Articles


After 10 years, our pediatrician-writer bids his readers farewell

By Dr. Alan Freshman

In the medical business, until the clock strikes midnight on June 30 of the last day of school, the medical student remains at the bottom of the food chain. He is used mainly for scut work—tasks the attending (The Big Boss), the fellow (The Academic) or the resident (The Day-to-Day Boss) would not deign to do.

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By Dr. Alan Freshman

Dear Dr. Lanny: The more I read on the Web about immunizations, the more concerned I get about the assault of all of those chemicals on my 7-week-old baby’s system. I’m considering asking my pediatrician to adjust the schedule of shots so my child doesn’t get so many at a time. I realize you think vaccines are great, but can’t they work just fine on a more extended schedule, while my baby builds up his own natural immunities and gets many from my breast milk?

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By Dr. Alan Freshman

Dear Dr. Lanny: I am a lifelong vegetarian and my husband is not. Our 4-year-old daughter eats meat, among other things, but I’d like to start switching her to a vegetarian diet at home. My husband is not convinced that it’s healthy for a growing child to not eat fish, chicken, etc. He might be more persuaded if a medical professional weighed in. What do you think?

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By Dr. Alan Freshman

Dear Dr. Lanny: At our last well-child visit, the pediatrician said he heard a heart murmur. The doctor said we didn’t need to worry about it, but now I wonder if I should get my 6-year-old daughter checked out by a specialist. What exactly is a heart murmur? Is it worth paying for a cardiologist to do more testing and examine her?

 

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By Dr. Alan Freshman

Dear Dr. Lanny: My 6-month-old baby boy is 27 inches long and weighs 18 pounds, at least according to his most recent measurements at the pediatrician. (Actually, I’m not entirely certain about the length because he didn’t really cooperate to stretch out to be measured.) Are those numbers appropriate for his age? Is there anything I can do to help him reach a healthy size?

 

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By Dr. Alan Freshman

Dear Dr. Lanny: My 2-year-old is such a picky eater. She subsists on macaroni and cheese, yogurt, milk (see a theme here?) and, for some reason, broccoli. I introduce her to new vegetables and fruits, but it gets frustrating to have her refuse to eat anything unfamiliar over and over and over. Do I need to worry about whether she’s getting enough of the right things to eat?

 

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By Dr. Alan Freshman

Dear Dr. Lanny:
How can I tell when my child’s cold has become a bacterial infection and might require antibiotics? I tend to think a little sniffling and coughing is nothing to worry about, but the last time I ignored my kid’s cold it didn’t go away and he left the doctor’s office with a prescription. And I felt guilty for not realizing he was “really” sick.

 

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By Dr. Alan Freshman

Dear Dr. Lanny:
I am highly allergic to bee stings. I don’t know if my children are, too. And I’m worried about how to prepare if they get stung at some point. What do I need to do to be ready?

 

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Dr. Alan Freshman

Dear Dr. Lanny:

What do you think of the “autism diet”? I’ve heard some children benefit a lot from eliminating gluten and casein from their meals. I’ve also read that diet doesn’t affect children on the autism spectrum one way or the other. What do you think?

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By Dr. Alan Freshman

Dear Dr. Lanny:
My 7-year-old had mononucleosis a few months back, and I had to keep her home for over a week. It took her a few weeks beyond that to recover her normal boundless energy levels. What can you tell me about mono? How does a little kid get what’s known as “the kissing disease”?

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Dr. Alan Freshman

Q: My child just turned 5 and I’m not sure when I should take him for an exam with an ophthalmologist. Is there a set suggested time for this? And does it matter if he sees an ophthalmologist or an optometrist? (And what’s the difference, by the way?)

 

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By Dr. Alan Freshman

Dear Dr. Lanny:
My 3-year-old godson just received a diagnosis of ringworm. I am pregnant with my first child. Do I need to avoid my godson? Is ringworm a worm? How do you catch it? Can you tell me how keep all the various rashes straight when my baby is born; I want to know what to watch out for.

 

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By Dr. Alan Freshman

Q: My 10-year-old son plays football. I’ve been reading a lot in the past year about head injuries in sports, especially football, and I’ve become concerned. What do I need to do to make sure my boy is as safe as possible while pursuing this sport? What should I watch out for and how should I respond if he does get a hard knock to the head?

