1001 Healthy Baby Answers

ISBN: 9781402219740

By: Gary Morchower

Published: 05/01/2008

1001 Healthy Baby Answers collects the most common questions parents have about a variety of different ailments, along with expert answers detailing everything the parent needs to know.

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What parent hasn’t had the experience of leaving a pediatrician’s office more confused than when they came in? Or gotten home and thought of 10 questions they should have asked after the diagnosis was given?

Dr. Morchower understands. As a board-certified pediatrician and President of the Pediatric Society of Greater Dallas, he has helped thousands of parents by helping keep their child healthy.

1001 Healthy Baby Answers collects the most common questions parents have about a variety of different ailments, along with expert answers detailing everything the parent needs to know.

Perfect for parents to have on hand and in the home for quick reference, this essential guide will alleviate fears and give parents the right advice to help their child feel better . . . without another trip to the doctor’s.

Find authoritative answers to your questions about:
- Jaundice
- Asthma
- Seizures
- Chicken pox
- Anemia
- Rapid breathing
- Autism
- Croup
- Pneumonia
- Diabetes
- Heart murmurs
- Sleep disorders
And much, much more.

“A must for a parent or grandparent caring for a sick child.”
—Carden Johnston, MD, past president, American Academy of Pediatrics

About the Author

Dr. Gary C. Morchower M.D.

Dr. Gary Morchower is a board-certified pediatrician and President of the Pediatric Society of Greater Dallas. A graduate of Tulane University and Tulane Medical School, he has received numerous honors and awards, including the Robert Moore M.D. Outstanding Teaching Award. He lives in Dallas, Texas.

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Table of Contents
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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
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
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
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
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

Excerpt
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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 pediatrician’s office, only to realize tha...

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 pediatrician’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 may change doctors as often as their employers change insurance plans. This can result in a game of “musical doctors,” with the parent having to adapt to the styles, routines, and personalities of different doctors all too frequently.

Also, in the past, parents often relied on a helpful nurse to explain everything after the doctor left the room and to answer questions that came up. Now, nurses are just as busy as doctors, and it’s less likely that you’ll develop any better relationship with them, as you may see different nurses or nurse assistants at every office visit.

Perhaps the biggest change, though, is the length of the office visit. Doctors nowadays are more pressed for time than ever. Once they’ve established the appropriate diagnosis, they frequently deliver the treatment plan quickly, bombarding the parent with information. Consequently, the parent leaves the office with only a vague idea of what is going on.

Adding to the problem is that parents are often leery of questioning medical advice. Questions that should be asked often don’t get asked. As a result, important areas of concern are not addressed—or worse, the treatment is misinterpreted or misunderstood.

Too often, I’ve heard parents say, “You mean he was supposed to finish the medicine even though he was feeling better?” or “I didn’t know I was supposed to bring my daughter back for a follow-up” or “I thought I was to continue giving my child only clear liquids until the diarrhea had completely cleared.” The consequences of these misunderstandings may be minimal in some cases, but other times the result is a recurrence of the original illness or the development of a complication.

I wrote this book because I don’t want that to happen to your child. I want you to feel like you can ask your doctor questions even if you think they might seem silly. It’s critical that you understand your child’s condition fully and that you have all the information you need to help your child get better.

The book is organized into three parts. The first deals with conditions specific to newborns—those that show up at birth or in the hospital. The second consists of the most common conditions experienced by children and adolescents. Finally, there is a section on questions to ask when choosing a pediatrician. The book is organized alphabetically by disease, with a series of questions listed for each condition. You don’t need to become a physician to help your child get better, you just need to know the right questions to ask.

In addition, there are reference answers listed for each question to supplement information obtained from your own pediatrician. The reference answers are supplied by the pediatric specialist physicians at Medical City Children’s Hospital in Dallas, Texas. Each of these specialists is an expert in his or her own medical field. The answers provided are an excellent source of information to better understand your child’s condition and how to manage it.

I hope you’ll bring this book with you to every office visit. Use it after the doctor has given you the diagnosis and formal treatment plan. If you forget or get distracted, call back later, book in hand, and use the questions to fill in the blanks to your understanding. Take plenty of notes, so along with the specialist reference answers, you will have something to refer to when the memory of the doctor’s verbal commentaries has faded.

How will your doctor feel about your newfound inquisitiveness? Many parents worry that questions such as these might irritate or alienate the doctor. I couldn’t disagree more! When it comes to caring for your sick child, you have every right to ask whatever questions you need to clarify what the illness is and how you should treat it.

In reality, the questions in this book and the reference answers provided are meant to complement the office visit and will only enhance the effectiveness of what the doctor is trying to accomplish. Most pediatricians want parents to leave with as much knowledge about the child’s illness as possible. Indeed, it is my sincere hope that this book will enhance the relationship between you and your child’s doctor and that you have many productive and healthy visits down the road for years to come.