Glossary

Acne

While seldom a serious problem in itself, acne and other dermatological problems experienced by children can have psychosocial (problems with their friends, their confidence, their self-image) impacts that far outweigh the physical problems brought on by this ailment. A host of medications exists for the treatment of acne in particular and your physician can help you pick the best one for your child's situation or refer you to a dermatologist for further evaluation.

Asthma

Asthma is a chronic condition in which one's airways constrict (close) in response to a something and then respond to a bronchodilator (airway opening) medication (called the 'bronchodilator response'). This common disorder can cause distress at home or at school and proper treatment is key to mitigating acute exacerbations. Albuterol inhalers and patient education are two key components of treating childhood asthma and allergy testing can be done to determine the specific triggers if so desired.

Autoimmune disorders

The body's immune system is a great tool for fighting off infections that might otherwise make us sick. Sometimes, unfortunately, our immune system can be incorrectly programmed to fight parts of our body. Such diseases are collectively called autoimmune disorders. These are chronic diseases which are treated by suppressing the body's immune system or in other cases, targeting the part of the immune system that is attacking the body. While many of these diseases cannot be cured, their symptoms can be alleviated through medication and lifestyle modifications. It's also important to note that the Kansas Newborn Screen tests for several autoimmune diseases and the NIH has developed ACT sheets - plans to follow if an autoimmune disorder has been detected or is suspected in a newborn.

Bullying

While bullying is a fairly common occurrence in many schools, proper parenting can help mitigate the stress and anxiety it may cause. If your child is being bullied, they may exhibit excess anxiety, stress, a fear of going to school, or being abnormally withdrawn or unwilling to talk about school. Often a simply solution to this problem doesn't exist - rather, the problem must be approached from multiple angles for the best chance of success. Branching out for new friends via extracurricular activities, enrolling in afterschool programs, or enhancing communication of bullying episodes with parents are all ideas to help cope with bullying. Ultimately, each situation will be different, but communicating with both your child and your child's doctor makes sure everyone is on the same page and your child can get the care they need.

  • NIH Medline Plus resource on bullying: http://www.nlm.nih.gov/medlineplus/bullying.html
  • StopBullying.gov homepage (Federal government resource regarding bullying): http://www.stopbullying.gov/index.html      

Celiac disease/Celiac sprue

Celiac disease (also known as 'sprue') is an autoimmune disorder in which the immune system attacks part of ingested (eaten) gluten. Gluten is a component of many grains including wheat (both white and whole wheat), durum flour, graham flour, triticale, kamut, semolina, and spelt. Avoiding foods containing these ingredients can help those affected by celiac disease avoid the symptoms of the disease including nausea, bloating, abdominal pain, and fatigue.

Cryptorchidism

During a male's development, his testicles descent from the abdomen to the scrotum through an opening called the inguinal canal. When this process occurs normally, both testicles descend into the scrotum and are held in place by several anatomic anchors. Sometimes, problems occur with the descent of the testicles which cause one or both of the testicles to remain above and outside of the scrotum. This is called cryptorchidism and is relatively common (~1% of newborn males and adults). While not life-threatening, this condition conveys an increased risk of infertility as well as testicular cancer.

Depression

Depression is one of the most common mental illnesses experienced by adolescence and some studies suggest up to 40% of teens experience some form of depression in their lives. The definition of depression is fairly broad and involves the occurrence of at least one episode of major depression. An episode of major depression involves thoughts of guilt or worthlessness, excessively sleeping, loss of appetite, changes in weight, or excessive fatigue. While pharmacologic solutions exist, psychotherapy or a combination of medication and psychotherapy (so-called combination therapy) has also proved valuable in the treatment of depression.

Developmental Disorders

Developmental or intellectual disorders are characterized by difficulty with adaptive functioning or intellectual functioning that arises before 18 years of age. These disorders can further be divided into problems specific to adaptive functioning (socializing, taking care of oneself, language and communication skills) or intellectual functioning (learning, abstraction reasoning, reasonable judgment). While these disorders all fall somewhere on a continuum, it is estimated that roughly 1% of the entire human population is affected in some way by a developmental disorder.

