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New guidelines for GERD: What every pediatrician should know

clinical guidelines for GERD

Spitting up is a normal occurrence for young infants — as long as a child is growing well and not developing other problems, such as breathing difficulties, the problem will resolve on its own without treatment. But how can you determine if your patient has gastroesophageal reflux disease (GERD)? New expert guidelines draw on the latest research findings to help advise specialists and primary care providers on the evaluation and treatment of GERD in infants and children.

Rachel Rosen, MD, MPH, director of the Aerodigestive Center at Boston Children’s Hospital, served as lead author on these international guidelines.

“Over the last 10 years, there has been an explosion of advances not only in our understanding the pathophysiology of reflux, but also in the diagnostic tests to evaluate reflux and problems that masquerade as reflux,” she explains. “In prior guidelines, the focus was on acid-related disease and treatment with acid suppression. We now know that gastroesophageal reflux, particularly in infants and young children, is often non-acidic, so treating patients with acid suppression is ineffective. This is a true paradigm shift.” Here, Rosen shares some highlights that every pediatrician should know.

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Children with congenital hand differences exhibit better emotional health

congenital hand differences Notes blog lead image

Approximately one in every thousand children is born with a congenital upper limb difference. These conditions can include complete or partial absence of a limb, failure of fingers to separate, duplication of fingers, overgrowth and undergrowth as well as constriction ring syndrome. Along with the physical differences this presents as a child grows and develops, there can also be mental and emotional challenges.

A recent study led by Donald S. Bae, MD, a pediatric orthopedic surgeon in the Hand and Upper Extremity Program at Boston Children’s Orthopedics and Sports Medicine Center, evaluated the physical level of function as well as the mental and emotional health of almost 600 children with congenital upper limb differences. Ultimately, the study found that while children with congenital hand differences had decreased upper limb function, they have better peer relationships and positive emotional states compared to population norms.

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Assessing pain in our tiniest patients

Babies in the NICU can feel pain

An infant rests in the Neonatal Intensive Care Unit (NICU), recovering from elective surgery. She’s crying, but is it because the procedure caused pain, because she’s hungry or for some other reason? An inspired research collaboration between the NICU and the Division of Pain Medicine at Boston Children’s Hospital is determined to find out. …Read More

Vaping: The new face of nicotine

Vaping-e-cigarettes

E-cigarettes. Vapes. E-hookahs. Cigalikes. It’s hard to keep up with the terminology but one thing is certain: teens are using these products at an alarming rate.

According to a 2016 Report of the Surgeon General, the number of high school students who have used e-cigarettes increased 900 percent between 2011 and 2015 — making e-cigarettes the most common type of tobacco product used by teens and young adults.

“These products pose an interesting public health question because they’ve been accepted by some in the public health community as a useful smoking cessation tool,” says Sharon Levy, MD, MPH, director of the Adolescent Substance Abuse Program (ASAP) at Boston Children’s Hospital.

Levy says that framing e-cigarettes in this way has led to mixed messages — and potential health risks. …Read More