Jeff Ryan

The world's best-known pediatrician, by a country mile, is still Benjamin Spock, MD, the author of 

The Common Sense Book of Baby and Child Care

. The book, an all-time bestseller, changed the face of parenting.  

Benjamin McLane Spock was born in 1903 in New Haven, Conn., to a strict mother and a distant father. Spock's mother Mildred, a believer in cold air, made him attend an open-air school and keep the windows open and the heat off all winter. For lack of any better advice, his mother (and others) thought a freezing child was a healthy child.  

He married Jane Cheney while attending Yale and switched concentrations from English to medicine. The honeymooners soon moved to New York, with Spock transferring to Columbia. The former C student came in first in his class.  

While there, Spock started learning about psychiatry from disciples of Sigmund Freud, MD. He was interested in pediatrics and psychiatry. But no one had ever seemed to try to combine the two and consider what went on in the mind of a child. Spock's customized study program made him the first child psychiatry specialist in the world.  

As a new pediatrician, Spock struggled to keep his bills paid during the Great Depression. He made house calls, took phone calls, and taught. When a publisher asked him to write a child care manual, though, Spock took a small royalty and no advance so that the book could be sold for a mere quarter. 

The  book's conversational tone was almost accidental: Spock dictated it to Jane, who was the one who knew how to type. He worked his Freudian studies into the text, couched in plain language. He was enlisted in the Naval Reserve, so had to dictate the last chapters over the phone to Jane.  

The disguised psychiatric wisdom, the humorous advice, and the vast scope of the book all clicked with its intended audience. Parents had an on-call pediatrician in book form. To paraphrase his famous introduction, when it came to child care, Spock knew more than he thought he knew. 

Articles

The world's best-known pediatrician, by a country mile, is still Benjamin Spock, MD, the author of The Common Sense Book of Baby and Child Care.

How Ben Spock became Dr. Spock

One day while on call as a pediatric resident in the emergency department, Charlotte Cowan, MD, noticed how many kids with asthma were waiting to be treated. The children were all weary and frightened of the nebulizer, and of the hospital itself.  

Raising three kids as a pediatrician doesn't leave much free time. But when her kids were older, Cowan took a sabbatical from her post at Massachusetts General Hospital to figure out how she wanted to write such a book. "When I began to write my stories," noted Cowan, "I looked up what the publishing world called 'sick books.' I found remarkably few." 

 The animal patients have clever connections to their diseases: the giraffe child gets a sore throat, and the elephant gets an earache. Dr. Hippo is an inside joke, too, about the Hippocratic oath. And what child could resist a book called 

Each story also comes with a glossy parent guide. "I could have written them in my sleep," Cowan laughed, since they are questions pediatricians know by heart. Her challenge was keeping them to the point. 

The five books focus on everyday children's disorders: gastroenteritis, otitis media, fever, cold, and strep throat. Since their publication, Cowan has received requests for other books on everything from diabetes to celiac disease. She's even received manuscripts for new Dr. Hippo tales! Her next book will be about obesity. 

To pass on even more information, Cowan started the Paging Dr. Hippo blog (

) this year. "Dr. Hippo" writes to a general audience on safe-parenting questions, and includes footnotes to the American Academy of Pediatrics and others. Cowan started her own publishing company, the Hippocratic Press, to release the series.  

The books have some powerful fans: Cowan was invited to the White House in June for an Office of Social Innovation and Civic Participation gala honoring individuals who were positively "having an impact" on society. She was one of "less than a handful" there to represent health care.  

"I was floored," she said. Not every person gets a pat on the back. Cowan got one from the President.   

Profile of Charoltte Cowan, MD, a pediatrician who has written a series of children's books about common child maladies such as earaches and fevers.

Children's author, and children's doctor, too

Certain birth control pills seem to inhibit growth of bone mineral density (BMD) in adolescent girls, a new study shows.

A poster by Jan Stepan, MD, at the American Society for Bone and Mineral Research meeting in Denver , spelled out the risk. About 90 girls ages 15 to 19 were divided into a control group, a group who took 15 mcg of ethinyl estradiol, and a group who took twice the amount, 30 mcg. Both drug groups also received 60 mcg of gestodene. After nine months, the treatment groups switched dosage strengths for another nine months.