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By Dr. Alan Freshman

Dear Dr. Lanny: It seems like my daughter just began sleeping through the night and she started getting nightmares. She’s 3. She screams and yells and sometimes wakes up upset. I, selfishly, would like to be sound asleep at 2 a.m. myself, but lately that doesn’t seem possible. Is there anything I can do?

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By Dr. Alan Freshman

Dear Dr. Lanny: I am a busy mother of two children, a 7-month-old baby girl and a 3-year-old boy. It seems as if not a week goes by that I don’t get an alarmed e-mail from a caring friend, urging me to avoid some kind of plastic, whether for bottles or sippy cups (bisphenol-A, or BPA, for example), or even containers labeled “microwave safe” for heating food for my kids. I never know how seriously to take all of this concern. I did toss out bottles and cups that I suspected contained BPA. On the other hand, I’ve read many cans are lined with possibly harmful plastics, and I can’t afford to toss out all of our food. What do you suggest?

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By Dr. Alan Freshman

Q: Dear Dr. Lanny: Can you talk about child proofing? My little guy is almost ready to crawl, and I wonder what a reasonable approach is to making our small, cluttered house as safe as possible. I want my son to be able to explore, but I don’t want him to have a terrible fall.

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What you need to know about children’s hearing


By Dr. Alan Freshman

Screening of newborn babies for hearing loss did not exist two decades ago. Today, two to four of every 1,000 newborns have some hearing problem and half of those have no identifiable risk factors at birth, such as family history of deafness or viral infection during pregnancy.

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By Dr. Alan Freshman

Dear Dr. Lanny: My baby girl is due for a blood draw to test for lead at her 12-month doctor’s visit. I am not looking forward to this. Why do they have to take blood? I’m also little concerned about the results because we live in an old house. (Our daughter seems to be developing normally, according to her pediatrician.) Can you tell me about the lead test?

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By Dr. Alan Freshman

Dear Dr. Lanny: I have two kids, one in school and one in daycare, and in the winter, especially, they’re always getting colds or flu. You seem pretty skeptical about alternative medicine—but what am I supposed to do when I’m not supposed to give cough medicines to my children and there seem to be a lot of other over-the-counter medicines that doctors frown on? How can I treat coughs, congestion, aches and other common symptoms? (And, yes, we try to wash hands and use hand sanitizer as often as is practical, given the children’s ages, but they still get sick.)

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Breast is best, but artificial milk isn’t so bad either

By DR. Alan Freshman

WARNING: This column is loaded with discussion about baby formula … and it’s not all bad!

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By Dr. Alan Freshman

Dear Dr. Lanny: High cholesterol and heart disease run in my family. My father died of a heart attack at age 52. I’m 37 and taking statins on doctor’s orders. What is your opinion of cholesterol-lowering drugs for kids? My son is 10—and active and healthy. I’d like him to stay that way.

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By Dr. Alan Freshman

Dear Dr. Lanny: My daughter is 12 and has to get yet another physical, this time for a sports team. What’s the purpose of all of these doctor’s visits when a child is clearly healthy?

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Sensible precautions diminish warm-weather hazards

By Dr. Alan Freshman

It’s summertime. Be afraid. Be very afraid!

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By Dr. Alan Freshman

Dear Dr. Lanny: I get really freaked out when I read about antibiotic-resistant bacterial infections like MRSA in the newspaper. What can I do to make sure that my kids don’t pick up a resistant bug? I know antibacterial soaps can help breed “superbugs,” and overuse of antibiotics is bad. But sometimes we really need antibiotics, right? Like for strep or a bad ear infection? I’d be interested in your advice because the recommendations I read can be really confusing.

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By Dr. Alan Freshman

Dear Dr. Lanny:
I have been told my younger son, age 2, has autism spectrum disorder. I wonder if I should seek out a new pediatrician, someone who treats a lot of autistic kids, or stick with our current doctor, who has been seeing my little boy and my older boy, age 6 (and “neurotypical”), since they were babies. What do you think?

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Dear Dr. Lanny:

Q: I buy expensive, special toddler toothpaste for my 18-month-old because he hasn’t learned how to spit yet (and he loves the berry-flavored one), and fluoride, I thought, is bad for kids to ingest in large quantities. When can I start giving my child a regular fluoride toothpaste that I don’t have to pay through the nose for?

