Posts for category: Child Health
By Belkis R. Cepero, MD
June 23, 2021
While children under 3 years old will not have control over their bladders, older kids that still have issues with bladder control may have something known as urinary incontinence or enuresis. As a pediatrician, we understand that this issue can be distressing for kids and their parents. Here’s what you should know if your child is dealing with daytime or bedtime enuresis.
When to See a Pediatrician
Accidents happen, but if bedwetting or daytime enuresis is becoming quite frequent in older children then it’s worth seeing your pediatrician for a closer evaluation. Girls happen to gain bladder control a little faster than boys. Girls are often diagnosed with enuresis if they continue to have bladder control issues past the age of 5, while it’s often diagnosed in boys after age 6.
The Causes of Enuresis
There are many reasons why your child might be dealing with enuresis, which is another reason to see a pediatrician for answers. Whether your child is dealing with nighttime or daytime enuresis, or both, gives us some idea of what the cause might be. Common causes of nighttime or daytime enuresis include:
- Overactive bladder
- Small bladder
- Intense deep sleep
- Urinary tract infection
- Sleep disorders (often obstructive sleep apnea)
- Structural issues within the urinary tract
Sometimes enuresis goes away on its own without treatment, while other causes may require treatment. For example, a urinary tract infection will require medication to treat the infection and alleviate the enuresis. Underlying health problems such as diabetes will also require proper treatment and long-term maintenance and care.
We will evaluate your child and ask a series of questions about their symptoms, including their fluid intake, whether they drink caffeine, issues with constipation, trouble or pain with urination, and stress levels. This is will give us clues as to what might be causing your child’s symptoms. From there, we can recommend the best course of action.
If you have any concerns about your child’s health, whether it’s bedwetting or immunizations, your pediatrician is the first person to turn to. If your child is wetting the bed or having issues with bladder control, don’t hesitate to talk with your child’s doctor to determine the cause.
By Belkis R. Cepero, MD
May 19, 2021
When you turn to your pediatrician for nutritional advice or help, they will always take a personalized approach to help your child meet their nutritional goals, whether that’s losing weight, getting more regular activity, or eating a healthier diet. You may have questions about your child’s nutritional needs, particularly as they grow. We’ve compiled some of the most frequently asked questions regarding childhood nutrition.
Is fruit juice healthy?
Many people seem to think that juice is healthy, and while it does contain vitamin C, there are certainly better sources for ensuring your child gets enough of this important nutrient. Today, most fruit juices found at the grocery store are chock full of sugar and can contribute to weight gain and increase the risk for cavities. A better alternative is whole fruits since they provide more nutritional value than juice will.
How many calories should my child consume a day?
How many calories your child consumes will depend on their gender, age, and activity level. A recommended calorie range for kids between 6-12 years old is between 1600-2200 per day. Verywell Family provides a more detailed breakdown by age and gender.
I’m worried that might child might not be getting the nutrients they need. What should I do?
First, it’s important to keep in mind that kids don’t need to eat as much as we do, so their portions will be considerably smaller than ours. If your child is growing then chances are good that they are getting the nutrients they need; however, if you find that your child is refusing meals or isn’t eating it’s important to bring this up with your pediatrician as soon as possible.
How can I prevent my child from becoming overweight or obese?
To help your child maintain a healthy weight they must be eating a healthy, balanced diet with fruits, vegetables, whole grains, and lean sources of protein. Make sure that they are also getting at least one hour of physical activity every day. Limit sugar and processed foods.
Is snacking okay for my child?
Young children may seem voraciously hungry and may beg for snacks. How many are actually okay? It’s normal for little ones to want food every 3-4 hours. While snacking can be a great way to prevent kids from overeating during mealtimes you don’t want to ply them with treats (and you want to be sure you’re providing them with nutrient-rich snacks rather than sugary ones).
A snack mid-day between lunch and dinner is typically the best time. If it’s only going to be a couple of hours before a meal, then something small like a piece of fruit or a slice of cheese with crackers is good. If your child isn’t going to eat for more than four hours then you’ll want a snack that incorporates protein, fat, and carbs to satiate their appetite.
If you are concerned about your child’s health because they are “picky eaters” or are struggling with their weight, you must speak with their pediatrician to find out options that can help them lead a healthier lifestyle.
By Belkis R. Cepero, MD
March 18, 2021
Reflexively, your baby is born with the ability to suck. It makes sense. After all, your little one must be able to suck to get nutrients, whether breastfeeding or bottle-feeding. Thumb sucking also has the ability to soothe and calm your little one. However, there are moments as your child gets older where thumb-sucking may become a problem. Your pediatrician can provide you with the tips and tricks to help your little one grow out of this habit.
This is a normal habit in newborns that typically goes away around 6-7 months; however, this seemingly innocuous habit may actually be a cause for concern if thumb sucking continues beyond 2-4 years, where it can alter the shape of the face or cause teeth to stick out.
When to Consider a Pacifier
Many children desire a pacifier between feedings, but this should not be a replacement for feedings. It’s important to recognize when your child is sucking because they are hungry and whether they merely want to self-soothe. If your child still has an urge to suck and they don’t need to nurse, then a pacifier is a safe way to soothe and ease your child’s needs (if they want it).
