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  • Are we putting too much pressure on our kids?

    Dreams.  Hopes.  Wishes.

  • Could cyberbullying be the cause of depression in your teen?

    Nearly everyone is familiar these days with the terms "cyberbullying" or "online bullying". This is a form of bullying where someone is harassed, threatened, or humiliated through the internet, usually through various social media networks. It is becoming increasingly common; statistics say about 58% of kids admit someone has said mean or hurtful things to them online. More than 4 out of 10 say it has happened more than once. These figures sound about right to me. At Teen Xpress, I have several students every week tell me that they are dealing with some sort of online bullying.

    Cyberbullying can lead to depression in teens

    Being intimidated, verbally abused, or harassed online can wreak havoc on a young person’s psyche, causing a multitude of issues, especially depression. When looking specifically at depression, it’s hard to know the exact numbers or relationship between the two because bullying is usually underreported (with an average of only 1 out of 10 young people telling an adult).

  • Why Feeding Your Baby Peanuts Sooner May Prevent Allergies

    Over the past couple of decades, recommendations for introducing peanuts to children have shifted dramatically. After recommendations in 2000 were made to delay introduction to high-risk infants until age 3, peanut and other food allergies have continued to increase significantly. 

  • The miraculous gift that saved Cameron's life

    Caroline believes in miracles. She believes in miracles because her son, Cameron, is a living, breathing example of a miracle, and she cherishes him every, single day.

  • The vaccine schedule is safe and effective

    Pediatricians often hear from parents that they are worried about giving too many vaccines at one time and “overloading the immune system” of their infant. As a result, parents ask to “spread the vaccines out more.” As pediatricians, we know that the vaccine schedule outlined by the Centers for Disease Control and Prevention (CDC) and recommended by nearly all pediatricians is safe and effective. We don’t understand how some rogue physicians and some well-meaning, but ignorant public figures can contradict good science and suggest that the vaccine schedule that we use is unsafe.

    All scientific evidence says that the vaccine schedule

    is indeed safe and very effective.

    Many people draw the conclusion that it must be dangerous to give vaccines all at once. But in fact, that could not be further from the truth. There are very specific reasons that we use each vaccine the way that we do, both when they are started, and how and when they are repeated. What I will give you in this post and in subsequent posts is hopefully a clear, understandable explanation of the design of the CDC’s recommended immunization schedule.

    The Hepatitis B Vaccine

    The hepatitis B vaccine is the one immunization that we routinely give as soon as a baby is born. This is for two reasons. First, it works that early. Newborns’ immune systems are already up and running and are able to respond to the hepatitis B vaccine and make antibodies right away. This is a very fortunate thing, as many of our vaccines don’t work in a newborn body. What we know about hepatitis B is that almost all cases in children are caused by spread from an infected mom during birth. Many moms who are carriers of hepatitis B are missed during pregnancy or in the hospital, either due to lack of prenatal care, lab error, or lack of communication. The amazing thing is that the one dose of hepatitis B vaccine, if given right after birth, is essentially perfect in preventing infection of the newborn. The birth dose of hepatitis B vaccine saves lives every day. The other nice thing about that vaccine is that there are essentially no relevant side effects, not even fever or discomfort.

    The Two-Month Wellness Visit

    We start our next routine vaccines at the two-month wellness visit. When we immunize we want to be sure that enough of mom’s antibodies are out of the newborn’s system and that the newborn’s immune system has matured enough to respond to our vaccines. We know that in the first month or more, some of the vaccines don’t work well yet. However, by six to eight weeks they work very well; this is why the DTaP, Polio, HIB, rotavirus, and pneumococcal vaccine series start when they do.

    This is NOT because the immunizations would

    “overwhelm” the immune system if given earlier.

    They just would not be effective.

    Of note, the most common and relevant side effects of the vaccines given to infants are a little bit of diarrhea or throw-up from the rotavirus vaccine, and maybe a little fever, fussiness, or local reaction in the thigh muscle for the others.

    The MMR Vaccine Controversy

    The MMR (measles, mumps and rubella) vaccine is one that has received a lot of attention since it was wrongly accused of causing autism.