Diabetes

Diabetes is a group of conditions in which the body has difficulty properly dealing with sugar from food. Sometimes the condition is present from birth and sometimes the condition is acquired. Whatever the cause, lifestyle modifications and proper pharmaceutical intervention can help those with diabetes lead a more normal life. Unfortunately, the increasing prevalence of obesity (being very overweight) seems to be related to the increasing prevalence of a certain type of diabetes, known as type 2 diabetes. Another type of diabetes, called gestational diabetes, can occur when a mother is pregnant due to the physiologic stress of pregnancy. To reduce one's risk of acquiring diabetes, proper diet and exercise are extremely important during all stages of life.

Dysplasia of Hips

After birth, a child's hips aren't totally developed. This is generally fine because the child isn't walking yet and the joint still has time to develop. Rarely, though, a child's hip may not develop properly and this is known as hip dysplasia. Through early identification and intervention with a special splint, long term complications of this can be avoided.

Head Circumference

While many will identify height and weight as important factors to measure during a doctor's visit, few realize that monitoring a child's head circumference can provide clues as to whether or not their child is developing properly. Head circumference is generally done up until the child is two years old and is measured with a tape measure around a specific ring of the head.

Heart Disease, Congenital

The heart is a very complicated organ involving muscle, connective tissue, and nerves. Sometimes, the heart doesn't develop completely and holes can be left between chambers (collectively known as septal defects) or valves can be stiff or open incompletely (known as stenosis or insufficiency). These problems can be heard with a stethoscope during a routine well-child visit. If caught early, many problems can be surgically corrected so no problems arise from the defect later in the child's life.

Hypospadias

The development of the penis in developing males is a very complicated, coordinated process that can sometimes encounter problems. One common problem that can occur is known as hypospadias which is when the opening to the penis is formed on the underside of the penis rather than at the tip. This problem can be corrected surgically by using the foreskin to remodel the hole in the penis from the underside to the tip. With this being said, a careful newborn examination is key to identifying this problem and subsequently saving the foreskin for hypospadias correcting surgery if this problem is present.

Infantile colic

Colic can be defined as excessive crying in a newborn, specifically crying for no reason for 3 or more hours on 3 or more days of the week in a child less than 3 months old. While this can be distressing, it typically resolves itself over time and the diagnosis is typically made after the child's crying fits resolve in a retrospective diagnosis.

Obesity

While malnutrition is still a problem in many countries, the U.S. actually has a bigger problem with childhood obesity. A sedentary lifestyle along with overconsumption of processed sugars can lead to accumulation of body fat in excess of what the body would normally store. The consequences of obesity range from mild to very severe: small things like joint pain, increased fatigability, and exercise intolerance may appear at first but more severe problems like diabetes, malignancies (cancer), and heart disease have been shown to exist with higher prevalence among obese populations. For these (among other) reasons, a healthy diet and lifestyle should be a high priority in children's lives.

Oral Health

Establishing regular brushing and flossing habits is key to maintaining good overall health. Seeing a dentist for regular checkups every six months is a great way to educate your child and yourself on the benefits of proper oral hygiene. Good oral health improves quality of life and can help reduce dental costs from the later effects of poor hygiene. Generally, after children develop good brushing habits, they should brush twice a day with fluoride toothpaste and be monitored each 6 months for signs of tooth decay or other dental or periodontal injury by a dentist.

Prematurity

A premature child is defined as a child that is born before 37 weeks of gestation (being inside the mother). If delivered before 37 weeks, the child's body may not be completely developed and can present a very risky delivery. In general, the longer the pregnancy is allowed to continue the greater the chance of survival of the baby. With this being said, ~90% of children born at 28 weeks survive, so prematurity can still be dealt with albeit often with long-term consequences including delayed physical development or even intellectual/cognitive disabilities. •         NIH MedlinePlus information on prematurity and high risk pregnancies: http://www.nlm.nih.gov/medlineplus/ency/article/001562.htm •         CDC resource on prematurity & national prematurity month: http://www.cdc.gov/features/prematurebirth/ •        

Prenatal care

Over a century old, prenatal care is one of the most common things that a woman seeks medical attention for. In fact, the median number of prenatal visits for women in 2001 was 12.3, and a large portion of the pregnant population had 17 or more visits. During a prenatal visit, a family physician or obstetrician will screen you and your fetus for problems that can complicate the pregnancy or delivery including gestational hypertension or diabetes, maternal blood problems (Rh disease of the newborn, various anemia), problems with the fetus's development, or problems that the fetus may be causing the mother.