It is safe for children to use a pacifier while sleeping, whether at bedtime or when they go down for their naps. Just prepare for babies to wake up fussy in the middle of the night when the pacifier falls out of their mouths, as they aren’t able to place the pacifier back in their mouths themselves. Make sure that you do not try to place the pacifier on a string around your baby’s neck or tie it to the crib, as this can lead to a serious and potentially deadly injury.
How to Phase Out the Pacifier
There will come a point when your child will need to give up their pacifier. While the medical community has different age ranges, The American Dental Association recommends that children stop using a pacifier by age 2, as going beyond two years old could alter the alignment of your child’s teeth or impact the shape of their face.
Here are some tips to phase out the pacifier,
- Do not tease or punish your child for using a pacifier, but instead praise them when they do not use it. Provide them with rewards when they go without it.
- Some children use pacifiers out of boredom, so give your child something to do to distract them such as playing with a game or toy (to keep their hands busy).
- If incentives and rewards aren’t enough and your child is still using a pacifier, your pediatrician may recommend a “thumb guard” that can prevent your child from sucking their thumb. While you may feel in a rush to get rid of your child’s pacifier, it’s important to be patient. All children eventually stop this habit.
Even if you are concerned about your child’s thumb-sucking, it’s important to know that most children do grow out of it not long after starting school. While you can provide them with helpful ways to ditch the habit it’s important not to put pressure on them. With the help of your pediatrician, your child can and will outgrow this habit.
By Belkis R. Cepero, MD
February 05, 2021
In the past, the most common type of diabetes to affect children and teens was type 1 diabetes. This is also referred to as juvenile diabetes. In children with type 1 diabetes, their bodies do not produce insulin, a hormone responsible for helping deliver glucose into the cells. While type 1 diabetes is quite common in children, pediatricians are also seeing a rise in type 2 diabetes in children and teens. This coincides with an increase in childhood obesity rates.
Symptoms of Type 1 Diabetes
While type 1 diabetes can appear in children of any age, it’s most commonly diagnosed in children between the ages of 5 and 6, and 11 to 13. It’s important to recognize the symptoms of type 1 diabetes early, as high blood sugar levels can lead to serious complications. Symptoms of type 1 diabetes typically appear suddenly, and the most common symptoms include,
- Frequent urination, particularly at night
- Excessive thirst or hunger
- Weight loss, despite increased appetite
- Cuts, bruises, and wounds that don’t heal or are slow to heal
Symptoms of Type 2 Diabetes
Unlike type 1 diabetes, type 2 diabetes symptoms usually appear gradually. While type 2 diabetes has always been considered “adult-onset” diabetes, this has changed over the years, thanks to the obesity epidemic in children. If your child is obese or overweight, they may be at an increased risk for developing type 2 diabetes. Symptoms of type 2 diabetes are similar to type 1 diabetes, the only marked differences in symptoms are,
- Blurry vision
- Severe fatigue
- Tingling or numbness in the hands and feet
Treating Diabetes in Children
Even though there is no cure for diabetes, there are ways that your child’s pediatrician can help manage their symptoms. The goal of treatment is to control blood sugar levels to prevent complications and lessen symptoms.
The standard treatment includes managing diabetes through insulin therapy, which involves either daily insulin injections or an insulin pump. You will also need to monitor your child’s blood sugar levels throughout the day. Along with insulin therapy, you will also want to make sure that your child is eating a healthy diet and is getting regular exercise (at least one hour a day).
If your child is overweight or showing signs of diabetes, you must talk with your child’s pediatrician right away. A simple blood test can check their blood sugar levels and determine whether or not they have diabetes. Since uncontrolled diabetes can lead to serious health problems, it’s a good idea to see a pediatrician as soon as possible.
By Belkis R. Cepero, MD
December 22, 2020
Tags: Broken Bone
Accidents happen. Perhaps your child hurt themselves falling off their bike or taking a rough tumble down the stairs. In these instances, the first thing you’ll probably do is check your child over for bumps, bruises, and possibly broken bones. It’s important to recognize whether your child could be dealing with a broken bone so that you can bring them in to see their pediatrician right away.
The warning signs of a broken bone include,
- A popping or snapping sound at the moment of impact or injury
- Trouble straightening out the limb or affected area
- Unable to put weight on the area
- Limited range of motion or unable to move normally
If the bone is visible through the skin, you must call 911 or head to your nearest emergency room for care. If there is no bone visible but your child is still experiencing the symptoms above, then call your pediatrician right away. This problem should be treated on the very same day by your child’s doctor.
The most common fractures that we see in kids often affect the bones of the elbows, ankles, and wrists. Falling off monkey bars and other injuries on the playground are incredibly common and can lead to wrist and elbow fractures.
How is a broken bone treated?
First, your pediatrician will run X-rays to determine the location and severity of the break. Your doctor will place a splint or cast around the broken bone to provide support and stabilization and to restrict certain movements that could impede healing.
Your doctor may also recommend certain exercises that your child should do at home every day to help ease symptoms such as pain, limited mobility, and swelling. Your doctor may also refer your child to a pediatric orthopedist for physical therapy, depending on the type and extent of the injury. You will also need to bring your child back into the office in a few weeks to see how the broken bone is healing.
A broken bone is considered a serious injury. If your child is displaying symptoms of a broken bone, it’s a good idea to call your pediatrician right away for a consultation.