The 1001 Healthy Baby Answers: Pediatricians' Answers to All the Questions You Didn't Know to Ask

594 Pages·1998·0.72 MB·English

by  Gary Morchower

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1001
Healthy
Baby
Answers
Pediatricians’ Answers to All the
Questions You Didn’t Know to Ask
Gary C. Morchower, MD
1001HealthyBabyAns.qxd:Layout 1 4/11/08 5:07 PM Page ii
Copyright © 2008 by Gary C. Morchower, MD
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quotations embodied in critical articles or reviews—without permission in writing from its publisher,
Sourcebooks, Inc.
DISCLAIMER: The contents of this book and all the information and suggestions provided herein is
intended as an aid to help parents communicate effectively and informatively with their physicians. It
is not intended as, nor should it ever be used or considered as, a substitute for a direct, personal on-site
clinical evaluation of the child by the child’s doctor or the relevant health care provider.
This publication is designed to provide accurate and authoritative information in regard to the subject
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ices of a competent professional person should be sought.—From a Declaration of Principles Jointly
Adopted by a Committee of the American Bar Association and a Committee of Publishers and Associations
This book is not intended as a substitute for medical advice from a qualified physician. The intent of
this book is to provide accurate general information in regard to the subject matter covered. If medical
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Library of Congress Cataloging-in-Publication Data
Morchower, Gary C.
The healthy baby handbook : expert answers to all the questions you didn’t know to ask / Gary C.
Morchower.
ISBN: 978-1-4022-1974-0
1. Children—Diseases--Handbooks, manuals, etc. 2. Children--Health and hygiene—Handbooks,
manuals, etc. I. Title.
RJ61.M7275 2008
618.92'02--dc22
2007051004
Printed and bound in the United States of America.
BG 10 9 8 7 6 5 4 3 2 1
1001HealthyBabyAns.qxd:Layout 1 4/11/08 9:24 AM Page iii
Dedication
To my children, Andrew and Karen, and to
my wife, Bette, the best mom of them all.
Acknowledgments
My sincere thanks to Lynda Pieper for her outstanding assistance in the
electronic editing of this book.
1001HealthyBabyAns.qxd:Layout 1 4/11/08 9:24 AM Page iv
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
Contributing Specialists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii
Part I: Common Conditions in Newborns . . . . . . . . . . . . . . . . .1
ARM PARALYSIS (Brachial Plexus Palsy) . . . . . . . . . . . . . . . . .3
BIRTH DEFECT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
BLOOD INFECTION (Bacterial Sepsis) . . . . . . . . . . . . . . . . . .10
CEPHALOHEMATOMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
CHROMOSOMAL ABNORMALITIES . . . . . . . . . . . . . . . . . .16
CLEFT LIP/CLEFT PALATE . . . . . . . . . . . . . . . . . . . . . . . . . . .20
CLUBFOOT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
HEART DISEASE—CONGENITAL . . . . . . . . . . . . . . . . . . . .29
HYPOGLYCEMIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
HYPOSPADIAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
INTESTINAL INFLAMMATION (Necrotizing Enterocolitis) .40
JAUNDICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
KIDNEY ENLARGEMENT (Hydronephrosis) . . . . . . . . . . . . .48
LUNG RUPTURE (Pneumothorax or Pneumomediastinum) . .52
MECONIUM ASPIRATION . . . . . . . . . . . . . . . . . . . . . . . . . .56
PNEUMONIA—NEONATAL . . . . . . . . . . . . . . . . . . . . . . . . .61
RAPID BREATHING (Respiratory Distress Syndrome/
Transient Tachypnea) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
SEIZURES—NEONATAL . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
UNDESCENDED TESTICLE(S) . . . . . . . . . . . . . . . . . . . . . . .73
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Contents v
Part II: Common Conditions in Children and Adolescents . . .77
ACNE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
ANEMIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85
APPENDICITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
ASTHMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
ATHLETE’S FOOT (Tinea Pedis) . . . . . . . . . . . . . . . . . . . . . . .99
ATTENTION DEFICIT HYPERACTIVITY DISORDER
(ADHD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
AUTISM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
BACK PAIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
BEDWETTING (Enuresis) . . . . . . . . . . . . . . . . . . . . . . . . . . .119
