommended at the 18- and 24-Month Well-Child Visits:The American Academy of Pediatrics (AAP) recommends screening all children for autism at the 18 and 24-month well-child visits in addition to regular developmental surveillance. This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as well as those with other developmental difficulties. For screening to be effective, it must be applied to all children – not only those with symptoms. Modified Checklist for Autism in Toddlers (M-CHAT): In most offices, pediatricians use the M-CHAT, a 23-point questionnaire filled out by parents. Most families find it easy to fill out. Using this standardized screening, pediatricians can pick up children at risk for ASD and will be prompted to start conversations about language delay, concerns about behavior, or possible next steps for a child at risk with additional genetic, neurologic, or developmental testing.Screening Isn’t Diagnosing!It’s important to note that screening isn’t diagnosing. If your child has a positive screen for an ASD, it doesn’t mean he or she will be diagnosed on the spectrum. And further, if your child screens normally but you continue to worry about ASD, don’t be shy. Screening tests are just that—screening—and don’t identify all children with ASD. The rate of success for the M-CHAT, for example, isn’t 100%, so it is used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the most importance.If You Are Concerned and Your Child Has Not Been Formally Screened:Talk with your pediatrician about doing a formal screening. Many screening tools are available.But know this: If you are concerned about your child’s communication or behavior due to a family hi​story of ASD, the way he or she talks or acts, or other people’s comments about his or her behavior, don’t wait to talk with your pediatrician about doing more. If the first doctor doesn’t respond to you or take you seriously, get a second opinion.Additional Information: Assessing Developmental Delays When Not to Worry About Autism? Early Signs of Autism Spectrum Disorders Diagnosing Autism Identification and Evaluation of Children With Autism Spectrum Disorders (AAP Policy Statement)  Article Body Last Updated 2/18/2016 Source Adapted from Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance (Copyright © 2014 Wendy Sue Swanson)"
114,4,"2018-04-19 02:48:19",Autism,114,"2018-04-19 03:10:28","How is Autism Diagnosed?","How is Autism Diagnosed? Page Content Article BodyIt would be so much easier if autism spectrum disorer (ASD) could be diagnosed with a blood test or an x-ray, but it's not that simple. Diagnosis is ultimately made based on your description of your child's development, plus careful observations of certain behaviors by autism experts, medical tests, and your child's history. Parent and Pediatrician PartnershipEarly diagnosis requires a partnership between parents and pediatricians. Within this partnership you, as the parent, should feel comfortable bringing up any concerns you have about your child's behavior or development—the way she plays, learns, speaks, and acts. Likewise, your child's pediatrician's role in the partnership is to listen and act on your concerns.During your child's visits, the pediatrician may ask specific questions or complete a questionnaire about your child's development. Pediatricians take these steps because they understand the value of early diagnosis and intervention and know where to refer you if concerns are identified. The importance of this partnership cannot be stressed enough.ASD Screening for All ChildrenIf your child does have autism, an early diagnosis is better because then your child can start receiving the help he or she needs. This is why the American Academy of Pediatrics (AAP) recommends that all children be screening for ASD at their 18- and 24-month well-child checkups. Talk with your doctor if you feel your child needs to be screened (regardless of their age) and share your concerns — you know your child the best! RememberIt can be difficult to learn that your child has a lifelong developmental disability. Naturally, you as a parent, other caregivers, and extended family need to grieve about this. You will undoubtedly worry about what the future holds. Keep in mind during these difficult times that most children with ASD will make significant progress in overall function. Some children with ASD can do exceptionally well and may even remain in a regular education classroom. Many will have meaningful relationships with family and peers and achieve a good level of independence as adults. It is important to remember that while a diagnosis of autism may change what you thought your parenting experience would be, we now know that children with ASD can achieve so much more in life as long as they are given appropriate support and opportunities. See Words of Support for Parents of a Child with Autism. Additional InformationIf Autism is Suspected, What's Next?How Doctors Screen for Autism When Not to Worry About AutismWhat is Early Intervention?​  Last Updated 9/4/2015 Source Adapted from Autism Spectrum Disorders: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2012)"
115,4,"2018-04-19 02:48:19",Autism,115,"2018-04-19 03:10:36","If Autism is Suspected, What’s Next?","If Autism is Suspected, What’s Next? Page Content Article Body​​When autism spectrum disorder (ASD) is suspected, your child will need a full assessment or evaluation and should be referred for early intervention (EI) services. This assessment includes asking parents and caregivers a number of questions, observing the child, performing a physical examination, and administering any tests that may assist in arriving at a specific diagnosis. Ideally, this is done by a team of professionals. Assessing Language and Social DelaysTypically, an evaluation to assess language and social delays can include: Careful observation of play and child-caregiver interactions. Detailed history and physical examination. Review of records of previous early intervention services, school, or other evaluations. Developmental assessment of all skills (motor, language, social, self-help, cognitive). ASD is suspected when the child's social and language functioning are significantly more impaired than the overall level of motor, adaptive, and cognitive skills. Hearing test. All children with any speech delays or those suspected of having ASD should have their hearing formally tested. Language evaluation that provides standardized scores of expressive language (including speech) and receptive language, as well as an evaluation of pragmatic language (social use of language) and articulation (pronunciation).Medical TestsAutism may be associated with a known syndrome or medical condition. Laboratory tests may be indicated to rule out other possible medical conditions that could cause ASD symptoms based on the child's history and physical examination. If needed, the child may be referred to other specialists, such as a geneticist or a pediatric neurologist, to help diagnose medical conditions that might cause or be associated with symptoms of ASD.Medical tests may include: Genetic tests. It is recommended that families be offered genetic testing, such as cytogenetic microarray testing. At present, up to 10% to 20% of children with ASD have abnormalities of their chromosomes identified using cytogenetic microarray testing. Genetic testing should be strongly considered if a child has unusual physical features or developmental delays or if there is a family history of fragile X syndrome, intellectual disability of unknown cause, or other genetic disorders. Other genetic tests may be needed in certain cases. Recommendations for genetic testing may change as new tests are developed. See Ethical and Policy Issues in Genetic Testing and Screening of Children (AAP Policy Statement). Lead test.Lead screening is an important component of primary care. A lead level should be performed when a child lives in a high-risk environment, such as older buildings, or continues to put things in his mouth. Other tests. Based on the child's medical history and physical examination, an electroencephalogram (EEG), a magnetic resonance imaging (MRI) scan, or tests for metabolic disorders may be ordered. Children with ASD may be picky eaters, so your child's pediatrician may recommend looking for evidence of iron or vitamin deficiencies (especially vitamin D).Medical tests not recommended:There is not enough clinical evidence to recommend any of the following tests specifically for ASD: Hair analysisRoutine measurement of multiple vitamin or nutrient levelsIntestinal permeability studiesStool analysisUrinary peptidesMeasurement of mercury or other heavy metalsDiagnosis of ASDDiagnosis of ASD is made by using all the information collected by history, observation, and testing. See How is Autism Diagnosed?If you have concerns about your child's behavior or development, talk to your pediatrician. Additional Information What is Early Intervention? Individualized Education Program (IEP) Words of Support for Parents of a Child with Autism Where We Stand: Autism​ ​ Last Updated 1/27/2016 Source Adapted from Understanding Autism Spectrum Disorders (ASDs): An Introduction (Copyright © 2012 American Academy of Pediatrics)"
116,4,"2018-04-19 02:48:19",Autism,116,"2018-04-19 03:10:42","Keep Kids with Autism Safe from Wandering: Tips from the AAP","Keep Kids with Autism Safe from Wandering: Tips from the AAP Page Content ​​​​​​By: Susan Hyman, MD, FAAP & Lori McIlwainAnyone who's been a parent long enough has felt that panic—often only temporary—when a child wanders out of sight. Kids can get lost anywhere—at an amusement park, in a store, in a crowd, and sometimes even right in your own neighborhood. Many parents of children with autism spectrum disorder (ASD) know this feeling all too well.The Scope of the Problem: The first study to quantify the scope of the problem was published in Pediatrics in 2012. Results were significant. Of the 1,218 children with ASD who were studied, almost half of those children had wandered off from home, school, or another safe place at least once after age 4. Many were missing long enough to cause concern, were in danger of drowning, or were at risk of being hurt by traffic. What Parents Can Do: There are things parents can do to protect their c​hildren with ASD from this very real and scary danger. Here are tips from the American Academy of Pediatrics: Know wandering triggers. Children with ASD can be impulsive and typically wander or bolt from a safe setting to get to something of interest, such as water, the park, or train tracks—or to get away from a situation they find stressful or frightening, such as one with loud noises, commotion, or bright lights.  Secure your home—regardless of your child's age. Shut and lock doors that lead outside. Consider putting alarms on doors to alert you if a door has been opened. Reinforce water and swimming safety. Home swimming pools should be surrounded by a fence that prevents a child from getting to the pool from the house. There is no substitute for at least a four-foot-high, non-climbable, four-sided fence with a self-closing, self-latching gate. Pool alarms and door alarms are also protection products that may have some benefits. Note, however, that swimming lessons are not enough to prevent drowning; swimming lessons in wet clothes and shoes could be suggested for children with ASD who tend to wander. Work on communication and behavior strategies. Teaching your child strategies to self-calm when stressed and appropriately respond to ""no"" can make a big difference. Make sure your child's teachers and other family members understand how important it is to keep your child engaged and busy to reduce his or her urge or opportunity to wander. Set expectations. Before going out in a public place, communicate the plan with your child and other family members—including the timeline and rules to follow. Consider noise-canceling headphones if noise is a trigger, and use the ""tag team"" approach to make certain your child is always supervised by a trusted adult. Consider monitoring technology and identification. More than 1/3 of children with ASD who wander are never or rarely able to communicate their name, address, or phone number. It may be helpful to have things like GPS devices, medical alert tags, and even their name marked in clothing. Project Lifesaver and SafetyNet Tracking or other programs may be available through your local law enforcement agencies. Rest. Children with ASD may be less hyperactive and less likely to wander during the night if they have a sleep management plan and a regular sleep schedule. Caregivers who get enough sleep are also more vigilant.  Worried about Wandering?  Talk with your child's pediatrician about creating a family wandering emergency plan. The diagnostic code for wandering is Z91.83, which can be used in your visits with medical professionals. Your pediatrician can give you additional strategies that may be helpful in increasing your child's safety, as well as information about local resources. Editor's note: Wandering behavior isn't unique to children with ASD. A variety of different developmental disorders, such as attention-deficit hyperactivity disorder, can also lead to children running off at any given moment.Additional Information & Resources: Drowning Prevention: Information for Parents Occurrence and Family Impact of Elopement in Children with Autism Spectrum Disorders (study published in Pediatrics, October 2012) Safety of Children with Disabilities: Wandering (Elopement) (Centers for Disease Control and Prevention) awaare.org (Autism Wandering Awareness Alerts Response and Education Collaboration)National Center for Missing & Exploited Children (NCMEC): 1-800-THE-LOST (1-800-843-5678) About Dr. Hyman: Susan Hyman, MD, FAAP is Associate Professor at the Department of Pediatrics at Golisano Children's Hospital at the University of Rochester Medical Center. She is board-certified by the American Board of Pediatrics in Developmental-Behavioral and Neurodevelopmental Disabilities. Within the American Academy of Pediatrics, Dr. Hyman is a member of the Council on Children with Disabilities Executive Committee, the Section on Developmental & Behavioral Pediatrics, and the Section on Integrative Medicine. As former Chair of the AAP Autism Subcommittee, Dr. Hyman led in the revision of the AAP publication, Autism: Caring for Children with Autism Spectrum Disorders: A Resource Toolkit for Clinicians, 2nd Edition. About Ms. McIlwain: ​Lori McIlwain is the mother of a teenage son with autism spectrum disorder and co-founder of the National Autism Association. In 2007, she began advocating for federal resources to reduce and eliminate injuries and deaths associated with autism-related wandering. She has been a contributor in The New York Times, and featured in USA Today, Time, Education Week, FBI's National Academy Associate Magazine, and NPR. In 2012, Ms. McIlwain assisted the National Center for Missing & Exploited Children in creating federal search and rescue guidelines for missing children with special needs, and in 2017 she presented on the topic of wandering among children with autism spectrum disorder at the federal Interagency Autism Coordinating Committee.  Article Body Last Updated 10/10/2017 Source Council on Children with Disabilities (Copyright © 2017 American Academy of Pediatrics)"
117,4,"2018-04-19 02:48:19",Autism,117,"2018-04-19 03:10:45","Public Health Minute: Early Identification of ASD","Public Health Minute: Early Identification of ASD Page Content​​Autism spectrum disorder (ASD) affects about 1 in 68 children. In this Public Health Minute, pediatrician Susan Levy, MD, FAAP, explains why early diagnosis is so important.The American Academy of Pediatrics (AAP) recommends that all children be screened for ASD at their 18- and 24-month well-child checkups. Segment: Early Identification of ASD​​​​​ Additional Information:Early Signs of Autism Spectrum DisordersDiagnosing AutismIdentification and Evaluation of Children With Autism Spectrum Disorders (AAP Policy Statement)   Article Body Last Updated 6/10/2016 Source PublicHealthMinute.com (Copyright © 2016)"
118,4,"2018-04-19 02:48:19",Autism,118,"2018-04-19 03:10:50","Sound Advice on Autism","Sound Advice on Autism Page Content Article BodyTo answer parents' questions about autism spectrum disorders, the American Academy of Pediatrics (AAP) offers a collection of interviews with pediatricians, researchers and parents.   Autism Research, Diagnosis and Treatment James M. Perrin, MD, FAAP (Recorded January 2013) Dr. James M. Perrin is a former president of the American Academy of Pediatrics. He is a professor of pediatrics at Harvard Medical School and heads the division of General Pediatrics at the MassGeneral Hospital for Children. Dr. Perrin leads the Clinical Coordinating Center for the National Autism Speaks Autism Treatment Network to improve care for children with autism and other developmental disorders. Listen to the entire interview Choose an individual question: Can you address the upcoming changes to the DSM-V? What is driving the increase in autism diagnoses? What have we learned recently about the causes of autism? What are the most effective treatments for autism? Do you have any final thoughts? Edited transcript Last Updated 1/27/2016 Source American Academy of Pediatrics (Copyright © 2013)"
119,4,"2018-04-19 02:48:19",Autism,119,"2018-04-19 03:10:57","What are the Early Signs of Autism?","What are the Early Signs of Autism? Page Content Article Body Editor's Note: Autism and ASD will be used interchangeably in this article.Many children with autism spectrum disorder (ASD) may show developmental differences when they are babies—especially their social and language skills. Because they usually sit, crawl, and walk on time, less obvious differences in the development of gesture, pretend play, and social language often go unnoticed. In addition to delays in spoken language and behavioral differences, families may notice differences in their child interacts with his or her peers.One child with ASD will not have exactly the same symptoms as another child with ASD—the number and severity of symptoms can vary greatly. Social Differences in Children with AutismDoesn't keep eye contact or makes very little eye contactDoesn't respond to a parent's smile or other facial expressionsDoesn't look at objects or events a parent is looking at or pointing toDoesn't point to objects or events to get a parent to look at themDoesn't bring objects of personal interest to show to a parentDoesn't often have appropriate facial expressionsUnable to perceive what others might be thinking or feeling by looking at their facial expressionsDoesn't show concern (empathy) for othersUnable to make friends or uninterested in making friendsCommunication Differences in Children with Autism Doesn't point at things to indicate needs or share things with othersDoesn't say single words by 16 monthsRepeats exactly what others say without understanding the meaning (often called parroting or echoing)Doesn't respond to name being called but does respond to other sounds (like a car horn or a cat's meow)Refers to self as ""you"" and others as ""I"" and may mix up pronounsOften doesn't seem to want to communicateDoesn't start or can't continue a conversationDoesn't use toys or other objects to represent people or real life in pretend playMay have a good rote memory, especially for numbers, letters, songs, TV jingles, or a specific topicMay lose language or other social milestones, usually between the ages of 15 and 24 months (often called regression)Behavioral Differences (Repetitive & Obsessive Behaviors) in Children with Autism Rocks, spins, sways, twirls fingers, walks on toes for a long time, or flaps hands (called ""stereotypic behavior"")Likes routines, order, and rituals; has difficulty with changeObsessed with a few or unusual activities, doing them repeatedly during the dayPlays with parts of toys instead of the whole toy (e.g., spinning the wheels of a toy truck)Doesn't seem to feel painMay be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touchUnusual use of vision or gaze—looks at objects from unusual anglesHow to Distinguish a Child with Autism from Other Typically Developing ChildrenHere are some examples that may help a parent identify the early signs of autism. At 12 Months A child with typical development will turn his head when he hears his name. A child with ASD might not turn to look, even after his name is repeated several times, but will respond to other sounds.At 18 Months A child with delayed speech skills will point, gesture, or use facial expressions to make up for her lack of talking. A child with ASD might make no attempt to compensate for delayed speech or might limit speech to parroting what is heard on TV or what she just heard.At 24 Months A child with typical development brings a picture to show his mother and shares his joy from it with her. A child with ASD might bring her a bottle of bubbles to open, but he does not look at his mom's face when she does or share in the pleasure of playing together. Trust Your InstinctsIf you have concerns about how your child plays, learns, speaks, acts, or moves, talk with your pediatrician. Before you go to the appointment, complete a free developmental milestone checklist, and read these tips about ""How to Talk with the Doctor.""  Remember, you know your child best and your concerns are important. Together, you and your pediatrician will find the best way to help your child. If you're uneasy about the doctor's advice, seek a second opinion. Don't wait. Acting early can make a big difference!Additional Information: How Doctors Screen for Autism When Not to Worry About Autism What is Early Intervention? Language Delay Learn the Signs. Act Early (CDC.gov) - Aims to improve early identification of children with autism and other developmental disabilities so children and families can get the services and support they need.​ Last Updated 9/4/2015 Source Adapted from Autism Spectrum Disorders: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2012)"
120,4,"2018-04-19 02:48:19",Autism,120,"2018-04-19 03:11:09","When Not to Worry About Autism","When Not to Worry About Autism Page Content Article Body​Many parents worry about their child’s development at one point or another. Competitive Parenting - Stop Comparing! Competitive parenting makes us all a little nuts; the act of comparing what our children do against what the cousins or our friends’ children do is very difficult to stop. And can make anyone unnerved. Talk with Your Child’s Doctor If You Are Worried at Any Time If at any time you worry that your child isn’t expressing joy, communicating thoughts, or reflecting an understanding of your language, visual cues, and behavior, talk with your child’s doctor. If you don’t feel heard or you continue to worry, schedule another visit. If you still worry, contact another doctor for a second opinion. Instincts serve us very well when it comes to parenthood. Further, find some peace of mind if your child is doing many of the behaviors listed here! Reassuring Developmental Milestones for Infants & Children The following are a few signs that your child is developing great communication skills on time: Responds to her name between 9 and 12 months of age Smiles by 2 months of age; laughs and giggles around 4 to 5 months; expresses great joy to your humor around 6 months Plays and thinks peek-a-boo is funny around 9 months of age Makes eye contact with people during infancy Tries to say words you say between 12 and 18 months of age Uses 5 words by 18 months of age Copies your gestures like pointing, clapping, or waving Imitates you, i.e., pretends to stir a bowl of pancake mix when you give him a spoon and bowl or pretends to talk on the phone with a play cell phone Shakes head “no” Waves bye-bye by 15 months of age Points to show you something interesting or to get your attention by 18 months of age Additional Resources: Assessing Developmental Delays How Doctors Screen for Autism Early Signs of Autism Spectrum Disorder Diagnosing Autism Author Wendy Sue Swanson, MD, MBE, FAAP Last Updated 9/4/2015 Source Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance (Copyright © 2014 Wendy Sue Swanson)"
121,4,"2018-04-19 02:48:19",Autism,121,"2018-04-19 03:11:16","Where We Stand: Autism","Where We Stand: Autism Page Content Article BodyThe American Academy of Pediatrics (AAP) encourages doctors to be aware of the signs of autism spectrum disorder (ASD), and to be on the lookout for these signs during every well-child visit.At the same time, the Academy urges parents to always let their pediatricians know of any concerns they may have about their child's behavior and development. Autism-Specific ScreeningThe AAP recommends autism-specific screening when children are at 18 and 24 months of age; the sooner an intervention program is started, the better. However, children should be evaluated at any age if a parent or professional has concern about the possibility of an ASD. Early Intervention for Children Ages 0-3If ASD is suspected or diagnosed, parents should seek a referral for early intervention and local specialists (like speech therapy or behavioral intervention to promote social skills). Early intervention programs are specific for children zero to three years of age. Intervention for Children Above Age 3Above the age of three, a referral should be made to your school district. Parents should make an effort to become as familiar as possible with available treatments and programs in their community, and support their child in learning the skills needed to be successful in the least restrictive educational setting.Additional Information Autism Spectrum Disorder How Doctors Screen for Autism Early Signs of Autism Spectrum Disorders Early Intervention (EI) Individualized Education Program (IEP) Last Updated 9/4/2015 Source Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)"
122,4,"2018-04-19 02:48:19",Autism,122,"2018-04-19 03:11:21","Words of Support for Parents of a Child with Autism","Words of Support for Parents of a Child with Autism Page Content Article Body​​Children with autism are affected by many factors that will shape their future. Overall, the long-term outcomes of children with autism spectrum disorder (ASD) have been improving. In general, the sooner ASD is identified, the sooner appropriate intervention programs can begin.While some children make significant developmental gains with early and intense intervention, some children may make slow progress depending on their intelligence, the severity of their ASD symptoms, and whether they have associated medical problems such as seizures or significant behavioral disorders.The goal of all parents is to help their child reach his full potential with the help of all available resources. ""Learning your child has autism can certainly change your perception of what you thought your life might be. You may have to restructure your priorities and develop new coping skills. And you may have to change some of your plans for the future. But in their place will be new dreams, new goals, and new priorities. The key is finding ways to adapt and adjust that suit your family, your needs, and your circumstances. It likely won't be easy. But people often find strength from within and from those around them to succeed. By loving your child dearly, you will be inspired to do what you can to learn as much as possible about ASD so that you too will be rewarded as you discover what works for your family.""​— Autism Spectrum Disorders: What Every Parent Needs to Know; Alan I. Rosenblatt, MD, FAAP, and Paul S. Carbone, MD, FAAP, editors ​ Last Updated 9/4/2015 Source Autism Spectrum Disorders: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2012)"
123,5,"2018-04-19 02:48:19",Cancer,123,"2018-04-19 03:11:31","Accommodating Children with Cancer in Child Care or School","Accommodating Children with Cancer in Child Care or School Page Content Article BodyChildren may come to school or child care as cancer survivors, or they may be diagnosed with cancer while enrolled. If children who have cancer are well enough during therapy or between rounds of therapy, they may attend child care or school.What adaptations may be needed?MedicationsSome children may be on low-dose antibiotics to prevent infection, but they are usually given at home.Dietary considerationsThere usually is no special diet, but children who are recovering from weight loss from chemotherapy may be on high-calorie foods or shakes.Physical environmentGood hygiene such as hand washing and avoiding infectious diseases. See Preventing the Spread of Illness in Child Care or School. Follow any guidance in the child's care plan about physical activity, but usually children who are well enough to attend child care or school will be able to participate in most activities.How teachers can help: Schedule a meeting with parents/guardians to go over the specifics of the child's condition because each case is unique.Have the child make a brief visit before the first full day returning to child care or school to meet with his teachers and classmates.The child's care plan will probably need to be updated frequently for a child who is still getting cancer treatments.Make sure the child's care plans are updated after each hospitalization or change in therapy.Explain to the other children about the child's condition, especially if the child's appearance has changed.Children sometimes feel guilty that they somehow caused their condition and may need reassurance that this isn't so.Immediately after chemotherapy or radiation, the child may be more tired or need to rest, but that will resolve over a few weeks.The child may have frequent absences for medical tests and treatments. Often child life specialists in the hospital help children adapt and keep up with any lessons they may miss.Benefits of being with peers:  Being with groups of children can provide a routine and the chance to interact with friends, which can be a welcome break from a hospital setting.Additional information: Chronic Conditions and SchoolChildhood Cancer: Coping With the DiagnosisTreating Cancer in ChildrenWhat Does the School Need to Know?Serving As A Child Advocate Last Updated 11/21/2015 Source Adapted from Managing Chronic Health Needs in Child Care and Schools: A Quick Reference Guide (Copyright © 2009 American Academy of Pediatrics)"
124,5,"2018-04-19 02:48:19",Cancer,124,"2018-04-19 03:11:37","Cancer Therapies","Cancer Therapies Page Content Article BodySurgery The objective of surgery is to completely remove the cancer and a margin of tumor-free tissue; or, if the tumor cannot be totally removed or a clear margin achieved, to eliminate as much of it as possible, so that subsequent measures such as chemotherapy and/or radiation therapy might be more effective. Radiation therapy External-beam radiation therapy destroys tumor cells using a narrow beam of high-energy X rays from a special machine. Chemotherapy The word chemotherapy literally means “drug therapy,” but it has become synonymous with cancer treatment. Surgery and radiation therapy treat cancer locally; chemotherapy is usually a systemic therapy. Ingested orally or injected, the chemicals hunt down vagrant tumor cells anywhere in the body and stop them from proliferating. Your youngster may be prescribed a single medication, but more likely she’ll receive combination chemotherapy of two, three, perhaps more drugs. One regimen used for advanced lymphoblastic lymphoma consists of no fewer than ten drugs. Anti-cancer agents owe their effectiveness to the fact that they zero in on rapidly dividing cells. While malignant cells sustain the most damage, normal cells in the lining of the digestive tract, the white blood cells and the hair also happen to be highly active, and they too incur the wrath of the chemo agents. Consequently, symptoms such as nausea, lowered resistance against infection, mouth sores, diarrhea and hair loss may accompany treatments. Radiation also targets rapidly dividing cells, but the adverse effects tend to be confined to the treatment area, or field. If defined loosely, chemotherapy can be said to include hormonal drugs and immunologic agents. This latter group, long regarded in some quarters as the future of cancer treatment, has been slow in fulfilling its promise. The principle behind immunotherapy is to beef up the body’s immune system against the intruders, or to direct antibodies (with or without a drug attached) to the surface of cancer cells. For the time being, immunologics have yet to assume their place as front-line treatments. Bone-marrow transplantation (BMT) Bone-marrow transplantation has two roles in cancer treatment. In leukemia, it may be curative therapy, replacing the diseased marrow with new marrow withdrawn from the hip bone of a family member or a matched unrelated donor, then infused into the patient’s bloodstream. In other pediatric cancers, BMT makes it possible for youngsters to receive higher-than-normal doses of chemotherapy and/or radiation therapy. The increased amounts of drugs wipe out more cancer cells but also destroy the bone marrow, which then must be replenished with healthy marrow cells—often the patient’s own. You may hear this procedure referred to as high-dose chemotherapy with stem-cell support. Stem cells are the undeveloped cells in the marrow that mature into blood cells. They are also found, in lesser numbers, in the bloodstream. Half the transplants performed in the United States now use peripheral-blood stem cells (PBSCs) in place of bone marrow. There are two main types of bone-marrow transplants: allogeneic and autologous. In an allogeneic transplant, the stem cells are harvested from another person with genetically compatible cells. A perfect match improves the chances that the body will accept the transplanted marrow, or graft, and that the graft will take to its new home. The most-likely matched donor is a brother or sister, followed by a parent. However, two in three BMT candidates do not have an immediate family member with matching cells. In that event, the patient’s doctor might arrange for him to be registered with the National Marrow Donor Program, which attempts to match patients with volunteer donors from its ever-expanding data base. In autologous stem-cell transplantation, the patient’s own marrow is aspirated through a needle during a period of remission, frozen, then given back to him later. (If the person never enters remission, the marrow can be treated with chemotherapy in the laboratory until it tests negative for cancer cells.) This technique, which has been used in relapsed Hodgkin’s disease and non-Hodgkin’s lymphomas, and experimentally for several other resistant pediatric cancers, is less dangerous and less costly. It is now the front-line treatment for neuroblastoma. Since the patient is receiving his own stem cells, there is no chance of the body rejecting the graft and avoids the chance that the graft will mistake its old haunt for a foreign invader and go on the attack. Graft-versus-host disease (GVHD), as this is called, is a common and potentially serious side effect of allogeneic BMT and is a particularly severe problem when unrelated donors are used. Side Effects of Cancer Treatment If your child should require chemotherapy, radiation therapy and/or bone-marrow transplantation, and so on, her oncologist will undoubtedly discuss with you the possible side effects that may occur during treatment. While it is important to be aware of the possibilities, don’t jump to conclusions that your child is going to be racked with nausea and diarrhea and lose all of her hair. There is no way to predict how a patient’s body will respond to the drugs or the radioactive rays. Some youngsters sail through their treatments, barely missing a day of school. It is hoped that will be your son’s or daughter’s story too. But it’s wise to be aware of potential problems. One of the first questions to ask the doctor in the wake of a cancer diagnosis is, “What steps can be taken to relieve any symptoms and side effects?” You and your child will probably be heartened by his answer, for some of the most striking progress in cancer care has come in the area of symptom management. For instance, we now have such effective antinausea drugs that many chemotherapy patients never spend a day feeling sick to their stomachs. The key to success is to have the doctor prescribe them prophylactically, to be taken just prior to treatments. This is a point to take up with the pediatric oncologist. Last Updated 11/21/2015 Source Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
125,5,"2018-04-19 02:48:19",Cancer,125,"2018-04-19 03:11:42","Childhood Cancer","Childhood Cancer Page Content​​​Approximately 1 in 285 children in the United States will be diagnosed with cancer before the age of 20. While advances in treatment have increased the survival rate for many childhood cancers, the disease is still the second leading cause of death (following accidents) in children ages 5 to 14.About Cancer: Cancer happens when abnormal cells grow and spread quickly. Unlike normal cells, cancer cells group or lump together to form a tumor. The body's healthy tissue is said to be benign (i.e. not cancerous). There are some tumors that are considered benign but may still require therapy to aid with symptoms management, etc.Sometimes cancer cells break away from the original tumor and invade other parts of the body. They can go on to form new tumors. If not treated successfully, these malignant masses will continue to enlarge and possibly spread to other parts of the body. The medical term for this is metastasis. It is important to keep in mind that cancer is identified according to the original location and cell type. Example: A colon tumor that metastasizes to the liver is not the same disease as primary liver cancer, nor is it treated the same way. The new malignancy would be referred to as ""colon cancer metastatic to the liver."" Its cells, though found in the liver, are colon-cancer cells. Early detection is crucial to a cancer patient's prognosis, because tumors that remain localized to the original site are generally more easily controlled or cured than tumors that have metastasized.Causes of Childhood Cancer: The cause of childhood cancer is largely unknown and the cancers that children get generally are not preventable. A small number of childhood cancers can be related to Down's syndrome, other chromosomal abnormalities, or exposure to radiation.Types of Childhood Cancers:Although cancer is the most deadly disease of childhood and adolescence, it strikes nearly 15,500 children a year, as compared to approximately 1.2 million adults. Nine in ten adult cancers are carcinomas, malignancies that take hold in the cells lining the inner or outer surfaces of organs such as the lung, breast, prostate, colon and bladder. Cancers of children and adolescents belong mainly to four other groups: leukemias, lymphomas, sarcomas, and gliomas.What are the most common cancers in children and adolescents? The most common cancers among children and adolescents vary by age and are shown in the chart below. LeukemiaLeukemia is cancer of the bone marrow, which produces three types of blood cells. Leukemias are also the most common of childhood cancers. White blood cells (leukocytes) serve as the body's defense system against infection. In leukemia, the marrow produces an overabundance of cancerous white cells. Eventually they crowd out the healthy, infection-fighting mature leukocytes in the marrow and the bloodstream, opening the door to viruses, bacteria and other microorganisms. At the same time, the impaired marrow grinds out fewer oxygen-toting red blood cells and fewer platelets, the clotting cells responsible for stopping bleeding. Types of leukemia include: Acute lymphoid leukemia (ALL) - Affects white blood cells called lymphocytes. Acute myeloid leukemia (AML) - Affects other white blood cells called granulocytes and monocytes. Because it floods the blood with malignant white cells, the disease is by nature systemic, or system-wide. When the cancer spreads outside the bone marrow, the blood vessels may whisk it to the brain and spinal cord, the testicles, the ovaries, the kidneys and other organs.LymphomaLymphoma is a cancer of the immune system and lymphoid tissues. They most often grow in lymph nodes and other lymph tissues, like the tonsils or thymus. Lymphomas can also affect the bone marrow and other organs, and can cause different symptoms depending on where the cancer is. Types of lymphomas include: Hodgkin disease (or Hodgkin lymphoma) - Usually progresses at a slow but predictable rate and is extremely responsive to treatment. It is seen more often in adolescent and young adults. With a five-year survival rate exceeding 90%, it is one of the most curable cancers of adolescence. Non-Hodgkin lymphoma - The three major types of childhood non-Hodgkin lymphomas are more aggressive and harder to control, although the overall cure rate is still a promising 75%. Doctors can determine whether a child has small-cell noncleaved lymphoma (the most common type), lymphoblastic lymphoma, or large-cell lymphoma (the least common type) by the appearance of the cells under the microscope and other more sophisticated tests. Because there is so much lymph tissue in the body, Hodgkin lymphoma and non-Hodgkin lymphoma can occur and spread virtually anywhere. When these cancers metastasize, it's often to the liver, the bone marrow or the spleen. Brain CancersThere are many types of brain tumors, and the treatment and outlook for each is different. Because the brain is a frequent site of metastatic tumors from other parts of the body, doctors look at the tumor's grade rather than its stage to help them determine the most appropriate treatment. The grade, expressed as low or high, describes the cancer cells' appearance and behavior. Pediatric brain tumors fall into one of four categories. Their names reflect the types of cells in which these tumors arise.   Astrocytomas - Low-grade astrocytomas, which look similar to healthy astrocytes, grow slowly and rarely spread to other parts of the brain, whereas high-grade brain tumors are much more aggressive. Primitive neuroectodermal tumors – Comes from primitive nerve cells and are rarely seen in adolescents. Brain-stem gliomas - Develop in the bundle of nerve tissue at the base of the brain, where crucial functions such as heart rate, breathing, and swallowing are regulated. Ependymomas - Usually arise in the membranous lining of the ventricles, the four interconnected hollow pockets within the brain. The ventricles produce the cerebrospinal fluid that surrounds and cushions the brain and the spinal cord. Consequently, the fluid often sends malignant cells up and down the central nervous system.RhabdomyosarcomaRhabdomyosarcoma is a cancer of muscle tissue. This type of cancer can start nearly any place in the body, including the head and neck, groin, abdomen, pelvis, or in an arm or leg. Children are more commonly diagnosed with the disease still limited to the original site. When rhabdomyosarcoma does spread, it typically creates new lesions in the lymph nodes, bone, bone marrow, or lung. There are two main types of pediatric rhabdomyosarcoma: Alveolar rhabdomyosarcoma – Is the rarer form more likely seen in teenagers and involves large muscles of the trunk, arms, and legs. Embryonal rhabdomyosarcoma - Seen in infants and young children and occurs most commonly in the head and neck, bladder, prostate, testicles, and vagina.Bone Cancer Primary bone cancers (cancers that start in the bones) occur most often in older children and teens, but they can develop at any age. Primary bone cancer is different from metastatic bone cancer, which is cancer that starts somewhere else in the body and then spreads to the bones. Metastatic bone cancer is more common than primary bone cancer, because many types of cancer (including many cancers in adults) can spread to the bones. Two main types of primary bone cancers occur in children: Osteosarcoma - It often strikes during the growth spurt of puberty. Boys and girls who sprout up rapidly can possibly be at greater risk of developing the disease than are children whose growth rate is average or less than average, although a growth spurt should not be cause for alarm. About half of osteosarcomas develop in the region of the knee.  Ewing sarcoma – It is a less common type of bone cancer. The most common places for it to start are the pelvic (hip) bones, ribs, shoulder blades, and the long bones in the upper legs and arms. Both cancers may spread to the lungs, as well as to other bones and soft tissue. Cancer Staging: Once cancer is definitively diagnosed, the oncologist orders additional tests to establish the size and extent of the tumor. Staging, as this is called, is really just a universal language for expressing this information. A commonly used staging system assigns each tumor a number from 0 to 4. Stage 1 and Stage 2 disease are still confined near the original site. Stage 3 tells the doctor that the cancer has invaded neighboring sites or has spread to nearby lymph nodes. Stage 4 is defined by spread to distant lymph nodes or organs. Not all cancers are staged using numbers; some are simply classified as localized or disseminated.Outlook: Cancers of childhood tend to be more curable than adult tumors. While the five-year survival rate for adults has struggled to exceed the 50% mark, survival rates in pediatrics are now approaching 90%—a dramatic increase from the mid-1970s, when nearly half of all children with cancer died. Additional Information: Symptoms of Childhood Cancers Diagnosing Cancer in Children Treating Cancer in Children National Cancer Institute resources for childhood cancer Article Body Last Updated 2/24/2016 Source Section on Hematology/Oncology (Copyright © 2016 American Academy of Pediatrics)"
