Charles A. Pohl, MD

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Heelys

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

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

How old does a child need to be before we can count on the accuracy of his or her response?

In recent years, adolescents have begun to turn to unconventional sources of drugs to abuse. One such drug that is becoming more and more popular among teenagers is dextromethorphan, a common ingredient in many cough and cold medications. In large doses, dextromethorphan is broken down into dextrorphan, which can produce euphoria and hallucinations--effects similar to those of phencyclidine

Lately, the media has been riddled with news about a recent study pertaining to brainstem abnormalities in sudden infant death syndrome (SIDS). How pertinent are the findings to your everyday practice? Should this study change the anticipatory guidance that you provide to new parents?