    In fact, vaccines have clearly and repeatedly been shown

    not to cause autism or other developmental disabilities.

    And yet, many parents still believe that we wait to give the MMR until a year of age because it might be harmful if given earlier. They then wonder if waiting even longer might be even better. The problem is that the younger you are when you get the measles, the sicker you get and the more likely you are to die. Our goal with the MMR is to protect small children as young as we possibly can, and to reduce the spread of disease in our communities.

  • Is 36 seconds enough time to talk about sex?

    A new study published in JAMA Pediatrics shows that doctors are spending an average of 36 seconds talking to teenagers about sex, that is if they talk about it at all. One-third of teenagers receiving a yearly check-up didn’t have any mention of sexual health or development.

  • Get to know Dr. Jeffery Johnson, pediatric nephrologist at the Hewell Kids’ Kidney Center

    The Hewell Kids' Kidney Center at Arnold Palmer Hospital oftentimes becomes a home-away-from-home for many children needing outpatient dialysis treatment in Central Florida. The Hewell Kids' Kidney Center cares for children who have been diagnosed with with kidney-related disease such as end-stage kidney disease and obesity-related kidney disorders, as well as those who have undergone a kidney transplant. The team consists of several pediatric nephrologists, nurse practitioners, renal nurses, nutritionists, and social workers. The team recently welcomed it's newest member, Dr. Jeffery Johnson, pediatric nephrologist, in June of this year. Get to know Dr. Johnson in the Q & A below!

    Where did you grow up?

    I grew up all over since my dad was in the Air Force. We finally settled in Ohio when I was in high school and then I moved to California in my adult years. I had lived in Los Angeles, CA for the past 14 years before moving to Orlando.

    Where did you go to school?

    For my undergraduate I went to Washington University in St. Louis, MO and then attended Case Western Reserve School of Medicine in Cleveland, OH for medical school.

    What did you want to be when you were a little kid?

    I wanted to be a soccer player, even though I was horrible! I didn’t know I wanted to go into the field of medicine until halfway through college. I thought I wanted to do medical research, but after I started doing it I realized it wasn’t for me. With medicine, there is something new every day, which keeps me going.

    What was your first job?

    I worked in a games department at a local amusement park. It was a lot of fun. I worked there in high school and through my first year of college.

    What are your hobbies?

    I run a lot – almost every day. Today I’ll be running eight miles. I like to scuba dive and travel. Bali was probably my most favorite place I’ve traveled to so far.

    What is your favorite sports team?

    The Cincinnati Bengals even they break my heart every year!

    How did you get into pediatric nephrology?

    It was when I did a pediatric nephrology rotation as part of my medical training that I knew that was what I wanted to do – it was very interesting to me.

    How did you know you wanted to work with kids?

    It was probably after my second or third month of working in the adult emergency room that I felt called to work in pediatrics. My mom and sister are both elementary school teachers, so I’ve spent most of my life being around and working with kids.

    When did you start at Arnold Palmer Hospital and what is it like working at the Hewell Kids’ Kidney Center?

    I moved to Orlando for this job and have been here since June 2014. One of the things I love about working here is the team that I am a part of. Everyone is fun and easy to work with. We usually all eat lunch together. It’s like a family here, which is evident in how we care for our patients. We take a team approach in being able to provide comprehensive care to our patients, and everyone is usually on the same page as far as what the protocol should be and what the treatment plan should look like.

    What is it like working with the whole family and not just the patient?

    It’s a fine balance, because I always try to acknowledge and engage the child while also working with the parents and families. But it’s something that I really enjoy. It might not always be an easy day at work, but being able to care for kids and knowing that I am helping them is a great feeling.

    What is one piece of advice that you always communicate to families and patients?

    I think one of the most important things in our patient population is for them to be taking their medicine. In our transplant population, most of them are on an immunosuppressant, and if they don’t take their medication for a few days, they could end up losing their kidney or having recurrent kidney disease. It’s important for me that they understand the importance of taking their medicine and that the family ensures that they will follow through with the treatment plan at home.

    What would you say has been your greatest accomplishment?