126,5,"2018-04-19 02:48:19",Cancer,126,"2018-04-19 03:11:51","Childhood Cancer: Coping With the Diagnosis","Childhood Cancer: Coping With the Diagnosis Page Content Article Body​Just the thought of a child getting cancer can be frightening and overwhelming. But while cancer can be life threatening, there’s encouraging news. Over the last few decades, improved therapies have helped childhood cancer survival rise to more than 80%. Many kinds of cancer can now be cured or controlled to help give children a better quality of life into adulthood.Leukemia: The Most Common Type of Childhood Cancer The most common type of childhood cancer is leukemia, a cancer of the blood. Leukemia begins in the bone marrow, the spongy substance inside our bones where blood cells are made. Other childhood cancers include lymphoma (blood cancer that begins in the lymph glands) and solid tumors (abnormal clumps of tissue). Solid tumors may occur throughout the body, such as in the brain, kidney, muscle or bone.  What Causes Childhood Cancer?The causes of childhood cancer are largely unknown. Childhood cancer can occur suddenly, with no early symptoms, and might get detected during a physical exam. “If you notice something unusual in your child—unexplained symptoms, not growing properly, belly distended, blood in urine—take your child to the doctor,” says Dr. Nita Seibel, a pediatric oncologist at NIH. If the doctor suspects cancer, a series of tests will help identify the type of cancer, where it’s located and whether it has spread to other parts of the body. Tips for Parents When Researching the DiagnosisCancers in children can be different from adult cancers. When you’re researching the diagnosis, be sure you’re looking at how that cancer affects children. Often, the outcomes may be better for children than for adults with the same type of cancer. For instance, Seibel says, childhood tumors tend to respond better to treatment than do tumors in adults. Cancer cells tend to grow very swiftly in the types of tumors seen in children. So therapies can be selected to interrupt this rapid growth. Children with leukemia, non-Hodgkin’s lymphoma or certain solid tumors tend to have a good outcome.Treatment Plans Doctors design treatment plans specific to each child. Children usually receive one or more of the following treatments: Chemotherapy drugsRadiationSurgery (for solid tumors)ImmunotherapyA bone marrow or blood stem cell transplantUnpleasant side effects are common and can include hair loss, nausea and diarrhea. But side effects tend to fade shortly after treatment ends.Dr. Stephen Hunger, a pediatric cancer specialist at the University of Colorado, says that most advances in treatment have come from improvements to chemotherapy drugs. For instance, treatment for childhood leukemia 30 years ago often involved radiation to the brain. But radiation can cause health problems later in life. Now, with improvements to chemotherapy, oncologists are using radiation less, if at all, for children with leukemia and some other types of cancer. “This is a good change because of the long-term side effects to thinking and learning, and the risk of later developing brain tumors,” Hunger says.Clinical Trials for Childhood Cancer Improvements to treatment are often based on clinical studies of people who have cancer. Children might be eligible to participate in certain clinical studies of cancer shortly after their diagnosis.“NIH supports clinical trials for most types of childhood cancer,” says Dr. Malcolm Smith, a pediatric oncologist at NIH. For types of cancer that already have good treatments, he says, trials aim to maintain survival while reducing side effects. Other studies evaluate the safety and effectiveness of experimental therapies for cancers that lack good treatment options. When standard therapy fails, some children may be able to participate in clinical trials that test promising new agents. One NIH-supported cancer research network links thousands of pediatric cancer experts. Together, they conduct clinical research trials for common types of childhood cancers. Another NIH-sponsored research group is testing potential new drugs for pediatric brain tumors at hospitals nationwide. Click here to learn more about cancer trials.Coping with Childhood Cancer When a child is being treated for cancer, family members may find it hard to move forward with everyday life. After chemotherapy or radiation therapy, children may be tired and need more rest. Even so, kids with cancer have the same needs as other young people. Encourage your child to stay in touch with friends. Keeping contact is easier if your child can keep going to school. Contact your child’s teachers and school nurse to discuss the disease, treatment, absences and any needed changes in activity.Children often worry about how their classmates will act toward them, especially if a child has missed a lot of school or has noticeable changes such as hair loss. Let your child know that many people, including kids, are uneasy about serious illness. These people may act differently or say hurtful things. Many kids will be accepting of a child with cancer, but they may have a lot of questions. Talk to your child about ways to answer.Be open with your child about the diagnosis and upcoming treatments. Age-appropriate discussions might help ease stress, fear and uncertainty. Emphasize that cancer isn’t contagious and isn’t anybody’s fault.If your child is diagnosed with cancer, you may need support as well. You and your family can get help from many sources. Click here for some ideas.Additional Information: Symptoms of Childhood CancersDiagnosing Cancer in ChildrenTreating Cancer in ChildrenShould My Child Join a Clinical Trial? Common Coping Styles of Teens Who Are Chronically Ill or DisabledHow Chronic Illness Affects the FamilyWhat Does the School Need to Know?Social Difficulties for Children with Chronic Illness Last Updated 11/21/2015 Source NIH News in Health, June 2013"
127,5,"2018-04-19 02:48:19",Cancer,127,"2018-04-19 03:11:54","Diagnosing Cancer in Children","Diagnosing Cancer in Children Page Content Article BodyThe incidence of cancer in the United States is second only to that of heart disease. Yet when you consider that there are more than one hundred different forms of cancer, you begin to appreciate how rare the majority of them are, pediatric cancers in particular. Childhood leukemia, the most common form, strikes a mere two thousand two hundred youngsters a year. Consequently, a general adult oncologist may go for years without seeing a case of cancer in an adolescent. Although research in cancer therapy hasn’t produced any major breakthroughs since the early 1980s, enough small victories have been won that the overall cancer survival rate has crept from 51 percent of patients in 1982 to 60 percent in 1994. Unless a cancer specialist treats a particular cancer regularly, he may not be aware of the latest treatment guidelines. A lengthy 1999 report from the National Cancer Policy Board concluded that a “substantial” number of cancer patients “do not receive care known to be effective for their condition.” Tests Used to Diagnose Pediatric Cancers Acute Leukemias Physical examination, complete blood count (CBC), bone-marrow biopsy, lumbar puncture (spinal tap), tumor-cell chromosome analysis, liver-function and kidney-function blood tests, imaging studies such as X rays, radionuclide bone scan, ultrasonography, computed tomography (CT scan) and/or magnetic resonance imaging (MRI scan) Hodgkin’s Disease and Non-Hodgkin’s Lymphoma Physical examination, imaging studies such as X rays, computed tomography (CT scan) and/or magnetic resonance imaging (MRI scan), lymphnode biopsy, bone-marrow biopsy Brain Cancers Physical examination, neurological exam, lumbar puncture (spinal tap), electroencephalogram (EEG), imaging studies such as magnetic resonance imaging (MRI scan), computed tomography (CT scan), positron emission tomography (PET scan), angiography, brain tumor biopsy Sarcomas of the Soft Tissues and Bones Rhabdomyosarcoma Physical examination, soft-tissue imaging, tumor, biopsy Osteosarcoma Physical examination, imaging studies such as X rays, computed tomography (CT scan), magnetic resonance imaging (MRI scan) and/or radionuclide bone scan, bone biopsy Ewing’s Sarcoma Physical examination, imaging studies such as X rays, computed tomography (CT scan), magnetic resonance imaging (MRI scan) and/or radionuclide bone scan, bone biopsy, complete blood count (CBC) Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
128,5,"2018-04-19 02:48:19",Cancer,128,"2018-04-19 03:12:01","Symptoms of Childhood Cancers","Symptoms of Childhood Cancers Page Content Article BodyMost patients, young or old, go through periods of extreme fatigue as the body expends extra energy healing itself from the cancer and the side effects of treatment. Most childhood cancer symptoms are nonspecific and can mimic normal childhood illnesses. The malignant cells also interfere with the process of metabolism, depriving their healthy counterparts of essential nutrients leading to loss of appetite and general malaise. Compounding matters, during treatment, patients often see their appetites wane. Now add to this the countless other reasons why a young child with cancer might feel exhausted: anemia, inadequately controlled pain, not to mention the wearing effect from the daily stress of coping with a life-threatening illness.Symptoms of Pediatric CancersAcute LeukemiasFever, chills, appetite loss, aching bones or joints, swollen lymph nodes, weakness, fatigue, shortness of breath, pale complexion and other symptoms of anemia, unexplained bleeding, bruising and other symptoms of a blood-clotting disorder, bone pain, joint pain, a swollen abdomen due to enlargement of the spleen and liver. Occasionally leukemia may present with neurologic symptoms such as headache, seizures or weakness.Hodgkin's Disease and Non-Hodgkin's LymphomaPersistent fever, night sweats, unexplained weight loss, fatigue, appetite loss, itching, painless swelling of the lymph nodes in the neck or armpit, distended stomach, from swelling of lymphoid tissue in the abdomen, constipation or urinary retention, from swelling of lymphoid tissue near the intestines or the kidneys, coughing or shortness of breath, from lymph node mass in chest.Brain CancersSymptoms depend on the tumor's location within the brain—and increased pressure within the skull: dizziness, seizures, changes in behavior and personality, memory loss, confusion, gradual weakness or paralysis, impaired vision, hearing, speech, smell, balance, motor skills, persistent headaches, morning vomiting and blurred vision.Sarcomas of the Soft Tissues and Bones Rhabdomyosarcoma: Painless mass or swelling, tumors located in the abdomen or pelvis can cause vomiting, pain and constipation. Osteosarcoma and Ewing's Sarcoma: Bone pain, swelling, a palpable mass, chest pain or cough if mass in chest.Additional Information: Diagnosing Cancer in Children Accommodating Children with Cancer in Child Care or School Are Your Kids Protected from Cancer Caused by HPV? Preservation of Fertility in Pediatric and Adolescent Patients with Cancer (AAP Technical Report)  Last Updated 11/5/2015 Source Section on Hematology/Oncology (Copyright © 2015 American Academy of Pediatrics)"
129,5,"2018-04-19 02:48:19",Cancer,129,"2018-04-19 03:12:09","The Major Types of Skin Cancer","The Major Types of Skin Cancer Page Content Article BodyBasal-Cell Carcinoma:The most common of all cancers, BCC arises in the tiny, round basal cells of the upper layer of the skin, or epidermis. Usually discovered on the face, ears, lips and around the mouth, basal-cell cancer rarely spreads and is nearly 100 percent curable when treated early. If missed, however, it can cause disfigurement. Affects approximately 800,000 Americans annually. Squamous-Cell Carcinoma:Forms in the flat scalelike squamous cells of the epidermis. Typically found on the face, ears, lips, mouth, neck, hands, arms and back. Unlike basal-cell carcinoma, SCC can spread to other parts of the body. With early treatment, is 95 percent curable. Affects approximately 225,000 Americans annually, claiming 2,000 lives. Malignant Melanoma:The most rapidly increasing malignant tumor in the United States. Melanoma is a cancer of the melanocytes. The disease may develop as a new mole (a mole is merely a cluster of melanocytes) or as part of a preexisting mole. Highly curable if diagnosed and treated early. When it spreads (metastasizes), typically to the lungs or liver, can be extremely difficult to cure. Affects approximately 48,000 Americans annually, claiming 9,600 lives. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
130,5,"2018-04-19 02:48:19",Cancer,130,"2018-04-19 03:12:13","Treating Cancer in Children","Treating Cancer in Children Page Content Article BodyLeukemia Combination chemotherapy, CNS prophylaxis: injecting chemotherapy into the cerebrospinal fluid (intrathecally) as a preventive measure against the leukemia spreading to the central nervous system, Radiation therapy to the head in selected cases, Allogeneic bone-marrow transplantation in first or second remission, depending on the type of leukemia, Investigational therapies Hodgkin’s Disease Chemotherapy, Radiation therapy, Investigational therapies Non-Hodgkin’s Lymphomas Chemotherapy, CNS prophylaxis: injecting chemotherapy into the cerebrospinal fluid (intrathecally) as a preventive measure against the lymphoma spreading to the central nervous system, Radiation therapy to the chest is sometimes given to shrink a lymphoblastic lymphoma that is obstructing breathing or circulation, Allogeneic bone-marrow transplantation (after relapse), High-dose chemotherapy followed by autologous bonemarrow transplantation (usually after relapse), Investigational therapies Brain Tumors Surgery to remove the tumor from the brain, Radiation therapy to the brain (and to the spine, if the cancer is disseminated), Chemotherapy, Investigational therapies Rhabdomyosarcoma Surgery to remove the tumor, Chemotherapy, Radiation therapy, High-dose chemotherapy followed by autologous bonemarrow transplantation (usually after relapse), Investigational therapies Osteosarcoma Preoperative chemotherapy, Limb-salvage surgery, to preserve the limb, or amputation, Chemotherapy, Surgery to remove any metastatic tumors that remain following chemotherapy, Investigational therapies Ewing’s Sarcoma Preoperative chemotherapy, Surgery to remove the tumor, Radiation therapy (if the tumor is not completely resected), Surgery, to remove metastases to the lungs, High-dose chemotherapy followed by autologous bonemarrow transplantation (after relapse) Investigational therapies Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
131,6,"2018-04-19 02:48:19","Chest & Lungs",131,"2018-04-19 03:12:18",Bronchiolitis,"Bronchiolitis Page Content Article BodyBronchiolitis is a common respiratory illness among infants. One of its symptoms is trouble breathing, which can be scary for parents and children. Read more to learn about bronchiolitis, its causes, signs, and symptoms.What is bronchiolitis?Bronchiolitis is an infection that causes the small breathing tubes of the lungs (bronchioles) to swell. This blocks airflow through the lungs, making it hard to breathe. It occurs most often in infants because their airways are smaller and more easily blocked than in older children. Bronchiolitis is not the same as bronchitis, which is an infection of the larger, more central airways that typically causes problems in adults.What causes bronchiolitis?Bronchiolitis is caused by one of several respiratory viruses such as influenza, respiratory syncytial virus (RSV), parainfluenza, and human metapneumovirus.  Other viruses can also cause bronchiolitis.Infants with RSV infection are more likely to get bronchiolitis with wheezing and difficulty breathing. Most adults and many older children with RSV infection only get a cold. RSV is spread by contact with an infected person's mucus or saliva (respiratory droplets produced during coughing or wheezing). It often spreads through families and child care centers. What are the signs and symptoms of bronchiolitis?Bronchiolitis often starts with signs of a cold, such as a runny nose, mild cough, and fever. After a day or two, the cough may get worse and the infant will begin to breathe faster. The following signs may mean that the infant is having trouble breathing:He may widen his nostrils and squeeze the muscles under his rib cage to try to get more air in and out of his lungs.When he breathes, he may grunt and tighten his stomach muscles.He will make a high-pitched whistling sound, called a wheeze, each time he breathes out.He may have trouble drinking because he may have trouble sucking and swallowing.If it gets very hard for him to breathe, you may notice a bluish tint around his lips and fingertips. This tells you that his airways are so blocked that there is not enough oxygen getting into his blood.If your baby shows any of these signs of troubled breathing, call your child's doctor.Your child may become dehydrated if he cannot comfortably drink fluids. Call your child's doctor if your baby develops any of the following signs of dehydration:Drinking less than normalDry mouthCrying without tearsUrinating less often than normalBronchiolitis may cause more severe illness in children who have a chronic illness. If you think your child has bronchiolitis and your child has any of the following conditions, call your child's doctor:Cystic fibrosisCongenital heart diseaseChronic lung disease (seen in some infants who were on breathing machines or respirators as newborns)Immune deficiency disease (like acquired immunodeficiency syndrome [AIDS])Organ or bone marrow transplantA cancer for which he is receiving chemotherapyAdditional Information:Treating Bronchiolitis in InfantsRespiratory Syncytial Virus (RSV)Protecting Your Baby from RSV Last Updated 11/21/2015 Source Bronchiolitis and Your Young Child Brochure (Copyright © 2005 American Academy of Pediatrics, Updated 7/2014)"
132,6,"2018-04-19 02:48:19","Chest & Lungs",132,"2018-04-19 03:12:24","Chlamydia Pneumoniae Infections","Chlamydia Pneumoniae Infections Page Content Article BodyWhen you hear the word chlamydia, you might think of the sexually transmitted disease (STD) by that name. The STD is caused by Chlamydia trachomatis, one species of Chlamydia bacteria. Another species, called Chlamydia (or Chlamydophila) pneumoniae, causes respiratory illnesses. These lung infections are spread in the same way as many other respiratory diseases. They are passed from person to person directly through coughs or sneezes and indirectly from germs on hands or other objects. The number of these infections peaks in school-aged children between 5 and 15 years of age. Signs and Symptoms Illnesses caused by C pneumoniae can cause a prolonged cough, bronchitis, and pneumonia as well as a sore throat, laryngitis, ear infections, and sinusitis. They usually start gradually with a sore throat that is followed by a cough about a week or more later. The cough may last for 2 to 6 weeks. In some cases, the child may get bronchitis or a mild case of pneumonia. While some infected children have only mild to moderate symptoms or no symptoms at all, the infection may be more severe in others. How Is the Diagnosis Made? Many cases of C pneumoniae are diagnosed by a pediatrician after doing a physical examination of the child and looking at his symptoms. The doctor can also order blood tests that detect antibodies to the bacteria. However, it can take a week or more for the antibodies to show up in the blood. Although there are special laboratories that can evaluate swab specimens from the nose or throat, there are no reliable commercially available studies at this time. Treatment Recovery from a Chlamydia respiratory infection may be slow. Your pediatrician can prescribe antibiotics such as erythromycin or tetracycline to clear up the infection and help your child get better faster. Prevention To lower the chances of your child getting a C pneumoniae infection, he should practice good hygiene, including frequent hand washing. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
133,6,"2018-04-19 02:48:19","Chest & Lungs",133,"2018-04-19 03:12:28","Coughs and Colds: Medicines or Home Remedies?","Coughs and Colds: Medicines or Home Remedies? Page Content Article Body​Medicines Over-the-counter (OTC) cough and cold medicines can cause serious side effects in young children. The risks of using these medicines outweigh any benefits from reducing symptoms. Therefore, in October 2008, the Food and Drug Administration recommended that OTC cough and cold medicines never be used in children younger than 4 years. From ages 4 to 6 years, they should be used only if recommended by your child’s doctor. After age 6 years, the medicines are safe to use, but follow the dosage instructions on the package. Fortunately, you can easily treat cough​s and colds in young children without these nonprescription medicines.Home RemediesA good home remedy is safe, inexpensive, and as beneficial as OTC medicines. They are also found in nearly every home. Here is how you can treat your child’s symptoms with simple but effective home remedies instead of medicines: Runny Nose: Just suction or blow it. And remember, when your child’s nose runs like a faucet, it’s getting rid of viruses. Antihistamines (eg, loratadine, cetirizine, fexofenadine) do not help the average cold. However, they are useful and approved if the runny nose is caused by nasal allergies (hay fever). Blocked Nose: Use nasal washes.Use saline nose spray or drops to loosen up dried mucus, followed by blowing or suctioning the nose. If these are not available, warm water will work fine.Instill 2 to 3 drops in each nostril. Do one side at a time. Then suction or blow. Teens can just splash warm water into their nose. Repeat nasal washes until the return is clear.Do nasal washes whenever your child can’t breathe through the nose. For infants on a bottle or breast, use nose drops before feedings.Saline nose drops and sprays are available in all pharmacies without a prescription. To make your own, add 2 mL of table salt to 240 mL of warm tap water. Sticky, Stubborn Mucus: Remove with a wet cotton swab. Medicines: There is no medicine that can remove dried mucus or pus from the nose. Coughing: Use homemade cough medicines. For Children 3 Months to 1 Year of Age: Give warm, clear fluids (eg, warm water, apple juice). Dosage is 5 to 15 mL 4 times per day when coughing. Avoid honey because it can cause infantile botulism​. If your child is younger than 3 months, see your child’s doctor. For Children 1 Year and Older: Use HONEY, 2 to 5 mL, as needed. It thins secretions and loosens the cough. (If honey is not available, you can use corn syrup.) Recent research has shown that honey is better than drugstore cough syrups at reducing the frequency and severity of nighttime coughing. Coughing Spasms: Expose your child to warm mist from a shower. Fluids: Help your child drink plenty of fluids. Staying well hydrated thins the body’s secretions, making it easier to cough and blow the nose. Humidity: If the air in your home is dry, use a humidifier. Moist air keeps nasal mucus from drying up and lubricates the airway. Running a warm shower for a while can also help humidify the air.Treatment Is Not Always NeededIf symptoms aren’t bothering your child, they don’t need medicine or home remedies. Many children with a cough or nasal congestion are happy, play normally, and sleep peacefully.Only treat symptoms if they cause discomfort, interrupt sleep, or really bother your child (eg, a hacking cough).Because fevers are beneficial, only treat them if they slow your child down or cause some discomfort. That doesn’t usually occur until your child’s temperature reaches 102°F (39°C) or higher. Acetaminophen (eg, Tylenol) or ibuprofen (eg, Advil, Motrin) can be safely used in these instances to treat fever or pain.Summary:If treatment is needed for coughs and colds, home remedies may work better than medicines.Additional Information: Antibiotics for a Sore Throat, Cough, or Runny Nose? Fever and Pain Medicine: How Much to Give Your Child ​ Choosing Over-the-Counter Medicines for Your Child  How to Manage Colds and Flu ​ Protecting Your Baby from RSV​​​ Last Updated 7/13/2015 Source Adapted from My Child Is Sick! Expert Advice for Managing Common Illnesses and Injuries (Copyright © 2011 Barton D. Schmitt, MD, FAAP)"
134,6,"2018-04-19 02:48:19","Chest & Lungs",134,"2018-04-19 03:12:34","Croup and Your Young Child","Croup and Your Young Child Page Content Article BodyCroup is a co​mmon illness in young children. It can be scary for parents as well as children. Read on for more information from the American Academy of Pediatrics about croup, including types, causes, symptoms, and treatments. What is Croup?Croup is a condition that causes a swelling of the voice box (larynx) and windpipe (trachea). The swelling causes the airway below the vocal cords to become narrow and makes breathing noisy and difficult. It is most commonly caused by an infection. Children are most likely to get croup between 3 months and 5 years of age. As they get older, it is not as common because the windpipe is larger and swelling is less likely to get in the way of breathing. Croup can occur at any time of the year, but it is more common in the fall and winter months. Types of CroupViral CroupThis is the most common type of croup. It is caused by a viral infection of the voice box and windpipe. It often starts out just like a cold, but then it slowly turns into a barky cough. Your child's voice will become hoarse and her breathing will get noisier. She may make a coarse musical sound each time she breathes in, called stridor. Most children with viral croup have a low fever, but some have temperatures up to 104°F (40°C). Spasmodic CroupThis type of croup is thought to be caused by an allergy or by reflux from the stomach. It can be scary because it comes on suddenly, often in the middle of the night. Your child may go to bed well and wake up in a few hours, gasping for breath. She will be hoarse and have stridor when she breathes in. She may also have a barky cough. Most children with spasmodic croup do not have a fever. This type of croup can recur. It is similar to asthma and often responds to allergy or reflux medicines. Croup with StridorStridor is common with mild croup, especially when a child is crying or active. But if a child has stridor while resting, it can be a sign of more severe croup. As your child's effort to breathe increases, she may stop eating and drinking. She also may become too tired to cough, and you may hear the stridor more with each breath. The danger of croup with stridor is that sometimes the airway may swell so much that your child may barely be able to breathe. In the most severe cases, your child will not be getting enough oxygen into her blood. If this happens, she needs to go to the hospital. Luckily, these most severe cases of croup do not occur very often. Home Treatment for CroupIf your child wakes up in the middle of the night with croup, try to keep him calm. Keeping him calm may help him breathe better. Ways to comfort your child may include:Giving your child a hug or a back rubSinging a favorite bedtime songOffering reassuring words such as, ""Mommy's here, you will be OK""Offering a favorite toyIf your child has a fever (a temperature of 100.4°F [38°C] or higher):Treat it with acetaminophen or ibuprofen (for children older than 6 months), as needed. Make sure he is drinking fluids to avoid dehydration. In the past, parents may have been advised to try steam treatment in the bathroom. Though some parents may find that this helps improve breathing, there are no studies to prove that inhaling steam in a bathroom is effective. There are also no studies to prove that breathing in moist, cool night airs helps improve breathing.  When to Call the DoctorIf you are concerned that your child's croup is not improving, contact your child's doctor, local emergency department, or emergency medical services (911) even if it is the middle of the night. Consider calling if your child: Makes a whistling sound that gets louder with each breathCannot speak or make verbal sounds for lack of breathSeems to be struggling to catch her breathHas bluish lips or fingernailsHas stridor when restingDrools or has extreme difficulty swallowing salivaTreating Croup with MedicineIf your child has viral croup, your child's doctor or the emergency department doctor may give your child a breathing treatment with epinephrine (adrenaline) to decrease the swelling. After epinephrine is given, your child should be observed for 3 to 4 hours to confirm that croup symptoms do not return. A steroid medicine may also be prescribed to reduce the swelling. Steroids can be inhaled, taken by mouth, or given by injection. Treatment with a few doses of steroids should do no harm. Steroids may decrease the intensity of symptoms, the need for other medications, and time spent in the hospital and emergency department. For spasmodic croup, your child's doctor may recommend allergy or reflux medicines to help your child's breathing. Antibiotics, which treat bacteria, are not helpful for treating croup because they are almost always caused by a virus or by allergy or reflux. Cough syrups are not useful and may do harm. Other InfectionsAnother cause of stridor and serious breathing problems is acute supraglottitis (also called epiglottitis). This is a dangerous infection, usually caused by bacteria, with symptoms that can resemble croup. Luckily, this infection is much less common now because of the Haemophilus influenzae type b (Hib) vaccine. Rarely, supraglottitis is caused by other bacteria. Acute supraglottitis usually affects children 2 to 5 years of age and comes on suddenly with a high fever. Your child may seem very sick. He may have a muffled voice and prefer to sit upright with his neck extended and face tilted upward in a ""sniffing"" position to make his breathing easier. He also may drool because he cannot swallow the saliva in his mouth. If not treated, this disease could rapidly lead to complete blockage of your child's airway. If your child's doctor suspects acute supraglottitis:Your child must go to the hospital right away. If he has supraglottitis, he will need antibiotics, and he may also need a tube in his windpipe to help him breathe. Call your child's doctor right away if you think your child may have supraglottitis. To protect against acute supraglottitis:Your child should get the first dose of the Hib vaccine when he is 2 months of age. This vaccine will also protect against meningitis (a swelling in the covering of the brain). Since the Hib vaccine has been available, the number of cases of acute supraglottitis and meningitis has dramatically decreased. Recurrent or Persistent CroupWhen croup persists or recurs frequently, it may be a sign that your child has some narrowing of the airway that is not related to an infection. This may be a problem that was present when your child was born or one that developed later. If your child has persistent or recurrent croup, your child's doctor may refer you to a specialist such as an otolaryngologist (ear, nose, and throat specialist) or pulmonologist (breathing and lung disease specialist) for further evaluation. Croup is a common illness during childhood. Although most cases are mild, croup can become serious and prevent your child from breathing normally. Contact your child's doctor if your child's croup is not improving or if you have other concerns. He or she will make sure your child is evaluated and treated properly. Additional InformationFever and Your BabyCoughs and Colds: Medicines or Home Remedies?Diagnosing Asthma in Babies & ToddlersTreating Bronchiolitis in InfantsProtecting Your Baby from RSV Last Updated 11/21/2015 Source Croup and Your Young Child (Copyright © 2009 American Academy of Pediatrics, Updated 08/2014)"
135,6,"2018-04-19 02:48:19","Chest & Lungs",135,"2018-04-19 03:12:38","Hantavirus Pulmonary Syndrome","Hantavirus Pulmonary Syndrome Page Content​​ Article BodyHantavirus pulmonary syndrome (HPS) was first identified in 1993 when an outbreak of this infectious lung disease took place in the southwestern United States. The viruses that cause HPS come from a group of organisms known as hantaviruses. These germs are carried by particular kinds of mice. People get the infection by direct contact with infected rodents or their droppings, urine, or saliva or breathing in air contaminated with the virus. On rare occasions, the infection is passed to humans by a mouse bite. There is no evidence that it can be spread from person to person. The incubation period (the time after contact with an infected mouse to the beginning of symptoms) may be 1 to 6 weeks, though that period has not been established definitively. The majority of cases of HPS occur during the spring and summer, mostly in rural areas. Although it is a relatively uncommon infection, it can be deadly. Signs and Symptoms In the first 3 to 7 days of HPS, many of its symptoms resemble those of a severe cold, the flu, or a gastrointestinal disease. Fever Chills Headaches Nausea Vomiting Diarrhea Dizziness Fatigue Muscle aches in the large muscle groups (ie, back, thighs, shoulders) After the first few days, respiratory difficulties begin abruptly and can progress rapidly. People with the infection will develop a condition called adult respiratory distress syndrome (ARDS), in which the lungs lose their ability to move oxygen to the blood. Patients may develop a cough and shortness of the breath. Very quickly every organ of the body is affected. When to Call Your Pediatrician If your child has the symptoms of a severe cold or the flu and then develops shortness of breath or other respiratory problems, contact your doctor at once or take your youngster to the emergency department. How Is the Diagnosis Made? Blood tests can be done at specialized laboratories to identify the hantavirus. Treatment No specific therapy is available to directly treat HPS. There are studies taking place on an antiviral medication called ribavirin. This drug may someday be an effective treatment for HPS. Children with HPS need to be hospitalized in an intensive care unit. They may require oxygen therapy and get help breathing with a ventilator for about 2 to 4 days to combat ARDS. What Is the Prognosis? About 45% of patients with HPS die from the infection. However, early identification and supportive care in the hospital will help the majority of infected people recover from this dangerous syndrome. Prevention Take steps to reduce the likelihood of rodents in your home and other areas where your child spends time. Seal all holes through which rodents may enter your home. Exterminate rodents in the area with spring-loaded traps and other measures. Wear rubber gloves when touching dead rodents, and disinfect the gloves after you use them. Remove brush and grass away from your home’s foundation to prevent rodents from nesting. When entering an area where rodents may have lived, avoid stirring up or breathing potentially contaminated dust. Consider using a mask when cleaning areas contaminated with rodent droppings. Use tightfitting lids on garbage cans to prevent rodents from getting into the trash. Last Updated 1/1/2006 Source Immunizations ＆Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
136,6,"2018-04-19 02:48:19","Chest & Lungs",136,"2018-04-19 03:12:41","Legionnaires Disease","Legionnaires Disease Page Content Article BodyLegionnaires disease, also called legionellosis, is caused by the bacteria Legionella pneumophila and related species. These organisms have been found in water delivery systems. The infection can be caught by inhaling mists from water contaminated with the germs. Outbreaks have been traced to contaminated whirlpool spas, humidifiers, and air conditioning cooling towers and have occurred in hospitals, hotels, and cruise ships. The incubation period for legionnaires disease is 2 to 10 days. The disease and the organism that causes legionnaires disease were identified and got their names from the first known outbreak, at an American Legion convention held at a Philadelphia, PA, hotel in 1976. A related disease called Pontiac fever is caused by the same Legionella species. It is a milder, less serious infection with an incubation period of 1 to 2 days. Signs and Symptoms The symptoms of legionnaires disease can range from mild to severe. A form of pneumonia is a key component of the disease and may have symptoms that include Fever Cough Chills Muscle aches Progressive breathing difficulties These symptoms can get worse for the first few days of the infection before the patient begins to get better. People at greatest risk of contracting legionnaires disease are the elderly and those with suppressed immune systems. Children rarely get the infection and when they do, their illness is usually mild or they may have no symptoms at all. Pontiac fever causes flu-like symptoms such as muscle aches and a fever, but there are no signs of pneumonia. When To Call Your Pediatrician Call your pediatrician if your child develops breathing problems. How Is the Diagnosis Made? Your pediatrician can collect a sample of the secretions from your child’s respiratory tract and send it to the laboratory for analysis. Urine tests can also be performed to look for the bacteria, as well as antibody tests that can be conducted on blood samples. Treatment Antibiotics such as azithromycin are used to treat legionnaires disease. No treatment is needed for Pontiac fever, which goes away on its own in 2 to 5 days. What Is the Prognosis? The most serious cases of legionnaires disease lead to respiratory failure and death, especially in the elderly or people with weak immune systems. These deaths occur in 5% to 15% of cases. 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"
137,6,"2018-04-19 02:48:19","Chest & Lungs",137,"2018-04-19 03:12:46","Mycoplasma pneumoniae Infections","Mycoplasma pneumoniae Infections Page Content Article BodySome lung infections, including many cases of mild pneumonia (also referred to as walking pneumonia), are caused by an organism called Mycoplasma pneumoniae. It is spread from person to person in secretions such as phlegm from the respiratory passages and has an incubation period of 2 to 3 weeks. Transmission of this organism usually takes place through close contact. Outbreaks have occurred and are common in summer camps and colleges, as well as within households among family members. While M pneumoniae infections are uncommon in children younger than 5 years, they are a leading cause of pneumonia in school-aged children and young adults. Community-wide epidemics of this illness occur every 4 to 7 years. Signs and Symptoms M pneumoniae infections cause symptoms that are usually mild. They can get worse over time in some children. The most common symptoms are Bronchitis Upper respiratory tract infections, including sore throats and, at times, ear infections Children with this infection may also have a high fever, long-lasting weakness, and in some cases, headaches and a rash. Their cough can change from a dry cough to a phlegmy one. On rare occasions, youngsters may develop croup and a sinus infection (sinusitis). When to Call Your Pediatrician If these symptoms, including a fever, last for more than a few days, contact your pediatrician. How Is the Diagnosis Made? Your pediatrician will give your child a physical examination. The doctor may order blood tests for antibodies to M pneumoniae or cold agglutinins, which are a special type of antibody. Special tests are being developed to identify the organism in throat and respiratory samples, but these are not generally available yet. Treatment In most cases, the bronchitis and upper respiratory tract illnesses associated with M pneumoniae infections are mild and get better on their own without antibiotic treatment. However, antibiotics such as erythromycin, azithromycin, or doxycycline may be given for more serious symptoms associated with pneumonia and ear infections. What Is the Prognosis? This infection often causes wheezing in children with asthma or reactive airways. Most people fully recover from this infection, even when antibiotics are not used. The death rate is quite low. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
138,6,"2018-04-19 02:48:19","Chest & Lungs",138,"2018-04-19 03:12:52","Parainfluenza Viral Infections","Parainfluenza Viral Infections Page Content Article BodyHuman parainfluenza viruses (HPIVs) are a group of organisms, types 1 through 4, that cause several different respiratory infections. For example, they are the major cause of croup, which is an inflammation of the voice box (larynx) and windpipe (trachea) that makes breathing more difficult. They also cause some cases of lower respiratory tract diseases, including pneumonia (a lung infection) and bronchiolitis (an infection of the lung’s small breathing tubes). They can make the symptoms of chronic lung disease worse in children. Parainfluenza viruses have an incubation period of 2 to 6 days. They are spread from person to person by direct contact or exposure to contaminated secretions from the nose or throat. Children are usually exposed to most types of parainfluenza by 5 years of age. Signs and Symptoms The following symptoms occur in many types of parainfluenza infections, although they may be different from child to child or one kind of infection to another: A rough, barking cough Rapid, noisy, or labored breathing Hoarseness and wheezing Redness of the eye A runny nose Cough Fever A decline in appetite Vomiting Diarrhea How Is the Diagnosis Made? The diagnosis of HPIVs may be made by testing the secretions collected from a sick child’s nose and throat. Viral cultures or tests are taken to look for parts of the virus. An increase in antibodies to parainfluenza may be found in the blood of infected children. As with most infections, it can take several weeks for the antibodies to appear. Treatment The treatment of viral illnesses, including those caused by parainfluenza viruses, should not involve the use of antibacterials, which are not effective against viruses. Most parainfluenza infections do not require specific treatment other than soothing the symptoms and making your child more comfortable until she feels better. The illness goes away on its own. Antibacterials should only be used if a secondary bacterial infection develops. Talk to your pediatrician about whether your child with a fever should be given acetaminophen to lower her body temperature. Make sure she drinks lots of liquids. Some supportive therapies are unique to the specific infection that is present. For croup, which is characterized by a barking cough, your child may feel better if you take her into the bathroom, turn on the hot water in the shower, and let the bathroom fill with steam. The warm, moist air should allow her to breathe easier. Breathing in steam is usually helpful, but if it isn’t, take your child outdoors for a few minutes. Inhaling the moist, cool night air may loosen up her airway, and she will be able to breathe easier. Your pediatrician may prescribe a dose of corticosteroids for croup. Usually a single dose is all that is needed. Prevention In the first few months of life, infants have protection against some parainfluenza types because of antibodies from their mothers. Keep your child away from youngsters who have viral infections, particularly in the early and most contagious stages. Regular and thorough hand washing is an important way to lower the chances of spreading most viral infections. Your child should not share eating utensils and glasses with a sick youngster. A vaccine against parainfluenza viruses is not available, although vaccines against viral types 1 and 3 are in development. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