The results of the regular whole-body bone mineral content and lumbar spine BMD tests showed girls on 15 mcg failed to gain or actually lost bone mineral density, down 2%. With 30 mcg, the density increased 1% to 2%. The lower dose of “the pill” wasn’t fully replacing estrogen, the theory goes.

Getting girls to increase bone mineral density now – via weight-bearing and resistance exercises, and calcium and vitamin D via salmon, dairy, and spinach – can be tough. As the saying goes, osteoporosis is a pediatric problem with geriatric manifestations. This adds one more thorny issue to the already tangled thicket of teenage reproductive health.

Certain birth control pills seem to inhibit growth of bone mineral density in adolescent girls, a new study shows.

15-mcg birth control pills inhibit BMD

The Food and Drug Administration (FDA) approved the H1N1 influenza vaccines from four different companies, ensuring a robust stockpile for the upcoming fu season.

The four companies, sanofi pasteur, MedImmune, CSL Limited, and Novartis Vaccines and Diagnostics, Limited, all have experience with immunizations, and used the same techniques to brew their batches of vaccines. ”The H1N1 vaccines approved today undergo the same rigorous FDA manufacturing oversight, product quality testing and lot release procedures that apply to seasonal influenza vaccines,” said Jesse Goodman, MD, acting chief scientist for the FDA.

As expected, the immunizations will be available to physicians by mid-October. Still, the flu season may be well underway in four weeks’ time, so the vaccine may come too late for some. 

The US government has order 195 million doses of the vaccines. While recent studies have found 

, children may still be recommended to get two doses. Some formulations are being made without the preservative thimerosal, which some parents distrust. There will also be a nasal-spray version available.

The FDA approved the H1N1 influenza vaccines from four different companies, ensuring a robust stockpile for the upcoming fu season.

Four different H1N1 vaccines approved

How does a vaccine supply get doubled overnight? By finding out that the second dose isn’t needed to get efficacy.

New research was published Thursday in the 

, and announced by Health and Human Services secretary Kathleen Sebelius. She said that the first of a planned two immunizations against H1N1 produced such a “robust” effect that 97% of recipients has enough present antibodies to be considered protected.

Since there was a rush to create as many H1N1 doses as possible, this means that the hundreds of millions of doses will now go twice as far. The Centers for Disease Control and Prevention recommends that at-risk populations should receive the immunization first – health care workers, people under 24, people taking care of infants or in bad health. The US government has purchased 195 million doses from multiple vaccine makers.

The first batch of H1N1 vaccines will be available in October, and will be reserved for the at-risk population. Young children may still need two shots, though, as with the first time they receive a traditional influenza immunization.

How does a vaccine supply get doubled overnight? By finding out that the second dose isn't needed to get efficacy.

H1N1 vaccine works, and in just one dose

Gardasil, the human papillomavirus (HPV) vaccine approved for females, may soon be approved for males as well.

A Food and Drug Administration (FDA) panel gave its thumbs up for broadening the HPV recommendation, from girls and women age 9 to 26 to include boys and men 9 to 26 as well. This isn’t an approval but it’s close:  FDA usually agrees with its advisory committees.

The HPV vaccine of Merck’s is touted as an ersatz cervical cancer vaccine, since eliminating HPV (technically four strains of the virus) plummets the chances of a woman having cervical cancer. It’s become controversial due to a push to immunize girls before they become sexually active (and thus susceptible to HPV): immunizing them, a few critics say, is akin to giving them permission for intercourse.

Most all girls and women who contract HPV do so via sexual contact with a male. Reducing that risk could enlarge the herd immunity effect against HPV. That wasn’t a benefit under consideration, though: the advisory committee stuck with primary benefits to the male immunizees. These include a lowered risk (89% effective) of genital warts, and a lowering of the already low chances for penile or anal cancer.

Gardasil, the human papillomavirus vaccine approved for females, may soon be approved for males as well.