BELLYACHES (Recurrent Abdominal Pain) . . . . . . . . . . . . .123
BLADDER INFECTION (Cystitis) . . . . . . . . . . . . . . . . . . . . .127
BLOOD IN URINE (Hematuria) . . . . . . . . . . . . . . . . . . . . . .132
BLOOD VESSEL BIRTHMARK (Hemangioma) . . . . . . . . . .136
BOIL (Carbuncle) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139
BREAST ENLARGEMENT IN MALES (Gynecomastia) . . .142
BREATH-HOLDING SPELLS . . . . . . . . . . . . . . . . . . . . . . . .145
BRONCHIOLITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148
BRONCHITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152
BRUISING (Excessive) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
CHICKEN POX (Varicella) . . . . . . . . . . . . . . . . . . . . . . . . . .158
COLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162
CONSTIPATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
CORNEAL ABRASION . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
CRADLE CAP (Seborrheic Dermatitis) . . . . . . . . . . . . . . . . .173
CRANIOSYNOSTOSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
CROHN’S DISEASE (Regional Ileitis) . . . . . . . . . . . . . . . . . .181
CROUP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
CUTS (Requiring Stitches) . . . . . . . . . . . . . . . . . . . . . . . . . . .190
DEVELOPMENTAL DELAY . . . . . . . . . . . . . . . . . . . . . . . . . .194
DIABETES (Mellitus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198
DIAPER RASH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203
DIARRHEA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
DYSPLASIA (DEVELOPMENTAL) OF THE HIP . . . . . . . . .211
EAR INFECTION—MIDDLE EAR (Otitis Media) . . . . . . . .214
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vi 1001 Healthy Baby Answers
EAR INFECTION—OUTER EAR (Otitis Externa) . . . . . . . .220
EAR WAX IMPACTION (Cerumen Impaction) . . . . . . . . . .224
EATING DISORDERS (e.g., Bulimia, Anorexia) . . . . . . . . . .227
ECZEMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
EYE INFECTION (Conjunctivitis) . . . . . . . . . . . . . . . . . . . . .241
EYELID GLAND SWELLING (Chalazion) . . . . . . . . . . . . . .244
EYE MUSCLE IMBALANCE (Strabismus) . . . . . . . . . . . . . .247
FAILURE TO THRIVE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249
FAINTING (Syncope) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253
FIFTH DISEASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256
FLU (Influenza) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259
FOOD ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
FOREIGN BODY ASPIRATION . . . . . . . . . . . . . . . . . . . . . .268
GANGLION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272
HAIR LOSS (Alopecia) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275
HAND, FOOT, AND MOUTH SYNDROME . . . . . . . . . . . .282
HAY FEVER (Allergic Rhinitis) . . . . . . . . . . . . . . . . . . . . . . .285
HEADACHES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290
HEAD ASYMMETRY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .294
HEAD LICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299
HEARING DEFICIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303
HEART MURMUR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .307
HEART RHYTHM IRREGULARITIES (Arrhythmias) . . . . .311
HEPATITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .314
HERNIA (Inguinal) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .319
HIP JOINT INFLAMMATION (Synovitis) . . . . . . . . . . . . . .324
HIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .329
HYDROCELE (of the Testes) . . . . . . . . . . . . . . . . . . . . . . . . .334
HYPERTENSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .338
HYPOTHYROIDISM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .345
INGROWN TOENAIL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349
INSECT BITE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .352
ITP (Idiopathic Thrombocytopenia Purpura) . . . . . . . . . . . . .355
KIDNEY INFECTION (Pyelonephritis) . . . . . . . . . . . . . . . . .359
LARGE HEAD (Macrocephaly) . . . . . . . . . . . . . . . . . . . . . . .363
LARYNGITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .366
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Contents vii
LEARNING DIFFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . .371
LEG AND FOOT STRUCTURAL DISORDERS
(e.g., Bowlegs, Knock-Knees, Pigeon-Toes, Flatfeet) . . . . . .375
LYME DISEASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .380
LYMPH NODE ENLARGEMENT (Lymphadenopathy) . . . . .384
MENINGITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .388