139,6,"2018-04-19 02:48:19","Chest & Lungs",139,"2018-04-19 03:12:56",Pneumonia,"Pneumonia Page Content Article Body The word pneumonia means ""infection of the lung."" While such infections were extremely dangerous in past generations, today most children can recover from them easily if they receive proper medical attention.Most cases of pneumonia follow a viral upper respiratory tract infection. Typically, the viruses that cause these infections (respiratory syncytial virus, influenza, parainfluenza, adenovirus) spread to the chest and produce pneumonia there. Pneumonia also can be caused by bacterial infections.Some of these are spread from person to person by coughing or by direct contact with the infected person's saliva or mucus. Also, if a viral infection has weakened a child's immune system, bacteria may begin to grow in the lung, adding a second infection to the original one.Certain children whose immune defenses or lungs are weakened by other illnesses, such as cystic fibrosis, abnormalities in the immune system or cancer (as well as by the chemotherapy used to treat cancer), may be  more likely to develop pneumonia. Children whose airways or lungs are abnormal in other ways may have a higher risk.Because most forms of pneumonia are linked to viral or bacterial infections that spread from person to person, they're most common during the fall, winter, and early spring, when children spend more time indoors in close contact with others. The chance that a child will develop pneumonia is not affected by how she is dressed or by air temperature.Signs and SymptomsLike many infections, pneumonia usually produces a fever, which in turn may cause sweating, chills, flushed skin, and general discomfort. The child also may lose her appetite and seem less energetic than normal. Babies and toddlers may seem pale and limp, and cry more than usual.Because pneumonia can cause breathing difficulties, you may notice these other, more specific symptoms, too:CoughFast, labored breathingIncreased activity of the breathing muscles below and between the ribs and above the collarboneFlaring (widening) of the nostrilsPain in the chest, particularly with coughing or deep breathing WheezingBluish tint to the lips or nails, caused by decreased oxygen in the bloodstreamAlthough the diagnosis of pneumonia usually can be made on the basis of the signs and symptoms, a chest X-ray sometimes is necessary to make certain and to determine the extent of lung involvement.TreatmentWhen pneumonia is caused by a virus, usually there is no specific treatment other than rest and the usual measures for fever control. Cough suppressants containing codeine or dextromethorphan should not be used, because coughing is necessary to clear the excessive secretions caused by the infection. Viral pneumonia usually improves after a few days, although the cough may linger for several weeks. Ordinarily, no medication is necessary.Because it is often difficult to tell whether the pneumonia is caused by a virus or by a bacteria, your pediatrician may prescribe an antibiotic. All antibiotics should be taken for the full prescribed course and at the specific dosage recommended. You may be tempted to discontinue them early, but you should not do so. Your child will feel better after just a few days, but some bacteria may remain and the infection might return unless the entire course is completed.Your child should be checked by the pediatrician as soon as you suspect pneumonia. Check back with the doctor if your child shows any of the following warning signs that the infection is worsening or spreading.Fever lasting more than a few days despite using antibioticsBreathing difficultiesEvidence of an infection elsewhere in the body: red, swollen joints, bone pain, neck stiffness, vomiting, or other new symptoms or signsPreventionYour child can be vaccinated against pneumococcal infections, a bacterial cause of pneumonia. The American Academy of Pediatrics recommends that all children starting at 2 months of age receive this immunization (called pneumococcal conjugate or PCV13). A series of doses needs to be given at two, four, six, and twelve to fifteen months of age, at the same time that children receive other childhood vaccines.Another pneumococcal vaccine (pneumococcal polysaccharide or PPV23) also is recommended for older children (twenty-four to fifty-nine months of age) who have a high risk of developing an invasive pneumococcal infection. These include children with:Sickle cell anemiaHeart diseaseLung diseaseKidney failureDamaged or no spleenOrgan transplantHIV (human immunodeficiency virus) infectionIt's also recommended for children taking medications or who have diseases that weaken their immune system.Additional Information: Pneumococcal Conjugate Vaccine: What You Need to KnowPneumococcal InfectionsProtecting Your Baby from RSV Last Updated 11/21/2015 Source Adapted from Caring for Your Baby and Young Child: Birth to Age Five (Copyright © 2009 American Academy of Pediatrics)"
140,6,"2018-04-19 02:48:19","Chest & Lungs",140,"2018-04-19 03:13:02","Protecting Your Baby from RSV","Protecting Your Baby from RSV Page Content Article BodyRSV is the most common cause of lower respiratory tract infections in infants and young children, and is one of many viruses that causes colds in children. Infecting the lungs and breathing passages, it is frequently responsible for bronchiolitis and pneumonia in children under age one. In fact, the highest incidence of RSV illness occurs in infants from two months to eight months of age. RSV is also the most common reason that infants under one year of age are hospitalized.RSV is a highly contagious infection, occurring most often during the months from fall through spring. It causes symptoms such as a runny or stuffy nose with or without an accompanying sore throat, a mild cough, and sometimes a fever. The infection can remain in the nose or involve the ears and it can spread to the lower respiratory tract causing bronchiolitis. The symptoms of bronchiolitis include abnormally rapid breathing and wheezing.If your baby was born prematurely, or has chronic lung disease, he has a higher risk of having a serious RSV infection. Premature babies frequently have underdeveloped lungs, and may not have received enough antibodies from their mother to help them combat RSV if they encounter it.How to Reduce Your Baby's Chances of Developing a More Serious RSV Infection:Having people wash their hands with warm water and soap before picking up and holding your babyReducing close contact with people who have runny noses or other sicknesses. Continue to breastfeed when you have a cold, however, since doing so will supply the baby with nourishment and protective antibodiesAs much as possible, limiting your baby's siblings from spending time with your infant when they have a cold (and make sure they wash their hands frequently)Keeping your baby away from crowded areas, such as shopping malls and elevators, where he'll have close contact with people who may be sickAvoiding smoking around your baby, since secondhand smoke could increase his susceptibility to a serious RSV infectionIf Your Baby Develops Bronchiolitis or Another RSV Infection:If your pediatrician determines that your baby has developed bronchiolitis or another RSV infection, she may recommend symptomatic treatment, such as easing nasal stuffiness with a nasal aspirator or mild salt-solution nasal drops. Severe pneumonia or bronchiolitis may require hospitalization in order to administer humidified oxygen and medications to help your child breathe more easily.Additional Information:Respiratory Syncytial Virus (RSV)RSV: When It's More Than Just a ColdTreating Bronchiolitis in InfantsFever and Your BabyWhen Mom Gets Sick: Minor Illnesses and Infections While Breastfeeding Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)"
141,6,"2018-04-19 02:48:19","Chest & Lungs",141,"2018-04-19 03:13:12","RSV: When It's More Than Just a Cold","RSV: When It's More Than Just a Cold Page Content Article BodyIt looks and sounds like a cold, but respiratory syncytial virus (RSV) can become something more. What’s the difference? What should you do about it? And when should you take your child to a pediatrician? Eighteen-month-old Janie woke up with a fever, stuffy nose, and some crankiness. She was coughing, and her breathing seemed to be a little labored. Great — another cold, her mom thought. But is it a cold, or could it be respiratory syncytial virus (RSV)? If your child is otherwise healthy, like Janie, then RSV may only produce the symptoms of the common cold. Wheezing and grunting with each breath or fast breathing may also occur. When It’s More of a Concern But if a premature infant, a young infant, or a child with a health condition that affects the lungs, heart, or immune system comes down with RSV, then the impact can be much greater. Those at high risk could develop bronchiolitis or pneumonia. In fact, RSV is the leading cause of infant hospitalizations for bronchiolitis in the United States, according to Henry Bernstein, D.O., FAAP, Chief, General Academic Pediatrics at Children’s Hospital at Dartmouth and Professor of Pediatrics at Dartmouth Medical School. “An infant’s chest wall is not very stiff because it is not well-developed,” says John Bradley, M.D., FAAP, Director, Division of Infectious Diseases, Children’s Hospital San Diego. “An older child has a better-developed chest wall and can cough up the mucus caused by RSV. But a baby can’t do this, so they are more likely to have plugged airways and a greater risk of further inflammation. That is why RSV is such a concern for the very young.” Like most other common colds, RSV is highly contagious and most often occurs in fall and winter (roughly November through April). It can spread directly from person to person, or indirectly when someone touches any object infected with the virus, such as toys, countertops, doorknobs, or pens. Children under the age of 2 are most frequently affected by the very serious symptoms of RSV. Prevent the Spread The best defense against RSV is to teach and encourage good handwashing habits to your children. In fact, this is the most effective way to avoid infection. Also, try to steer clear of anyone who has obvious symptoms of a cold as much as you can. Because RSV is so infectious, it spreads easily and quickly at shopping malls, child care centers, and schools. Many times, younger children are infected because an older child brings the virus home. If one child comes down with the virus, it is best to separate the child who has symptoms from others until the symptoms subside. If at all possible, parents of premature or very young infants and parents of children with a health condition that affects the lungs, heart, or immune system should keep their children away from child care centers during the peak of RSV season. “Those with RSV can shed the virus for as long as a week,” says Dr. Bernstein, a member of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases. “That makes it necessary to keep the infected separated from those who have no symptoms for quite some time.” Also, steer clear of tobacco smoke. “Avoiding smoking is key,” Dr. Bernstein emphasizes. “Parents who smoke are more likely to acquire viral respiratory infections and then pass them on to their children.”   Diagnosis and Treatment If a child is otherwise healthy, there is really no need to obtain a formal RSV diagnosis. The condition will generally run its course without specific medical treatment. If your child is at higher risk as a premature infant or because of other medical conditions, then a doctor can diagnose RSV by taking a swab of nasal fluids. Doctors can also decide which young or premature infants might benefit from RSV antibodies during the peak season. This would likely be children who have heavy scarring of the lungs because they were on a respirator at birth. The antibodies help reduce the likelihood of the child developing pneumonia and can therefore prevent a hospital stay. “These injections are technically engineered, very expensive, and not for every child. But they can make at-risk babies far less sick than they would be otherwise,” says Dr. Bradley, who is also a member of AAP’s Committee on Infectious Diseases. Because RSV is a virus rather than a bacterial infection, it cannot be treated with antibiotics, and there is no vaccine available yet. “A vaccine is in the laboratory stage, but we probably won’t see anything in human trials for the next couple of years,” Dr. Bradley explains. “And because even natural infection with the virus does not provide perfect immunity from getting RSV again, a vaccine will most likely not provide perfect immunity either.” So what’s a parent to do with a child suffering from RSV? Here are some guidelines:   Give plenty of fluids. Use a cool-mist vaporizer during the winter months to keep the air moist. (Be sure to clean the vaporizer regularly.) Blow little noses frequently (or use a nasal aspirator for infants). Give non-aspirin pain reliever, such as acetaminophen. Aspirin should not be used because it has been linked to Reye syndrome, a disease that affects the brain and liver. Knowing how to avoid spreading the virus can help keep your children healthy. And recognizing the symptoms that signal greater inflammation can prevent a trip to the hospital for those a higher risk. The good news is that the majority of children who come in contact with RSV will never know they had anything more than just a “bad cold. When to Call the Doctor Children may need treatment if they show any of the following symptoms: Great difficulty or fast breathing Excessive wheezing Gray or blue skin color High fever Thick nasal discharge that is yellow, green, or gray Worsening cough Extreme tiredness (especially during times they are normally active) This article was featured in Healthy Children Magazine. To view the full issue, click here. Last Updated 11/21/2015 Source Healthy Children Magazine, Winter 2008"
142,6,"2018-04-19 02:48:19","Chest & Lungs",142,"2018-04-19 03:13:17","Respiratory Syncytial Virus (RSV)","Respiratory Syncytial Virus (RSV) Page Content Article Body The respiratory syncytial virus (RSV) is a major cause of infections of the breathing passages and lungs in infants and young children., It is one of many viruses that can cause  bronchiolitis (an infection of the bronchioles, the small breathing tubes of the lungs). Other causes of bronchiolitis, are influenza, parainfluenza virus, or adenovirus.Respiratory virus  is transmitted from an infected child by secretions from the nose or mouth of an infected person, by direct contact, or airborne droplets. The period of greatest contagiousness is in the first few days of the infection. The incubation period of RSV ranges from 2 to 8 days, commonly 4 to 6 days. Annual epidemics take place during the winter and early spring.Signs and SymptomsMost children with respiratory infections have only mild symptoms, typically similar to the symptoms of a common cold. In children younger than 2 years, the infection may progress to symptoms more commonly found in bronchiolitis.Initially, the child will have a runny nose, mild cough, and in some cases, a fever.Within 1 to 2 days, the cough will get worse.At the same time, the youngster's breathing will become more rapid and difficult. He may wheeze each time he breathes out.Your child will have a hard time drinking because he is using so much energy breathing. Even swallowing becomes very difficult for these infants.His fingertips and the area around his lips may turn a bluish color, a sign that his strained breathing is not delivering enough oxygen to his bloodstream.What You Can DoIn the early stages of a respiratory infection, help ease your child's cold-like symptoms. Gentle suctioning of the nose may be useful to clear the nostrils. You should not use medications as they may cause side effects and are not effective in the young child.Mist has not been shown to be useful. Hot-air vaporizers should be avoided because of the risk for scald burns, and cool-mist vaporizers are often contaminated with molds. Make sure your child drinks enough liquid to prevent dehydration.When to Call Your PediatricianContact your pediatrician immediately if your baby or child:Has breathing difficultiesIs younger than 2 or 3 months and has a feverShows signs of dehydration, such as a dry mouth, crying without tears, and urinating less oftenHow Is the Diagnosis Made?Your pediatrician may order laboratory tests of specimens taken from your child's nose and throat to see if RSV or another virus is present. The virus can be grown in special cultures, or parts of the virus can be identified by rapid tests.TreatmentThere is no effective treatment for RSV or other viruses (other than influenza). Observation for worsening is necessary. If worsening occurs, you should call your doctor. Some youngsters with bronchiolitis may have to be hospitalized for treatment with oxygen. If your child is unable to drink because of rapid breathing, he may need to receive intravenous fluids. On rare occasions, infected babies will need a respirator to help them breathe.Antibacterials are not used for treating viral infections.What Is the Prognosis?Most children with viral infections are well on their way to recovery in about a week, and almost all fully recover. Nearly all children are infected with RSV at least once by 2 years of age, and a mild recurrence of the infection throughout life is common. As the child grows, viral infections become less serious than when they were infants and are usually hard to distinguish from a cold.These infections can make chronic breathing conditions worse. Infants with congenital heart disease may have a more severe case of RSV. Some children will require hospitalization, and a few will need intensive care.PreventionYour child should avoid close contact with other children and adults who are infected with viruses. In child care centers, good hygiene practices should be used by the staff and the children, including frequent and thorough hand washing.Palivizumab is an antibody that may reduce the risk of RSV infection. It is given as an intramuscular shot once a month to children who are at increased risk for serious illness caused by RSV. These include very premature babies and some babies with chronic lung disease.Additional Information: Protecting Your Baby From RSVTreating Bronchiolitis in InfantsFever and Your BabyBronchiolitis Fever and Pain Medicine: How Much to Give Your ChildPreventing the Flu: Resources for Parents & Child Care Providers Last Updated 11/21/2015 Source Adapted from Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
143,6,"2018-04-19 02:48:19","Chest & Lungs",143,"2018-04-19 03:13:21","Severe Acute Respiratory Syndrome (SARS) and Other Coronaviruses","Severe Acute Respiratory Syndrome (SARS) and Other Coronaviruses Page Content Article BodyIn late 2002 and early 2003, reports of a new disease called severe acute respiratory syndrome (SARS) emerged from parts of Asia. Since then, the illness has been found in other parts of the world, including Europe and North and South America. During the initial 2003 outbreak, only 8 people in the United States were diagnosed with SARS. All of them had traveled to parts of the world where there were people infected with SARS. In all of those areas, SARS was uncommon in children. Severe acute respiratory syndrome is caused by a specific virus from a family of organisms called coronaviruses. They received their name because when examined under the microscope, they look something like a halo or crown. Other coronaviruses are a common cause of mild to moderate upper respiratory tract infections in children and adults. The incubation period is 2 to 7 days. Signs and Symptoms In many places, SARS has been a very contagious disease. In most cases, it starts with a high fever. People with the infection may then develop other symptoms, including Body aches Headaches Vague feelings of illness (malaise) Mild respiratory problems (shortness of breath) Diarrhea A dry cough tends to occur after several days. Pneumonia then develops in most people. What You Can Do Before traveling to Asia and other areas where cases of SARS have been most prevalent, seek the advice of your pediatrician and keep up-to-date on travel advisories from the Centers for Disease Control and Prevention. When to Call Your Pediatrician If your child develops these symptoms, particularly breathing difficulties that might indicate the development of SARS or other pneumonia-like infections, contact your pediatrician. Also contact your pediatrician if your child develops any respiratory symptoms after traveling to an area with a known SARS outbreak or being in contact with anyone known or suspected of having SARS. How Is the Diagnosis Made? Because the symptoms of SARS are similar to those of other respiratory infections, your pediatrician will conduct a physical examination and perform tests that may rule out other conditions. Diagnostic tests specifically for coronaviruses are generally unavailable. Treatment The treatment of SARS is similar to that given to patients with viral pneumonia and is generally supportive. It may include giving oxygen during hospitalization (in some cases, a ventilator or breathing device will be used). A number of antiviral medications are being tested for use in SARS, but no specific medication has been proven to be effective. What Is the Prognosis? Most people recover from SARS. However, in the initial outbreaks of 2002 and 2003, there were 774 deaths among the more than 8,000 cases that were identified. At this time, the risk of SARS in children and adults in the United States is thought to be relatively low. Public health officials continue to monitor the worldwide patterns of the disease. Prevention Severe acute respiratory syndrome is spread during close contact with a person who has the infection, usually during sneezing or coughing. A child can also pick up the virus if she touches a toy or other object or surface that has been contaminated with the virus. To reduce the risk of SARS, make sure your child washes her hands frequently with soap and hot water. No vaccination is available to prevent SARS. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
144,6,"2018-04-19 02:48:19","Chest & Lungs",144,"2018-04-19 03:13:26","Severe Cases of Croup: When Your Child Needs Hospital Care","Severe Cases of Croup: When Your Child Needs Hospital Care Page Content​​Most cases of croup can be treated successfully at home. However, children with severe cases of croup may need to be treated in the hospital.Call 911 or an ambulance right away if your child: Makes a whistling sound (called stridor) that gets louder with each breath.Cannot speak because of a lack of breath.Seems to struggle to get a breath.Has a bluish color of the lips, mouth, or fingernails.Drools or has trouble swallowing.Care of Your Child at the Hospital:At the hospital, your child's doctor will decide the best way to treat your child. Treatments may include the following: Epinephrine. This medicine can help reduce swelling in the upper airways so that your child can breathe better. Epinephrine is given through a nebulizer. A nebulizer is a machine that turns liquid medicine into a fine mist. The mist is breathed in through a mouthpiece or face mask. Often, when this medicine is used, doctors prefer to continue to watch a child for several hours after it is given. This sometimes requires a stay in the hospital.Corticosteroids. These medicines can be useful in reducing inflammation in the body. They work in 2 ways. Systemic corticosteroids must go through the body to treat the inflammation in the upper airway. Inhaled or intranasal corticosteroids go directly to where the inflammation is. Oxygen. Sometimes when breathing is very difficult for a child, the body may not get enough oxygen and the work of breathing increases. Oxygen given through a mask or a small tube near the nose will make it easier to breathe.When Can My Child Go Home?As soon as your child's breathing improves, usually within a few hours, he will be allowed to go home. Sometimes a child with croup will stay in the hospital overnight for observation.  Additional Information from HealthyChildren.org: Croup and Your Young ChildFever and Your BabyDiagnosing Asthma in Babies & ToddlersTreating Bronchiolitis in InfantsProtecting Your Baby from RSV Article Body Last Updated 11/23/2016 Source Croup: When Your Child Needs Hospital Care (Copyright © 2008 American Academy of Pediatrics)"
145,6,"2018-04-19 02:48:19","Chest & Lungs",145,"2018-04-19 03:13:29","The Flu","The Flu Page Content​Flu is the short term for influenza. It is an illness caused by a respiratory virus. The infection can spread rapidly through communities as the virus is passed person to person. When someone with the flu coughs or sneezes, the influenza virus gets into the air, and people nearby, including children, can inhale it. The virus also can be spread when your child touches a contaminated hard surface, such as a door handle, and then places his hand or fingers in his nose/mouth or rubs his eye.Flu SeasonThe flu season usually starts in the fall and ends in the spring. When there is an outbreak or epidemic, usually during the winter months, the illness tends to be most pronounced in preschool or school-aged children. Adult caregivers are easily exposed and can come down with the disease. The virus usually is transmitted in the first several days of the illness.Flu SymptomsAll flu viruses cause a respiratory illness that can last a week or more. Flu symptoms include:A sudden fever (usually above 101°F or 38.3°C)Chills and body shakesHeadache, body aches, and being a lot more tired than usualSore throatDry, hacking coughStuffy, runny noseSome children may throw up (vomit) and have loose stools (diarrhea). After the first few days of these symptoms, a sore throat, stuffy nose, and continuing cough become most evident. The flu can last a week or even longer. A child with a common cold usually has only a low-grade fever, a runny nose, and only a small amount of coughing. Children with the flu—or adults, for that matter—usually feel much sicker, achier, and more miserable. Healthy people, especially children, get over the flu in about a week or two, without any lingering problems. However, you might suspect a complication if your child says that his ear hurts or that he feels pressure in his face and head or if his cough and fever will not go away, talk with your child's doctor.  Children with chronic health conditionsChildren who appear to have the greatest risk of complications from the flu are those with an underlying chronic medical condition, such as heart, lung, or kidney disease, an immune system problem, diabetes mellitus, some blood diseases, or malignancy. As these children may have more severe disease or complications, they should, when possible, avoid other children with the flu or flu-like symptoms. Their pediatrician may suggest additional precautions that should be taken. If your child has flu-like symptoms along with any difficulty breathing, seek medical attention right away. There can be serious complications, even death, from the flu, but thanks to the flu vaccine these are less common.Flu TreatmentFor all children who don't feel well with the flu, lots of tender loving care is in order. Children may benefit from extra rest and drinking lots of fluids. If your child is uncomfortable because of a fever, acetaminophen or ibuprofen in doses recommended by your pediatrician for his age and weight will help him feel better. Ibuprofen is approved for use in children six months of age and older; however, it should never be given to children who are dehydrated or who are vomiting continuously. It is extremely important never to give aspirin to a child who has the flu or is suspected of having the flu. Aspirin during bouts of influenza is associated with an increased risk of developing Reye syndrome.Flu Prevention Everyone should get the flu vaccine each year to update their protection. It is the best way to prevent getting the flu. Safe vaccines are made each year and the best time to get the flu vaccine is the late summer/early fall or as soon as it is on hand in your community.Vaccination is especially important for:Children, including infants born preterm, who are 6 months to 5 years of age, Children of any age with chronic medical conditions that increase the risk of complications from the flu Children of American Indian/Alaskan Native heritageAll contacts and care providers of children with high risk conditions and children younger than 5 years (especially newborns and infants younger than 6 months because these young infants are not able to receive their own vaccination)All health care personnelAll women who are pregnant, are considering pregnancy, have recently delivered, or are breastfeeding during the flu seasonThe flu virus spreads easily through the air with coughing and sneezing, and through touching things like doorknobs or toys and then touching your eyes, nose, or mouth. Click here for some tips that will help protect your family from getting sick.Flu VaccineOnly the Inactivated (killed) vaccine, also called the ""flu shot"", given by injection into the muscle, should be used for influenza vaccination this season. There are two types of inactivated flu vaccine based on the number of flu virus strains it contains: A trivalent (3 strains = two A and one B viruses) and a quadrivalent (4 strains = two A and two B viruses) vaccine. There is no preference for the use of either of these formulations. Any of these vaccines should be given as available in your area.The American Academy of Pediatrics recommends that an influenza vaccine be given annually to all children starting at six months of age. Children 6 month through 8 years old may need two doses of the vaccine given at least four weeks apart. Children 9 years of age and older only need one dose.Flu vaccines are especially important for children at high risk for complications from the flu such as those with a chronic disease such as asthma, heart disease, decreased immune system function due to a primary condition or from medications such as steroids, renal disease, or diabetes mellitus.  All eligible children may receive the inactivated flu shot. All also adults should receive the flu vaccine yearly; this is especially important for adults who live in the same household as someone who has a high risk for flu complications or who care for children under the age of five. Side effectsThe flu vaccine has few side effects, the most common being fever and redness, soreness or swelling at the injection site. Although flu vaccines are produced using eggs, influenza vaccines have been shown to have minimal egg protein so that all children with presumed or confirmed egg allergy may still safely receive the flu vaccine unless they have had an allergic reaction specifically to the flu vaccine before.  Talk with your doctor if you have any questions.AntiviralsAntiviral medications are available by prescription to treat an influenza infection. Your pediatrician can help decide whether or not to treat the flu with an antiviral medicine. Antiviral medications work best if started within the first 1 to 2 days of showing signs of the flu. However, in some children with increased risk for influenza complications, treatment could be started later.Call your pediatrician within 24 hours of the first flu symptom to ask about antiviral medications if your child Has an underlying health problem like asthma, diabetes, sickle cell disease, or cerebral palsyIs younger than 6 month old.Is younger than 5 years old, especially if less than 2 years oldAdditional Information & Resources:Preventing the Flu: Resources for Parents & Child Care ProvidersHand Washing: A Powerful Antidote to Illness Influenza Prevention and Control: Strategies for Early Education and Child Care Programs (AAP.org) Article Body Last Updated 9/1/2017 Source American Academy of Pediatrics (Copyright © 2017)"
146,6,"2018-04-19 02:48:19","Chest & Lungs",146,"2018-04-19 03:13:34","Treating Bronchiolitis in Infants","Treating Bronchiolitis in Infants Page Content Article BodyThere is no specific treatment for RSV or the other virus that cause bronchiolitis. Antibiotics are not helpful because they treat illnesses caused by bacteria, not viruses. However, you can try to ease your child's symptoms.To relieve a stuffy nose:Thin the mucus using saline nose drops recommended by your child's doctor. Never use nonprescription nose drops that contain any medicine.Clear your baby's nose with a suction bulb. Squeeze the bulb first. Gently put the rubber tip into one nostril, and slowly release the bulb. This suction will draw the clogged mucus out of the nose. This works best when your baby is younger than 6 months.To relieve fever:Give your baby acetaminophen. (Follow the recommended dosage for your child's age). Do not give your baby aspirin because it has been associated with Reye syndrome, a disease that affects the liver and brain. Check with your child's doctor first before giving any other cold medicines.To prevent dehydration:Make sure your baby drinks lots of fluid. She may want clear liquids rather than milk or formula. She may feed more slowly or not feel like eating because she is having trouble breathing.How will your pediatrician treat bronchiolitis?Your pediatrician will evaluate your child and advise you on nasal suctioning, fever control, and observation, and when to call her back. Some children with bronchiolitis need to be treated in a hospital for breathing problems or dehydration. Breathing problems may need to be treated with oxygen and medicine. Dehydration is treated with a special liquid diet or intravenous (IV) fluids.In very rare cases when these treatments aren't working, an infant might have to be put on a respirator. This usually is only temporary until the infection is gone.How can you prevent your baby from getting bronchiolitis?The best steps you can follow to reduce the risk that your baby becomes infected with RSV or other viruses that can cause bronchiolitis include:Make sure everyone washes their hands before touching your baby.Keep your baby away from anyone who has a cold, fever, or runny nose.Avoid sharing eating utensils and drinking cups with anyone who has a cold, fever, or runny nose.If you have questions about the treatment of bronchiolitis, call your child's doctor.Additional Information: BronchiolitisRespiratory Syncytial Virus (RSV)Protecting Your Baby from RSVFever and Pain Medicine: How Much to Give Your Child Last Updated 11/21/2015 Source Bronchiolitis and Your Young Child Brochure (Copyright © 2005 American Academy of Pediatrics, Updated 7/2014)"
147,6,"2018-04-19 02:48:19","Chest & Lungs",147,"2018-04-19 03:13:38","Tuberculosis in Children","Tuberculosis in Children Page Content​What is tuberculosis?Tuberculosis (TB) is an airborne infection that primarily affects the lungs. Who is at riskWhile TB is less common than it once was, some groups of children have a higher risk of developing tuberculosis, including:Children living in a household with an adult who has active tuberculosis or has a high risk of contracting TBChildren infected with HIV or another condition that weakens the immune systemChildren born in a country that has a high prevalence of TB Children visiting a country where TB is endemic and who have extended contact with people who live thereChildren from communities that generally receive inadequate medical careChildren living in a shelter or living with someone who has been in jail How it is spread:Tuberculosis usually is spread when an infected adult coughs the bacteria into the air. These germs are inhaled by the child, who then becomes infected. Children younger than about ten years old with TB of the lungs rarely infect other people, because they tend to have very few bacteria in their mucus secretions and also have a relatively ineffective cough.Fortunately, most children exposed to tuberculosis don't become ill. When the bacteria reach their lungs, the body's immune system attacks them and prevents further spread. These children have developed a symptom-free infection indicated only by a positive skin test. However, the symptom-free child still must be treated to prevent an active disease from ever occurring. Symptoms:Occasionally, in a small number of children without proper treatment, the infection does progress, causing fever, fatigue, irritability, a persistent cough, weakness, heavy and fast breathing, night sweats, swollen glands, weight loss, and poor growth.In a very small number of children (mostly those less than four years old), the tuberculosis infection can spread through the bloodstream, affecting virtually any organ in the body. This illness requires much more complicated treatment, and the earlier it is started, the better the outcome. These children have a much greater risk of developing tuberculosis meningitis, a dangerous form of the disease that affects the brain and central nervous system. DiagnosisChildren who are at risk for contracting TB should receive a tuberculin skin test (sometimes called a PPD (purified protein derivative off tuberculin). Your child may need a skin test if you answer yes to at least one of the following questions:Has a family member or contact had tuberculosis disease?Has a family member had a positive tuberulin skin test?Was your child born in a high-risk country (countries other than the United States, Canada, Australia, New Zealand, or Western European countries)?Has your child traveled (had contact with resident populations) to a high-risk country for more than one week?The test is performed in your pediatrician's office by injecting a purified, inactive piece of TB germ into the skin of the forearm. If there has been an infection, your child's skin will swell and redden at the injection site. Your pediatrician will check the skin forty-eight to seventy-two hours after the injection, and measure the diameter of the reaction. This skin test will reveal past infection by the bacteria, even if the child has had no symptoms and even if his body has fought the disease successfully. Treatment: If your child's skin test for TB turns positive: A chest X-ray will be ordered to determine if there is evidence of active or past infection in the lungs. If the X-ray does indicate the possibility of active infection, the pediatrician also will search for the TB bacteria in your child's cough secretions or in his stomach. This is done in order to determine the type of treatment. If your child's skin test turns positive, but he does not have symptoms or signs of active tuberculosis infection: He still is infected. In order to prevent the infection from becoming active, your pediatrician will prescribe a medication called isoniazid (INH). This medication must be taken by mouth once a day every day for a minimum of nine months. For an active tuberculosis infection: Your pediatrician will prescribe three or four medications. You will have to give these to your child for six to twelve months. Your child may have to be hospitalized initially for the treatment to be started, although most of it can be carried out at home. Controlling the spread of TB If your child has been infected with TB, regardless of whether he develops symptoms, it's very important to attempt to identify the person from whom he caught the disease. Usually this is done by looking for symptoms of TB in everyone who came in close contact with him, and having TB skin tests performed on all family members, babysitters, and housekeepers; the most common symptom in adults is a persistent cough, especially one that is associated with coughing up blood. Anyone who has a positive skin test should receive a physical examination, a chest X-ray and treatment. When an active infection is found in an adult: He will be isolated as much as possible–especially from young children–until treatment is under way. All family members who have been in contact with that person usually are also treated with INH, regardless of the results of their own skin tests. Anyone who becomes ill or develops an abnormality on a chest X-ray should be treated as an active case of tuberculosis.Tuberculosis is much more common in underprivileged populations, which are more susceptible to disease due to crowded living conditions, poor nutrition, and the probability of inadequate medical care. AIDS patients, too, are at a greater risk of getting TB, because of their lowered resistance. If untreated: Tuberculosis can lie dormant for many years, only to surface during adolescence, pregnancy, or later adulthood. At that time, not only can the individual become quite ill, but he also can spread the infection to those around him. Thus, it's very important to have your child tested for TB if he comes in close contact with any adult who has the disease and to get prompt and adequate treatment for him if he tests positive.Additional Information: Precautions for International Travel: Information for Parents Serious Illnesses and Breastfeeding Swollen Glands TB in Children in the United States (Centers for Disease Control and Prevention)  Article Body Last Updated 2/11/2016 Source Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)"
148,6,"2018-04-19 02:48:19","Chest & Lungs",148,"2018-04-19 03:13:44","Whooping Cough","Whooping Cough Page Content Article BodyWhat is whooping cough? Pertussis, or whooping cough, is less common in young children than it used to be, as the pertussis vaccine has made most children immune. Before this vaccine was developed, there were several hundred thousand cases of whooping cough each year in the United States. Now there are approximately 1 million cases a year in the US, but these are mostly in adults and adolescents. This illness is caused by pertussis bacteria, which attack the lining of the breathing passages (bronchi and bronchioles), producing severe inflammation and narrowing of the airways. Severe coughing is a prominent symptom. If not recognized properly, the bacteria may spread to those in close contact with the infected person, through her respiratory secretions. Who is at risk? Infants under one year of age are at greatest risk of developing severe breathing problems and life- threatening illness from whooping cough. Because the child is short of breath, she inhales deeply and quickly between coughs. These breaths (particularly in older infants) frequently make a ""whooping"" sound—which is how this illness got its common name. The intense coughing scatters the pertussis bacteria into the air, spreading the disease to other susceptible persons. Symptoms Pertussis often acts like a common cold for a week or two. Then the cough gets worse, and the older child may start to have the characteristic ""whoop""s. During this phase (which can last two weeks or more), the child often is short of breath and can look bluish around the mouth. She also may tear, drool, and vomit. Infants with pertussis become exhausted and develop complications such as susceptibility to other infections, pneumonia, and seizures. Pertussis can be fatal in some infants, but the usual course is for recovery to begin after two to four more weeks. The cough may not disappear for months, and may return with subsequent respiratory infections. When to call the doctor Pertussis infection starts out acting like a cold. You should consider the possibility of whooping cough if the following conditions are present. The child is a very young infant who has not been fully immunized and/or has had exposure to someone with a chronic cough or the disease. The child's cough becomes more severe and frequent, or her lips and fingertips become dark or blue. She becomes exhausted after coughing episodes, eats poorly, vomits after coughing, and/or looks ""sick."" When your child needs hospital care The majority of infants with whooping cough who are less than six months old, and slightly less than one-half of older babies with the disease, initially are treated in the hospital. This more intensive care can decrease the chances of complications. These complications can include pneumonia, which occurs in slightly less than one fourth of children under one year old who have whooping cough. (If your child is older, she is more likely to be treated only at home.) While in the hospital, your child may need to have the thick respiratory secretions suctioned. His breathing will be monitored, and he may need to have oxygen administered. For several days, your youngster will be isolated from other patients to keep the infection from spreading to them. Treatment Whooping cough is treated with antibiotics, usually for two weeks. These medications are most effective when they are given in the first stage of the illness before coughing spells begin. Although antibiotics can stop the spread of the whooping cough infection, they cannot prevent or treat the cough itself. Because cough medicines do not relieve the coughing spells, your pediatrician probably will recommend other forms of home treatment to help manage the cough. Let your child rest in bed and use a cool-mist vaporizer to help soothe his irritated lungs and breathing passages. A vaporizer also will help loosen secretions in the respiratory tract. Ask your pediatrician for instructions on the best position for your child to help drain those secretions and improve breathing. Also ask your doctor whether antibiotics or vaccine boosters need to be given to others in your household to prevent them from developing the disease. Prevention The best way to protect your child against pertussis is with DTaP vaccination (immunizations at two months, four months, and six months of age, and booster shots at twelve to eighteen months and at four or five years of age). See Recommended Immunization Schedules. Tdap also protects against pertussis. A single dose of Tdap vaccine should be administered to children 7 through 10 years of age who were underimmunized with DTaP or who have an incomplete vaccine history. The American Academy of Pediatrics (AAP) continues to recommend vaccination of adolescents, including pregnant adolescents. Pregnant women should also receive the vaccine. A single dose should be given to adults who have contact with infants, even if they are older than 65, and for health care workers of any age. Last Updated 11/21/2015 Source Adapted from Caring for Your Baby and Young Child: Birth to Age Five (Copyright © 2009 American Academy of Pediatrics)"