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By Dr. Alan Freshman

Dear Dr. Lanny:

I’m pregnant with my first child and have heard that a newborn in the hospital needs to get all kinds of shots and things within hours of being born. I’ve been following a very careful diet, avoiding additives in my food, and I’m hoping to have a natural childbirth with no medications. So I wonder how necessary all these injections are and if they pose risks to my infant. Why do new babies need vitamin K, eye drops and a hepatitis B inoculation right after birth? Are there any other standard care measures that I should know about?

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By Dr. Alan Freshman

Dear Dr. Lanny: How do I know when it is necessary to keep my child home sick from school? I know she should stay home if she has a fever, but what about sniffles or stomachache?

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By Dr. Alan Freshman

Dear Dr. Lanny: I’m scheduled for a visit with a new pediatrician for my son, age 4, and daughter, age 8. I don’t want to start off on the wrong foot. What are some of your pet peeves that we ought to avoid? What are some things we ought to do to lay groundwork for a good relationship with the new doctor?

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By Dr. Alan Freshman

Dear Dr. Lanny:

How do you know when your child is depressed—not just with “the blues,” but something that won’t go away and that needs to be treated? My 11-year-old son has started sleeping a lot. He never seems to talk to his friends anymore.
How is clinical depression treated in children? Do we have to find a child psychiatrist (which I’ve heard are pretty rare in this area)?

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By Dr. Alan Freshman

Dear Dr. Lanny: My 5-year-old is starting kindergarten in September, and I’ve heard about lice outbreaks at his elementary school before. No outbreaks I knew of at his preschool—but now I worry that he’ll be exposed to lice in the new place. Any advice on what to do if he happens to bring any of those things home? I’m pretty squeamish about the idea of lice, not to mention worried about the time involved in getting them out of our household.

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By Dr. Alan Freshman

Dear Dr. Lanny:
My kids, ages 3 and 6, love petting zoos, the State Fair, farms—anywhere they can get up close to animals. We try to keep the children cleaned up, but sometimes it’s a challenge to wipe off their hands or get them to use hand sanitizer. Do we need to be more careful about letting the kids get in contact with animals?

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By Dr. Alan Freshman

Dear Dr. Lanny:
My 3-year-old daughter has tested positive for a soy allergy. We had been trying to figure out why she seemed to have so much indigestion so often. I’m told we’re lucky: The allergy could be much more severe. Her pediatrician said we need to eliminate from her diet all foods with soy in them, for a year, and then we’ll test again after that. Did you know that soy and soy derivatives are in practically every processed food there is? Can you suggest ways we can cope? Is my daughter likely to outgrow this allergy? (I hope so!)


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By Dr. Alan Freshman

Dear Dr. Lanny:

My daughters, ages 5 and 7, are very active and in and out of the pool all summer long. What value is there in applying sunblock to their skin every time they roll around in the grass or get wet? What type of sunscreen (SPF, etc.) do you recommend? Please don’t tell me to keep them indoors during the sunniest hours; summer vacation is challenging enough without restricting outdoor time, and isn’t some sunlight good for them anyway, especially in mostly overcast Central New York?

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By Dr. Alan Freshman

Dear Dr. Lanny:
My 7-year-old son got a Webkinz animal for his birthday and now he spends an hour a day, maybe two on weekends, in Webkinz World—decorating his virtual beagle’s room or playing games online. He also watches an hour a day of television. All the kids in my son’s class are into Webkinz or Club Penguin, or both, and I don’t want him left out. At the same time, I worry that he might be spending too much time sitting in front of a screen. (By the way, he’s not fat and seems to get plenty of exercise.) What do you think?

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By Dr. Alan Freshman

Dear Dr. Lanny:
Our daughter is 8 years old and still sometimes wets the bed at night. I was a late bed wetter, and I’ve heard this can run in families. We’re going to bring this up with our pediatrician, since the problem is starting to interfere with her being able to go on sleepovers. What kind of options do we have to deal with this? How common is the problem?

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By Dr. Alan Freshman

Dear Dr. Lanny:

Our 8-week-old spits up all the time. I’m beginning to wonder if she’s getting any
formula at all. Could this be esophageal reflux? How do we get her to take in some nutrition?