  • Prenatal care is very cost effective - in fact, one study done in Missouri suggested that for every $1 of prenatal care administered, the mother saved roughly $1.49 in postpartum (after giving birth to the child) costs.

Pyloric stenosis

Sometimes, a child's stomach can have difficulty passing food through it. This can occur for many reasons, but one common reason is called pyloric stenosis, or when the exit hole of the stomach to the small intestines is too small. The most obvious symptom of this disorder is projectile vomiting with no bile in it ('non-bilious'). Because the infant isn't keeping any food down, they may be extra fussy or hungry. In any case, this problem can be surgically corrected and the child can lead a normal life should the issue be caught early enough.

Puberty

Puberty refers to the time in a child's life when they begin to grow physically (up to 17-18%) as well as sexually (in terms of sex characteristics like pubic hair and breast tissue and psychosocial interactions like dating). Females generally undergo puberty before males; however, the average age of puberty's onset has been decreasing over the past 30 years. Puberty and the changes associated with it can be very disconcerting and stressful for the child involved and for this reason it's important to be cognizant of the child's situation as to not cause them undue anxiety.

Second-hand smoke

While many cities have banned cigarette smoking from public places, second-hand smoke can still present a problem if a child has a parent that smokes around them. Second-hand smoke can be just as harmful if not more so than first-hand smoke due to its composition (it contains more toxic compounds than does first-hand smoke) and the number of non-smokers it can affect at the same time. Educating parents about going outside to smoke is a great first step in alleviating the second-hand smoke problem experienced by children (helping the parent quit would be even better), but this doesn't take into account the toxins from smoke that are deposited on surfaces around the smoker that the child could later be exposed to (so-called third-hand smoke).

Sick-child visit

Everyone gets sick at some point during their childhood and during these times it's appropriate to visit the doctor to evaluate the acute (or short term) illness. It should be noted, however, that if a child is sick a physician can't evaluate them in their normal, everyday state. With this being said, it makes sense that a physician cannot perform a well-child visit during a sick-visit - it's simply impossible.

Strabismus

Strabismus is a common ocular (eye) condition in which one or both eyes have difficulty aligning. The alignment can come and go with fatigue or be present all the time. Strabismus is present in 2-4% of newborns and can sometimes resolve spontaneously. Strabismus can be caused by many different things, some of which are life-threatening, so it's very important to have any suspected strabismus checked out by your doctor. The goals of strabismus, ultimately, are correction of ocular (eye) alignment and binocularity (use of both eyes regularly).

STIs

As teens undergo puberty, sexual education is very important for the teen to understand the responsibility and the risks associated with sexual behavior. One common risk associated with sexual activity is that of sexually transmitted infections. These include bacterial infections like chlamydia and gonorrhea as well as viral infections like HPV (Human papilloma virus) and can have long term consequences if left untreated. As teens enter sexual maturity, it's important as a parent to allow for private discussions between your teen and his or her doctor so the teen doesn't feel pressured to answer a certain way in your presence and can establish an honest rapport with his or her doctor. If an STI is suspected or detected, it should be dealt with plainly (with the emphasis being on education rather than shame or guilt) with the teen's partners and local health department being notified in addition to properly treating the disease itself. Sexuality is a normal part of development and fostering a nurturing environment helps teens feel safe and confident talking to parents and guardians regarding issues of sexual health.