149,6,"2018-04-19 02:48:19","Chest & Lungs",149,"2018-04-19 03:13:54","Why Does My Child Have a Chronic Cough?","Why Does My Child Have a Chronic Cough? Page ContentWhile all children will experience coughing, the development of chronic cough—one that lasts more than 4 weeks—warrants a visit to the pediatrician. In this video, Matthew T. Brigger, MD, MPH, a pediatric otolaryngologist at Rady Children's Hospital San Diego, explains the many different causes for a persistent or chronic cough in children. Ultimately, your pediatrician is your best source for evaluation and can refer you to a pediatric specialist if needed.   Additional Information from HealthyChildren.org: Coughs and Colds: Medicines or Home Remedies?Whooping Cough BronchiolitisWhy Most Sore Throats, Coughs & Runny Noses Don't Need Antibiotics ​​ Article Body Last Updated 2/7/2017 Source Copyright © 2016 American Academy of Pediatrics and American Society of Pediatric Otolaryngology"
150,7,"2018-04-19 02:48:19","Chronic Conditions",150,"2018-04-19 03:13:58","Anemia and Your Child: Parent FAQs","Anemia and Your Child: Parent FAQs Page ContentAnemia is a condition in which the amount of red blood cells in the body is decreased below normal for your child's age. It can make your child appear pale in color and feel cranky, tired, or weak. Though these symptoms may worry you, anemia is generally easy to treat, especially when it is detected early.  In addition, parents need to be aware of the steps to take to prevent this condition.Because rapid growth is a potential cause of the condition, the first year of life and adolescence are two age groups where infants and children are especially prone to anemia.What is anemia?Anemia means there are not enough red blood cells in the body. Red blood cells are filled with hemoglobin, a special pigmented protein that makes it possible to carry and deliver oxygen to other cells in the body. The cells in your child's muscles and organs need oxygen to survive, and decreased numbers of red blood cells can place stress on the body. Your child may become anemic if his or her body:Does not produce enough red blood cells. This can happen if she does not have enough iron or other nutrients in her diet (e.g. iron-deficiency anemia). Destroys too many red blood cells. This type of anemia usually happens when a child has an underlying illness or has inherited a red blood cell disorder (e.g. sickle-cell anemia).Loses red blood cells through bleeding. This can either be obvious blood loss, such as heavy menstrual bleeding, or long-term low-grade blood loss, perhaps in the stool. What are the common signs and symptoms of anemia? Pale, gray, or ""ashy"" skin (also, the lining of the eyelids and the nail beds may look less pink than normal)IrritabilityMild weaknessTiring easilyChildren experiencing red blood cell destruction may become jaundiced (yellowing of the skin or eyes)Children with severe anemia may have additional signs and symptoms:Shortness of breathRapid heart rateSwollen hands and feetChildren with anemia caused by very low levels of iron in their blood may also eat strange things such as ice, dirt, clay, and cornstarch. This behavior is called ""pica"" (pronounced pie-kuh). It is not harmful unless your child eats something toxic, such as lead paint chips. Usually the pica stops after the anemia is treated and as the child grows older.If your child shows any of these signs or symptoms, please see your pediatrician. Even a low level of anemia can affect your child's energy, focus, and ability to learn. Chronic iron deficiency anemia can result in long term, permanent impairment of development. In most cases, a simple blood count can diagnose anemia.How can I prevent my child from becoming anemic? Iron-deficiency anemia and other nutritional anemias can be prevented by ensuring that your child eats a well-balanced diet. Talk to your doctor about any specific dietary restrictions in your household as your child may require a nutritional supplementation to prevent anemia. To prevent nutritional anemias:Do not give your baby cow's milk until he or she is over 12 months old. Giving cow's milk before your child is ready may cause blood loss in his or her stool and can also decrease the amount of iron absorbed in the gut.If you are breastfeeding: Your baby will have an adequate supply of iron until at least 4 months of age. After that time, if your child continues to be breastfed and has begun taking solid food, give him foods with added iron. Talk to your pediatrician about foods best suited for this purpose. If you formula-feed your baby: Give your baby formula with added iron. Low-iron formula can result in iron-deficiency anemia. See Choosing a Formula.  Avoid giving your older children more than 2 cups a day of whole cow's milk. Milk is low in iron and can make children feel full, which can decrease the amount of other iron rich foods they eat.Feed older children a well-balanced diet with foods that contain iron. Many grains and cereals have added iron (check labels to be sure). Other good sources of iron include red meat, egg yolks, potatoes, tomatoes, beans, molasses, and raisins. See Pump Up the Diet with Iron. Encourage the whole family to drink citrus juice or eat other foods high in Vitamin C to increase the body's absorption of iron. Although green vegetables contain lots of iron, the iron from many vegetables comes in a form that is difficult for your body to absorb, but Vitamin C can help!To prevent anemia in children with inherited red blood cell disorders:Your pediatrician will likely refer you to a pediatric hematologist to provide you with supportive care and education on your child's specific condition.Remember…If your child starts to show any signs or symptoms of anemia, be sure to tell your pediatrician. Also, find out if anyone in your family has a history of anemia or problems with easy bleeding. With proper treatment, your child's anemia should improve quickly. Additional Information: Ask the Pediatrician: Is blood work routine for a 9-month-old? Pump Up the Diet with IronVitamin & Iron Supplements Diagnosis and Prevention of Iron Deficiency and Iron Deficiency Anemia in Infants and Young Children (0-3 Years of Age) (AAP Clinical Report) ​ Article Body Last Updated 3/7/2016 Source Section on Hematology/Oncology (Copyright © 2016 American Academy of Pediatrics)"
151,7,"2018-04-19 02:48:19","Chronic Conditions",151,"2018-04-19 03:14:03","Causes of High Blood Glucose and Low Blood Glucose","Causes of High Blood Glucose and Low Blood Glucose Page Content Article BodyLow or high blood sugar in a child with diabetes can cause loss of responsiveness. All of the cells in our body depend upon sugar in our blood as the main source of energy. This sugar comes from the foods that we eat. Certain organs in our body also make and store sugar. When the body is working properly, it automatically regulates the amount of sugar in the blood. When there is too much sugar in the blood, the body makes insulin, which lowers blood sugar. When blood sugar levels are too low, the body cuts back on the amount of insulin that it is making and lets the blood sugar levels rise. When blood sugar levels in the body are lower than normal, a child has hypoglycemia. Signs of hypo-glycemia in a healthy child are usually mild, such as irritability. In a child with diabetes, hypoglycemia can lead to loss of responsiveness if not treated quickly. A diabetic child can get hypoglycemia if he doesn’t eat enough or doesn’t eat at the right time. He can get hypoglycemia if he takes too much insulin. Blood sugar levels may drop because of exercise, being overheated, or illness.A diabetic child may have too much sugar in the body. This is called hyperglycemia. It is the opposite of hypoglycemia. This condition may be caused by too little insulin, illness, or stress. It may be caused by overeating, inactivity, or a combination of all of these factors. If you are not sure if the child has hypoglycemia or hyperglycemia, give sugar. See if the symptoms improve. Always call EMS if symptoms are severe or if the child becomes unresponsive. Signs of Hypoglycemia and Hyperglycemia Signs of Hypoglycemia​ ​Signs of Hyperglycemia ​IrritabilityPalenessDrowsinessConfusionTremblingExcessive SweatingPoor coordinationSlurred speechStaggeringEventual loss of responsiveness ​Extreme ThirstVery frequent urinationDrowsinessFruit smell on child's breathFast breathingWarm, dry skinVomitingEventual loss of responsiveness   Last Updated 11/21/2015 Source First Aid for Families (PedFACTs) (Copyright © 2012 American Academy of Pediatrics)"
152,7,"2018-04-19 02:48:19","Chronic Conditions",152,"2018-04-19 03:14:08","Children with Chronic Illness: Dealing with Emotional Problems and Depression","Children with Chronic Illness: Dealing with Emotional Problems and Depression Page Content Article BodyFeelings of sadness, depression, or being overwhelmed may come and go for both you and your child. This is normal and healthy. As tumultuous as these times can be, most youngsters and their families emerge with few if any long-term behavioral problems or lasting psychological scars. In fact, the majority of children really do manage their situation well, despite riding an emotional roller coaster on occasion. Researchers believe that the likelihood of emo­tional and behavioral problems associated with chronic illness has been de­creasing recently because parents, school staffs, and health-care providers are learning more effective ways to help children and their parents meet their psy­chological needs. Nevertheless, children who have a chronic illness or condition often feel ""different,"" socially isolated, and restricted in their activities. They may have school problems and feel overprotected. They may experience recurrent fear and pain. When these emotional difficulties are not dealt with, they can lead to anxiety, sadness, withdrawal, rebelliousness, or a decreased interest in school. School-age children rarely state that they are sad or depressed. Instead, they may withdraw from friends and family or exhibit rebellious or angry be­havior. They may do poorly in school. They may interfere with their medical treatments, perhaps by refusing to take medication as scheduled. They might experiment with alcohol, drugs, or early sexual activity. Or they may run away from home or contemplate suicide. Make an ongoing effort to discuss with your child what he is experiencing. Do you think he is displaying signs of despair and hopelessness related to his illness and future? Encourage him to talk about these feelings with you or with another trusted adult. Because your child may not even be aware of his feel­ings, try beginning these conversations with statements like ""If I were you, I think I would be feeling..."" or ""I have read that many kids with this condition feel lonely and sad. How do you feel?"" Some parents are hesitant to discuss feelings about the disease with their child, in an effort to protect the youngster from emotional hurt. Most experts, however, disagree with that point of view. Children can usually adjust much better to an unpleasant truth than to the perception that their parents are up­set and hiding something from them. If parents and children do not talk openly, the opportunities for misinterpretation are high. A youngster's imagi­nation can run wild, and fears may emerge or be exaggerated. Thus, it is best to make a commitment to be as communicative as possible. Remind your child that he is not going through this alone and that you will re­main a constant source of love and support. Many studies show that the key to a child's resilience is a relationship with a caring, loving, accessible adult—someone the child can count on and trust. If you are concerned about your child's coping with these stresses, talk to your physician. If your youngster is exhibiting destructive or unusual behav­ior, if he refuses to take his medication, if he is severely withdrawn or if his schoolwork has deteriorated, your doctor might recommend some counseling for the child or the entire family. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
153,7,"2018-04-19 02:48:19","Chronic Conditions",153,"2018-04-19 03:14:14","Chronic Conditions and School","Chronic Conditions and School Page Content Article BodyMy child has a chronic health condition. What do I need to tell the school? If your child has special health needs, the school should have a written document outlining a health care and emergency plan. The following information should be in the document: A brief medical history The child's special needs Medicine or procedures required during the school day Special dietary needsTransportation needs Possible problems, special precautions Pediatrician's name Emergency plans and procedures (including whom to contact) Once the school is informed a student has a chronic health condition, a meeting is often scheduled to discuss what services may be needed. The meeting should include parents, the student (if old enough), school health staff, the coordinator of special needs services, student aids, and the child's primary teacher. Health care providers, such as the child's pediatrician, also should be invited or asked to provide information in writing. One goal of this meeting is to develop a written plan that clearly describes the services the student needs. Depending on the child's needs, this plan may be described as a 504 Plan or an Individualized Education Program (IEP). This legal document outlines exactly what services the child will receive and sets short- and long-term goals for the child. The plan should be reviewed regularly to ensure it continues to meet the child's needs. Parent Responsibilities The following are ways you can help your child receive the education and services he or she needs to succeed in school: Talk to the school. Don't be afraid to tell the school about your child's condition. Some parents worry about sharing this information, but the more informed teachers and other school staff are, the better prepared they will be to help your child. If the school staff don't have all the facts, they may make wrong assumptions about your child's behavior or performance. Make an emergency plan. Ask your pediatrician to help you write down exactly what the school should do if your child has certain health needs. School staff should know how to reach you or your pediatrician in case there is an emergency. Remember to call the school right away when contact information has changed. Make a health plan. If your child takes medicine at school, ask about the school's policies for storage and self-usage. Make sure your child is able to take her medicine in a comfortable place, and that the school is provided with an adequate supply. Remember to call the school right away if there are any changes in your child's condition. Give your consent. You will have to sign a release form that gives the school permission to contact your pediatrician. Also, your pediatrician will need your written permission to discuss your child's condition with the school. If your child requires medicine or special procedures, the school must receive written instructions from your pediatrician. Plan ahead. Meet with your child's teachers regularly to talk about how your child is doing at school. Ask if your child's health condition is affecting her schoolwork or behavior. If your child is missing a lot of school due to illness, talk with her teacher about ways to help her keep up with her work. Know the Law By law, your child is entitled to an education that will help her develop to her full potential. Schools may be required to provide additional services that will assist in both in-school programs and after-school events. Federal laws such as the Individuals with Disabilities Education Act (IDEA) and the Americans with Disabilities Act (ADA) state that every child should be allowed to attend school in the ""least restrictive"" setting possible. Last Updated 11/21/2015 Source Students With Chronic Health Conditions: Guidance for Families, Schools, and Students (Copyright © 2004 American Academy of Pediatrics)"
154,7,"2018-04-19 02:48:19","Chronic Conditions",154,"2018-04-19 03:14:22","Chronic Fatigue Syndrome","Chronic Fatigue Syndrome Page Content Article BodyChronic fatigue syndrome can affect teens as well as adults. The cause of the syndrome is unknown, but symptoms may include bouts of exhaustion, muscle ache, or sore throat. If these symptoms persist for 6 months or more your teen may have chronic fatigue syndrome.  Click here to listen  Last Updated 11/21/2015 Source A Minute for Kids"
155,7,"2018-04-19 02:48:19","Chronic Conditions",155,"2018-04-19 03:14:31","Chronic Kidney Disease in Children","Chronic Kidney Disease in Children Page Content​Over the past 20 years, the incidence of chronic kidney disease (CKD) in children has steadily increased. What is CKD?CKD is a chronic condition in which the kidneys are permanently damaged. Kidney function is decreased, and it gets worse over time. CKD is also called chronic renal disease or chronic kidney failure. It affects people of all ages and races.  What causes CKD?The causes of CKD are very different in children than in adults.   In infants and children: Birth defects, congenital abnormalities, and hereditary diseases, like polycystic kidney disease, are the most common causes of CKD. Frequent urinary tract infections (UTIs) in children should be promptly treated and further evaluated, as urinary tract abnormalities could potentially lead to CKD. In teenagers: In children over the age of 12, glomerulonephritis (inflammation of the kidneys) is the most frequent cause of kidney failure. Other conditions that may damage the kidneys, like nephrotic syndrome, or diseases that affect many organs, like lupus, are also common causes. In adults: CKD is mainly caused by diabetes and high blood pressure. In contrast to adults, high blood pressure does not usually cause kidney failure in children, but often is caused by the renal failure. However, it is important to note that many of the risk factors for CKD, such as obesity leading to type 2 diabetes, start in childhood and may contribute to progressive kidney disease in adulthood.What are common symptoms of CKD in children?As CKD progresses, symptoms in children may include:Swelling and/or puffiness around the eyes, feet, and anklesFrequent urination or, in children 5 years or older, prolonged bedwettingStunted or poor growth, as compared to similar age group peersLoss of appetite and chronic nauseaFatigueFrequent severe headaches from high blood pressureAnemia and pallor from decreased red blood cell productionHow is CKD diagnosed?CKD is diagnosed many ways. Some kidney problems are found before birth by ultrasound. Sometimes, children are diagnosed with other conditions where kidney problems are known to be more common. Usually, there are other concerns about a child's health that lead to a diagnosis of CKD.Based on a child's health issues or symptoms, his or her pediatrician may run the following tests: Urinalysis: A child's urine will be collected to check for protein. Protein in the urine may be a sign of kidney damage. Blood tests: Blood tests can help show many things, including kidney function level, blood chemical levels, and red blood cell levels, all of which the kidneys help to control. Sometimes, there are also specialized blood tests that may help diagnose specific kidney diseases such as lupus. Ultrasound and X-rays: Pictures of the kidneys help show any damage to the kidney and surrounding structures. They may also give hints about what caused the kidney problem. Kidney biopsy: A small piece of kidney tissue is taken out and examined under a microscope to determine the cause of and extent of damage to the kidneys.  What kinds of CKD are there?CKD is staged to show how much kidney function is left. Because kidney function decreases over time, the stage of CKD changes. When a person is first diagnosed, it could be in any of the five stages; not everyone progresses from Stage 1 to Stage 5. A value called glomerular filtration rate (GFR) is determined to help to estimate kidney function. Note that GFR values for CKD staging are for children older than 2 years of age, because the GFR values for children under two are low due to ongoing kidney growth.  How is CKD treated?CKD is considered permanent damage to the kidneys that cannot be cured. However, there have been major improvements in the care of children with CKD that can slow the progression of the disease and can prevent other serious conditions developing. The main goals of treatment are to:Help treat the condition that may be causing CKDControl symptoms of CKD Slow down progression of CKD with proper diet and medicationsPrepare for eventual kidney failure (Stage 5) and the need for dialysis and/or kidney transplantWho is involved in the medical care for a child with CKD?The child's pediatrician will continue to oversee routine healthcare, including immunizations.  The pediatrician will work with the pediatric nephrologist who will assist in the child's health care management including diet and medications. Other pediatric specialists, such as a pediatric urologist, may be included in the child's care based on the child's health care needs and on his or her own characteristics.Parents and other caretakers at home provide the cornerstone of their child's care, as they provide emotional support and help their child follow the proper diet and take all prescribed medications.​ Additional Information: Children with a Single Kidney  Kidney Cysts in Infants, Children & Teens  What is a Pediatric Nephrologist?   American Society of Pediatric Nephrology National Kidney Foundation​  Article Body Last Updated 1/28/2016 Source Section on Nephrology (Copyright © 2016 American Academy of Pediatrics)"
156,7,"2018-04-19 02:48:19","Chronic Conditions",156,"2018-04-19 03:14:35","Clean Intermittent Catheterization","Clean Intermittent Catheterization Page Content Article BodyWhat are the steps for clean intermittent catheterization for girls and boys? If your child cannot empty his or her bladder completely, or has a problem with urine leakage, your child may need to start a catheterization program. These problems are commonly seen in children with spina bifida, spinal cord injuries, or some urinary tract defects. The following information explains the steps for CIC. This should not take the place of one-to-one teaching. If your child needs CIC, contact your pediatrician, doctor, or nurse practitioner for more information. CIC For Girls First wash your hands with soap and water, then dry them. You also can use a waterless cleaner, such as an antibacterial cleanser that does not require water. Next have your box of supplies within easy reach. Place your daughter on her back or position her on the toilet or in her wheelchair. You should practice CIC in the position you will be using most often. If she is on the toilet, separate her legs widely enough to be able to clearly see her urethra. If she is doing her catheterizations herself, she will practice identifying her urethra by touch. When your daughter is learning to catheterize herself, she can use a mirror to see where her urethra is located. Clean your daughter's genitalia with a washcloth or disposable wipe. Separate the labia and wipe thoroughly from front to back. Place a generous amount of the water-soluble lubricant on the end of the catheter with the holes. Place the other end of the catheter into a container or let it drain into the toilet. Find your daughter's urethra. Gently insert the lubricated end of the catheter into the urethra about 2 to 3 inches. It may become slightly more difficult to insert just prior to entering the bladder. That is because a muscle called the sphincter sits at the opening of the bladder and is naturally tightly contracted. The sphincter will relax as you continue to gently insert the catheter until you reach the bladder and see urine flow. Once the catheter is in the bladder, hold it there until the urine flow stops. Then move the catheter slightly, or insert it a little more, to see if the flow continues. Gently press on your daughter's lower abdomen with your hand or ask your daughter to lean forward to be certain there is no more urine in the bladder. Slowly remove the catheter, holding your finger at the tip or pinching the catheter end before removing the final portion. Pull catheter out in a downward movement to prevent backflow of urine. Wash your hands. Clean and store your catheter as directed. CIC For Boys First wash your hands with soap and water, then dry them. You also can use a waterless cleaner, such as an antibacterial cleanser that does not require water. Next have your box of supplies within easy reach. Place your son on his back or, if it is easier for both of you, have him sit on the toilet or in his wheelchair. If he is doing his own catheterization, he may stand or sit on the toilet or in his wheelchair. Clean the tip of his penis with a washcloth or disposable wipes in a circular motion starting at the center and working outward. If your son is uncircumcised, pull back the foreskin so that the tip of his penis is visible before cleansing. Place a generous amount of the water-soluble lubricant on the end of the catheter with the holes. Place the other end of the catheter into a container or let it drain into the toilet. Hold your son's penis upright. Gently insert the lubricated end of the catheter into the urethra about 4 to 6 inches until urine begins to flow. You may need to lower the penis as you continue to insert the catheter. It may become more difficult to advance the catheter as you get closer to the bladder. Do not worry, this is normal. Continue to gently insert the catheter with steady pressure until you feel the catheter slip into the bladder. Once urine flow begins, insert the catheter about an inch farther to allow the urine to flow better. Hold the catheter in place until the urine flow stops. You may gently press on your son's lower abdomen or ask him to squeeze his abdominal muscles or lean forward to be sure the bladder is empty. Remove the catheter once the urine flow stops completely. Hold your finger over the end of the catheter while removing it. This will prevent any urine in the tube from dripping out. If your son is uncircumcised, gently replace the foreskin over the end of his penis by pushing it forward. Wash your hands. Clean and store your catheter as directed. Supplies Needed It is best to have all of your supplies organized and ready when you need them. Keep the following items in a clean, dry container such as a plastic shoe box or cosmetic case. Catheters. Your doctor will give you a prescription for the appropriate catheter size for your child. Disposable wipes or a washcloth. Your child's genitalia will need to be cleaned before CIC. Lubricant. Use only a water-soluble lubricant. You can buy the lubricant at pharmacies or drug stores. Do not use oil-based lubricants such as petroleum jelly because they do not dissolve in water. Container. You may need a container to drain the urine into if you are not doing the catheterizations on the toilet, or if you need to keep a record of how much your child drains. Syringe. You will need a syringe for cleaning the catheter. Last Updated 11/21/2015 Source What is Clean Intermittent Catheterization? (Copyright © 2003 American Academy of Pediatrics)"
157,7,"2018-04-19 02:48:19","Chronic Conditions",157,"2018-04-19 03:14:41","Common Coping Styles of Teens Who Are Chronically Ill or Disabled","Common Coping Styles of Teens Who Are Chronically Ill or Disabled Page Content Article BodyDenial An example of denial in action is the teen with diabetes who wolfs down two pieces of birthday cake at a party, knowing full well that she’s going to regret it later; or the young person with hemophilia who insists on performing daredevil stunts on his dirt bike. But suppressing the reality of a health condition is also an effective coping strategy that allows people to go on living productively. Denial becomes a problem only when it leads to dangerous outcomes. Intellectualization This defense mechanism, seen mainly with younger adolescents, consists of partial denial. The teenager accepts her condition and often exhibits a firstyear medical student’s knowledge about it, but chooses to block out how she feels about it. Intellectualization can be useful when employed as a delay tactic; it gives the young patient time to sort out and deal with her emotions. But if it persists, the adolescent never truly comes to grips with her situation. She may also fall into a pattern of shutting out all uncomfortable feelings, at which point intervention from a health-care professional is certainly warranted. Regression When the going gets tough, even the most outwardly stoic youth may revert to childish behavior. Regression provides temporary escape from stressful situations. The proper parental response? Be firm about what you will and will not tolerate, but show plenty of caring and patience. In time, the young person will learn to cope with his circumstances in a more mature fashion. Acting-Out Behavior This is another short-term survival tool, frequently wielded like a battering ram. Defiance, combativeness and testing limits at home and at school are all expressions of a teenager’s anger and depression over his predicament: I’m furious that I have this stupid disease! And even though I know it’s irrational, Mom and Dad, sometimes I can’t help venting my rage in your direction. Acting-out behavior can be hurtful to anyone who stumbles into its path. It may also manifest in self-destructive ways, such as poor performance in school, experimenting with substances and/or sex and run-ins with the law. Involving a mental-health expert from the beginning can help to prevent things from spinning out of control. Last Updated 1/1/2003 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
158,7,"2018-04-19 02:48:19","Chronic Conditions",158,"2018-04-19 03:14:46","Cystic Fibrosis","Cystic Fibrosis Page Content Article BodyWhat is cystic fibrosis? Cystic fibrosis (CF) is a disease that changes the secretions of certain glands in the body. It is inherited from parents who carry the gene that cause this disease. For a child to get cystic fibrosis, both parents must be carriers of the gene that causes it. Although the sweat glands and the glandular cells of the lungs and pancreas are affected most often, the sinuses, liver, intestines, and reproductive organs also can be involved. Great progress has been made in treating this disease and its symptoms, but there is still no cure. However, children with CF are living longer, thanks to the scientific progress that has occurred. Who Gets CF? For a child to get cystic fibrosis, both parents must be carriers of the gene that causes it. In the United States, CF is most common in the Caucasian population, where 1 out of every 20 people is a carrier, and 1 of every 2,000 to 3,000 Caucasian babies have CF. The disease is much less common in African Americans (1 in 17,000 live births) and Hispanics (1 in 11,500 live births), and even rarer among Asians. About 60,000 children and adults worldwide have been diagnosed with CF; approximately half of them (30,000) are in North America. In 1989 researchers discovered the gene that causes CF. Couples planning to have children can undergo genetic testing and counseling to find out if they are carrying the CF gene. Signs and Symptoms The majority of CF cases are diagnosed within the first two years of life; in many states, newborn screenings now include mandatory testing for CF. (CF can be diagnosed even before the baby is born with genetic testing as well as through detection of an abnormality found on an ultrasound in the later stages of pregnancy). Your pediatrician may suspect CF if your child is failing to gain weight, which often accompanies this disease. Other signs and symptoms vary with the degree of the involvement of organs like the lungs. More than half of the cases of CF are diagnosed because of repeated lung infections. These infections tend to recur because mucus in the airways is thicker than normal and more difficult to cough out. A child with CF is likely to have a persistent cough that gets worse with colds. Since the secretions of the lungs remain in the airways longer than normal, the airways are more likely to become infected, increasing the chances of pneumonia or bronchitis. Over time, these lung infections cause damage to the lungs, and are the major cause of death in CF. Diabetes and chronic liver disease are other complications that may occur in children with CF. Most children with CF are deficient in digestive enzymes, making it difficult for them to digest fats and proteins as well as they should. As a result, these children have large, bulky, foul-smelling stools. Loose stools may result from an inability to digest formula or food, and are one of the causes of the child’s failure to gain weight. Diagnosis To confirm the diagnosis, your pediatrician will order a sweat test to measure the amount of salt your child loses as he perspires. Children with cystic fibrosis have much more salt in their sweat than do children who do not have CF. Two or more of these tests may be required to ensure an accurate diagnosis, since the results are not always clearly positive or negative. If your child is diagnosed as having the disease, your pediatrician will help you get the additional specialized medical help that is necessary. Treatment Treatment of CF’s lung infections is the most important aspect of your child’s care. The goal is to help clear the thick secretions from your youngster’s lungs, which may involve various techniques that help him cough out the sputum more easily. The lung infections themselves are treated with antibiotics. Periods in which the lung infections worsen are called exacerbations, which are associated with more coughing and sputum production, and may require treatment with the use of intravenous antibiotics. To treat the lack of digestive enzymes in CF, your child will be prescribed capsules containing enzymes to be taken with every meal and every snack. The amount of enzymes is based on the level of fat in the diet and the weight of your child. Once the correct amount of enzymes is taken, your youngster’s stool pattern will become more normal and he’ll begin gaining more weight. He also will need to take supplemental vitamins. Emotional Burden of CF Because CF is a hereditary disease, many parents feel guilty about their child’s illness. However, CF is a genetic disease that is no one’s fault, so there’s no reason to blame anyone. Instead, you should channel your emotional energies into your child’s treatment. It is important to raise your child as you would if he did not have this disease. There is no reason to limit his educational or career goals. The majority of children with CF can expect to grow up and lead productive adult lives. Your child needs both love and discipline, and should be encouraged to develop and test his limits. Balancing the physical and emotional demands created by this disease is hard on both the CF patient and his family, so it is very important that you get as much support as possible. Ask your pediatrician to put you in touch with the nearest CF center and CF support groups. The Cystic Fibrosis Foundation also can be of help. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
159,7,"2018-04-19 02:48:19","Chronic Conditions",159,"2018-04-19 03:14:53","Dealing With Your Own Feelings","Dealing With Your Own Feelings Page Content Article Body""When I found out my child had a chronic illness, it seemed like the end of the world. I ached so bad and I felt so angry."" Parents often experience an array of emotions as they come to terms with their youngster's illness. Immediately after the diagnosis, many mothers and fathers enter a mourning period, grieving over the ""loss"" of their healthy child. They must cope with the shock and the pain and try to accept the new reality of having a youngster with a chronic illness. Parents often deny this reality and tell themselves things like ""This can't be happening... The laboratory must have gotten our test results mixed up with someone else's. When am I going to wake up from this nightmare?"" Eventually, parents usually begin to find ways to accept their child's illness, despite periodically feeling sad, resentful, anxious, and angry. Common Feelings of Parents of Children with Chronic Illnesses Guilt is common among parents, often feeling that they somehow caused the illness. Self-blame is particularly prevalent when the condition was present at birth, has a genetic basis, and/or when the cause is not known. Guilt can be an excruciating and disabling emotion, adding to the stress within the family and sometimes making it difficult for parents to be supportive of their children and each other. If guilt or other emotional difficulties are interfering with your par­enting abilities or the quality of your family life, you may benefit from some professional counseling. Negative Positive Anger Achievement Anxiety Closeness Embarrassment Joy Frustration Love Grief Mastery Guilt Pride Isolation Self-Confidence Powerlessness Self-Esteem Resentment Strength Sadness Usefulness Other adjustments may be necessary as well. There can be considerable fi­nancial cost associated with a child's chronic illness. As medical bills mount—with frequent doctors' visits, medications, hospitalizations, and other outpatient services—worry over finances can intensify. Many parents find it to be very difficult to discipline their chronically ill child. However, all children need and benefit from having clear limits and consistent expectations. In their absence, children may become overly de­pendent, have lower self-esteem, and begin to have behavioral and social problems. Parents should establish a consistent set of expectations, adjusting them as needed for acute episodes as the child's health fluctuates. They should provide an environment that encourages independence and self-confidence. Sometimes a parent may have to give up a career or education to become the primary caretaker at home; this is particularly true when the child re­quires a great deal of assistance with daily activities. A parent may have to change jobs, or take on a second job, to increase the family income. These ad­justments are sometimes complicated when a new job necessitates switching health insurance policies, causing a situation in which medical bills associated with the child's chronic illness (referred to as a pre-existing condition) are not covered. The family might also have to move, relocating closer to the medical services the child needs. Several state and federal programs are available to help families with the costs of chronic health care. Recent changes in the eligibility criteria for Sup­plemental Security Income (SSI) for children, for example, now provide cash benefits to many families with children with chronic illnesses. Eligible young­sters generally include those with significant psychiatric conditions and se­vere chronic illnesses, such as cystic fibrosis, congenital heart disease, malignancies, and many others. Your physician or the social worker at your lo­cal hospital should be able to refer you to the proper agencies for help. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
