Health & Fitness

Pediatric Medicine: Helping Our Kids Feel Their Best

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Parents have plenty to worry about — sickness, injuries, disease — but thankfully our region’s health systems are an ever-present partner in keeping our youngsters healthy. Discover a few ways our local hospitals are staying engaged.

Dr. Luan Elezi of Beloit Health System and NorthPointe Health Clinic in Roscoe, Ill., works with a young patient.

Dr. Luan Elezi of Beloit Health System and NorthPointe Health Clinic in Roscoe, Ill., works with a young patient.

The bad news is that today’s parents face more challenges, more tough decisions and more threats to their children’s health and well-being than ever before.

The good news is that concerned, proactive parents have a wealth of assistance in dealing with both the day-to-day and sudden issues that arise.

Medical systems and centers recognize the growing need not only for advanced diagnosis and treatment but also for education, instruction, resourcing and prescreening. Integral to these health care organizations are medical staff members who not only treat young patients but also address prevention and symptom recognition.

Vaccinations

Immunization is one of the most effective tools used to prevent disease. In fact, it has proven so effective that some of the illnesses that plagued mankind for centuries have been eradicated through the consistent use of vaccinations. This wasn’t always the case.

Decades ago, when one child in a family came down with measles, mumps or other childhood diseases, it was common to have them sleep with their siblings so that they all got the disease together. Dr. Robert Geller, a board-certified infectious disease specialist with FHN in Freeport describes this as natural immunization. Since then, a battery of vaccinations has been developed to eliminate many of those infectious diseases.

The Center for Disease Control and Prevention (CDC) recommends childhood immunization for chickenpox, diphtheria, influenza, hepatitis A and B, pertussis (whooping cough), polio, pneumonia, rotavirus (which causes severe diarrhea), tetanus and the MMR combination that prevent measles, mumps and rubella.

“Most doctors know whether or not their patients have allergic reactions to certain vaccinations and how to address the issues,” says Geller.

Geller has observed that parents who once would have accepted standard vaccination schedules for their children without question now express concerns and ask questions about the benefits versus risks.

“Look at it this way,” Geller says. “Overwhelming evidence points to MMR as safe. But should the child not receive the MMR immunization, the risk that he or she will get measles that could escalate into pneumonia or encephalitis is possible. In this case, the benefit definitely outweighs any perceived risk.”

Another serious consideration is the spread of illness from unvaccinated children to vulnerable children and adults.

“In 2009, a number of pregnant women died from the H1N1 flu,” Geller says. “This is why we give pregnant women flu shots. According to the CDC, flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. Pregnant women with the flu also have a greater chance of seeing serious problems develop in their unborn babies, and may experience premature labor and delivery. Moreover, the CDC reports that flu shots have not been shown to cause harm to pregnant women or their babies.”

Geller emphasizes that risk-versus-benefit values are firmly rooted in evidence-based medicine.

“For example, health professionals are promoting the human papilloma virus (HPV) vaccination for girls and boys in their early teens, 11 to 13. This helps to lower the risk of cervical cancer in adult women.”

So effective are the majority of standard vaccinations that health professionals are looking forward to having access to protection against such deadly diseases as malaria, tuberculosis and AIDS.

“We’re still not there yet, but there’s hope,” Geller says. “For me, one of the most horrible aspects of deciding not to vaccinate is that these diseases can and do kill children.”

A new Illinois law requires health providers to sign a form stating that they educated parents or guardians on the risks of not vaccinating their children.

“Why take chances on a child’s succumbing to a preventable disease?” Geller says. “And why risk that child passing the illness on to someone who could suffer worse consequences?”

Autism

While there are no vaccines to prevent diseases like cancer, diabetes, spina bifida, cerebral palsy, autism or cystic fibrosis, parents can rely on specialists to help them when symptoms of early childhood diseases begin to manifest.

There’s no known single cause for autism spectrum disorder, according to the Autism Society of America (ASA), but it’s generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape of the brain in children with autism when compared to neuro-typical children.

Researchers are investigating a number of theories, including links to genetics and medical problems.

Researchers are searching for irregular segments of genetic code that children with autism may have inherited. It appears that some children are born with a susceptibility to autism, but researchers have not yet identified a single “trigger” that causes it to develop.

Dr. Avi Domnitz-Gebet, D.O., a child neurologist with Rockford Health System, says parents should become concerned when their toddler exhibits certain symptoms.

“If a child is not talking by the age of 2 and has difficulty communicating in any form, including pointing at or looking at things in order to get the parents’ attention, the parents should take the child to his or her primary doctor or pediatrician for autism screening,” Domnitz-Gebet says. “Other signs to watch for include the child’s preference to play alone to the point where he or she does not want the parents or others to interfere. The child might become upset if toys are moved from where he or she put them. Eye contact or demonstrations of affection are often avoided.”

Domnitz-Gebet says screening should start with the primary care physician. Parents should discuss concerns about rigid character traits and sensory issues at routine doctor visits. Autistic children thrive in structured environments and often become frustrated when there’s a change in their routine.

“Just the drive to school or the grocery store can be traumatic for an autistic child,” she explains. “If the parent takes a different route or encounters construction, the child may become agitated. Then there is sensory overload. Loud noises or conversation may be upsetting, such as an ambulance passing by. Visual and textural senses are often too acute for the child to bear. Autistic children also tend to have very strong food preferences.”