MENSTRUATION—ONSET (Menarche) . . . . . . . . . . . . . . .392
MOLE (Pigmented Nevus) . . . . . . . . . . . . . . . . . . . . . . . . . . .396
MONONUCLEOSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401
MOOD DISORDER (e.g., Depression, Anxiety, Mania) . . . . .405
MOUTH INFECTION (Stomatitis) . . . . . . . . . . . . . . . . . . . .409
NECK MUSCLE CONTRACTION (Torticollis) . . . . . . . . . .413
NEPHRITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .416
NEPHROTIC SYNDROME . . . . . . . . . . . . . . . . . . . . . . . . . .421
NOSEBLEEDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .427
OBESITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .432
PIN WORMS (Enterobiasis) . . . . . . . . . . . . . . . . . . . . . . . . . .436
PITYRIASIS ROSEA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .439
PNEUMONIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .442
POISON IVY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .446
PRECOCIOUS PUBERTY . . . . . . . . . . . . . . . . . . . . . . . . . . .449
PSORIASIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .453
PYLORIC STENOSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .458
RHEUMATOID ARTHRITIS—JUVENILE . . . . . . . . . . . . . .462
RINGWORM OF BODY (Tinea Corporis) . . . . . . . . . . . . . . .467
RINGWORM OF SCALP (Tinea Capitus) . . . . . . . . . . . . . . .470
ROSEOLA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .475
SCABIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .478
SCHOOL PHOBIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .481
SCOLIOSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .484
SEIZURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .491
SEXUAL ABUSE (Suspected) . . . . . . . . . . . . . . . . . . . . . . . .495
SEXUALLY TRANSMITTED INFECTIONS (STIs)
(e.g., Gonorrhea, Syphilis, Herpes) . . . . . . . . . . . . . . . . . . .498
SHORT STATURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .501
SINUSITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .505
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viii 1001 Healthy Baby Answers
SKIN INFECTION (Impetigo and Cellulitis) . . . . . . . . . . . . .512
SLEEP DISORDERS (e.g., Night Terrors, Nightmares,
Difficulty Getting to Sleep, Sleepwalking) . . . . . . . . . . . . .515
SMALL HEAD (Microcephaly) . . . . . . . . . . . . . . . . . . . . . . .519
SPITTING UP (Gastroesophageal Reflux—GER) . . . . . . . . .521
SPRAIN OF EXTREMITY (e.g., Toe, Ankle, Knee,
Finger, Wrist, Elbow) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .527
STYE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .532
TEAR DUCT OBSTRUCTION (Nasolacrimal Obstruction) 534
THRUSH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .537
TIC DISORDERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .541
TONSILLITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .544
TORSION OF THE TESTICLES . . . . . . . . . . . . . . . . . . . . . .550
UMBILICAL CORD STUMP INFLAMMATION
(Umbilical Granuloma) . . . . . . . . . . . . . . . . . . . . . . . . . . . .553
UMBILICAL HERNIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .556
VOMITING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .559
Part III: Choosing a Pediatrician . . . . . . . . . . . . . . . . . . . . .563
Afterword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .566
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .567
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .577
About Medical City Children’s Hospital . . . . . . . . . . . . . . . . . . .578
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Introduction
Definition:
A Message to Every Parent Who’s Ever
Taken a Child to the Doctor
How many times have you returned with your child from the pedia-
trician’s office, only to realize that you remember little of what was
said to you during the visit? Perhaps it was because your mind was
numb from staying up late taking care of your sick child, or possibly
you were so worried about your child’s illness that you could only
focus on a few things that were discussed during the visit. Maybe you
just accept that your doctor is knowledgeable, and the only issue of
concern to you now is that your child gets better.
If any of these scenarios sound familiar, you are not alone. In my
thirty-seven years of practice, I’ve seen medicine change dramatically,
and that has impacted the type, length, and tenor of the pediatric
office visit. Traditionally, families stayed with the same pediatrician
throughout childhood, so they became comfortable with each other
over the years. Now, with the emergence of managed care, families