160,7,"2018-04-19 02:48:19","Chronic Conditions",160,"2018-04-19 03:14:59","Diabetes Treatment","Diabetes Treatment Page Content Article BodyAlthough diabetes is incurable at present, blood-sugar levels can be managed through diligent monitoring, exercise and balancing medication along with diet. In the wake of a diagnosis, parents need to impress upon their youngster that adhering to the four-prong program will help him to sidestep not only acute adverse effects like elevated blood sugar (hyperglycemia) and ketoacidosis but serious long-term consequences. Ketoacidosis may occur when there is not enough insulin to handle the glucose that is present; fats and proteins are used and there is a rise in fatty acid metabolites, called ketones, which may be detected in the blood and in urine. Ketoacidosis can be a life-threatening condition that must be corrected immediately. Diabetes is the sixth most fatal illness in the United States. Years of elevated blood sugar damage blood vessels; later in life, that may come back to haunt patients in the forms of cardiovascular disease, kidney failure, vision problems (diabetic retinopathy, the leading cause of acquired blindness in this country), lack of sensation (diabetic neuropathy) and poor blood flow to the lower legs. Conversely, diabetics who keep their glucose levels within a normal range as much as possible significantly reduce their odds of developing lifethreatening complications. In a government-funded study called the Diabetes Control and Complications Trial (DCCT), patients with type 1 disease received either standard management or more aggressive care. At the end of nine years, the latter group had a 62 percent lower risk of eye disease than those treated less aggressively; their progression of kidney impairment and nerve damage was approximately 60 percent lower as well. A few years later, a British study of type 2 diabetics yielded similar results. Hormone Therapy All adolescents with type 1 must learn to give themselves subcutaneous injections (in the fatty tissue beneath the skin) of insulin two, three or more times a day. Type 2 patients, on the other hand, control their disease through diet and exercise, and possibly the oral medications described below. Although formerly referred to as “non-insulin-dependent diabetes,” type 2 diabetes may eventually require insulin because the pills used to control blood sugar may eventually lose their effectiveness in about one-third of all patients. Insulin administration must be timed with eating, so that the hormone reaches the circulation around the same time that glucose from food makes its arrival. This task has been simplified somewhat by the introduction of different types of insulin programmed to commence working, achieve their maximum effect, and then subside at various times. Standard therapy calls for two shots a day. In the more aggressive approach, patients self-administer three or four doses of various insulins. Most insulin-dependent youngsters soon become quite proficient at wielding the needle syringe. However, many are now switching to an external insulin pump, which administers a continuous dose of the hormone at the same rate as a healthy pancreas. The programmable device, about the size of a pager, can be slipped into a pocket. A thin catheter tube delivers the insulin into the tissue below the surface of the skin. Drug Therapy The current drug regimen for type 2 diabetes combines the biguanide agent metformin with a sulfonylurea (chloropropramide, glimepiride, glyburide, glypizide, tolbutamide, tolazamide). Biguanides prevent the liver from producing glucose, while sulfonylureas work by prevailing upon the pancreas to secrete more insulin. A third type, glucosidase inhibitors (acarbose), inhibits a key enzyme that reduces the intestines’ absorption of carbohydrates. Side effects such as flatulence and bloating make this drug less than popular with the teen set. Dietary Measures Virtually all endocrinologists have a dietitian on staff to counsel teenage patients and their parents on making necessary changes in the diet. Current recommendations are for food intake to be at or under 30 percent as fat, 50 to 60 percent as carbohydrate and the rest protein. The teen should check with his physician and dietitian to work out a specific meal plan that is right for him. Blood-Glucose Monitoring This simple blood test, performed several times daily, measures the concentration of sugar in the circulation. Based on the results, which are logged on a chart, the drug dosage and/or diet may be adjusted in order to help patients maintain control of their blood-glucose level. Most young people with diabetes are taught “carb counting” at mealtime and snack time, so that they can become adept at balancing the carbohydrate content of the food they eat and the amount of insulin they must take. Controlling diabetes can be akin to piloting a ship between two icebergs. Veer off course in one direction, and your blood sugar rises alarmingly high. Stray too far the other way, and you’re confronting an equally dangerous situation: blood-glucose deficiency, or hypoglycemia, the most common acute complication among young persons with diabetes. Even the most conscientious patients overshoot or undershoot their marks now and then, due to their own miscalculations of how much insulin to take or to complicating factors like physical illness, exercise or emotional stress. Ironically enough, both insulin and oral diabetes medications can perform too well and bring about hypoglycemia, which is defined as a blood-sugar level below 40 to 50 mg/ml. These insulin reactions can be serious, so an endocrinologist deciding on a target blood-sugar range for an adolescent usually builds in margins for error at both ends. When Symptoms Point to High Blood Sugar (In a Person With Diabetes) If the teen feels ill, contact your pediatrician or endocrinologist immediately for instructions. Otherwise, step one is to test the blood-glucose level. If the concentration of sugar in the blood is higher than normal but under 240 mg/ml: Drink at least eight glasses of water a day. Eat according to the prescribed treatment program. Continue to check blood glucose four times a day until it returns to a safe level. Take extra short-acting insulin. If blood sugar regularly exceeds 239 mg/ml, the teen is at risk for ketoacidosis and should: Test a urine sample for excess ketones (ketonuria). Testing strips are available over the counter in most pharmacies. If the urine tests negative for ketones or contains only a trace amount: Repeat blood and urine tests. Drink at least eight glasses of water a day until the urine is clear of ketones. If the urine tests positive for ketones: Call your pediatrician or endocrinologist right away. Keep drinking plenty of water. Do not exercise. In this state, physical activity can nudge blood glucose higher still. When Symptoms Point to Low Blood Sugar (In a Person With Diabetes) Hypoglycemia, though usually mild, comes on suddenly. As with hyperglycemia, the blood should be tested at once, because the symptoms of low blood sugar mimic those of other medical conditions. Report repeated episodes to your doctor, who may need to adjust the dosage of insulin or oral diabetes medication. If blood sugar is below 60 mg/ml, indicating hypoglycemia, and the teen is alert, he should: Eat or drink one of these rapidly digested starches, such as: glucose tablets orange juice non-diet soda grape jam, honey or sugar If the symptoms do not improve after fifteen minutes, call your pediatrician or endocrinologist for instructions. Continue feeding the teen sweets every fifteen minutes until the blood sugar climbs back up to at least 70 mg/ml. Once he is out of danger and feeling better, give him something more substantial to eat, such as bread or crackers with peanut butter or cheese, or a bowl of cereal with milk. If the blood sugar is below 60 mg/ml and the teen is convulsing or too drowsy to swallow safely, or unconscious: A family member or friend should inject him with the hormone glucagon. Alert your pediatrician or endocrinologist immediately. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
161,7,"2018-04-19 02:48:19","Chronic Conditions",161,"2018-04-19 03:15:04","Diabetes in Children","Diabetes in Children Page Content Article BodyDiabetes mellitus is a very serious metabolic disor­der that prevents the normal breakdown and use of food, especially sugars (carbohydrates) by the body. It can damage the heart, blood vessels, kidneys, and neuro­logical system and can cause a progressive loss of vision over many years.Forms of Diabetes There are multiple forms of diabetes but the two most common forms are called type 1 and type 2 diabetes. Both forms can occur at any age, but a child is more likely to be diagnosed with type 1 diabetes. About type 1 diabetes  Type 1 diabetes is caused by inade­quate production of the hormone insulin by the pancreas. When that happens, the body is unable to properly metabolize sug­ars, which build up in the bloodstream; these sugars (also called glucose) cannot be used by the body and are excreted in the urine. This leads to the major symptoms of diabetes:Increased urinationThirstIncreased appetiteWeight lossWhile type 1 diabetes can begin at any age, there are peak periods at about ages five to six and then again at ages eleven to thir­teen. The first sign is often an increase in the frequency and amount of urination. This is often most notable at night, including recurrence of bedwetting in children who are potty-trained. However, the other cardinal symptoms must be present as well for the diagnosis of diabetes: Your child will complain of being thirsty and tired, will begin to lose weight, and will have an increase in appetite. It is important to identify these symptoms early, since children that are diagnosed late may become ill, because of the high blood sugars and dehydration, requiring intravenous insulin and fluids in a pediatric emergency room or critical care unit to stabilize their condition.Controlling and Managing Diabetes Although there is no cure for diabetes, children with this disease can lead a nearly normal childhood and adolescence if their disorder is kept under control. It is essen­tial to control diabetes properly in order to avoid complications. Management focuses on routine blood sugar monitoring, insulin therapy, given as multiple injections per day or through an insulin pump, and close regulation of a healthy diet.  Maintaining blood sugars within a normal range can re­duce the likelihood of symptoms of high or low blood sugars and decrease the risk of long-term health problems related to poor diabetes control. In addition to a healthy diet, at least thirty minutes of exercise a day can help your child man­age their disease as well.What Parents of Children with Diabetes Can DoBy working with and supporting your child as they learn to become more independent, you can help them gradually begin to take responsibility for caring for their diabetes while maintaining a sense of independence. Children above the age of seven typically have the fine motor skills to be able to start giving them­selves insulin injections with adult supervision. They can also check the sugar in their blood several times per day, using simple, chemically treated test strips and a blood sugar meter. However, these self-care tasks need to be supervised by an adult familiar with diabetes care to make certain your child is properly caring for their diabetes according to your doctor's guidelines.If your child takes too much insulin: Their blood sugar can become too low (hypoglycemia), prompting symptoms, including trembling, a rapid heartbeat, nausea, fatigue, weakness, and even loss of consciousness. If your child takes too little insulin: The major symptoms of dia­betes (weight loss, increased urination, thirst, and appetite), can return.Developing good diabetes management habits when a child is young can have a dramatic impact on their management habits as they get older. Many communities also have active parent groups that are available in which the parents of children with diabetes can meet to discuss their common concerns. Ask your doctor for a recommendation.  Additional Information: Type 1 Diabetes: A Guide for Families Type 2 Diabetes: Tips for Healthy LivingJuvenile Diabetes Research Foundation (JDRF)American Diabetes Association (ADA) Last Updated 11/28/2015 Source Section on Endocrinology (Copyright © 2014 American Academy of Pediatrics)"
162,7,"2018-04-19 02:48:19","Chronic Conditions",162,"2018-04-19 03:15:09","Diagnostic Tests for Diabetes","Diagnostic Tests for Diabetes Page Content Article BodyDiabetes is diagnosed through physical examination and thorough medical history, plus one of the laboratory procedures measuring the concentration of glucose in the blood. These procedures are conveniently compared in this table. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
163,7,"2018-04-19 02:48:19","Chronic Conditions",163,"2018-04-19 03:15:15","Fetal Alcohol Spectrum Disorders","Fetal Alcohol Spectrum Disorders Page Content Article Body​Fetal alcohol spectrum disorders (FASDs) is an umbrella term used to describe the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects can have lifelong implications including physical, mental, behavior, and or learning disabilities. The exact number of children who have an FASD is difficult to determine. The Centers for Disease Control and Prevention (CDC) estimates between 800 and 8,000 babies in the U.S. could be born each year with full FAS. Conditions on the FASD Spectrum The term FASD encompasses a number of conditions:Fetal Alcohol Syndrome (FAS)FAS is on the most severe end of the FASD spectrum. It describes people with the greatest alcohol effects, causing signs and symptoms so distinct that the diagnosis is based on special measurements and findings in each of the 3 following areas:Three specific facial abnormalities: smooth philtrum (the area between nose and upper lip), thin upper lip, small palpebral fissures (the horizontal eye openings)Growth deficit (lower than average height, weight or both) Central nervous system (CNS) abnormalities (structural, neurologic, functional, or a combination of these)Partial fetal Alcohol Syndrome (pFAS)When a person does not meet the full diagnostic criteria for FAS but has a history of prenatal alcohol exposure and some of the facial abnormalities, as well as a growth problem or CNS abnormalities that person is considered to have partial FAS (pFAS).Alcohol-Related Neurodevelopmental Disorder (ARND)People with ARND do not have abnormal facial features or growth problems, but do have problems with how their brain and nervous system were formed as well as how they function. These individuals may have: Intellectual disabilities Behavior or learning problemsNerve or brain abnormalitiesIn particular, a 2011 federally convened committee that reviewed the science noted that these children are most likely to have problems with neurocognitive development, adaptive functioning, and or behavior regulation.Alcohol-Related Birth Defects (ARBD)People with ARBD have problems with how some of their organs were formed and or how they function, including:HeartKidneyBones (possibly the spine)HearingVisionThese individual also may have one of the other FASDs.CauseFASDs can happen only when a pregnant woman consumes alcohol. The alcohol crosses the placenta and enters the baby’s blood where it can damage the developing brain and other organs leading to an FASD. FASDs are 100% preventable if a woman does not drink alcohol during pregnancy.Diagnosis It is difficult to diagnosis FASDs, because there is no single or simple test that can cover the broad range of FASD signs and symptoms. Certain physical findings, developmental problems, behavioral concerns, or school failure should trigger the parents and or the pediatric medical home provider or other pediatric developmental specialist to consider FASDs as potential diagnoses. A known history of alcohol consumption during the pregnancy aids in diagnosis but is not required for diagnosis of an FASD.​Children with an FASD can have brain abnormalities that lead to problems in day-to-day functioning despite having a normal IQ, so a comprehensive evaluation is indicated. All children with involvement in foster care or adoption processes, especially international adoptions, should always be evaluated for a possible FASD.TreatmentNo one treatment is right for every child, as FASD differs from one child to another. FASDs need a medical home to provide, coordinate, and facilitate all the necessary medical, behavioral, social, and educational services. Many types of available treatments include:Developmental servicesEducational interventionsBehavior modificationParent trainingSocial skills trainingMedicationsOther medical therapiesTransition planningAdvocacy in school and the workplaceReferral for community support servicesTreatment plans should be adaptable to the child’s and family’s needs, plus include close monitoring and follow-up. Outlook for Children with FASDsFASDs last a lifetime. There is no cure for FASDs, but identifying children with FASDs as early as possible can help them reach their potential. Research has shown that early identification and enrollment in treatment can significantly improve an affected child’s development and life. Additional Resources: Fetal Alcohol Syndrome Disorders: FAQs of Parents and Families Fetal Alcohol Syndrome (Audio) Where We Stand: Alcohol During Pregnancy Fetal Alcohol Spectrum Disorders (CDC.gov) Living with FASD: Strategies for Daily Living (National Organization on Fetal Alcohol Syndrome [NOFAS]) Circle of Hope (Birth Mother's Network) (National Organization on Fetal Alcohol Syndrome [NOFAS])  Treatments That Work (National Child Traumatic Stress Network [NCTSN]) Family-to-Family Health Information Centers (F2F HICs) Reach to Teach: Educating Elementary and Middle School Children with FASDs (samhsa.gov) Teaching Students with FASDs: Building Strengths, Creating Hope (Alberta Learning) Making a Difference: Working with Students Who Have FASDs (Yukon Education) Last Updated 11/21/2015 Source Adapted from Fetal Alcohol Syndrome Toolkit (Copyright © American Academy of Pediatrics 2012)"
164,7,"2018-04-19 02:48:19","Chronic Conditions",164,"2018-04-19 03:15:19","Fetal Alcohol Spectrum Disorders: FAQs of Parents and Families","Fetal Alcohol Spectrum Disorders: FAQs of Parents and Families Page Content Article Body​What are FASDs? The term fetal alcohol spectrum disorders, or FASDs, describes a broad group of conditions that an individual can have as a result of their birth mother drinking alcohol during pregnancy. Signs and symptoms of the various FASDs range from mild to severe and include a combination of physical, emotional, behavioral, and learning problems that reflect alcohol’s effect on the developing brain and other organs of the body. Each person with an FASD is affected slightly differently. How common are FASDs? The exact number of children who have an FASD is difficult to determine. However, based on studies of the Centers for Disease Control and Prevention and others, it is estimated that in the United States, somewhere between 800 and 8,000 babies could be born each year with full FAS. Further, researchers believe that there are at least 3 times as many cases of FASDs beyond those with full FAS. Some experts estimate that approximately 40,000 babies may be born with an FASD in the United States each year. Much more work is needed in the area of diagnosis and estimating prevalence of FASDS to have more accurate numbers.  Can a father’s use of alcohol lead to FASDs? No, a father’s use of alcohol cannot lead to FASDs. FASDs can only happen when a pregnant woman consumes alcohol. However, it is important for the father of the baby or the supportive partner to encourage the pregnant woman to abstain from alcohol throughout the pregnancy.  How are FASDs prevented? FASDs are 100% preventable. The only sure way to prevent FASDs is to completely avoid alcohol use while pregnant. Women who are trying to get pregnant or who could get pregnant also should avoid alcohol. This is because damage from prenatal alcohol exposure can occur even during the earliest weeks of pregnancy, even before a woman realizes she’s pregnant. What is considered “a drink”? In the United States, a “standard drink” is defined for as any alcoholic beverage that contains 0.6 fluid ounces (14 g) of pure alcohol. In general, the means 12 oz of beer, 5 oz of wine, or 1.5-oz shot of liquor are each one standard drink. Mixed drinks or alcohol served in restaurants/bars often contain more than one standard drink.  Is there is a safe amount of alcohol consumption during pregnancy? There is no safe amount of alcohol when a woman is pregnant. Research evidence indicates that even drinking small amounts of alcohol while pregnant can lead to: Miscarriage Stillbirth Prematurity Sudden infant death syndrome Does more drinking cause more harm? Pregnant women who drink alcohol often or in higher amounts increase the risk for their babies to have alcohol-related damage and for the damage to be more severe. However, even low to moderate amounts of alcohol can have adverse effects. Thus the best advice is to abstain from drinking alcohol while pregnant.  Is there any kind of alcohol that is safe to drink during pregnancy? There is no safe type of alcoholic beverage. Red wine is no safer than white wine, beer, or mixed drinks, since all contain alcohol. Is there a safe time during pregnancy when a woman can drink alcohol? There is no point during pregnancy when drinking alcohol is considered safe. Adverse effects can happen at the earliest stages of pregnancy, even before a woman realizes she’s pregnant. Because different aspects of the child are developing at all stages of pregnancy, alcohol’s effects on a developing baby can result from alcohol use at any point during pregnancy. Alcohol is a known neurotoxin, so since the brain develops throughout pregnancy, the developing brain and nervous system are always at risk. What do I do if I did not know I was pregnant and have been drinking? Stop drinking as soon as you find out you are pregnant. This is the best thing you can do for yourself and your baby. In general, babies of mothers who stop drinking do better than babies of mothers who continue to drink. In addition, make sure you get regular prenatal checkups and discuss your alcohol use with your health care provider. Don’t hesitate to ask for advice, especially if you think you might have difficulty stopping your use of alcohol. A wide variety of referrals and resources are available.  If I drank when I was pregnant, does that mean my baby will have an FASD? Every pregnancy is different, and a lot of factors such as genetics, nutrition, and other exposures like smoking affect the developing fetus. Also, alcohol affects unborn babies in a variety of ways, resulting in effects that range from subtle to obvious and may be difficult to identify in the newborn period. Discuss your FASD concerns with your child’s health care provider. Is it okay to drink alcohol if I am trying to get pregnant? When a woman is trying to get pregnant, she might already be pregnant and not know it for up to 4 to 6 weeks. This means that if she is drinking alcohol, she is also exposing her fetus to all the alcohol-related risks. A woman also is at risk for other adverse reproductive outcomes such as miscarriage. The best advice is to stop drinking when you start trying to get pregnant. Why should I worry about alcohol use if I am not pregnant and not trying to get pregnant? Half of all pregnancies in the United States are unplanned. If a woman is not trying to get pregnant, she should be sure to use an effective form of birth control until she is ready to become pregnant.  Can FASDs be passed along through breast milk? Alcohol passes through your milk to your baby, so it’s best to avoid habitual use while breastfeeding. And while drinking beer does not increase your milk supply, as urban myth suggests, consuming alcohol of any kind may decrease the amount of milk your baby drinks. Alcohol can change the taste of your milk, and this may be objectionable to some babies. If you choose to have an alcoholic drink, it’s best to do so just after you nurse or express milk rather than before, and allow at least 2 hours per drink before your next breastfeeding or pumping session. That way, your body will have as much time as possible to rid itself of the alcohol before the next feeding and less will reach your infant. There are concerns about long-term, repeated exposures of infants to alcohol via the mother’s milk, so moderation is definitely advised. Chronic consumption of alcohol may also reduce milk production. How are FASDs diagnosed? Diagnosing FASDs can be difficult because there is no single or simple test that can cover the broad range of FASD signs and symptoms. A pediatric medical home provider and/or other pediatric or developmental specialists usually make the FASD diagnosis after one or more appropriate evaluations. Certain physical findings, developmental problems, behavioral concerns, or school failure should trigger the parents and the pediatric medical home to consider FASDs as potential diagnoses. Children with an FASD can have brain abnormalities that lead to problems in day-to-day functioning despite having a normal IQ, so a comprehensive evaluation is indicated. All children with involvement in foster care or adoption processes, especially international adoptions, should always be evaluated for a possible FASD. Is there a cure for FASDs? FASDs last a lifetime. There is no cure for FASDs, but identifying children with FASDs as early as possible can help them reach their potential. Research has shown that early identification and enrollment in treatment can significantly improve an affected child’s development and life. Are there treatments that help with FASDs? Treatments have been shown to help, but no one treatment is right for every child since one FASD differs from another. FASDs need a medical home to provide, coordinate, and facilitate all the necessary medical, behavioral, social, and educational services. Many types of treatment are available, including: developmental services educational interventions behavior modification parent training social skills training medications other medical therapies transition planning advocacy in school and the workplace referral for community support services Treatment plans should be adaptable to the child’s and family’s needs, plus include close monitoring and follow-up. For more treatment information, visit www.cdc.gov/fasd. Are FASDs genetic or hereditary? There is no evidence that FASDs are genetic or hereditary. FASDs can only happen if a woman consumes alcohol during a pregnancy. A woman who has an FASD does not have greater risk of having a child with an FASD unless she consumes alcohol during her pregnancy. However, individuals with FASDs are at increased risk for substance use and other secondary conditions associated with FASDs. For these reasons, a woman who has an FASD herself can indeed be at increased risk for having a child with an FASD. What if my doctor tells me it is okay to drink during pregnancy? Your doctor is not giving you advice based on the best and most recent research available. Your doctor should know that every major medical organization in the United States, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, the US Surgeon General, and the Centers for Disease Control and Prevention, agree and consistently state that the best advice is for women not to drink alcohol while pregnant or trying to become pregnant. What if my biological child is diagnosed with an FASD? Discuss all your questions and concerns with your child’s medical home provider and other specialists caring for your child. You may need reassurance as a parent and may benefit from greater personal and emotional support. There may be a support group to which your child’s doctor can refer you, or you can find one through your community, church, or school system. The National Organization on Fetal Alcohol Syndrome has a Circle of Hope/Birth Mother’s Network that can be contacted in person or online (www.nofas.org).  Any continued alcohol use should be discussed regarding your own safety and that of future pregnancies. I've tried in the past to stop drinking alcohol, but I just couldn't do it. Where can I get help? If you cannot stop drinking, talk with your doctor or contact local Alcoholics Anonymous (AA) groups, particularly a women’s group, or a local alcohol counselor or treatment center. AA is a cost-free fellowship of men and women who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism. Locate an AA program near you by visiting www.aa.org. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment facility locator. This locator helps people find drug and alcohol use treatment programs in their area. Visit http://findtreatment.samhsa.gov. Where can I get more information about FASDs? Fetal Alcohol Syndrome (Audio) Where We Stand: Alcohol During Pregnancy Fetal Alcohol Spectrum Disorders (CDC.gov) Living with FASD: Strategies for Daily Living (National Organization on Fetal Alcohol Syndrome [NOFAS]) Circle of Hope (Birth Mother's Network) (National Organization on Fetal Alcohol Syndrome [NOFAS]) Treatments That Work (National Child Traumatic Stress Network [NCTSN]) Family-to-Family Health Information Centers (F2F HICs) Reach to Teach: Educating Elementary and Middle School Children with FASDs (samhsa.gov) Teaching Students with FASDs: Building Strengths, Creating Hope (Alberta Learning) Making a Difference: Working with Students Who Have FASDs (Yukon Education) All About Me-Getting to Know Child Affected by Prenatal Alcohol Exposure Last Updated 11/21/2015 Source Fetal Alcohol Syndrome Toolkit (Copyright © American Academy of Pediatrics 2012)"
165,7,"2018-04-19 02:48:19","Chronic Conditions",165,"2018-04-19 03:15:24","Fitness and Children with Chronic Illnesses","Fitness and Children with Chronic Illnesses Page Content Article BodyExercise is a way for children to keep fit, have fun, build self-esteem, and re­late to other children. Even children with a serious chronic disease can enjoy the benefits of participating in safe and appropriate physical activity. Talk with your pediatrician about whether restrictions are necessary for your child with a chronic illness; if they are, explain the situation fully to your youngster before imposing them. Obviously, she should not be in an athletic environment where her limitations place her in danger or significantly limit her opportunity to have some success. Nearly every child can find an appropriate level of activity in which she can participate successfully and without frustration, while developing muscle strength and coordination. Every child should be encouraged to become as active as possible. Most chronic health problems actually require few, if any, restrictions. Chil­dren with asthma, for example, can usually participate in sports, although they may have to follow carefully their doctor's guidelines for medication ad­ministration before exercising. Youngsters with well-controlled seizure disor­ders can enjoy nearly all sports, from baseball to basketball to soccer— although if a child has occasional seizures, it is probably sensible to avoid ac­tivities such as rope climbing, high diving, and workouts on parallel bars, where a fall could cause a serious injury; while swimming, these children should be supervised by an adult who is in the water with them. Children with heart disease or high blood pressure can participate in most sports, although your child's cardiologist may have specific recommendations about how strenuous an activity should be. Youngsters with musculoskeletal problems like scoliosis can also lead an active life, as can most children with rheumatoid arthritis. Some youngsters have impaired, uncorrectable vision in one eye. In these cases, talk to an ophthalmologist about protecting the good eye from injury. Special protective eyewear may be suggested. Children who participate in sports where eyes are frequently injured, such as baseball, racquetball, and handball, are also advised to use protective eyewear. The Special Olympics program offers unique, exciting experiences for dis­abled children, providing opportunities for physical fitness, competition, and enjoyment. Through their participation, children can enhance their self-esteem, and parents can connect with a valuable support system. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
166,7,"2018-04-19 02:48:19","Chronic Conditions",166,"2018-04-19 03:15:28","Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions","Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions Page Content​What is the flu? Influenza (flu) is an infection of the nose, throat and lungs caused by the influenza viruses. It can cause mild to severe illness, pneumonia, and other complications. Children younger than five, but especially children younger than 2 years old, and children and adolescents with chronic health conditions are at greater risk for serious flu complications. These flu complications can result in hospital stays and even death. The best way to prevent the flu is by getting a flu vaccine each year. How do I know if my child is at greater risk for flu-related complications? Your child is at risk if he or she has any of the following conditions: Asthma Neurological and neurodevelopmental conditions including disorders of the brain; spinal cord; peripheral nerve; and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury Chronic lung disease (such as cystic fibrosis, or chronic lung disease of prematurity) Heart disease (such as congenital heart disease and congestive heart failure) Blood disorders (such as sickle cell disease) Endocrine disorders (such as diabetes mellitus) Kidney disorders Liver disorders Morbid Obesity Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)Weakened immune system due to disease or medication (such as children or adolescents with HIV or AIDS, cancer, bone marrow or solid organ transplantation, or those on chronic steroids or other immune suppressive treatment)Receiving long-term aspirin therapy for chronic disordersPregnancyWhat are symptoms of the flu? Symptoms of the flu can include:FeverCoughSore throatRunny or stuffy noseBody achesHeadacheChillsFatigueSometimes vomiting and diarrheaIt is important to note that some people sick with flu may not have a fever. What is a flu complication? Most people who get the flu will recover in a few days to less than 2 weeks, but some people will develop complications because of the flu, some of which can be life-threatening and result in death.Pneumonia, bronchitis, and sinus and ear infections are examples of complications from the flu. The flu can also make chronic health conditions worse. For example, people with asthma may experience asthma attacks while they have the flu.How can I protect my child against the flu? Flu Vaccines: The most important thing is for your child to get a flu vaccine every year. Children younger than 6 months are at high risk of serious flu illness, but are too young to be vaccinated. People who care for them should be vaccinated instead in order to protect them. When a pregnant woman is vaccinated, the antibody produced in response to the vaccine also offers protection to the developing baby. Distance: Your child should avoid close contact with people who are sick. Hand washing: Wash hands often with soap and running water (as long as it takes to sing the ""Happy Birthday"" song twice). If soap and water are not available, use an alcohol-based hand sanitizer. Help your child wash their hands if needed. Germ control: Encourage your child to avoid touching their eyes, nose, mouth, and to use a tissue or elbow to cough or sneeze into. Cleaning: Keep surfaces in the house and toys clean by wiping them down with a household disinfectant according to the directions on the product label. Health: If your child has a chronic health condition, make sure that it is under the best control. Plan: Have a plan in case your child becomes sick with the flu.What can I do if my child gets sick? Doctor: Call or take your child to the doctor if your child develops flu-like symptoms. The doctor may want to begin antiviral drugs as quickly as possible. Antiviral drugs are prescription medicines that fight against the flu in your body. Home care: Excluding doctor visits, keep your child at home until they no longer have a fever for at least 24 hours and are feeling more like themselves. Covering coughs: Ensure that your child covers coughs and sneezes. Rest and fluids: Make sure your child gets plenty of rest and drinks fluids to keep them from becoming dehydrated. Medicines: Ask your doctor about fever-reducing medicines based on your child's age. Children younger than 4 years of age should not be given over-the-counter cough/cold medicines without approval from a health care provider. Aspirin should not be given to children or teenagers who have the flu; this can cause a rare but serious illness called Reye's syndrome. Remember that the fever helps your child fight the infection, so it is not always necessary to give fever-reducing medicines. Sick room: Keep your sick child in a separate room (sick room) in the house. Limit as much contact as possible with other members of the household who are not sick. Make one person in the house the main caregiver for the sick child. Protect pregnant women: Pregnant women should get a flu shot. If possible, pregnant women should not be the main caregivers of a child with the flu until they recover.When can my child go back to school after being sick?Usually, your child should stay home for at least 24 hours after the fever is gone. A fever is defined as 101° F/38.3° C or greater. The fever should be gone without the use of a fever-reducing medicine. Is the flu vaccine safe for my child with chronic health problems? Yes. The flu vaccine is approved for use in children 6 months and older, including both healthy children and those with chronic health problems. Because children with chronic health conditions are at a higher risk of getting flu related complications, it is especially important that they get a flu shot.What types of vaccine should my child receive and how many doses?Children with or without chronic health conditions should get the flu shot (inactivated flu vaccine) only. The nasal spray vaccine is not recommended this season. There are two type of flu vaccine based on the number of flu virus strains they contain: the trivalent flu shot (two A and one B viruses), and the quadrivalent flu shot (two A and two B viruses). Any of these can be used, without preference for one over the other. Children 6 months to 8 years old may need 2 doses of the vaccine. Children 9 years of age and older need only one dose. Talk with your doctor to discuss how many doses are recommended for your child.How can I plan ahead with my child's school or child care?Find out your child's school or child care providers plan for flu season. Let them know your child is at high-risk for flu related problems.The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that all children 6 months and older, especially those with chronic health conditions, get a seasonal flu vaccine. Additional Information & Resources: Preventing the Flu: Resources for Parents & Child Care Providers Preventing the Spread of Illness in Child Care or School Treating Your Child's Cold or Flu (Video) Flu Fighter Coloring Book  (National Foundation for Infectious Diseases) Influenza Prevention and Control: Strategies for Early Education and Child Care Programs (AAP.org)   Article Body Last Updated 9/15/2017 Source Adapted from the Centers for Disease Control and Prevention"
167,7,"2018-04-19 02:48:19","Chronic Conditions",167,"2018-04-19 03:15:34","Healthy Children Radio: Type 1 Diabetes","Healthy Children Radio: Type 1 Diabetes Page Content Article Body​Pediatrician Debra Lotstein, MD, lead author of the study, “Transition from Pediatric to Adult Care for Youth Diagnosed with Type 1 Diabetes in Adolescence,” in Pediatrics, comes on the Healthy Children Radio show on RadioMD to talk about how adolescents with type 1 diabetes can manage the transition from a pediatrician to an adult health care provider.  Segment 1: Type 1 Diabetes & Your Child: Growing Out of the Pediatrician Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2013)"
168,7,"2018-04-19 02:48:19","Chronic Conditions",168,"2018-04-19 02:50:36","How Chronic Illness or Disability Affects a Family",
169,7,"2018-04-19 02:48:19","Chronic Conditions",169,"2018-04-19 03:16:05","Living with a Chronic Illness or Disability","Living with a Chronic Illness or Disability Page Content Article BodyOur child has a chronic illness or disability. How can we help him learn to live as best as he can with his condition?When you first learn that your child has a disability or a chronic illness, the news is often unexpected and can seem devastating. Many families experience a sense of powerlessness in the beginning at the prospect of dealing with a chronic illness, health problem, or disability and often feel very stressed at facing a future filled with unknowns.Knowledge Is PowerAs a first step, it is important for you and your child to try to understand your child's special needs, and try to find out as much as you can about her condition and its care. The more information parents and children have, the less frightening the present and future will seem. Knowledge is empowering. It can help both you and your child feel more in control of the condition and the impact and effects on your child's life and on your family.Information will also help you plan, guide and advocate for and with your child. Over time, you can teach him (if possible) to manage his own condition and learn to be his own advocate through the potentially complicated pediatric and adult health care and educational systems.Informing Your Child about His ConditionThe type of information you convey to your child should be appropriate for your child's age and developmental abilities. You can gauge this best by listening to her questions. Studies show, for instance, that kindergarten-age children typically view illness as quite magical: One child, when asked ""How do you get better from an asthma attack?"" simply responded, ""Don't wheeze.""Young children who have diabetes may sometimes believe their illness is because of eating too much candy. Some children believe they have become ill and been hospitalized as punishment for not listening to their mother or father.Beginning at about ages 10 to 12, children begin to grasp the complex ways that things can cause or be a factor in a disease or disability. By the fourth grade, children tend to believe that germs cause all illness. These older children may be capable of understanding more factual information about their condition. Remember that as children grow up, their ability to understand information and take responsibility for their own care increases. Every year or so, someone should check out what the child understands about his illness or disability, fill in the gaps and correct information that he does not understand correctly. All too often, the explanations and details about the condition discussed with a child and youth stop at the time of diagnosisHelping Your Child Manage Stress Stress is a part of life. It motivates us to succeed, but it can also interfere with life's joys and accomplishments. Children with chronic illnesses and disabilities often deal with more stress than other children. For example, they may have to cope with an imperfect body, frequent hospitalizations, painful injections, surgery, or even premature death.A child with kidney disease who requires dialysis three times a week has regular and repeated periods of stress to address. A child with cancer, who must undergo repeated chemotherapy, often has to manage the fears and anxieties of each future treatment. A child with epilepsy may feel anxious about the possibility of having another seizure.Unfortunately, there are no simple ways to help your child avoid these stresses. Suggestions to Reduce the Negative Impact or Effects of These Stresses on Your Child: Listen to your child. Whether she or he is feeling sadness, frustration, or rage, it is helpful for a child to express these emotions. A child should feel that she can share her thoughts and fears with you freely and without you overreacting or becoming upset. Ask how she is feeling if your child does not say anything. Be available and supportive. Listen not only to what your child says, but also try to hear what is left unspoken. Inform your child about what lies ahead. Anxiety is often based on the unknown or on inaccurate beliefs about the future. Find out what your child does and does not know. Explain exactly what will happen during an upcoming doctor's appointment or hospital visit; if you are unable to answer all your child's questions, both of you should talk to the doctor. Do not expose a child to a frightening procedure unless she has been told about it ahead of time. Talking with other children who have gone through the same experiences can be very helpful. ""Rehearsal"" can help children cope with new situations that appear frightening. Many hospitals can now arrange for children to spend time in the children's ward before they undergo surgery or other procedures. These visits can make clear to children about what the hospital setting is like and what to expect. Encourage your child to spend time with other children with a chronic illness or disability that is the same or similar to your child's condition. Frequently talk about the illness or condition so that your child feels comfortable being open about it. Emphasize your child's strengths and support efforts to develop new strengths – the things she can do well despite the condition. Help your child feel that he can be in control of some aspects of each health care related event or situation. Try to find choices that can be given to him, such as which arm to have blood drawn from, when a procedure will occur, or what reward he will get for cooperating. Call your pediatrician for an appointment if you have concerns about your child's mood or behavior at home or school (i.e., sad, anxious, irritable, aggressive). Your pediatrician will want to talk with you and your child and determine if your child needs to be evaluated and treated by a therapist or counselor or other mental health provider.IndependenceChildren's capacity for independence varies from illness to illness and child to child and will steadily increase with maturity. If your child has diabetes, you may have to test her blood sugar level and make sure insulin injections are given regularly during her younger years. If she requires a special diet, you will need to supervise food choices and eating habits closely. At the same time, watch for signals from her that she is able to assume greater responsibility, and help her take on more of the management of the illness little by little as she gets older.Some children avoid accepting more independence and self-management of their condition. Families may not mean to but foster dependency because they find it easier to maintain responsibility for their child's care, rather than teaching the child to perform certain tasks and relying on her to do so. Also, some children may enjoy being the object of their parents' special attention. They may relish having certain tasks' performed for them, and may resist taking responsibility.It is critical to help your child come to terms with his health condition and accept developmentally and age appropriate responsibility for caring for himself. Try not to deprive your child of the important and rewarding experience of mastering day-to-day tasks; it instills pride and self-confidence that prepares him for adult life. Praise his efforts at assuming responsibility, and applaud yourself for having the wisdom and courage to let him take these very important steps.Self-management skills should also be more formally assessed and encouraged in youth starting at age 14 years of age with your child's pediatrician. Youth should help develop a shared medical summary and emergency care plan with their health care providers and develop linkages to any needed community-based supports. Parent and youth should also begin to address issues of legal decision-making and guardianship as appropriate with their providers starting at age 16 years of age. Youth and families should also ask about options for adult health care providers and the process for transferring care.Your Pediatrician Can HelpDiscuss any of your concerns and any limitations with your child's pediatrician. Using your doctor's input, develop some guidelines for sensible restrictions if needed while also encouraging your child to participate in a diversity of activities and gain more responsibility for their care. Parents need to recognize their children's changing needs and to plan for them. It is also important for parents to be educated and up-to-date about their child's illness or disability and about new treatments and their effects.Most children with chronic illnesses or disabilities do well in school, develop appropriately and achieve their goals in much the same way that other children do. Most are healthy children who happen to have a chronic illness or disability. While their illness may create certain difficulties, with the support of their parents and other community based services as needed most lead happy, effective and exciting lives and grow up to become productive adults.Additional Information: Common Coping Styles of Teens Who Are Chronically Ill or Disabled How Chronic Illness Affects the Family Serving As A Child Advocate Supporting a Child With a Chronic Illness The Stresses Faced By Teenagers Who Are Chronically Ill or Disabled Healthy Children Radio: Tips for Parents of Children with Special Needs (Audio) Last Updated 11/21/2015 Source Committee on Psychosocial Aspects of Child and Family Health (Copyright © 2014 American Academy of Pediatrics)"