In extreme cases, a 10-year-old child may not be potty-trained, because he or she does not like how wiping feels.
And while some of these reactions can occur in healthy children, autistic children may react in much more extreme ways. Sensory overloads can result in what Domnitz-Gebet describes as a “meltdown” that can happen any place, including in public.

“Onlookers don’t understand,” she says. “They see what they believe is a spoiled child throwing a temper tantrum. I would like to see a lot more tolerance and understanding not only for the child, but also for what the parent has to go through.”

Early diagnosis is essential to the child’s future, notes Domnitz-Gebet.

“The parents are referred to me for a clinical assessment,” she says. “We must make a determination whether we are dealing with autism or a host of other possibilities, including attention deficit disorder, learning disorders, sensory integration disorder or something else. The most vital part of the evaluation is close observation.”

And that, Domnitz-Gebet points out, basically determines what therapies the child will need, during as many as 40 hours of clinical treatment weekly by a board-certified behavioral analyst, speech therapist and occupational therapist. The therapies focus on teaching children how to communicate their needs and emotions; children also work on sensory issues and social skills.

Domnitz-Gebet urges parents to learn the techniques the therapist uses during sessions in order to provide consistency at home so the child can master the concepts.

It’s very important for a child’s parents to commit to learning techniques that are applicable in various day-to-day situations. Such techniques can help to curb a meltdown, help a child to engage in a new activity, or teach a child not be afraid to go to a new store.

“This is so important because autistic children can be aggressive at times, and it’s important for parents to be able to keep their child and others around them safe,” Domnitz-Gebet says. “Autistic children look exactly like every other child, and it’s often hard for outsiders to sympathize or comprehend what a family goes through on a daily basis.”

A Healthy Weight

When you consider all the diseases that children encounter and parents fear, it may seem as if the weight of a child should be the least of their concerns. Not so, says Dr. Luan Elezi, a board-certified family medicine physician with Beloit Health System and NorthPointe Health Clinic in Roscoe, Ill.

“Children have growth cycles during which they grow rapidly, then the rate of growth slows,” Elezi says. “Up until age 2 to 4, we can usually accept a little bit of overweight as what is affectionately called ‘baby fat.’ Then they grow taller and more proportionate.”

Because Elezi normally sees children on an annual basis, it can be challenging to recognize an ongoing weight problem. However, when he sees it, he acts.

“The most important thing I do is talk to the child’s parents about my concerns,” Elezi says. “While we make the diagnosis of being overweight based on standardized growth charts, we know that a child prone to being overweight does not necessarily have to become overweight.”

External influences are mostly to blame for this phenomenon, including family eating and activity habits, a lack of school physical education classes, community and social pressures, and the fast food industry.

“Children spend an average of 7.5 hours daily in front of screens, instead of playing and getting involved in crafts or other activities,” Elezi says. “They eat at fast-food restaurants far too often. I recommend to parents that they should limit meals in these restaurants to around once a month.”

Instead of eating fast food, buy healthy food, he says.

“By keeping a wide variety of healthful, fresh fruits, vegetables, lean meats and quality dairy products on hand, they encourage their children to make wiser choices,” Elezi adds. “Because of economic constraints, however, many families rely on canned foods, which are laden with salt, sugar and other unhealthy additives.”

Elezi points out that just one can of regular soda provides 19 teaspoons of sugar, more than a full day’s allotment.

“Just as parents warn their children of the dangers of smoking cigarettes and drinking alcoholic beverages, they need to talk to them about eating right,” he says. “It’s as important as making sure they are buckled into seat belts while in the car.”

Elezi believes schools have short-changed children by de-emphasizing physical education, until recently.
“Plus, we involve our children in competitive sports, often for a full year at a time, making it more like a job,” he says. “I tell parents to just let them go out and have fun.”

The good news is that the incidence of being overweight in American children is declining, thanks to such programs as President Obama’s “Move More” campaign and a physical literacy campaign by the Centers for Disease Control (CDC).

“Still, it’s scary how much we still don’t know about the dynamics of being overweight in children,” Elezi adds. “There are so many new, good programs out there, but I believe that the physical literacy program is among the best. I would like to see more schools implement the CDC’s program and bring in more trained physical education teachers.”

A child’s healthy weight is important to healthy development, Elezi says. Overweight children not only face the stigmas of peer pressure and bullying, but also are more injury-prone.

“Fat cells never go away,” he says. “They shrink, when the child experiences a growth spurt or loses weight, but they’re always there, signaling the brain that they’re hungry. We don’t necessarily put the child on a diet as much as we try to prevent them from gaining weight and allow them to grow into the weight they are.”

The exception, Elezi says, is when he sees a child who is morbidly overweight. Then, action must be taken or the child will grow up facing the liklihood of developing diabetes, high blood pressure and heart disease.

“When this happens, I work with the parents to monitor the child’s weight through checkups every three months,” he says. “I don’t charge for weigh-ins, and the child knows I will be waiting and hoping to see improvements. In these cases, I strive to be more of a coach and mentor than a doctor.”

When you consider all of the challenges parents already face while raising their children today, such as discouraging drug and alcohol use, handling peer pressure and bullying, and coping with violence in schools and neighborhoods, the thought of seeing your child suffer a debilitating disease may feel overwhelming.

Fortunately, a wealth of information, advice and medical support is close at hand. Vigilance and awareness combined with medical astuteness are the tools parents need to safeguard their children’s health and help them grow into healthy, happy adults.

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