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By Dr. Alan Freshman

Dear Dr. Lanny:
Our family's pediatrician retired and now we're faced with finding a new one for our sons, ages 4 and 9. It's been such a long time since we had to see a new doctor, I'm at a loss. What questions should I ask and what should I look for in picking a new physician for our boys?

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Asthma (Part 2)

By Dr. Alan Freshman

When last we met, I had completed an answer to a query about diagnosing asthma, but I ran out of space before beginning to touch on treatment.

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By Dr. Alan Freshman

Dear Dr. Lanny:
Last winter my 6-year-old daughter had a cough that seemed to last forever, and from time to time she's made some wheezy noises; they sound like "hee-eeh, hee-eeh." As the soccer season starts, I've started to hear the wheezing sound again. We're wondering if she has asthma. How do we find out, and what do we do if she does have asthma? Is this a lifetime thing?

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By Dr. Alan Freshman

Dear Dr. Lanny:
My 15-year-old son just got a diagnosis of whooping cough from his pediatrician. How is this possible? I thought the Dtap vaccine he got as a kid protected him. Not only that, I've since heard Onondaga County is a hotbed of whooping cough cases. Now I'm wondering if I need to have my 8-year-old son vaccinated. What do you think?

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By Dr. Alan Freshman

Dear Dr. Lanny: My 11-year-old son has told me on a few occasions that his chest hurts. He's pretty active–plays soccer and basketball–and not overweight. Sometimes he complains of pain after he's eaten a big cheeseburger. Other times I can't figure out why he's hurting. He's too young to have heart disease, right? This is a little worrisome because heart problems run in my husband's family.

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By Dr. Alan Freshman

Dear Dr. Lanny:
What’s the right way to handle the discovery of a tick? Last summer my 5-year-old nephew got one while playing in his back yard in DeWitt. It was embedded in his skin and had to be removed surgically. Is Lyme disease a concern in this area, and if so, what do we need to watch out for?

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By Dr. Alan Freshman

Dear Dr. Lanny: A couple of months ago, my 10-year-old daughter seemed to be coming down with a cold, so I gave her echinacea capsules twice a day for four days to boost her immune system. And it worked: She didn’t get a cold. At her next pediatrician’s appointment, I told the doctor about my success with echinacea. The doctor clearly disapproved of herbal supplements and told me they can be very dangerous. I disagree. Do you think I should try to find a pediatrician who is more accepting of alternative medicine?

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By Dr. Alan Freshman

Dear Dr. Lanny: I’ve just had my second child and my pediatrician is recommending a new oral vaccine only for newborns that is supposed to prevent diarrhea, to be given when my daughter is 2 months old. I’m a little concerned about adding yet another vaccine to all that she is already getting. A friend also told me that there could be some scary side effects to this new vaccine. Do you think it’s safe?

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By Dr. Alan Freshman

In February’s column I discussed issues concerning the diagnosis of attention deficit hyperactivity disorder (ADHD). I would like to now focus on treatment options for children with attention deficit disorder (ADD) or ADHD. This is not meant to be an in-depth discussion but rather an overview to give you some sense of comfort when thinking or talking about this topic. Although ADD and ADHD are different entities, they are largely treated the same, and for the purposes of this column I will consider them as one.

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By Dr. Alan Freshman

Dear Dr. Lanny:
My 6-year-old son has been doing poorly in school. His first-grade teacher says he’s easily distracted and disruptive to the other children. She suggested he be evaluated for attention deficit hyperactivity disorder (ADHD). My heart sank when I heard that. What do we do now?

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By Dr. Alan Freshman

Dear Dr. Lanny: My daughter is 14 and has terrible acne. She’s a wonderful young woman with plenty of friends, but she’s getting interested in boys and the pimples make her very self-conscious about her looks. I’ve heard Accutane can make a big improvement but also that it’s got a lot of potentially serious side effects. What is your opinion?

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By Dr. Alan Freshman
Dear Dr. Lanny:

I love getting the kids outside more during warmer weather, but it also seems summer is full of hazards: swimming pools; stinging insects; playground accidents; sunburn; unleashed dogs; etc. What is the most common threat, or injury, you see during summer?


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By Dr. Alan Freshman

Dear Dr. Lanny: What is the difference between an urgent-care center and the emergency room? And how do I know when to go to which?

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