170,7,"2018-04-19 02:48:19","Chronic Conditions",170,"2018-04-19 03:16:12","Reproductive Health in Teens with Chronic Health Conditions","Reproductive Health in Teens with Chronic Health Conditions Page Content Article Body​Reproductive health is an integral component of physical, social, and emotional well-being. Most adolescents with chronic conditions can be expected to experience similar normative stages of physical and emotional development, including: Puberty Desire for romantic relationships Envisioning future parenthood Varying Concerns As Children with Chronic Conditions Mature There may be specific risks of hormonal contraception, sexually transmitted infections, and pregnancy depending on disease processes or therapeutic regimens. A significant subset of teens with intellectual disability or developmental delay will experience the same physical maturation as their age-matched peers with a mismatch in expected emotional and cognitive development. Teens with severe neurodevelopmental disability often have difficulty during puberty with unpredictable mood swings and emotional outbursts, severe pain with menstruation, challenges with hygiene, and regulating normal sexual urges in socially acceptable ways. Practical Ways for Parents of Teens with Chronic Conditions to Address Reproductive Health Issues Include the Following: For some teens with chronic illness, menstrual challenges, such as difficulty wearing a sanitary napkin and knowing when to change it, are common issues. Resources can be provided, such as picture boards and incorporating self-care goals into an individualized educational plan (IEP). Discuss boundaries in relationships. Crushes or sexual feelings for another person are normal and happen to everyone. Sometimes they can be mutual, but sometimes they are one-sided, which can be confusing. While difficult, most teens during adolescence experience unreciprocated feelings. It provides an opportunity to discuss respect for the feelings of others and that crushes are personal. Remind your child that, in time, they will likely be attracted to someone who has similar feelings for them. Do not assume your child is not involved in romantic relationships because they have a chronic condition. Disclosure in relationships is an important issue if a chronic illness is transmissible (eg, HIV or hepatitis) or requires daily ongoing care (eg, cystic fibrosis or diabetes). As adolescence progresses to young adulthood, how the chronic illness affects fertility or how it could be passed on to offspring might also affect disclosure. A key factor affecting one’s ability to disclose disease status is acceptance of one’s own medical condition. Acceptance is necessary to adapt to an illness while tolerating the unpredictability of the disease while staying engaged in a meaningful life. The need for psychosocial support for teens with chronic conditions as they negotiate acceptance might only come to light during discussions regarding complex relationship dynamics. See Common Coping Styles of Teens Who Are Chronically Ill or Disabled. Additional Information: The Stresses Faced By Teenagers Who Are Chronically Ill or Disabled Supporting a Child with a Chronic Illness Social Difficulties for Children with Chronic Illness Children with Chronic Illness: Dealing with Emotional Problems and Depression Author Edited by Kenneth R. Ginsburg, MD, MS Ed, FAAP, FSAHM and Sara B. Kinsman, MD, PhD Last Updated 11/21/2015 Source Reaching Teens: Strength-based Communication Strategies to Build Resilience and Support Healthy Adolescent Development (Copyright © 2014 American Academy of Pediatrics)"
171,7,"2018-04-19 02:48:19","Chronic Conditions",171,"2018-04-19 03:16:16","Siblings of Children with Chronic Illnesses or Disabilities","Siblings of Children with Chronic Illnesses or Disabilities Page Content Article BodyParents are not the only ones who must adjust to a child's illness or disability. Life changes for the entire family.Parents have to pay extra attention to a child with a chronic illness or disability, and brothers and sisters may often feel neglected. They might also have difficulty learning to live with the stresses of having a sibling with a chronic health problem or disability.How Siblings Might Feel:Guilt that they are not sick (""Why him and not me?"") Wonder whether they might have caused their sibling's illness Anxious about becoming sick themselvesJealous and wish could become the center of the family's attentionAngry if they are asked to assume more household chores than their sibling with a chronic health problemGuilty when they resent the additional responsibility they are tasked with Embarrassed or even angry when strangers stare at their brother or sister in a wheelchair, or when other children tease their sibling because he or she looks differentWhat Parents Can Do:Be aware that while attending to the needs of your child with a chronic illness or disability, you may be neglecting – or creating unfair expectations for – your other children. At times, siblings may feel invisible unless they demand attention. However, siblings can learn to participate in the family and feel pride and love in helping their brother or sister with his or her health problem. The presence of a family member with a chronic illness provides opportunities for increased empathy, responsibility, adaptability, problem solving and creativity.Try to establish some balance between the needs of your child with a chronic health problem or disability and those of your other children. Spending some time with each child individually may help. Develop a special relationship with each one of your children. Keep in mind that siblings need to have honest information about the condition and to have their questions listened to and answered.Signs Siblings Are Having Trouble:When there is a child with a chronic illness or disability in your family, your other children may experience negative effects. Warning signs the siblings of your child with a chronic health condition or disability may need some extra attention: Anxious DepressedWithdrawnAngryLosing interest in friends Doing poorly in school Pushing too hard to achieveRebelliousLosing interest in activities that once brought pleasure, such as sports or music lessonsActing out in other ways to get attention If you are concerned, ask your child's pediatrician for help. He or she can guide you to local psychologists, social workers, family therapists, child life specialists, and/or support groups for siblings of children with chronic health problems or disabilities. You should not expect or attempt to solve these concerns related to the siblings of your child with a chronic illness or disability by yourself. Developing Resilience in Your Family: Every family will learn how to embrace and show love for a child with a chronic health problem or disability. There is no right way or wrong way for siblings to live and grow together; rather, every family should strive for its own balance and determine what are some strategies and supports that help the child with chronic health problems and her siblings to thrive and be resilient. The ultimate goal is to build internal strengths and coping skills in your child with a chronic health problem or disability and in all of the members of your family. Many factors will influence this process, including the course of the chronic condition and the external and internal supports and resources available to the child with special needs, her siblings, and the rest of the family. While most families with chronic health problems or disabilities struggle through times of fear and despair, many also develop an internal resilience, a creativity, and a closeness or cohesiveness that helps the children with and without chronic health problems and rest of the family to manage and cope together with the many stressors that may develop over time. Often as a result of these experiences, adults and children learn about their strengths and limitations, talk more openly, and learn new ways to solve problems which fosters mastery and pride. In the months and years ahead:Continue to reassess the needs and goals for your child with chronic illness or disability, their siblings, and your family. Be willing to learn new skills, search for supports and make changes as needed that serve both the child with the chronic health problem, their siblings, and everyone else in the family. As much as possible, involve all of your children in shared decision making about any health care that affects them. Stay informed and give yourself credit for all the hard work you and your family have done and the resiliency you have developed in your family.Additional Information: How Chronic Illness or Disability Affects a Family How to Support Your Child's Resilience in a Time of Crisis When Things Aren't Perfect: Caring for Yourself & Your Children Recognizing & Managing Stress in Children (Video) Last Updated 11/21/2015 Source Committee on Psychosocial Aspects of Child and Family Health (Copyright © 2014 American Academy of Pediatrics)"
172,7,"2018-04-19 02:48:19","Chronic Conditions",172,"2018-04-19 03:16:21","Sickle Cell Disease: Information for Parents","Sickle Cell Disease: Information for Parents Page Content Article BodyWhat is Sickle Cell Disease?Sickle cell disease is an inherited disorder of the red blood cells. There are several different types of sickle cell disease.Normal red blood cells are shaped like disks and can move normally through the blood vessels. In sickle cell disease, the iron-rich protein called hemoglobin forms strands inside the blood cells. These strands cause the cell to be sickle (U-shaped). Sickle cells cannot move normally through the blood vessels, because they are stiff and sticky. They block blood flow in the blood vessels, keeping blood and oxygen from reaching the tissues.Blocked blood flow causes pain that might last hours or days. It can also damage many major organs in the body. Children, especially young children, with sickle cell disease are also at higher risk of serious infection.Why Sickle Cell Disease is also called Sickle Cell Anemia?Because sickled cells don't last as long as normal cells do, a child with sickle cell disease may not have as many red blood cells in their blood as people who don't have sickle cell disease. This is called anemia.Children with sickle cell disease usually have a lower red blood cell count than children who do not have sickle cell disease. Sometimes, children with sickle cell disease need a blood transfusion because of their anemia. How do children get Sickle Cell Disease?Sickle cell disease is a condition that children get in the same way they get the color of their eyes, skin, and hair. A child with sickle cell disease is born with it; he or she inherits it. How sickle cell disease is inherited:The gene that is important in sickle cell disease produces the special protein called hemoglobin within the red blood cells that carries oxygen from the lungs to the rest of the body. Hemoglobin is what makes your blood look red in color. Everyone has one hemoglobin trait inherited from our mother and one inherited from our father. The most common traits are called A, S, and C. The combination of traits is important in whether a child has sickle cell disease or not. The following combinations can occur:DO NOT have sickle cell disease:A + A  (AA)   no sickle cell diseaseA + S   (AS) carrier of the sickle cell ""S"" traitA + C   (AC) carrier of the sickle cell ""C"" traitDO have sickle cell disease:S + S   (SS)  Sickle cell diseaseS + C   (SC) Sickle cell diseaseWhy is sickle cell disease more common in people of African American heritage?The trait for sickle cell disease is more common in people who have distant or recent ancestors from Africa. About one out of 12 people who have African ancestry carry the S or C trait. That is, they do not have sickle cell disease but have the trait (AS or AC). If their partner also has the S or C trait, then their children may have a chance of having sickle cell disease. This is why even bi-racial or multi-racial children can have sickle cell disease. About one in 400 people of African ancestry have sickle cell disease. How do I know my child's Sickle Cell type?Every state in the US provides a newborn screening test for sickle cell trait and sickle cell disease. This is the way most infants are identified with sickle cell disease before they show some of the problems and can begin treatment to prevent some of the serious problems that can occur. Learn more here. Who are the doctors that care for children with sickle cell disease?In addition to a child's pediatrician, he or she may also see a pediatric hematologist. These doctors specialize in the care of children with sickle cell disease. In some areas of the country, there are also Comprehensive Sickle Cell Centers, where doctors care for people of all ages with sickle cell disease and similar blood conditions.     Last Updated 11/21/2015 Source Section on Genetics and Birth Defects (Copyright © 2015 American Academy of Pediatrics)"
173,7,"2018-04-19 02:48:19","Chronic Conditions",173,"2018-04-19 03:16:32","Social Difficulties for Children with Chronic Illness","Social Difficulties for Children with Chronic Illness Page Content Article BodyA chronic illness can present a special challenge for your child as she relates to other children. Youngsters constantly scrutinize one another. A child with a visible disability or one who receives special treatment may be singled out by classmates because of those differences. Middle childhood is a hard time of life for children to feel that they are different in their appearance or their ca­pacity to keep up with classmates. A condition that requires medication, fre­quent absences from school, rest periods, or special equipment, such as braces or eye patches, can cause embarrassment and make children feel like outsiders. However, children who differ in health, race, religion, family, and a myriad of other circumstances can discover that they have more similarities than differ­ences. One of the goals for your child's school experience is that she learn to accept and be accepted by others, regardless of differences. Bear in mind that while feeling different can be traumatic, most youngsters are quite resilient. They and their families not only usually learn to accept their limitations, but also find creative alternatives to problems that initially may have seemed overwhelming. These children—when assisted and supported by family, friends, and professionals—can develop into stronger individuals, despite their extra burdens. On the academic side, children with chronic illnesses and normal intelli­gence should demonstrate classroom achievement just as high as that of their peers. Yet studies show that many of these youngsters underachieve at school. This may occur for a number of reasons. Their stamina may be lower, or their medication may impair their alertness or make them irritable. If their illness causes them frustration, they may have emotional or behavioral prob­lems that can interfere with schoolwork. With diseases like sickle-cell anemia, asthma, cystic fibrosis, and diabetes, youngsters may frequently miss several days of school at a time, a period that may not be long enough to qualify for a home teacher. Hospitalizations may also keep them away from the classroom. In situations like this, your child could be at a disadvantage. If she falls behind her classmates because she is absent from school too much, she may become frustrated and her motivation may falter. She might also become anxious about having to catch up on missed assignments. This anxiety can lead her to avoid school, even when she is phys­ically able to attend. Most of these issues, however, can be dealt with successfully by working with the teacher, the pediatrician, and/or a child psychologist. If your child has a health problem that is likely to interrupt her regular attendance at school, plan ahead. Meet with her teacher at the start of each school year to discuss how best to keep your child up to date on her work. Plan how home­work will be sent home and thereby prevent your child from slipping too far behind. Since your child may have frequent doctor's appointments, discuss with your child's physician the importance of scheduling them after school hours whenever possible so as to avoid missing class. Also, by keeping your youngster's teacher updated about her health condi­tion, you and your pediatrician can work with the teacher to prevent unnec­essary disruptions of your youngster's academic progress. However, be cautious about requesting preferential treatment for your youngster at school. If her teacher frequently excuses her from homework or exams, your child may become overly dependent on this kind of special attention. The teacher may also underestimate the child's real capacity for learning and therefore have lower expectations. Most schools provide home teaching for long or in­termittent, frequent absences; this usually requires a statement of necessity from your child's pediatrician or primary physician and should be based on a careful assessment of the benefits and risks for your child. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
174,7,"2018-04-19 02:48:19","Chronic Conditions",174,"2018-04-19 03:16:40","The Stresses Faced By Teenagers Who Are Chronically Ill or Disabled","The Stresses Faced By Teenagers Who Are Chronically Ill or Disabled Page Content ​In the immediate aftermath of a diagnosis, expect your teen to ask countless questions: “Is this going to affect the way I look?” “Am I going to have to miss a lot of school?” “Don’t tell me I won’t be able to go out for the lacrosse team this year!” “What if the other kids laugh at me because the chemotherapy makes my hair fall out?” These questions may demand thoughtful, well-informed answers. Bear in mind that young people’s fears about medical matters may be based on misinformation. For instance, a patient recently diagnosed with Hodgkin’s disease might sadly conclude that he doesn’t have long to live. After all, everyone knows that cancer is deadly; only the year before, his favorite aunt died of ovarian cancer. What he needs to hear from both his doctor and his parents is that there are more than one hundred forms of cancer—many of them highly treatable. In addition, the outlook for children’s malignancies tends to be more favorable than for adult tumors. Hodgkin’s disease happens to be the most curable pediatric cancer; nine in ten kids live five years from the time of diagnosis, at which point they can essentially be declared cured. Another frequent source of anxiety is upcoming medical tests and procedures. A fourteen-year-old boy slated to undergo magnetic resonance imaging (MRI) is utterly convinced that the scan is going to hurt. It’s got to: ""Did you see the size of that machine? Or what if it zaps me and I become radioactive?!"" The scanner is an imposing piece of equipment, to be sure. But he’ll be relieved to hear tha​t an MRI uses electromagnetic energy, not radiation, to visualize the body. He won’t feel any pain, and he most certainly won’t glow in the dark. A kid who is prone to claustrophobia, though, may turn panicky when the portable examining table draws her into the narrow tunnel. Mom and Dad, as her advocates within the medical system, should alert the doctor ahead of time about her aversion to confined spaces. He might prescribe a mild shortacting sedative to be taken prior to the test or arrange for an “open” MRI scanner to be used. To find out what your child can expect, ask the physician or one of the nurses to describe the procedure step by step. Many medical practices routinely provide informative, illustrated pamphlets beforehand. An adolescent should feel that he can always share what is worrying him. But, kids don’t always say what’s on their minds. In addition to being active, empathetic listeners, we need to anticipate what they may be feeling.“Honey, you seem a bit down today. I know that having diabetes is hard for you sometimes...”“Yeah, a little down... A lot, really.""“What is it exactly that’s bothering you? Maybe I can help.”“I’m just scared, that’s all.”“Scared about the future?”“Yeah, that. What if one of those terrible things that happens to people with diabetes happens to me, like losing my sight? Or what if the diabetes messes up my kidneys? I don’t want to have to go on one of those artificial kidney machines. I can’t believe I’m seventeen and have to worry about this stuff. It’s not fair!” Perhaps nothing we say will dispel our child’s sadness or resentment or rage at being saddled with a health problem. However, listening nonjudgmentally and letting our children know they can talk to us any time is beneficial. For a young person, the realization that he can express his feelings freely, without being told, “You shouldn’t be (angry, depressed, etc.),” is psychologically therapeutic in itself.Honesty Is the Best Policy Some mothers and fathers deliberately conceal all details of the illness from the young patient, operating under the misconception that they are safeguarding their child from potentially devastating news. Seriously ill teenagers instinctively know about their condition. Ironically, they frequently refrain from discussing this with Mom and Dad for much the same reason: to protect their grief-stricken parents. How do they know? Their bodies tell them. In addition, no matter how careful the adults around them are, kids glean fragments of conversations and take notice of grim expressions. Ultimately, to deny a sick person the truth about his condition is an unintentionally selfish act; all the more so in the setting of a terminal disease. Children need to talk about what they’re feeling—including their fears, their conceptions of death and dying; whatever is on their minds. No one should take away their right to talk about these issues. On the other hand, while it’s important to answer questions honestly, try to emphasize the positive whenever possible. Let’s return to the earlier example of the adolescent diabetic who is concerned that he might develop a serious long-term complication. His mother and father might say something like this:“The doctor doesn’t know for sure what’s going to happen years from now. But most kids with diabetes go on to live normal life spans. We’re confident that you will, too. The best thing we can do is to make sure that you stay healthy by keeping your blood sugars within a normal range. Never think that you’re all alone in this; we’re here to help you, and so are your brothers and sister.”Tips for Reducing AnxietiesTechniques such as deep breathing, progressive muscle relaxation and visualization can help to soothe jangled nerves before and during medical procedures.Tell your teenager about thought stopping, which will allow him to control the mind instead of the other way around. Each time a negative thought comes a-knocking—about an impending needle stick, for example—the teenager literally orders his brain to switch channels. “Okay, stop it! Turn off that thought right now! Think about something else.” It may sound overly simplistic, but with practice, this method can be extremely effective. ​ Article Body Last Updated 1/1/2003 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
175,7,"2018-04-19 02:48:19","Chronic Conditions",175,"2018-04-19 03:16:43","Type 1 Diabetes: A Guide for Families","Type 1 Diabetes: A Guide for Families Page Content Article BodyWhat is Type 1 Diabetes? Type 1 diabetes is a disease caused by a lack of insulin. Insulin is needed to allow sugar to move from the bloodstream into the cells to be used for energy. Nutrients in food are changed into a sugar called glucose. People with type 1 diabetes cannot make insulin, and without insulin, glucose is ""stuck"" in the bloodstream, leading to a high level of glucose in the blood. Type 1 diabetes affects about 1 in 400 children, adolescents, and young adults under 20 years of age. Currently, once diagnosed, type 1 diabetes is a lifelong disease that cannot be cured. However, the administration of insulin is a very effective treatment for type 1 diabetes. What Causes Diabetes? Type 1 diabetes is caused by the inability of the pancreas to produce insulin. Insulin is produced in special cells (called beta cells) in the pancreas, which is an organ located in the belly. In children with type 1 diabetes, the immune system ""misbehaves."" Normally, the immune system produces special proteins called antibodies that defend the body against infections, but in type 1 diabetes, the immune system attacks its own beta cells by producing antibodies against them. This ongoing attack results in over 90% destruction of beta cells, which may occur quickly or over a period of years, and ultimately leads to an inability to produce adequate levels of insulin. SymptomsThe symptoms of type 1 diabetes are largely due to the lack of energy caused by an inability to use the nutrients eaten and by the high sugar levels in the bloodstream pulling water from the body into the bloodstream and spilling into the urine, causing dehydration (lack of fluids). These symptoms include:Hunger, at times extreme, and associated with weight lossIncreased thirst and increased urination – the latter can be missed in infants who are not toilet trained, because parents may not realize that they are in need of more frequent diaper changes; also, ""accidents"" in a toddler and older children previously toilet trained may be overlooked.FatigueIrritability or unusual behaviorBlurry vision (not a common symptom but can occur if the sugar is very high) If untreated, the following symptoms can occur that require immediate medical care: NauseaVomitingBelly painRapid breathing and drowsinessLoss of consciousnessHow is Type 1 Diabetes Diagnosed? The diagnosis is made when a child has classic symptoms of diabetes as described above with abnormally high blood sugar levels and ketones in the urine. Diabetes can also be diagnosed by a test that reflects what the average blood sugar has been in the blood over the previous 3 months. This test is called hemoglobin A1c (HbA1c). A result that is equal to or greater than 6.5% is suggestive of diabetes. If you are worried that your child may have symptoms of type 1 diabetes:Bring your child to his doctor right away, and the doctor can easily check for sugar in the urine or obtain a drop of blood from the finger to check the blood sugar level with a glucose meter (a small portable machine). We advise that you do not try to borrow a glucose meter from a relative or friend to check the blood sugar, because you may not do it correctly and/or the home meter may not be working properly. Before a child develops full-blown type 1 diabetes, a phase of prediabetes may be present. How is Type 1 Diabetes Treated?Diabetes is treated by giving back the very hormone that is missing, called insulin. Insulin is given as several daily injections with small syringes with very thin and short needles that make the injections almost pain free. The injections are most commonly given in the upper part of the arms, in the front of the thighs, and in the fatty skin of the belly. Insulin can also be given continuously via a small machine (often referred to as a ""pump"") that gives insulin through a small plastic tube (called a ""catheter""), which can be inserted by the parent or the affected child. Treatment is aimed at normalizing blood sugar levels, but this is not a simple task, and patients need to check blood sugars several times daily with a finger stick. To measure blood sugar, a small drop of blood is obtained using a very fine lancet device and then put on a strip that is then inserted into a home glucose meter. A healthy diet is also very important in type 1 diabetes, and insulin dosing needs to be matched with the amount of sugar (called carbohydrate) taken in. Being physically active is also key, and insulin often needs to be reduced at times of physical activity. Some people with insulin pumps also wear continuous glucose monitors that measure the levels of sugar in the fatty space under the skin through another catheter. Islet cell and pancreas transplantation is an experimental treatment carried out in adults only and in very limited settings throughout the United States. Can Type 1 Diabetes Be Prevented? Thus far, a strategy for preventing the development of type 1 diabetes is not available. Relatives of people with type 1 diabetes are at higher risk of developing type 1 diabetes compared with children and young adults who do not have any relatives with type 1 diabetes in their extended family. Diabetes cannot be predicted with certainty; however, special blood tests are available to measure the risk of diabetes in an unaffected relative of a person with type 1 diabetes. Last Updated 11/21/2015 Source Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society"
176,7,"2018-04-19 02:48:19","Chronic Conditions",176,"2018-04-19 03:16:54","Type 2 Diabetes: Tips for Healthy Living","Type 2 Diabetes: Tips for Healthy Living Page Content Article BodyChildren with type 2 diabetes can live a healthy life. If your child has been diagnosed with type 2 diabetes, your child's doctor will talk with you about the importance of lifestyle and medication in keeping your child's blood glucose (blood sugar) levels under control. About Blood Glucose Glucose is found in the blood and is the body's main source of energy. The food your child eats is broken down by the body into glucose. Glucose is a type of sugar that gives energy to the cells in the body. The cells need the help of insulin to take the glucose from the blood to the cells. Insulin is made by an organ called the pancreas. In children with type 2 diabetes, the pancreas does not make enough insulin and the cells don't use the insulin very well. Managing Blood Glucose Levels Glucose will build up in the blood if it cannot be used by the cells. High blood glucose levels can damage many parts of the body, such as the eyes, kidneys, nerves, and heart. Your child's blood glucose levels may need to be checked on a regular schedule to make sure the levels do not get too high. Your child's doctor will tell you what your child's blood glucose level should be. You and your child will need to learn how to use a glucose meter. Blood glucose levels can be quickly and easily measured using a glucose meter. First, a lancet is used to prick the skin; then a drop of blood from your child's finger is placed on a test strip that is inserted into the meter. Medicines for Type 2 Diabetes Insulin in a shot or another medicine by mouth may be prescribed by your child's doctor if needed to help control your child's blood glucose levels. If your child's doctor has prescribed a medicine, it's important that your child take it as directed. Side effects from certain medicines may include bloating or gassiness. Check with your child's doctor if you have questions. Along with medicines, your child's doctor will suggest changes to your child's diet and encourage your child to be physically active. Tips for Healthy Living A healthy diet and staying active are especially important for children with type 2 diabetes. Your child's blood glucose levels are easier to manage when you child is at a healthy weight. Create a Plan for Eating Healthy Talk with your child's doctor and registered dietitian about a meal plan that meets the needs of your child. The following tips can help you select foods that are healthy and contain a high content of nutrients (protein, vitamins, and minerals): Eat at least 5 servings of fruits and vegetables each day. Include high-fiber, whole-grain foods such as brown rice, whole-grain pasta, corns, peas, and breads and cereals at meals. Sweet potatoes are also a good choice. Choose lower-fat or fat-free toppings like grated low-fat parmesan cheese, salsa, herbed cottage cheese, nonfat/low-fat gravy, low-fat sour cream, low-fat salad dressing, or yogurt.  Select lean meats such as skinless chicken and turkey, fish, lean beef cuts (round, sirloin, chuck, loin, lean ground beef—no more than 15% fat content), and lean pork cuts (tenderloin, chops, ham). Trim off all visible fat. Remove skin from cooked poultry before eating. Include healthy oils such as canola or olive oil in your diet. Choose margarine and vegetable oils without trans fats made from canola, corn, sunflower, soybean, or olive oils. Use nonstick vegetable sprays when cooking. Use fat-free cooking methods such as baking, broiling, grilling, poaching, or steaming when cooking meat, poultry, or fish. Serve vegetable and broth-based soups, or use nonfat (skim) or low-fat (1%) milk or evaporated skim milk when making cream soups.  Use the Nutrition Facts label on food packages to find foods with less saturated fat per serving. Pay attention to the serving size as you make choices. Remember that the percent daily values on food labels are based on portion sizes and calorie levels for adults. Create a Plan for Physical Activity Physical activity, along with proper nutrition, promotes lifelong health. Following are some ideas on how to get fit: Encourage your child to be active at least 1 hour a day. Active play is the best exercise for younger children! Parents can join their children and have fun while being active too. School-aged child should participate every day in 1 hour or more of moderate to vigorous physical activity that is right for their age, is enjoyable, and involves a variety of activities. Limit television watching and computer use. The AAP discourages TV and other media use by children younger than 2 years and encourages interactive play. For older children, total entertainment screen time should be limited to less than 1 to 2 hours per day. Keep an activity log. The use of activity logs can help children and teens keep track of their exercise programs and physical activity. Online tools can be helpful. Get the whole family involved. It is a great way to spend time together. Also, children who regularly see their parents enjoying sports and physical activity are more likely to do so themselves. Provide a safe environment. Make sure your child's equipment and chosen site for the sport or activity are safe. Make sure your child's clothing is comfortable and appropriate. Last Updated 11/21/2015 Source Type 2 Diabetes: Tips for Healthy Living (Copyright © American Academy of Pediatrics 2013)"
177,7,"2018-04-19 02:48:19","Chronic Conditions",177,"2018-04-19 03:16:59","Types of Insulin","Types of Insulin Page Content Article BodyControlling diabetes can be akin to piloting a ship between two icebergs. Veer off course in one direction, and your blood sugar rises alarmingly high. Stray too far the other way, and you’re confronting an equally dangerous situation: blood-glucose deficiency, or hypoglycemia, the most common acute complication among young persons with diabetes. Even the most conscientious patients overshoot or undershoot their marks now and then, due to their own miscalculations of how much insulin to take or to complicating factors like physical illness, exercise or emotional stress. Consult the table available here to learn more about types of insulin treatments. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
178,8,"2018-04-19 02:48:19","Cleft & Craniofacial",178,"2018-04-19 03:17:02","Baby Helmet Therapy: Parent FAQs","Baby Helmet Therapy: Parent FAQs Page Content Article BodyWhat is helmet therapy?Helmet therapy, or the use of a cranial orthosis, is a type of treatment prescribed for infants to help correct the baby's skull shape. Helmets work by directing growth from the flat spot, but they must be worn during the time when the skull (and therefore the brain) is actively growing.What causes a baby to need a helmet? The most common cause for helmets today is a positional head shape deformity, or positional plagiocephaly. There are a number of factors that could contribute to this problem. A thorough exam of each child helps doctors determine the specific cause.In a small percentage of cases, children with an abnormal head shape have craniosynostosis. This condition occurs when there is an abnormal fusion of the skull bones that results in abnormal skull shape and restricted brain growth. This condition is corrected by cranial surgery and may also be followed by post-operative helmet therapy.Is helmet therapy the only treatment for a child with positional plagiocephaly?  In many cases, a child's doctor may recommend a trial of conservative treatments including physical therapy to see if the head shape problem will correct without the need for a helmet. This is especially the case if the child has torticollis, which is when the neck muscles shorten on one side, causing baby’s neck to turn in a twisted position, tilting his head to one side with his chin often pointing to the other side.  In these cases, physical therapy can help with muscle weakness and head turning preferences so that the plagiocephaly improves. However, children who don't respond to physical therapy and repositioning techniques are often prescribed helmets.What is the initial process for getting a helmet?  A child's doctor initially recommends a helmet after an evaluation of the child's head shape. The doctor then gives the parents a referral to a certified orthotist near them so that a custom helmet can be made for their child. Does insurance pay for helmet therapy?Contact your insurance company and employer benefits coordinator to determine the type and level of coverage and what documents are needed from your child's doctor. Insurance varies on types of coverage, but helmet therapy is covered as medically necessary under certain guidelines. What special training do orthotists have that prepares them for taking care of babies with positional plagiocephaly?Only a few universities in the U.S. have programs for orthotics; these programs must meet stringent criteria set by the American Board for Certification in Orthotics, Prosthetics, and Pedorthotics. Once an orthotist finishes the formal educational portion of training, he or she begins a residency program under the supervision of a certified practitioner to gain practical experience. A year's experience and references are required before the resident can submit an application to take both a written and a practical examination. When a resident passes the exam he can use the credentials of C.O. (certified orthotist), so it is important for parents to check that the orthotist their child is seeing is a C.O. How does an orthotist fit the baby for a helmet? A laser light scan may be taken of the child's head shape, or the orthotist may instead make a plaster mold. From these measurements, a custom-fitted helmet is designed.Helmets are designed with foam lining inside that may require adjustments after the baby wears it for a little while. The purpose of the helmet is to hold the round areas of the skull steady while allowing the flat spot to gradually grow and round out on its own.Does a baby need to wear a helmet all day?   Generally, the doctor will ask that the baby wear the helmet 23 hours each day.  It can be taken off for bathing and cleaning. Are there any side effects to wearing a helmet? If worn properly, problems such as skin irritation, discomfort, and bad odor should not occur. If a child does have any of these problems, the orthotist can adjust the helmet. In most cases, however, children adapt quite easily to helmets. With younger babies, it even becomes something like a security blanket. What is the best age for a baby to begin wearing a helmet?The earlier a child is diagnosed with positional plagiocephaly and started on helmet therapy, the shorter the period of wear and the higher the chance of achieving full correction of the asymmetry.  Babies referred for helmets at a later age (e.g., 6-8 months), or after having failed to improve with conservative treatments, can still get helmets, but they may have to wear them for a longer period of time than if they had started at a younger age.  Helmets are not effective once brain growth is complete. Three quarters of brain growth occurs by age 2.On average, how long do babies have to wear a helmet? This is different in every case. A lot depends on the age helmet therapy started. In early infancy, the brain and skull grow very quickly. Therefore, the helmet can direct growth over a shorter time.The orthotist will check your child's progress at each visit to see if the head shape is improving. In some cases, a short 1-2 months may be all that is needed. In other cases, it may be longer (3-4 months, possibly even requiring a second helmet).What are the consequences if a baby does not wear a helmet? This again depends on age and how severe the abnormality. In these cases, a helmet can help improve the overall shape significantly, whereas minimal change can be expected if nothing is done.Uncorrected plagiocephaly will not influence a child's neurological development, but it can affect a child's social well-being later in life.Additional Information: Habilitative Services for Children Guidelines for Referral to Pediatric Surgical Specialists Prevention and Management of Positional Skull Deformities in Infants  (AAP Clinical Report) Last Updated 9/16/2015 Source Section on Plastic Surgery (Copyright © 2015 American Academy of Pediatrics)"
