TakeHomePediatrics Newsletter

Hope all our readers are ready for some great information!  Before we begin, I want to dedicate this newsletter to my father who instilled in me the love of reading and constantly learning.  Even though I hated waking up in the morning, my father and I read the newspaper together every weekday morning at 6 am.  As I continue to learn, I now would love to share my knowledge with those who also enjoy the art of learning!  Thank you dad!

Did you know...

There is a rise of a drug resistant stomach bug known as Shigella.  It can cause mild to severe diarrhea, abdominal pain, fever and vomiting.  Majority of cases are self limiting, but severe cases may need to be treated with antibiotics to decrease the severity of symptoms in high risk patients.  However, this strain is resistant to antibiotics!

Eating disorders significantly impact our youth.  One in 5 children are now at risk for an eating disorder.  This includes anorexia, bulimia, and restrictive food intake. Our society has placed emphasis on thinness; and with the progression of technology, people now alter their images on social media.  Most of these body images are nearly impossible to attain, yet our youth are exposed to it and encouraged to attain it with certain diets and certain exercises.  As parents and medical providers, we need to reassure our children that healthy lifestyle is important and every human is given a different body shape.  We should focus on whole food eating with less processed and sugary foods for health reasons, not for body image.  We should encourage a healthy amount of physical activity - about 60 minutes daily but not excessive exercise.  Let's be vigilante of signs that may indicate risk. Does your child seem to focus on body image and dissatisfaction on the way he/she/they looks? Does your child refuse meals or only takes few bites at meal time? Does your child exercise excessively? Does your child seem to binge eat and then go to the bathroom?  Unfortunately, these eating disorders can lead to many complications such as electrolyte imbalances, nutritional deficiencies, menstrual irregularities, dental enamel erosion, esophageal tears, dehydration, depression, anxiety, and more.  If you have concerns about your child, please seek medical evaluation.

Eczema or atopic dermatitis is a common issue in infancy and childhood.  Mild eczema consists of small areas of dry, red, itchy skin.  Moderate and severe cases have more significant itching and discomfort, interfering with daily activity and even sleep. The goal of treatment is to improve symptoms as there is no cure, just control.  A  recent study showed an increased link to fatigue.  This is definitely a symptom that is not appreciated by most.  Most common therapy for mild eczema is good moisturizing, with hypoallergenic cream or ointment at least 2-3 times a day.  You can bathe your child daily but pat dry and apply moisturizer immediately. It is important to avoid triggers such as heat, and fragrances or irritants in soaps and detergents.  If linked to environmental allergens like dust and pollen, control is important in those cases.  There is controversary about food allergies and eczema. We do not recommend food elimination unless allergy testing is positive for those foods.  For more severe eczema, additional measures include topical steroids to the red flared areas (start with low potency and increase per instruction of your doctor), use of wet wraps at night, prescription eczema creams, and antihistamine for itching.  

Concussions are a real concern in today's sports focused world.  What is a concussion? It is the onset of neurological symptoms which are usually short term, sustained after a head injury. Structural brain injury is ruled out.  Protocols for concussion have been established to help recreational, competitive and high school sports team handle the injury.  Each team should have a written protocol. The goal of concussion treatment is to avoid further head injury, so the player is immediately removed from the game, examined to rule out more severe brain injury, then physical activity restricted and cognitive rest recommended. The recommendation is rest for 24-48 hours and then gradual return to play depending on resolution of symptoms. Gradual means light activity first and ultimately complete return.  If a child returning to play has worsening neurological symptoms, previous restrictions are reinstated.  Returning to cognitive activity also should be gradual with limiting screen use and reading. As soon as the child can tolerate light activity of 30-40 minutes, they can return to school.  Common symptoms of post concussion are headache, dizziness, nausea, and sleep disturbance. Most of the guidance can be given by your primary care provider with an initial checkup after the injury and then follow-up every 1-2 days until asymptomatic.   Specialist referral will be needed for complicated cases.

Don't forget to check out these recalls. Just click on each to get more details... High Chair, Bookcase, Air Fryer, Candle

Dear Dr. Bhumi, can pre-puberty or puberty hormone fluctuation cause hair loss or hair thinning in adolescent girls?

Dear Reader, what a great question. First lets talk about what is normal.  Most people lose 50-100 strands daily and new hair grows in those follicles.  Losing more than that or having patches of hair loss is abnormal. Patches are commonly caused by fungal or bacterial infection of the scalp, behavioral pulling of hair (trichotillomania), traction such as wearing hair tight in braids or ponytail, other diseases of hair shaft or skin, and inflammatory disease of the scalp.  Hair thinning or falling out diffusely can be attributed to autoimmune diseases such as thyroid and lupus , iron deficiency, malnutrition causing other vitamin deficiencies, and even stress and acute illnesses.  Lastly, sexual hormones can be linked to hair loss when there is an imbalance- higher androgen, which means testosterone, leads to hair loss of scalp. Lower estrogen also has the same effects, so this is more likely in menopause not puberty.  Polycystic ovary disease can cause hair loss in adolescents since androgens levels are higher.  Problem with pinpointing cause of hair loss in adolescent girls is that it is likely multifactorial- stress, poor nutrition, use of hair products, hair styling that causes traction, and use of certain medications.  Your doctor can run some labs at least to rule out autoimmune disease, iron or vitamin deficiencies, diabetes, and polycystic ovary disease. We cannot forget medications that can cause hair loss- chemotherapy drugs, ADHD medications, acne medications, arthritis medications and some heart medications.  Hope this helps!

Send your questions here!  Dear Dr. Bhumi

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

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