TakeHomePediatrics Newsletter

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Asthma affects nearly 6 million children in the US. The main rescue medication, albuterol, comes in nebulizer and inhaler form. The nebulized version has been on the short supply list since 2022 but worsened recently since one manufacturer stopped producing it. Inhalers are still available. Few tips for those with asthma is to monitor and avoid triggers, call you doctor's office if you are out of medication, monitor use and if using more then twice a week, see your doctor to ensure starting a controller/preventative medication. It is extremely important to establish an Asthma Action Plan with your provider so you have a guideline on when to use preventative medication, when to use rescue medication and when to seek medical attention.

Could there really be truth to the saying, "Healthy gut is a healthy body." A large international research grant has been given to study children's gut health since there is evidence that how the gut develops affects child's growth, immune system and cognitive development in the future. This study will analyze the gut of children 5 yrs and younger, at a microscopic level and see effects of genetics and the environment (such as heavy metals) to the gut. What an exciting endeavor that may positively affect our future health!

Concerns about mental health in our children has continued to linger even after the pandemic. While depression and suicide were increasing prior to the pandemic, the affects worsened with isolation, lack of activity, stress of online learning, falling sick or seeing family or friends sick or die from COVID. Of course, other contributors to the increase is social media and the inundation of negative news. What can we do as a society to help our young children? There are initiatives to educate and support our schools as they are a big foundation for our kids. More resources are needed as many patients wait months to be seen by mental health providers. Primary care providers have taken courses and training to start supporting patients. Please seek medical attention if you notice your adolescent becoming withdrawn and not engaging with friends or family, staying in the bedroom most of the day, eating less or overeating, crying more, grades in school dropping, not sleeping well- these may be signs of depression.

Childhood obesity also increased in prevalence since the COVID pandemic. American Academy of Pediatrics released new guidelines for obesity treatment in Jan 2023. Almost 15 million children are considered obese in the US. Obesity in childhood makes way for increased risk of diabetes, high blood pressure, cardiovascular disease and mental health issues. First line of therapy for obesity has always been education, lifestyle changes with nutrition and physical activity. However, now for the first time, medication and surgery are in the mix as studies have show success in adolescents. These new recommendations stem from the discovery that genetics and hormones do play a role in obesity. In addition, our environment has become conducive to obesity, especially in working households that need less expensive fast food. There are 4 medications that are approved for 12yrs and older. Surgery is recommended in severe obesity in 13 yrs and older. There still is more work to be done because the access to these treatments are still expensive.

Don't forget to check out these recalls. Just click on each to get more details... Portable Power Bank, Crib Bumper, Bottle and Pacifier Accessories, Nursing Hoodies, Cooler

Dear Dr. Bhumi, Do teens/young adults females who run regularly need higher levels of ferritin for optimal performance? My ferritin is at 30, but I still feel weak.

Dear Reader, first lets talk about what is ferritin? It is a protein that stores iron in your cells. Low levels may indicate iron deficiency. Normal levels for adolescents and adults are 25-300. Given such a wide range, it is important to evaluate other markers that may diagnose iron deficiency- complete blood count (CBC)- this will look at red blood cell count, shape and size; transferrin ( this transports the ferritin from gut to cells), TIBC (total iron binding capacity). Now to answer your question- there is a two part answer. First, do athletes need more vitamins and minerals then the average person. There is no consensus to the answer but there is no proven need for increased amount. However, maintaining a healthy diet that ensures good vitamin levels is important. Vitamins that are involved in energy production include thiamin, vitamin B6 and Niacin. For performance and energy levels ensure you get enough Vitamin B12, iron, and Vitamin A. With activity levels impacting bones, make sure Vitamin D and calcium levels are normal. Remember, you don't need higher levels, just normal. Since your ferritin level is on the low end of normal, you may want to discuss iron supplementation with your doctor depending on your other labwork. Second part of the question entails making sure we rule out any other causes of tiredness or weakness. Remember, most common and important factor is getting enough sleep and good quality sleep, enough water intake, and healthy nutritional diet with sufficient calories. Other causes for tiredness/weakness can be ruled out by your doctor- Explore sleep quality ( no snoring or apnea), autoimmune disease (especially if symptoms of joint pain or swelling, rashes, fevers), thyroid disease, recent mono infection or other acute infections affecting the liver, allergies, being overweight or underweight, stress, depression or anxiety, and certain medications. Lastly, if you are not feeling tired but more of muscle weakness then ensure you are incorporating strength training in your regimen and not just running, ensure adequate caloric intake, and talk to your doctor about ruling out any muscular diseases and autoimmune diseases. Keep up the good work with your physical activity!

Send your questions here! Dear Dr. Bhumi

Click here to see a video on Scoliosis with Dr. Bhumi.

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