179,8,"2018-04-19 02:48:19","Cleft & Craniofacial",179,"2018-04-19 03:17:06","Caring for Babies Born with Cleft Lip and/or Palate: AAP Report Explained","Caring for Babies Born with Cleft Lip and/or Palate: AAP Report Explained Page Content​​One in every 700 babies is born with a cleft lip, a cleft palate, or both—making it one of the most common birth defects. Babies born with a cleft lip and/or palate need special care from a team of different health professionals. Their care must be well managed because of the difficult medical, surgical, dental, and social factors important to treatment decisions. To help pediatricians better manage children with cleft lip/palate, the American Academy of Pediatrics (AAP) published the clinical report, ""The Primary Care Pediatrician and the Care of Children with Cleft Lift and/or Cleft Palate."" The following information explains these recommendations to parents and families involved in caring for a baby born with a cleft lip and/or palate. Different Types of Cleft Lip and/or Palate: The type of cleft lip and/or palate a child has will determine the kind of care that he or she needs. A cleft lip means that there is a gap in the baby's lip. The cleft may be on one or both sides of the upper lip and may reach all the way to the nose. Often, a baby with a cleft lip may have a gap in the upper gum. A cleft palate has a gap in the roof of the mouth that connects to the nose. The combination of a cleft lip with a cleft palate is more common than just a cleft lip or just a cleft palate. ​Detecting Cleft Lip and/or Palate:Many, but not all, parents know in advance that their newborn infant will have a cleft lip from the prenatal ultrasound. The mother's doctor or the baby's future doctor can help parents meet with experts—called a cleft/craniofacial team. Prenatal consultation involves parents meeting various members of the cleft/craniofacial team and learning about the care of children born with cleft lip. Normally, a cleft palate is not seen until after a baby has been born. A nurse, a doctor, or a parent may notice that the top of the mouth looks different. The cleft palate may involve most or just the farthest part of the roof of the mouth. Common Concerns from Parents: Being the parent of a newborn with a cleft lip, cleft palate, or both can feel overwhelming. Simple things like feeding your baby might now be more complicated. Parents wonder how people may react when they see their baby has a cleft lip. Parents also worry how the cleft lip or cleft palate will affect their child long-term—socially and developmentally.  If you are worrying about any of these things or others, talk with your child's pediatrician. He or she can help answer questions and even direct you to a parent support group near you. Feeding a Baby with Cleft Lip and/or Palate:In general, babies with a cleft palate either as cleft lip with cleft palate or cleft palate alone, suck weakly and need a special bottle to feed. Support from a feeding therapist, certified lactation consultant, and/or nurse experienced in feeding children with cleft palate is recommended for parents. A baby born with a cleft lip without cleft palate may also need extra help with feeding. However, most babies with cleft lip can feed from the breast or a normal bottle. This is also true for babies with cleft lip and cleft gum.Care and Treatment from the Cleft/Craniofacial Team:  Various specialists will care for your child at different times and stages. The cleft/craniofacial team usually includes nurses, social workers, nutritionists, audiologists, speech-language pathologists, geneticists, pediatricians, dentists, orthodontists, and pediatric surgeons (otolaryngologists, oral and maxillofacial surgeons, and plastic surgeons). These providers understand common concerns and know the answers to parents' questions.  First Appointment: A newborn should see his or her cleft/craniofacial team within one week (or as soon as possible) from the day he or she first leaves the hospital. In the beginning, the team will make sure the baby is feeding and growing well. The team will also check for other medical problems common in babies with a cleft lip or palate, answer parents' questions, and discuss the next steps for treatment. Surgery: Surgical repair of a child's cleft is one part of the care that the cleft/craniofacial team provides. ​When Will My Child Need Surgery?The most common question parents have is, ""When will my child have surgery to repair his or her cleft lip or cleft palate?""  The AAP recommends initial reconstructive surgeries for cleft lip or cleft palate occur within the first year of life. Cleft lip repair: A cleft lip usually is repaired between 3 and 6 months of age. Many things will determine the right time for surgery; the right time for one child may not be good for another. Cleft palate repair: A cleft palate is commonly fixed between 9 and 14 months of age. If there is a separation in the gum line, it usually is repaired when a child is 8-10 years of age. A child's cleft/craniofacial team will determine the best time for cleft palate surgery. Every child is different: Children with cleft lip and/or cleft palate often need additional surgeries and treatments as they grow. For example, they may need braces during childhood. Each child will need different numbers and types of surgeries—why individualized coordination of care is so important. Most children born with clefts will need regular visits to their cleft/craniofacial team until they are adults.​What Does a Cleft Look Like Before and After Surgery?It is common for parents to worry about how their child will look before and after the cleft lip and/or palate repair. Below are pictures of a child before surgery and immediately after.​​Below are pictures of a child before surgery and once he has completely healed. Additional Information & Resources: Tests & Screenings During PregnancyCongenital Abnormalities Language Delays in Toddlers: Information for ParentsAmerican Cleft Palate-Craniofacial Association - Provides guidelines and standards for cleft-related and craniofacial care.Cleft Palate Foundation – Offers telephone and online counseling and support service through the Cleftline 1-800-24-CLEFT (800-242-5338).​ Article Body Last Updated 4/24/2017 Source American Academy of Pediatrics (Copyright © 2017)"
180,8,"2018-04-19 02:48:19","Cleft & Craniofacial",180,"2018-04-19 03:17:10","Children with Congenital Hand Anomalies & Malformations","Children with Congenital Hand Anomalies & Malformations Page ContentOf the 1% to 2% of babies born with congenital defects, 10% are born with malformations to the hand. These anomalies occur in early pregnancy and are sometimes diagnosed by ultrasound during pregnancy. When they are not, they often come as a surprise to parents. The cause of congenital hand anomalies is unknown. Depending on the type and extent of a hand malformation, some babies may have little trouble adapting and functioning well. Others, however, may face various challenges as they grow and learn:  Developmental problems such as delayed or deficient motor skillsDifficulties with activities of daily living activities and basic self-care skillsLimitations on certain types of exercises and sportsPotential emotional and social harm from childhood teasing about appearanceIf child is functioning well and is happy, treatment is not always necessary. If a child is having difficulty doing the things he or she wants to do because of a hand malformation, treatment options may be available.Treatment OptionsThe most important goal of any treatment for hand malformations is to help a child function as independently as possible. Your pediatrician will often provide referrals to pediatric plastic surgeons or pediatric orthopedic surgeons. Treatment may involve: Orthotics (splints or braces)Prosthetics (artificial limbs) Physical therapySurgery Types of Hand MalformationsPediatric plastic and orthopedic surgeons diagnose and treat children with all types of hand malformations. There are many types. The following are those most often seen.Extra Digits (Polydactyly)Polydactyly is the most common congenital hand deformity. It affects boys and girls equally. A baby born with polydactyly has more than five fingers on one hand. An extra finger is often a small piece of soft tissue that can be simply removed. Sometimes, the extra finger contains bones but not joints. Very rarely, the extra finger is a fully functioning digit. A baby may be born with several extra fingers. There are different types of polydactyly:Preaxial polydactyly: Involves having an extra thumb. It is more common in Caucasians. A pediatric surgeon can remove the extra bone and skin and repair the tendons.Postaxial polydactyly: Involves having extra fingers on the opposite (the ""pinkie"" side). It is more common in African-Americans. These may occur as complete, separate fingers or just as small stumps. Stumps can be treated by a hand specialist in the office. Central polydactyly: Extra fingers can be located between center fingers, although this is less common. Fused Fingers (Syndactyly)Syndactyly is one of the most common birth defects of the upper limbs—seen in as many as 1 in every 2,000 live births. This condition occurs when two or more fingers fail to separate when a baby is in the womb—resulting in ""webbed"" fingers at birth. It usually involves the middle and ring fingers.Syndactyly affects twice as many boys as girls. There is often a family history, and these cases often involve both fingers and toes.Surgery is generally needed before a child is 18 months old to separate the fingers or toes and may require extra skin to be taken from a separate area on the body, depending on the extent the fingers were joined. Categories of the condition include:Complete syndactyly: The skin is fused all the way to the tip of affected fingers or toes.Incomplete syndactyly: The fingers or toes are joined only part of the way to the tips.Simple syndactyly: The fingers or toes are joined by skin and soft tissue only.Complex syndactyly: The bones of fingers next to each other are fused.  Underdeveloped Hand (Symbrachydactyly)Babies born with symbrachydactyly have small or missing fingers. They also may have webbed fingers or a short hand or forearm.Mild symbrachydactyly: The hand has slightly short, mobile fingers with minor webbing. The hand bones and some of the finger bones and the thumb are present. Moderate symbrachydactyly: Most or all of the finger bones are missing, and the baby has small projections of skin and soft tissue. The thumb is usually present, but it may be short. Severe symbrachydactyly: The baby has either a partial thumb or no thumb and no fingers.Club HandBabies born with club hand are partially or completely missing one of the two long bones that make up the forearm—the radius or the ulna. As a result, the forearm may be shorter than normal. The hand turns inward, causing limited range of motion at the wrist. A child with the condition may have trouble performing tasks that require his or her hands.  The condition is usually more prominent on one side of the hand or the other—the radial (thumb) side or the ulnar (little finger) side.Radial club hand: Children with club hand on the radial side (radial dysplasia) often have a short forearm and wrist curved toward the thumb side. Once a baby is between 6 and 12 months of age, surgery may be recommended to straighten the forearm bone and to fix the tendons. The condition may also be related to other medical syndromes such as Fanconi anemia, Holt-Oram syndrome, and VATER syndrome.Ulnar club hand: This condition is less common than radial club hand and is usually unrelated to other syndromes. It can range from mild to more severe cases with the baby's wrist to be in a fixed and bent position toward the little-finger side of the hand. The thumb by be deformed or absent.Cleft Hand (Ectrodactyly)Cleft hand (also called ectrodactyly or split hand) is when the middle part of the hand develops abnormally. Babies with this condition are missing one or more central fingers on the hand. There are generally two types:Typical cleft hand: V-shaped and usually missing or partially missing middle fingers. Both hands are usually affected, and sometimes the feet are, too. There is often a family history of this type of cleft hand.Atypical cleft hand: U-shaped and usually involves only one hand. This type of cleft hand is not often inherited. Atypical cleft hand may be a symptom of Poland syndrome.Small (Hypoplastic) ThumbsA hypoplastic thumb did not fully form in the womb or was missing altogether at birth. Treatment depends on how secure or stable the joint is that connects the base of the thumb to the wrist. Children with stable joints tend to use the thumbs in regular play. Children whose have unstable joints tend to ignore the thumb. For stable thumb-wrist joints, reconstructive surgery is generally recommended to build up the thumb and its tendons. For loose or floating unstable joints, the small thumb is removed and the index finger is converted to a thumb.Trigger ThumbSometimes babies are born with an abnormality of the tendon in the thumb that makes it difficult for it to bend it. This condition may disappear on its own by about age 1. Other times, surgical correction may be recommended before age 3 to release the tendon and allow for the thumb to properly function.​ Article Body Last Updated 3/27/2017 Source Section on Plastic Surgery (Copyright © 2017 American Academy of Pediatrics)"
181,8,"2018-04-19 02:48:19","Cleft & Craniofacial",181,"2018-04-19 03:17:17","Children with Facial Asymmetry","Children with Facial Asymmetry Page Content​All people have asymmetric faces. When one looks closely, these differences become more apparent. However, there are conditions in children in which the normal minor differences are much more significant. Craniofacial Microsomia Children born with this congenital condition have one half of the face that didn't develop as well as the other. It occurs during fetal development. Common affected areas: Ear: Anything from a change in shape to an absent ear Ear canal: May be absent with decreased hearing as a result Lower jaw (mandible): Less growth, chin point to side of decreased growth, and abnormal bite Facial movement: A single nerve (facial nerve) with many branches controls facial movement, and one or more of these may be affected Eye socket and/or eye: May be small or absent. Whatever the child is born with, he/she will maintain, but it will not get worse with growth.These children are cared for by a craniofacial team, including a pediatric plastic surgeon, ENT surgeon, speech therapist, dentist, and orthodontist. Surgery may be needed to help the jaw grow and to reconstruct the ear. Why this condition occurs is not fully understood, although genetic and environmental factors are both likely.Congenital Facial Nerve PalsyOn each side of the face, there is one main facial nerve with several branches that travel to the muscles of facial expression. Children can be born with a deficiency of this nerve, usually on one side. Sometimes both nerves are affected. This is a rare problem. The causes of congenital facial nerve palsy are usually birth trauma or developmental. ​Developmental: When one side is affected, it is typically seen as muscular weakness, with difficulties raising the eyebrow, closing the eye, feeding difficulties, or smiling on the affected side. A bilateral (both sides) form of this problem is known as Mobius Syndrome. Mobius syndrome is a congenital paralysis of the muscle of facial expression, usually due to deficiency of the facial nerve as well as one of the nerves controlling movement of the eye. Birth trauma: 90% of the cases related to birth trauma will improve without treatment. If it does not go away spontaneously, then based on the location of the nerve damage, a surgical procedure called a neurorrhapy (stitching nerve ends together) or nerve graft may be performed to restore normal nerve function.​Aside from the inability to communicate to others with facial expression, children with facial nerve weakness/paralysis may have difficulty closing the eye on the affected side, and thus have eye irritation and/or corneal ulceration. Prolonged exposure can lead to infection or loss of vision.​There are two forms of treatment: Eye protection: A small weight is surgically placed into the upper eyelid on the affected side. This will make it easier to close the eye, with the goal of keeping the cornea protected, and the eye free of infection. Smile recreation: The ability to smile can be restored either by transferring one of the surrounding muscles of the face to the corner of the mouth, or by implanting a new muscle taken from another part of the patient's body. With new muscle, arteries, veins, and nerves must be reconnected under a microscope to restore function. The nerve that powers the new muscle comes either from a chewing muscle on the same side of the face or from a normal facial nerve branch on the patient's other side.Acquired Facial Nerve PalsyChildren can develop facial nerve weakness/paralysis during life due to trauma, tumors, or from a third condition called Bell's palsy. Bell's palsy is thought to result from a viral infection that affects the facial nerve, and therefore often results in a unilateral (one-sided) facial paralysis. With time, the nerve can regain function. Many children get full function back, while others regain only partial function. In the case of no return of function, treatment can be offered as described above for congenital cases.Additional Information: What is a Pediatric Plastic Surgeon? Guidelines for Referral to Pediatric Surgical Specialists Flat Head Syndrome & Your Baby: Information about Positional Skull Deformities​​ Article Body​​ Last Updated 9/29/2016 Source Section on Plastic Surgery (Copyright © 2016 American Academy of Pediatrics)"
182,8,"2018-04-19 02:48:19","Cleft & Craniofacial",182,"2018-04-19 03:17:22","Children with Prominent Ears","Children with Prominent Ears Page Content Article Body​Having prominent ears may negatively affect a child’s self-image because he looks different and may be teased by peers. This can lead to poor development of interpersonal relationships, social withdrawal, and even depression. For minor degrees of deformity, no intervention may be needed. Surgical Correction For severe degrees of congenital deformity or birth defect, otoplasty (surgical correction) is warranted in children who are not at excessive risk of under anesthesia and surgery. If the auricle (outer projecting portion of the ear) is 85% of adult size by the time a child is 4 years old, otoplasty can be considered. The procedure is not very painful or risky and generally yields good results, although occasionally, revision surgery is needed. Insurance Coverage for Otoplasty Unfortunately, health insurance companies frequently consider otoplasty to be a cosmetic procedure and will not provide payment for the operation. Check your plan for specifics. Additional Resources Guidelines for Referral to Pediatric Surgical Specialists What is a Pediatric Plastic Surgeon? Exclusions & Limitations: Reading the Fine Print Last Updated 2/20/2016 Source Pediatric Otolaryngology (Copyright © 2012 American Academy of Pediatrics)"
183,8,"2018-04-19 02:48:19","Cleft & Craniofacial",183,"2018-04-19 03:17:26","Flat Head Syndrome & Your Baby: Information about Positional Skull Deformities","Flat Head Syndrome & Your Baby: Information about Positional Skull Deformities Page Content​​​​​Did you know 1 in 3 of all babies will show some type of positional skull deformity?Positional skull deformities, often referred to as ""flat head syndrome,"" are changes to the shape of a baby's head related to spending more time in one position than in others. The risk is greatest during the first four months of life and generally shows improvement by 6 months of age as babies become more mobile and turn their heads on a regular basis on their own.3 Common Head Shapes Associated with a Positional Skull Deformity Brachycephaly—Head is symmetrically flat in the back and wide from side to side.  There may be prominence of the bone above the ears. This is often seen in babies who spend a lot of time on their backs and do not get enough tummy time. Posterior plagiocephaly—Asymmetric head that is flat in the back on one side.  The forehead may be more prominent causing the head to look like a parallelogram. The ear may also shift forward on the flat side. This is often seen in babies who also have torticollis. Scaphocephaly—Head is narrow and long. This is most common in preemies who have spent their first few months of life in the neonatal intensive care unit (NICU).What Causes a Baby's Head to Become Flat?A baby's skull is soft, with mobile bones. This allows the head to pass through the birth canal at the time of delivery and gives the brain room to grow rapidly during the first year of life. There are many reasons why a baby's head becomes flat. Some of the most common risk factors associated with positional skull deformities include: Twins or triplets— When multiples are cramped or in unusual positions in their mother's womb, their head shape can change. Prematurity—Sometimes, the prolonged periods of lying flat on his or her back in the hospital can cause a baby's head to become misshapen. The bones of preemies are also softer than and not as fully-formed as the bones of full-term babies.   Birth complications—Strains on the head can occur at birth based on the way the baby was positioned as he or she moved through the birth canal. External force such as from forceps, vacuum extraction, or even a difficult labor can also impact head shape. Preferred head position—Unfortunately, some babies show a preference for sleeping or sitting with their heads turned in one direction most of the time. When the head is constantly turned to one side or stays in the center, the consistent pressure molds a flat spot into the skull. Limited exposure to tummy time—Lack of tummy time can not only affect head shape, but also how long it takes for a baby to master basic milestones such as head lifting, turning over, sitting up, and crawling. Torticollis—An estimated 85% of babies with torticollis, a condition where the neck muscles are tight or imbalanced, have a positional skull deformity.  It is important to note that positional skull deformities are purely cosmetic. They do not change the volume or contents of the head, nor cause problems with brain growth or intellectual development. Early Detection of Flat Head Syndrome After bath time when a baby's hair is wet, parents and caregivers can easily check for:Symmetrical roundness in the back of the headEvenness of the earsSymmetrical width of the headSymmetrical width of the forehead If asymmetries or unevenness is seen, talk to your pediatrician. Most changes to the shape of the head are related to position and are not dangerous. However, your pediatrician will need to differentiate between a positional skull deformity and craniosynostosis, an uncommon, but more serious cause of infant head shape change.PreventionThe best treatment for a flat head is to prevent it from happening. It is important to establish these habits early! When flattening is noticed early, the same techniques used for prevention can help nip it in the bud. When possible, avoid pressure on the back of the head, such as prolonged time in a car seat, bouncy seat, baby swing, or other carriers.Increase ""tummy time,"" which is supervised time during the day when your baby lies on his or her stomach.  Start with small spurts of time and gradually work up to an hour per day in several shorter increments. Tummy time also lets your baby exercise their neck, back, shoulders, arms and hips.Put your baby to sleep on a firm, flat surface (on his or her back).Alternate arms when holding and feeding your baby.Alternate your baby's head position by frequently placing him or her down for sleep at opposite ends of the crib.See Back to Sleep, Tummy to Play for other things you can do.Early Intervention & TherapyYour pediatrician may refer your baby for early intervention services and an evaluation from a pediatric physical therapist specializing in the assessment and treatment of infants. The therapist will check your baby for delayed motor skills caused by poor head and neck control and teach you stretching and positioning exercises to do with your baby at home. Depending on the severity of your baby's condition, weekly therapy may be recommended. In addition, some babies will need to wear a helmet to re-shape their heads. See Baby Helmet Therapy: Parent FAQs. Surgery should only be considered when all other options have been exhausted, and after consulting with a pediatric plastic surgeon who specializes in these types of cases.Additional Information: Your Baby's Head   Tummy Time Activities Prevention and Management of Positional Skull Deformities in Infants (AAP Clinical Report) Article Body Last Updated 2/12/2016 Source Section on Plastic Surgery (Copyright © 2016 American Academy of Pediatrics)"
184,8,"2018-04-19 02:48:19","Cleft & Craniofacial",184,"2018-04-19 03:17:31","Head Tilt","Head Tilt Page Content Article BodyHead tilt is a condition that causes a child to hold her head or neck in a twisted or otherwise abnormal position. She may lean her head toward one shoulder and, when lying on her stomach, always turn the same side of her face toward the mattress. This can cause her head to flatten on one side and her face to appear uneven or out of line. If not treated, head tilt may lead to permanent facial deformity or unevenness and to restricted head movement.  Most cases of head tilt are associated with a condition called torticollis (described below), although in rare instances a head tilt can be due to other causes such as hearing loss, misalignment of the eyes, reflux (a flowing back of stomach acid), a throat or lymph node infection, or, very uncommonly, a brain tumor.  Congenital Muscular Torticollis  By far the most common cause of head tilt among children under age five, this condition is the result of injury to the muscle that connects the breastbone, head, and neck (the ster-nocleidomastoid muscle). The injury may occur during birth (particularly breech and difficult first-time deliveries), but it also can occur while the baby is still in the womb. Whatever the cause, this condition usually is detected in the first six to eight weeks of life, when the pediatrician notices a small lump on the side of the baby’s neck in the area of the damaged muscle. Later the muscle contracts and causes the head to tilt to one side and look toward the opposite side.  Klippel-Feil Syndrome In this condition, which is present at birth, the tilt of the neck is caused by a fusion or bony connection between two or more bones in the neck. Children with Klippel-Feil syndrome may have a short, broad neck, low hairline, and very restricted neck movement.  Torticollis Due to Injury or Inflammation This is more likely to occur in older children, up to the age of nine or ten. This type of torticollis results from an inflammation of the throat caused by an upper respiratory infection, a sore throat, an injury, or some unknown factor. The swelling, for reasons still not known, causes the tissue surrounding the upper spine to loosen, allowing the vertebral bones to move out of normal position. When this happens, the neck muscles go into spasm, causing the head to tilt to one side.  Treatment  Each type of head tilt requires a slightly different treatment. It is very important to seek such treatment early, so that the problem is corrected before it causes permanent deformity. Your pediatrician will examine your child’s neck and may order X-rays of the area in order to identify the cause of the problem. X-rays of the hip also may be ordered, as some children with congenital muscular torticollis also have an abnormality known as developmental dysplasia of the hip. If the doctor decides that the problem is muscular torticollis due to a birth-related injury to the sternocleidomastoid muscle, you will learn an exercise program to stretch the neck muscles. The doctor will show you how to gently move your child’s head in the opposite direction from the tilt. You’ll need to do this several times a day, very gradually extending the movement as the muscle stretches. When your child sleeps, it is best to place her on her back or side, with her head positioned opposite to the direction of the tilt. She can be placed on her stomach if she allows you to turn her face away from the side of the muscle injury, and if she then keeps her head in this position while sleeping. When she is awake, position her so those things she wants to look at (windows, mobiles, pictures, and activity) are on the side away from the injury. In that way, she’ll stretch the shortened muscle while trying to see these objects. These simple strategies cure this type of head tilt in the vast majority of cases, preventing the need for later surgery.  If the problem is not corrected by exercise or position change, your pediatrician will refer you to a pediatric neurologist or orthopedist. In some cases it may be necessary to lengthen the involved tendon surgically.   If your child’s head tilt is caused by something other than congenital muscular torticollis, and the X-rays show no spinal abnormality, other treatment involving rest, a special collar, traction, application of heat to the area, medication, or, rarely, surgery may be necessary. To treat Klippel-Feil syndrome, a specialist may recommend treatments ranging from physical therapy to an operation. For treating torticollis due to injury or inflammation, your doctor may recommend applying heat, as well as using massage and stretching to ease head and neck pain. Your pediatrician can refer you to a specialist for a definitive diagnosis and treatment program. Last Updated 2/6/2016 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
185,8,"2018-04-19 02:48:19","Cleft & Craniofacial",185,"2018-04-19 03:17:37","Micrognathia & Pierre Robin Sequence","Micrognathia & Pierre Robin Sequence Page Content Article BodySometimes babies are born with a small lower jaw. It is called micrognathia, which means ""small mandible."" It can occur in isolation, but is also a symptom of a variety of craniofacial conditions. Micrognathia may interfere with a child's feeding and breathing. For example, infants with this condition may need special nipples and positioning in order to feed properly. Outcomes for children with micrognathia are generally good, but can vary depending on the severity of the condition.Infants Micrognathia can appear in infants by itself or as part of a syndrome (where more than one body system is involved). A syndrome may be inherited (passed down from the parents) or come about spontaneously.Pierre Robin Sequence A small jaw is often seen as part of Pierre Robin Sequence. Pierre Robin occurs in about one per 8,500 live births. It is called a ""sequence,"" because while the baby is growing in the womb, the lower jaw does not grow enough. This causes the tongue to be pushed back and the palate bones to remain separated in the middle. Babies born with Pierre Robin may have difficulty with breathing, feeding, and/or sleeping. It can be a very mild problem to quite severe. Babies born with mild forms of Pierre Robin will be discharged home with close follow up in the pediatrician's office. Parents are advised to keep a close watch on their baby due to partial airway blockage associated with obstructive sleep apnea. These infants may also have trouble feeding and suffer from gastrointestinal reflux. Babies born with more severe forms Pierre Robin can't leave the hospital after birth and need extra measures to protect their breathing. A breathing tube attached to a ventilator may be needed temporarily. Obstructive Sleep Apnea The airway is at the most risk for blockage at night when all the muscles are relaxed. When a child's tongue is in a backward position due to a small jaw, his or her attempts to breath when sleeping can be met with partial or complete blockage. This is called obstructive sleep apnea. It occurs in about 2% of children. Obstructive sleep apnea causes decreases in the blood's ability to carry oxygen to the developing organs, so it can interfere with development. In children with obstructive sleep apnea and micrognathia, surgical treatment of the airway can be an emergency. Treatment of MicrognathiaEarly diagnosis and ongoing monitoring help with a multi-disciplinary team of specialists will determine the best time to medically or surgically intervene. If your baby has micrognathia, you may meet with: A pediatric otolaryngologist (ENT) A craniofacial plastic surgeon A pediatric geneticist A pediatric pulmonologist If the child can tolerate it, a sleep study is done to see how bad his or her airway is obstructed. If the results are severe, then a formal airway evaluation by the pediatric ENT is done in the operating room to assess the anatomy of the upper airway. Mandibular Distraction Osteogenesis Mandibular Distraction Osteogenesis (MDO) is a surgical procedure that makes the lower jaw larger by slowly lengthening the lower jaw bone.  The surgeon makes cuts on both sides of the lower jaw and attaches turning devices which expand the space in the bone cut. By turning the devices, the jaw moves forward (and with it, the tongue). The airway will then get bigger, and within a couple of weeks from the surgery, the breathing/sleeping problem will be improved.Risks for MDO surgery include damage to tooth buds, sensory nerve damage, facial nerve damage, relapse of the original condition, and infection. After 6 weeks, the new bone has formed and the devices are removed. Usually, the child can go home during this period of bone formation. Additional benefits of MDO are improved feeding, decreased reflux, and avoidance of a permanent breathing tube called a tracheostomy. Childhood ConcernsRegardless of whether or not a child undergoes MDO as an infant, he or she will need to be followed for:Jaw growthDental (tooth) developmentLower lip sensationAirway healthSometimes, a second (or even first) MDO is needed during childhood if breathing and sleep apnea problems persist. Many children born with micrognathia will eventually need orthodontic care, as well. Some eventually require corrective jaw surgery after growth is complete in adolescence.  Additional Information: Sleep Apnea Detection Dental Health and Orthodontic Problems GERD/Reflux Last Updated 10/20/2015 Source Section on Plastic Surgery (Copyright © 2015 American Academy of Pediatrics)"
186,8,"2018-04-19 02:48:19","Cleft & Craniofacial",186,"2018-04-19 03:17:41","Sound Options: Treating Abnormal Ear Shape in Infants and Children","Sound Options: Treating Abnormal Ear Shape in Infants and Children Page Content​By: Nicholas Bastidas, MD, FAAPBabys’ ears play a big role in helping them take in the world around them. They let them hear vibrations as sound, help them learn to talk, and even balance so they can begin to walk. As children get older, ear shape also can play a role in their social confidence.For babies born with structural abnormalities of the ears, a range of treatment options can help prevent these conditions from affecting a child's development.Taking ShapeOf the roughly four million babies born in the United States each year, an estimated 15 percent or 600,000 of them have some abnormally shaped ears. Doctors used to believe that misshapen ears would correct on their own as a baby grew. Current research shows this is not the case, with about 70 percent of untreated ear deformities lasting into childhood.A better understanding of the cartilage that forms the outer ear, as well as advances in biomedical engineering, have led to more treatment options to correct ear abnormalities in children. Some treatments help a child's ears work properly, while others are more about making them look better.For example, surgery can rebuild parts of the ear that didn’t form fully and help a baby hear properly. For other cases, simple molding devices designed for infants to wear can help correct ear shape deformities.Types of Ear AbnormalitiesThere are many different types of ear abnormalities, including: Prominent Ear: Ear sticking out more than 2 cm from the head Constricted (lop/cup) Ear: The outer rim of ear is rolled or folded. Cryptotia: When the upper rim of the ear is tucked underneath scalp skin. Stahl's Ear: Pointy shaped ear. Microtia: The outer ear is underdeveloped or small. Anotia: Missing ear. Congenital Earlobe Deformities: Split or double earlobes, sometimes with skin tags. Accessory Tragus (ear tag): Bump of skin or cartilage in front of the ear.Non-Surgical TreatmentsEars that are folded, stick out or are otherwise irregularly shaped can be a source of embarrassment and teasing for young children. It’s often why they may want surgical correction (called otoplasty). However, there are non-surgical treatments that can be done shortly after birth that can avoid the need for corrective surgery, which is often postponed until a child is around five years old and requires an operation under general anesthesia. Ear Molding. Using custom devices, pediatric plastic surgeons can mold the ears into a more “normal” shape, proportion or position. Generally, the earlier the ear is molded, the more successful the outcome. Less than three weeks of age is considered the ideal time to begin ear molding, though some improvement can still be achieved if started later. There are several ear molding methods. One of the more common techniques involves placing a soft silicone cradle around the ear and applying plastic retainers to reshape the ear cartilage. The device is held on using tape and is worn for a period of 4-6 weeks. After the molding devices are removed, double sided tape may be placed to hold the position for another 2 weeks. An estimated 90 percent of all ear deformities can be corrected using this non-surgical method. When Surgery Can Help Otoplasty. Older children with ear malformations may not benefit much from simple techniques such as ear molding. For these children, surgical options, such as otoplasty, are available. Otoplasty reshapes the outer ear using permanent stitches placed through a hidden scar behind the ear. This procedure is performed as an outpatient surgery in early childhood after the ear has completed most of its growth. Reconstructive surgery. Ear deformities such as microtia (small ears) may need more complex reconstruction procedures. Microtia reconstruction is often performed in two or three operations by pediatric plastic surgeons. The surgeons use either cartilage from the rib or a synthetic material such as porous polyethylene to build or shape the ears. Ear reconstruction is usually delayed until a child is 6 to 10 years old when using rib cartilage, and 3 to 5 years old if synthetic material is used. An artificial, prosthetic ear may also be an option. The ear canal may be missing in children with microtia. As a result, these children may benefit from a bone anchored hearing aid (BAHA) to improve the quality of hearing.Related ConditionsEar abnormalities such as microtia sometimes are related to congenital disorders that may affect the other parts of the child's body such as the kidneys or other organs, so your pediatrician may recommend an ultrasound or other tests.Additional Information: Children with Prominent Ears What is a Pediatric Plastic Surgeon? About Dr. Bastidas: Nicholas Bastidas, MD, FAAP, is a member of the American Academy of Pediatrics Section on Plastic Surgery. He also serves as Assistant Professor of Surgery and Pediatrics at the Hofstra School of Medicine, Northwell Health System and the Director of the Institute of Pediatric Plastic and Craniofacial Surgery (www.ippcs.org) based in New York.   Article Body Author Nicholas Bastidas, MD, FAAP Last Updated 2/1/2018 Source AAP Section on Plastic Surgery (Copyright @ 2018 American Academy of Pediatrics)"
187,9,"2018-04-19 02:48:19","Developmental Disabilites",187,"2018-04-19 03:17:48","Atlantoaxial Instability in Children with Down Syndrome","Atlantoaxial Instability in Children with Down Syndrome Page Content​Children with Down syndrome are at increased risk of developing compression of the spinal cord called atlantoaxial instability. This problem is caused by a combination of low tone, loose ligaments and bony changes. The spinal cord can be pressed by the bones and cause nerve damage. Symptoms of nerve damage can occur at any time and there is no test or x-ray that can tell who is at risk. Parents should watch their child for any changes in how they walk, use their arms or hands, a head tilt, complaints of pain in the neck, or change in bowel or bladder function, change in general function or new onset weakness. Contact physician immediately for an x-ray of the neck in neutral position if your child has: Change in how he or she walksChange in how he or she uses arms/handsChange in bowel or bladder control Head stays tilted Neck Pain New onset weakness Decreased activity level or function If the x-ray is abnormal or symptoms persist, the child should be referred as soon as possible to a pediatric neurosurgeon or pediatric orthopedic surgeon experienced in managing atlantoaxial instability. Additional Information & Resources: Children with Down Syndrome: Health Care Information for FamiliesMedical Conditions That May Rule Out Sports ParticipationHealth Supervision for Children With Down Syndrome (AAP Clinical Report) Article Body Author Marilyn J. Bull, MD, FAAP Last Updated 5/25/2016 Source Used with Permission of Marilyn J. Bull, MD, FAAP (Copyright © 2016)"