Temper Tantrums

A normal part of a child's development may include temper tantrums. These tantrums may include, crying or screaming, kicking or hitting, thrashing about, breath-holding, or other destructive behaviors involving toys or household objects. Keeping a daily routine is a good way to help avoid such tantrums; however, sometimes they are unavoidable. While it may be difficult, the best thing to do regarding temper tantrums is to ignore the behavior as it is ultimately attention seeking - this will, in time, decrease the frequency and recurrence of these episodes.

Toilet training

Toilet training can be a frustrating part of parenting. A child may not be ready to begin toilet training until 30 months of age and parents shouldn't rush into the training before the child becomes interested in such bathroom activities. When the child is ready, the parents may initiate training by removing the child's diaper and placing them on a training potty at a time the child is likely to urinate/defecate (such as after drinking or eating). Accidents will occur and the child shouldn't be punished or shamed for such occurrences. Conversely, a successful trip to the bathroom should be rewarded. As with any childrearing issue, consistence and a feeling of security in the home should help the training situation.

Vaccination

A vaccination is a controlled exposure to a something that can cause disease (usually a bacteria or a virus) with the possible goals being:

  • Control the disruptive symptoms of the disease (ex. Reducing number of days a child is out with chicken pox)
  • Eliminate the disease from a defined geographic area or region (or sometimes just reduce the sustained transmission of the disease)
  • Eradicate the disease by making everyone in the population immune to the virus, thereby taking away any possibly that the disease causing organism can live or be spread. So far, the only example of an eradicated disease is smallpox.
  • Vaccines are a relatively cheap way to make a big impact with respect to public health. In the U.S. alone, routine vaccination of children have saved an estimated 33,000 premature deaths, prevented 14 million illnesses, and saved the U.S. roughly $33 billion in indirect societal savings (not to mention $9 billion in direct medical costs) (data from 2012).
  • CDC Childhood vaccination information/schedules: http://www.cdc.gov/vaccines/schedules/
  • Basics and Common Questions: What you need to know about vaccinations'

Well-adult visit

After age 21, routine healthy check-ups are known as well-adult visits (as opposed to well-child visits for those under 21).

Didn't find what you were looking for in this glossary? Have a look at Children's Mercy Hospital's 'Pediatric Advisor' tool for more help: http://www.childrensmercy.org/PediatricAdvisor/  

References

  1. Taras HL. Taras H.L. Chapter 9. Children. In: Feldman MD, Christensen JF. Feldman M.D., Christensen J.F. eds. Behavioral Medicine: A Guide for Clinical Practice, 3e. New York, NY: McGraw-Hill; 2008. http://accessmedicine.mhmedical.com/content.aspx?bookid=373&Sectionid=39732006. Accessed June 26, 2014.
  2. Srinivasan S, Middleton DB. Srinivasan S, Middleton D.B. Chapter 1. Well Child Care. In: South-Paul JE, Matheny SC, Lewis EL. South-Paul J.E., Matheny S.C., Lewis E.L. eds. CURRENT Diagnosis & Treatment in Family Medicine, 3e. New York, NY: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com/content.aspx?bookid=377&Sectionid=40349391. Accessed June 26, 2014.
  3. Goldson E, Reynolds A. Goldson E, Reynolds A Chapter 3. Child Development & Behavior. In: Hay WW, Jr, Levin MJ, Deterding RR, Abzug MJ, Sondheimer JM. Hay W.W., Jr, Levin M.J., Deterding R.R., Abzug M.J., Sondheimer J.M. eds. CURRENT Diagnosis & Treatment: Pediatrics, 21e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=497&Sectionid=40851670. Accessed June 26, 2014.
  4. http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/A-Pediatricians-Training.aspx
  5. Schuchat A, Jackson L.A. (2012). Chapter 122. Immunization Principles and Vaccine Use. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L, Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e. Retrieved July 03, 2014 from http://accessmedicine.mhmedical.com/content.aspx?bookid=331&Sectionid=40726864.
  6. Diamond B, Lipsky P.E. (2012). Chapter 318. Autoimmunity and Autoimmune Diseases. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L, Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e.Retrieved July 10, 2014 from http://accessmedicine.mhmedical.com/content.aspx?bookid+331&Sectionid=40727119
Last modified: Mar 23, 2015
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