    I would say it was when I took over the dialysis unit at Children’s Hospital of Los Angeles. I had to basically redo the unit and start over from scratch, building it from the ground up.

    What is one thing that patients and families wouldn’t otherwise know about you?

    I want families to know that I am honest with them, whether I have good or bad news to share. I would want my physician to be honest with me, so I try and do the same for our families.

    Click here to learn more about the Kids’ Kidney Center at Arnold Palmer Hospital

  • What to expect at your child's therapy evaluation

    Your child has been referred to Occupational Therapy, Physical Therapy or Speech Therapy. So, what's next? First of all, don't dread this appointment. Therapists can be a wealth of information and you will leave that first appointment with some useful tools. Part of a therapist’s job is to share valuable information with you about your child- both their strengths and weaknesses. Their job is to help your child reach their maximum potential and equip you to be an expert about your child’s abilities. This is a good thing.

    For All Evaluations

    Bring your child in comfortable clothing that allow full movement Make sure they are well rested Bring any specific equipment they use such as walkers, splints, or communication devices Be prepared to share concerns you or your doctor may have Provide a list of their medications Be prepared to leave for part of the session if asked (so that therapist can build rapport and see how your child works on their own)

    What to bring for Feeding Concerns

    A hungry kiddo Food you’re sure your child will eat Food you have tried to give your child but they haven’t accepted A drink your child typically accepts: bottle, sippy cup, straw cup, etc. A list of their allergies or recent notes from any specialists

    What to Bring for School Related Concerns

    A copy of their 504 Plan, IEP, Behavior Contract or Health Plan A letter from the teacher expressing any specific concerns (if possible) A sample of their written work from class (if this is a concern) Report a from the school psychologist or therapist (if it’s available)

    During the Evaluation

    Let the therapist take the lead but feel free to comment if you feel your child is not showing their full potential. Be as specific as possible. Remember, you are the expert on your child and the therapist is getting a one-time snapshot. Any information on how your child typically functions is very much appreciated. During the evaluation, your therapists will gather valuable information on how your child responds- or doesn't respond- to certain tasks. The therapist is likely to approach your child in a specific way to achieve a desired outcome. For this reason, resist the urge to help your child complete tasks presented. Remember, therapists are looking to build rapport with your little one and form a partnership with you to ensure your child’s success. They’ll definitely let you know if they need you to jump in and help out.

    After your Evaluation

    Ask the therapist for their professional opinion on what strengths they observe in your child and what areas of concern they have. Would they recommend referrals to other professionals or further testing? If therapy is recommended, how often will they need to be seen to achieve their goals? What skills does the therapist see your child achieving through their intervention? How much work at home will be required to achieve these results? Although most of the recommendations will come during your child’s treatment sessions, you can still leave the evaluation equipped with something beneficial for your child. Ask for a few suggestions on what you can work on at home while you await your first therapy session. Therapists want to build your child’s skills and maximize their strengths so they’ll have great suggestions for toys and fun activities to help your child achieve their goals.

  • Like mother, like child: How mom’s activity level influences the little ones

    One of the many memories I have as a child is going to the gym with my mom, and while she worked out, I got to hang out in childcare. And boy, I did not like it! Knowing this, my mom would often let me sit on the couch in the entryway where she could keep an eye on me while I colored or read books. The gym my mom was a member of was extremely family-oriented and my parents had become friends with the owner – hence, the only way I was able to weasel my way out of childcare, opting for the cozy leather couch instead. Even though I hated being there at the time and was so bored, I realize looking back that by doing this, my mom was setting a positive example for me and what living a healthy lifestyle looks like. Fast-forward to today, and one of my biggest passions in life is health and fitness – and I credit those many (dreaded) trips to the gym to instilling this passion in me at such a young age.

  • Why W-sitting might be a cause for concern

    Chances are if you’re reading this, you have probably heard the term “W-sitting” which is why you’d like to know more. If it’s new to you, and you have little ones in your family then you are probably going to come across it at some point. It usually comes up when someone is speaking to a child and might sound something like this, “Please fix your legs and stop W-Sitting.” Ouch. First of all what does that mean and how could it possibly matter how my child chooses to sit? I hope this post will give you a quick snapshot of this issue.