188,9,"2018-04-19 02:48:19","Developmental Disabilites",188,"2018-04-19 03:17:52","Cerebral Palsy","Cerebral Palsy Page Content Article BodyChildren with cerebral palsy have an impairment in the area of the brain that controls movement and muscle tone. Many of these youngsters have normal intelligence, even though they have difficulty with motor control and movement. The condition causes different types of motor disability, which can vary from quite mild and barely noticeable to very profound. Depending on the severity of the problem, a child with cerebral palsy may simply be a little clumsy or awkward, or he may be unable to walk. Some children have weakness and poor motor control of one arm and one leg on the same side of the body (called hemiparesis). Many have problems with paralysis of both upper or lower extremities; this is called diplegia. In some children the muscle tone generally is increased (called spasticity or hypertonia), while others are abnormally limp (called hypotonia). While many of these children understand language, their ability to produce speech may be affected. Cerebral palsy is caused by malformation or damage to the brain, usually during pregnancy, but occasionally during delivery, or immediately after birth. A report by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists concluded that the majority of cerebral palsy cases are not the result of events during labor and delivery, such as an insufficient supply of oxygen (hypoxia). Premature birth is associated with an increased risk of cerebral palsy. A baby also can get cerebral palsy from very severe jaundice after birth, or later on in infancy from an injury or illness affecting the brain. Although it may be challenging, it is important to focus your energy on optimizing your child’s development and remember that in many cases a cause cannot be identified. Signs and Symptoms The signs and symptoms of cerebral palsy vary tremendously because there are many different types and degrees of disability. The main clue that your child might have cerebral palsy is a delay in achieving the motor milestones. Here are some specific warning signs. In a Baby Under Six Months His head lags when you pick him up while he’s lying on his back. He feels stiff. He feels floppy. When held cradled in your arms, he seems to overextend his back and neck—constantly acts as if he is pushing away from you. When you pick him up, his legs get stiff and they cross or “scissor.” In a Baby Over Six Months He continues to have the asymmetrical tonic neck reflex He reaches out with only one hand while keeping the other fisted. In a Baby Over Ten Months He crawls in a lopsided manner, pushing off with one hand and leg while dragging the opposite hand and leg. He scoots around on his buttocks or hops on his knees, but does not crawl on all fours. If you have any concerns about your child’s development, talk to your pediatrician at your routine visit. Because children’s rates of development vary widely, it is sometimes difficult to make a definite diagnosis of mild cerebral palsy in the first year or two of life. Often a consultation with a developmental pediatrician or pediatric neurologist will assist in the diagnosis. A CT (computed tomography) or MRI (magnetic resonance imagery) of the head may be recommended to determine whether a brain abnormality exists. Even when a firm diagnosis is made during these early years, it often is difficult to predict how severe the disability will be in the future. However, usually by three to four years of age there is enough information to predict accurately how a child will function in years to come. Treatment If your pediatrician suspects that your child has cerebral palsy, you will be referred to an early intervention program. These programs are staffed by early childhood educators; physical, occupational, and speech and language therapists; nurses; social workers; and medical consultants. In such a program you’ll learn how to become your child’s own teacher and therapist. You will be taught what exercises to do with your infant, what positions are most comfortable and beneficial to him, and how to help with specific problems such as feeding difficulties. You’ll be introduced to some of the newer treatment options, such as the medication baclofen, that may be able to manage the spasticity associated with cerebral palsy, and botulinum toxin type A (called Botox), which is a muscle-relaxing drug that can help relieve the toe-walking that is related to muscle tightening. You’ll receive information about so-called adaptive equipment that can help your child participate in everyday activities despite the physical problems he may have; this equipment includes special utensils to make eating easier, pencils that can be held more easily, wheelchairs, and walkers. Through these programs you also can meet parents of other children with similar disabilities and share experiences, concerns, and solutions. The most important thing you can do for your child is to help him develop skills, become resilient, and gain positive self-esteem. When he is old enough to ask or understand, explain to him that he has a disability and reassure him that he’ll be able to make adjustments in order to succeed in life. Encourage him to perform the tasks he is ready for, but do not push him to do things at which he might fail. The professionals at early intervention centers can help you evaluate your child’s abilities and teach you how to reach appropriate goals. Although it may be tempting, be careful about wasting time, energy, and money searching for magical cures or undertaking controversial treatments. Instead, ask your pediatrician, or contact the United Cerebral Palsy Association at www.ucp.org, for information about resources and programs available in your area. Associated Problems Intellectual Disability It has been estimated that more than half of children with cerebral palsy have problems with intellectual functioning (thinking, problem solving). Many are classified as mentally retarded (or having intellectual disabilities), while others have average abilities with some learning disorders. Some have perfectly normal intelligence. Seizures One out of every three people with cerebral palsy has or will develop seizures. (Some start having them years after the brain is damaged.) Fortunately, these seizures usually can be controlled with anticonvulsant medications. Vision Difficulties Because the injury to the brain often affects eye muscle coordination, more than three out of four children with cerebral palsy have strabismus, a problem with one eye turning in or out. If this problem is not corrected early, the vision in the affected eye will get worse and eventually will be lost permanently. Thus it is extremely important to have your child’s eyes checked regularly by your pediatrician. Limb Shortening and Scoliosis Of those children with cerebral palsy affecting only one side of the body, over half will develop a shortening of the involved leg and arm. The difference between the legs is rarely more than two inches (5 cm), but an orthopedic surgeon should be consulted if shortening is noticed. Depending on the degree of difference between the legs, a heel or sole lift may be prescribed to fit into the shoe on the shorter side. This is done to prevent a tilt of the pelvis, which can lead to curvature of the spine (scoliosis) when standing or walking. Sometimes surgery is required to correct a serious degree of scoliosis. Scoliosis also can develop in the other forms of cerebral palsy involving both sides of the body. Dental Problems Many children with cerebral palsy have a greater risk of developing oral diseases from poor oral hygiene. This means more gingivitis (gum disease) and cavities for these children with special needs. One reason may be that it is difficult for them to brush their teeth. However, they also have more enamel defects than other children, which may make their teeth more susceptible to decay. In addition, some medications such as seizure or asthma drugs may contribute to cavity formation. Hearing Loss Some children with cerebral palsy have a complete or partial hearing loss. This happens most often when the cerebral palsy is a result of severe jaundice or anoxia (a deficiency of oxygen) at birth. If you find that your baby does not blink at loud noises by one month, is not turning his head toward a sound by three to four months, or is not saying words by twelve months, discuss it with your pediatrician. Joint Problems In children with spastic forms of cerebral palsy, it is often difficult to prevent “contracture,” an extreme stiffening of the joints caused by the unequal pull of one muscle over the other. A physical therapist, developmental pediatrician, or physiatrist (doctor of physical medicine) can teach you how to stretch the muscles to try to prevent the onset of contracture. Sometimes braces, casting, or medication may be used to improve joint mobility and stability. Problems with Spatial Awareness Over half the children with cerebral palsy affecting one side of the body cannot sense the position of their arm, leg, or hand on the affected side. (For example, when a child’s hands are relaxed, he cannot tell whether his fingers are pointing up or down without looking at them.) If this problem exists, the child rarely will attempt to use the involved hand, even if the motor disability is minimal. He acts as if it is not there. Physical or occupational therapy can help him learn to use the affected parts of his body, despite this disability. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
189,9,"2018-04-19 02:48:19","Developmental Disabilites",189,"2018-04-19 03:17:59","Children with Down Syndrome: Health Care Information for Families","Children with Down Syndrome: Health Care Information for Families Page ContentDown syndrome is a common condition caused by having “extra” copies of genes on the 21st chromosome. Those extra genes change development during pregnancy and continue to have effects after birth and throughout a person’s life. Each person with Down syndrome is unique, having some of the many possible health, learning, and related differences that can occur with this condition.Treatments for Children with Down SyndromeSome of the differences in people with Down syndrome are common and visible, like the facial appearance. Other changes are less common or less visible but can still cause problems or may need special treatments. The “special treatments” may include medicines, surgeries, or changes in what you should expect. There are no medicines or therapies that are needed by all people with Down syndrome. There are also no medicines or therapies that can “cure” Down syndrome. Your child’s doctor should be your starting point. Your child needs regular doctor visits and a few special tests. Pediatric specialists may also need to be involved.AAP Guide for Families of Children with Down SyndromeThe American Academy of Pediatrics (AAP) has developed a special guide to help parents and families of children with Down syndrome. This document focuses on medical topics that affect physical health. Other issues can affect social and school success. While these issues may not require doctors or other medical resources, they are still important issues for children with Down syndrome.   Click here to download the complete guide, ""Health Care Information for Families of Children with Down Syndrome"" (PDF).​The medical issues for a child with Down syndrome change with age. For this reason, the document is divided into several age groups (available as PDF downloads below). Each age group includes a list of issues that may be important to your child at that age.IntroductionThe Prenatal Period (the time before birth)Birth to 1 Month1 Month to 1 Year1 Year to 5 Years5 Years to 13 Years13 Years to 21 Years or OlderThe information in these guidelines has grown with the help of families, Down syndrome clinics, and doctors around the world. Most of the information is easy to follow. Many tests only need to be done once. Some areas might need to be looked at again, or even many times, as the child grows to an adult. Some tests or pediatric specialists might be needed that are not available in your area. Your doctor can help to sort out the best next steps when something can’t be done quickly or nearby.Parent Support GroupsLocal parent support groups can be a very good place to learn about doctors, therapists, and other providers in your community. They may also be able to help with questions about child care, preschools and schools, other local developmental programs, problems with behavior, etc. Your doctor’s office should have names and contact information for groups in your area. Article Body Last Updated 9/5/2013 Source Adapted from the “Health Supervision for Children with Down Syndrome” clinical report, available at: http://pediatrics.aappublications.org/content/128/2/393.full"
190,9,"2018-04-19 02:48:19","Developmental Disabilites",190,"2018-04-19 03:18:02","Children with Intellectual Disabilities","Children with Intellectual Disabilities Page Content Article BodyIntellectual Disability (ID) (formerly called mental retardation) is the most common developmental disability–nearly 6.5 million people in the United States have some level of ID. (more than 545,000 are ages 6-21). What is an ""Intellectual Disability""? Children with IDs have significant difficulties in both intellectual functioning (e.​g. communicating, learning, problem solving) and adaptive behavior (e.g.  everyday social skills, routines, hygiene).  IDs can be mild or more severe. Children with more severe forms typically require more support–particularly in school. Children with milder IDs can gain some independent skills, especially in communities with good teaching and support. There are many programs and resources available to help these children as they grow into adulthood. ​With the passage of Rosa's Law in 2010, many states replaced all terminology from ""mental retardation"" to ""intellectual disability."" Unfortunately, it has taken time for people to use the new term. The general public, including families, and public policymakers at local, state and federal levels, are becoming aware of how offensive this term is. The American Academy of Pediatrics (AAP) does not encourage the use of nor promote the term ""mental retardation."" How Do I Know If My Child Has an Intellectual Disability?To help your child reach her full potential, it is very important to get help as early as possible. Talk with your child's doctor if you think there could be a problem. You may be referred to a developmental-behavioral pediatrician or other pediatric specialist for further evaluation and screening. There are many signs of an Intellectual Disability. For example, children may: Sit up, crawl, or walk later than other children Learn to talk later or have trouble speakingHave trouble understanding social rulesHave trouble seeing the consequences of their actionsHave trouble solving problemsHave trouble thinking logicallyAbout developmental delays: Your doctor might initially say your child has developmental delay. Later, your child may be diagnosed with ID. Even though all children with ID show signs of a developmental delay early in life, not all children with a developmental delay end up having ID. Sometimes, a mild ID may not be recognized until a child starts school and struggles to learn at the same pace as his peers.How are Intellectual Disabilities Diagnosed? A child has to have both a significantly low IQ and considerable problems in everyday functioning to be diagnosed with ID.About the IQ test: IQ (""Intelligence Quotient"") measures a child's learning and problem solving skills. A normal IQ score is around 100. Children with ID have a low IQ score–most score between 70 and 55 or lower. Usually, children are not able to do an intelligence test (Intelligence Quotient Test or IQ test) until they are 4 to 6 years old. Therefore, parents may have to wait until a child reaches that age before knowing for sure if their child has ID. Sometimes, it can take longer. About adaptive behavior: As previously mentioned, a child must also have considerable problems in everyday functioning to be diagnosed with ID. To measure adaptive behavior, doctors and other evaluators look at what a child can do in comparison to other children the same age. Examples include: Personal care skills (e.g. getting dressed, going to the bathroom, self-feeding) Communication and social skills (e.g. having conversations, using the phone)  School or work skillsLearning routinesBeing safeAsking for help Using moneyMost children with IDs can learn a great deal, and as adults can lead at least partially independent lives. What is the Treatment and Outlook for an Intellectual Disability? There is no cure for IDs, however most children can learn to do many things. It just takes them more time and effort.  Support resources: Many families have a child with ID. One way to find a family support agency in your state is by going to Family Voices and clicking on the state map or calling them toll free at 888-835-5669.  ​Every state also has a Parent Information Center (PIC) to help families with their child's special education needs. What are Common, Coexisting Conditions in Children with Intellectual Disabilities?  Children with severe IDs are more likely to have additional disabilities and/or disorders compared to children with milder IDs.Examples of associated disabilities: Cerebral palsy Epilepsy Vision impairment Hearing loss Speech and language problems ​Your child's doctor or local developmental service agency can help you to get to those supports or services in your area. Additional Information: Outlook for Children with Intellectual Disabilities Early Intervention (EI) Individualized Education Program (IEP) Healthy Children Radio: Tips for Parents of Children with Special Needs (Audio) American Association on Intellectual and Developmental Disabilities​​ Last Updated 12/18/2015 Source Section on Developmental and Behavioral Pediatrics (SODBP) (Copyright © 2015 American Academy of Pediatrics)"
191,9,"2018-04-19 02:48:19","Developmental Disabilites",191,"2018-04-19 03:18:09","Congenital Abnormalities","Congenital Abnormalities Page Content Article BodyAbout 3% to 4% of all babies born in the United States have congenital abnormalities that will affect the way they look, develop, or function—in some cases for the rest of their lives. Congenital abnormalities are caused by problems during the fetus's development before birth. It is important for moms and dads to be healthy and have good medical care before and during pregnancy to reduce the risk of preventable congenital anomalies. Advances in perinatal testing and new diagnostic tests (i.e. amniocentesis, chorionic villus sampling, etc.) have made it possible to detect chromosomal and genetic related causes of congenital abnormalities earlier. 5 Categories of Congenital Abnormalities Chromosome AbnormalitiesChromosomes are structures that carry genetic material inherited from one generation to the next. Twenty-three come from the father; twenty-three come from the mother. The genes carried on the chromosomes determine how the baby will grow, what she will look like, and to a certain extent, how she will function.When a child is born without 46 chromosomes, or when pieces of the chromosomes are missing or duplicated, she may look and behave differently from others her age and may develop serious health problems (e.g. Down syndrome). Single-Gene AbnormalitiesSometimes the chromosomes are normal in number, but one or more of the genes on them are abnormal. Autosomal dominant inheritance is a genetic abnormality that can be passed on to the child if one of the parents has the same abnormality. Autosomal recessive inheritance is a genetic abnormality that can be passed on to the child only if both parents carry the same defective gene (e.g. Cystic fibrosis, Tay-Sachs disease, sickle cell anemia). In these cases, both parents are normal, but 1 in 4 of their children would be expected to be affected. X-linked conditions are genetic abnormalities that mainly occur in males (e.g. hemophilia, color blindness, forms of muscular dystrophy). Females may carry the abnormal gene that causes X-linked recessive disorders, but they may not show the actual disease. X-linked dominant conditions occur in both males and females; however, they are more severe in males (e.g. certain neurological conditions affecting the brain, skin disorders and types of skeletal or craniofacial disorders). Conditions During Pregnancy That Affect The BabyCertain illnesses during pregnancy, particularly during the first nine weeks, can cause serious congenital abnormalities (e.g. maternal infections such as cytomegalovirus, chicken pox or rubella). Chronic maternal conditions (e.g. diabetes, hypertension, autoimmune diseases such as lupus, myasthenia gravis or graves disease)  can negatively affect the developing fetus. Maternal hypertension can affect blood flow to the fetus impair fetal growth.Alcohol consumption and certain drugs during pregnancy significantly increase the risk that a baby will be born with abnormalities (e.g. fetal alcohol spectrum disorders). Eating raw or uncooked foods during pregnancy can also be dangerous to health of the mother and fetus and should be avoided.Certain medications, if taken during pregnancy, also can cause permanent damage to the fetus, as can certain chemicals that can pollute air, water, and food. Always check with your doctor before using any medication or supplement while you are pregnant. Combination of Genetic and Environmental ProblemsSome congenital abnormalities may occur if there is a genetic tendency for the condition combined with exposure to certain environmental influences within the womb during critical stages of the pregnancy (e.g. Spina bifida and cleft lip and palate).  Taking folate supplements prior to conception and during pregnancy decreases the risk of neural tube defects. However, there is also a genetic influence to this type of congenital anomaly.Unknown CausesThe vast majority of congenital abnormalities have no known cause. This is particularly troubling for parents who plan to have more children, because there is no way to predict if the problem will reoccur. If Your Family Has Experienced a Genetic-Related Birth AbnormalityAsk your pediatrician for a referral to a genetic counseling service. These services have expertise with a variety of genetic abnormalities and may be able to advise you as to the proper course of action.Additional InformationYour Family Health History & GeneticsDetecting Genetic AbnormalitiesPrenatal Genetic CounselingChildren with Down Syndrome: Health Care Information for Families Last Updated 11/21/2015 Source Genetics in Primary Care Institute (Copyright © 2014 American Academy of Pediatrics)"
192,9,"2018-04-19 02:48:19","Developmental Disabilites",192,"2018-04-19 03:18:12","Healthy Children Radio: Cerebral Palsy","Healthy Children Radio: Cerebral Palsy Page Content Article Body​Children with cerebral palsy have an impairment in the area of the brain that controls movement and muscle tone. Many of these children have normal intelligence, even though they have difficulty with motor control and movement. The signs and symptoms of cerebral palsy vary tremendously because there are many different types and degrees of disability. Pediatrician Garey Noritz, MD, medical director of the Complex Health Care Clinic at Nationwide Children's Hospital, comes on the Healthy Children Radio show to talk about what characterizes this disability and new adaptive technologies to help children with CP. Segment 1: Living with Cerebral Palsy Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2013)"
193,9,"2018-04-19 02:48:19","Developmental Disabilites",193,"2018-04-19 03:18:16","Healthy Children Radio: Down Syndrome","Healthy Children Radio: Down Syndrome Page Content Article BodyWorldwide, about one in 800 babies is born with Down syndrome, which is caused by the presence of an extra chromosome. In this segment of the Healthy Children show on RadioMD, pediatrician Marilyn Bull, MD, FAAP, comes on the Healthy Children show on RadioMD to discuss how parents expecting a child with Down syndrome can prepare.  Segment 1: Down Syndrome: What New Parents Need to KnowAdditional Information: Children with Down Syndrome: Health Care Information for Families Detecting Genetic AbnormalitiesPrenatal Genetic CounselingOutlook for Children with Intellectual Disabilities Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2014)"
194,9,"2018-04-19 02:48:19","Developmental Disabilites",194,"2018-04-19 03:18:19","Healthy Children Radio: Tips for Parents of Children with Special Needs","Healthy Children Radio: Tips for Parents of Children with Special Needs Page Content Article Body​Do you have a child with special health care needs? If so, you know it's not an easy road when it comes to all aspects of life. However it may raise some concerns specifically when it comes to the medical care of your child.  Pediatrician Jennifer Lail, MD, FAAP, joins the Healthy Children show on RadioMD to offer her top five tips for parents of children with special health care needs. Segment 1: Top 5 Tips for Parents of Special Needs Children Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2013)"
195,9,"2018-04-19 02:48:19","Developmental Disabilites",195,"2018-04-19 03:18:29","Individualized Education Program (IEP)","Individualized Education Program (IEP) Page Content Article BodyTo determine exactly which services your child needs, you will work with a team of specialists to complete a written document known as the Individualized Education Program (IEP). Every child who receives special education services must have an IEP. The IEP is the educational road map for children with disabilities. It spells out your child’s goals and outlines the exact education, services, and supplementary aids that the school district will provide for your child. IEP Evaluation Parents who feel their child might benefit from special education services should request an IEP evaluation in writing. Your pediatrician can also help draft a letter of request. Parents should work with personnel from their child’s EI program to help with this transition. You can begin this process when your child turns 2.An IEP is written after an evaluation. During the evaluation, current performance levels are established and documented. To be eligible for special education services, your child must be identified with a recognized disability (there are 14 different disability categories under IDEA) and the disability must adversely affect her educational performance. IEP Components Every IEP should have several key pieces of information. It should include: Your child’s current levels of performance Measureable goals for the school year When reports about your child's progress will be provided How well your child is able to function in school How your child will be included with peers with typical development How your child will be assessed on statewide and district-wide tests In addition, should your child qualify for extended school year services, the IEP should lay out the kinds of interventions that your child should receive when school is not in session. The IEP establishes dates and locations of when services will begin, where they will be held, and how long they will last. The IEP should also discuss what will be done when your child’s needs change. In addition, the IEP may outline whether your child gets “related services” such as special transportation, speech therapy, occupational therapy, and counseling. IEP Team The IEP is written collaboratively by a group—often called an IEP team—made up of: Child’s parents Regular education teacher Special education teacher Psychologists Therapists School administrator Possibly other school personnel A meeting to discuss the IEP must be held within 30 days after a school determines that a child needs special education services. Parents may invite anyone to this meeting, including personnel such as an advocate or the child’s case manager from the EI program. The IEP is evaluated at least every year to determine whether goals are being met and may be adjusted if your child’s needs change. IEPs for Children with ASDs Unfortunately, research has found that many IEPs for children with autism spectrum disorders (ASDs) are lacking and do not meet recommendations of the National Research Council or requirements of IDEA. Many IEPs omit important information and may not provide services to a child outside of the traditional school year. Many do not adequately describe how goals are to be measured or how certain goals will help the child in school. Many IEPs also fail to say how teachers intend to motivate the child or how they would engage the child in developmentally appropriate tasks or play. Many IEPs do not include parent concerns. Understanding Your Rights When formulating your child’s IEP with your school district, it’s important to know exactly what your rights are and what to do if you are not happy with the resulting IEP. Before going to your first IEP meeting, do your research. Become familiar with your state’s education laws, and know the types of interventions available to your child based on her needs. A good book to start with is Educating Children with Autism, published by the Committee on Educational Interventions for Children with Autism of the National Research Council. You may also want to visit the US Department of Education one-stop shop for resources related to IDEA and rules and regulations concerning the IEP process at http://idea.ed.gov. Last Updated 11/21/2015 Source Autism Spectrum Disorders: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2012)"
196,9,"2018-04-19 02:48:19","Developmental Disabilites",196,"2018-04-19 03:18:32","Involving Your Child in the Decision-Making Process: AAP Report Explained","Involving Your Child in the Decision-Making Process: AAP Report Explained Page Content​By: Richard C Adams, MD, FAAP and Susan E Levy, MD, MPH, FAAPTreatment should never be a process done to your child. Rather, decisions about care should be implemented with your child's input—as much as possible—with support, guidance, and assistance from you and other care team members. The American Academy of Pediatrics (AAP) clinical report, Shared Decision-Making and Children with Disabilities: Pathways to Consensus, states that children, when cognitively able, should be involved in decisions about their care. Parents and professionals too often look to this process for ""the big decisions,"" however smaller decisions can have a significant impact over time.Presenting children with information—appropriate for their developmental age—can help in their understanding of their condition and treatments, reduce fear, and enhance self-confidence.Shared Decision-Making Tips for Parents of Children with Disabilities: Educate your child about his or her condition. Find out what your child understands and/or wants to know. Work with your child's doctors and others in your community to identify books, videos, websites, and other resources to help your child learn about his or her condition. Identify future goals. Have a discussion with your family and your child's doctors. Start picking out goals for your child's future—short-term (e.g., within the year) and long-term (e.g., as an adult).Have quick check-ins with your child. Once you have identified the goals for your child and their priority, make sure he or she understands them as fully as possible given his or her level of understanding—especially if things don't make sense or just don't feel right.Have your child present. Your child should be present whenever possible for at least part of meetings concerning his or her condition or treatment. Parts of the discussion should address your child directly at his or her level of understanding.Consider who else should be present. Some decisions are relatively straightforward (e.g., antibiotics for strep throat) and may not require long or difficult discussions, but others (e.g., starting a psychotropic medication for behavior) may be tougher. In addition to having your child present for these decisions—if he or she is able—it is also a good idea to have another family member(s) there. For example, grandparents, siblings, or child care providers involved in day-to-day care may have input and even act as a scribe in the meeting. Sometimes, it can be difficult to hear and process information correctly after the fact. The other family member there can help recall the conversation later and clarify for questions.Ask about breaking up appointments. Sometimes, it can be helpful to separate long, complex discussions into shorter, topic-based meetings. This also gives everyone—including the doctors and other professionals—more time to prepare. Having a set time limit for the discussion can be helpful, as well. Be aware that this is a ""process."" There are situations where a ""yes"" or ""no"" decision is needed immediately. Considering data, reflecting on choices, and coming to a consensus can be accomplished either quickly (if needed) or within a longer timeframe if shared decision-making techniques are used regularly. Know teens need time alone with the doctor. Adolescents may benefit from time alone with their doctor(s) or other health professionals without parents present. The shared decision-making process allows for more input from your child. Ask your child about what he or she would like to talk about and arrange a separate meeting if he or she would like one.  Realize participation prepares your child for adulthood. Your child's prioritizing of his or her condition-related problems should be taken seriously. Teach your child to consider his or her strengths, obstacles, and abilities to function in different situations and to monitor any changes. It's never too early to start talking about these topics. Ask your child's doctors for more ideas on how to include your child in this process, as well as any additional resources. About Crisis & Emergency Situations:Shared decision-making should be implemented for routine decisions and well in advance of predictable (or unpredictable) crises, such as those requiring intensive care or do-not-resuscitate decisions. Complex or serious decisions are often easier to make if a foundation of trust was already built through prior experiences in the shared decision-making process. Crisis and emergency medical situations can also change the process to accomplish shared decision-making. Components of shared decision-making can and should be used if possible, but the AAP report acknowledges that it may not always possible or allowed in an acute or serious emergency. Additional Information & Resources:  Common Coping Styles of Teens Who Are Chronically Ill or DisabledReproductive Health in Teens with Chronic Health Conditions       The Stresses Faced by Teenagers Who Are Chronically Ill or Disabled For Families and Caregivers (National Center for Medical Home Implementation) Fostering Partnership and Teamwork in the Pediatric Medical Home: A ""How-To"" Video Series (National Center for Medical Home Implementation) Family-Centered Care Self-Assessment Tool (Family Voices) Health Care Transition for Youth with Disabilities and Chronic Health Conditions (Rhode Island Department of Health) Youth & Families: What Is Health Care Transition? (GotTransition.org) ​About Dr. Adams: Richard C Adams, MD, FAAP, is Professor of Pediatrics and the Division Director of Developmental Behavioral Pediatrics at UT Southwestern Medical Center and serves as the Medical Director of Developmental Disabilities at Texas Scottish Rite Hospital for Children in Dallas. Within the AAP, Dr. Adams is a member of the Section on Developmental & Behavioral Pediatrics and Council on Children with Disabilities (COCWD), previously serving as a member of the COCWD Executive Committee. In 2009, he was the recipient of the AAP Special Achievement Award for his work on behalf of quality outcome measures for children with special needs across the State of Texas.About Dr. Levy:  Susan E Levy, MD, MPH, FAAP, is a member of the Center for Autism Research and Vice Chair, Committee for Protection of Human Subjects at the Children's Hospital of Philadelphia, and Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Within the AAP, Dr. Levy is a member of the following Sections: Epidemiology, Public Health & Evidence, Obesity, Developmental & Behavioral Pediatrics, and Integrative Medicine. She is a current member and past Executive Committee member of the AAP Council on Children with Disabilities (COCWD) and Chairperson of the COCWD Autism subcommittee. ​​ Article Body Last Updated 5/29/2017 Source Council on Children with Disabilities (Copyright © 2017 American Academy of Pediatrics)"
197,9,"2018-04-19 02:48:19","Developmental Disabilites",197,"2018-04-19 03:18:39","Occupational Therapy","Occupational Therapy Page Content Article BodyChildren with autism spectrum disorders (ASDs) and other developmental disabilities often have deficits in the areas of fine motor skills, sensory processing, and motor planning. These can show up as difficulties with basic self-care skills such as: Getting dressed Using a spoon Brushing teethPlay skills, such as building puzzles or using scissors Basic life skills, such as sitting still in a classroom Occupational therapists often can help with these issues. Occupational Therapy (OT) Evaluation An OT evaluates the child’s fine motor skills and sensory processing development and prepares strategies for learning tasks of daily living. These interventions may be delivered in sessions with a therapist and then practiced at home and school. Goals will depend on the needs of the individual child, but occupational therapy strives to help children gain more independence and live a higher quality of life. Last Updated 11/21/2015 Source Autism Spectrum Disorders: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2012)"
198,9,"2018-04-19 02:48:19","Developmental Disabilites",198,"2018-04-19 03:18:43","Outlook for Children with Intellectual Disabilities","Outlook for Children with Intellectual Disabilities Page Content Article BodyWhat is the outlook for children with intellectual disabilities? About 2 percent to 3 percent of children are considered intellectually disabled (formerly called mentally retarded). Their general intelligence is significantly below average, and they have difficulty adapting to their environment. As measured by standardized tests, the average IQ (intelligence quotient) is 100; normal ranges from 90 to 110. The degree of an intellectual disability depends upon how far below this normal range a child's IQ falls. Experts use these lower IQ scores to label a child as mildly, moderately, severely or profoundly retarded. The majority of children with below-average IQ scores are not considered to have an intellectual disability, but below average, with test scores between 70 and 89. Diagnosis The diagnosis of an intellectual disability can be made only by a certified psychologist capable of administering, scoring, and interpreting a standardized intelligence or cognitive test. The psychologist must also be able to observe and assess adaptive behavior. Although screening for developmental delays and intellectual disabilities is a central part of pediatric care from birth onward, some children with mild intellectual disabilities and developmental disabilities are not identified until the early school years. Early identification is critical to a better outcome, because a child's developmental handicaps are not necessarily fixed or set, and in fact they are often responsive to appropriate treatment. Adaptive behavior enables children to interact with, adjust to, and meet the demands of other people and day-to-day living. Specific adaptive behavior includes a child's motor skills, communication abilities, self-help and independent living skills (eating, dressing, toileting), and other everyday skills (using public transportation, maintaining an appropriate job, taking care of a house). Causes Intellectual disabilities can have a variety of causes, including hereditary disorders such as phenylketonuria (PKU), early alterations in the embryo's development (Down's syndrome), and exposure to toxic substances (alcohol) or infections while the child is in the mother's uterus. Problems in labor and birth that put stress on the baby, or problems after birth like injuries to the brain, can result in an intellectual disability and/or loss of specific functions, such as memory or language abilities. In most cases the cause of intellectual disabilities is not known, having no specific identifiable source. Education By middle childhood most youngsters with an intellectual disability have already been assessed and provided with an appropriate school setting. If you have a intellectually disabled child, she is entitled to an education just as any other youngster is. Federal law mandates evaluations to identify children with suspected handicaps and to provide appropriate services for them. As children with intellectual disabilities progress through the school system and through their own developmental stages, they require an evolving training and/or educational program that is appropriate for their abilities and responsive to their needs and the needs of their families. Initially, these children may need help in acquiring the basic developmental skills (fine and gross motor skills, speech and language skills) that are within their capabilities. As children acquire competence in these areas, they are better able to learn academic and other school-related skills. Even so, these children still require a special educational setting with more individual attention and support. This is especially true of youngsters who also have behavior problems. However, some of these children can engage in non-academic activities, such as sports, physical education, art, and singing, with their peers who are not intellectually disabled. Increasingly, children with mild cognitive impairments (i.e., mild intellectual disabilities) are being mainstreamed into inclusion classrooms. Vocational training Preparing children with intellectual disabilities for both lifelong vocational pursuits and as much independence as possible is the major goal of their education. Even in the elementary-school years, a child with a particular interest or talent might benefit from special training in or exposure to relevant vocations. Specialized vocational training is a major goal in the high school years. Severe intellectual disabilities Children with severe and profound degrees of intellectual disabilities constitute a small percentage of intellectually disabled children. These youngsters lack self-care skills. They communicate poorly and often have behavioral problems including repetitive or self-stimulating behavior. Home care is frequently difficult or impossible for parents, and these children are often placed in residential settings and receive special education. Nevertheless, with new trends and philosophies, many experts feel that these children, especially as teenagers or adults, are best served in smaller, more normal environments such as group homes within the community. Parents can obtain information, support, and services through medical centers, community schools, respite care programs, family support networks and their pediatricians. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
199,9,"2018-04-19 02:48:19","Developmental Disabilites",199,"2018-04-19 03:18:48","Sensory Integration Therapy","Sensory Integration Therapy Page Content Article BodySensory integration is a term that has been used to describe processes in the brain that allow us to take information we receive from our 5 senses, organize it, and respond appropriately. We also have a vestibular sense (balance) that tells us how to position our bodies and heads, and a proprioceptive sense (awareness of body in space) that helps us know what we do with our joints, muscles, and ligaments. Sensory Processing Deficits and Children with Autism Spectrum Disorders (ASDs) In children who have ASDs, sensory processing deficits have been theorized to cause difficulties that affect behavior and life skills. As a result, some children may be hypersensitive or hyposensitive to stimuli in the surroundings. Loud music, for instance, may cause intense discomfort, while bright fluorescent lights that bother others may be riveting to some children with ASDs. Children with sensory processing deficits may have difficulty with motor skills, balance, and eye-hand coordination. Some children will look for ways to seek out certain sensations and engage in self-stimulating behaviors like rocking back and forth, head banging, and oral exploration of nonedible objects. What is Sensory Integration Therapy? Sensory integration therapy, which was developed in the 1970s by an OT, A. Jean Ayres, is designed to help children with sensory-processing problems (including possibly those with ASDs) cope with the difficulties they have processing sensory input. Therapy sessions are play-oriented and may include using equipment such as swings, trampolines, and slides.Sensory integration also uses therapies such as deep pressure, brushing, weighted vests, and swinging. These therapies appear to sometimes be able to calm an anxious child. In addition, sensory integration therapy is believed to increase a child’s threshold for tolerating sensory-rich environments, make transitions less disturbing, and reinforce positive behaviors. Effectiveness of Senosry Integration Therapy Although there are scientific studies to show that children with ASDs are more likely to have sensory-processing problems, the effectiveness of sensory integration therapy as a therapy for ASDs is limited and inconclusive. While this does not mean that the therapy might not be helpful in some children, effectiveness so far is mainly based on personal experiences. Talk with your child’s pediatrician if you suspect that your child has difficulties with sensory processing; there may be resources in the community for further evaluation. Other Methods For Controlling Sensory Input You may also learn about auditory integration training or behavioral optometry as methods for controlling sensory input. Both treatments aim to alter the child’s response to sensory stimuli, but neither method has proved to be scientifically valid. Also, there is no evidence that any problems seen with ASDs are related to these auditory or visual problems. Last Updated 11/21/2015 Source Autism Spectrum Disorders: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2012)"
200,9,"2018-04-19 02:48:19","Developmental Disabilites",200,"2018-04-19 03:18:52","Social & Economic Factors Associated with Developmental Disabilities","Social & Economic Factors Associated with Developmental Disabilities Page Content Article BodyChildren who grow up in environmental circumstances of social and economic disadvantage are more likely to have developmental disabilities. Maternal Risk Factors:PovertLow socioeconomic statusMental illnessSubstance abusLiving in communities where environmental hazards are plentiful and resources are limitedPrenatal & Perinatal Risk Factors:Preterm birthLow birth weightCentral nervous system abnormalitiesProlonged hospitalizations that can drain family resources and interfere with parent-infant bondingChildren in Poverty: Complex and Far-Reaching Risk Factors  For many children, the environmental risks are compounded during their early years. Poverty remains one of the most complex and far-reaching risk factors, because it affects so many aspects of the life of a child. In 2006, approximately 1 in 5 US children younger than 6 years and 16% of children ages 6 to 17 years lived in poverty. The rate for children of all ages living in single female-headed families was 42%. During that same year, approximately 17% of children (12.6 million) lived in households with food insecurity. Children who were impoverished were also more likely to have a blood lead level of 10 μg/dL or greater. Children living in poverty are 1.7 times more likely to be born at a low birth weight. Cycle of Disadvantage: Difficult to Escape Too often, children and their families are trapped in a cycle of disadvantage and disability that is difficult to escape unless interrupted by outside social forces or the extraordinary efforts of individuals and families.Additional InformationHospital Care Coverage: Information for ParentsBlood Lead Levels in Children: What Parents Need to KnowThe Challenges of Single Parenthood Nutrition and Exercise During Pregnancy Reduce the Risk of Birth Defects Last Updated 11/21/2015 Source Pediatric Environmental Health, 3rd Edition (Copyright © American Academy of Pediatrics 2011)"