Stories about: Ask the Expert

Retro parenting: Three things we should go back to doing

Children playing in the mud

The world is a different place than it was when I grew up in the 1960s and 1970s. Mostly, that’s a good thing. There are so many ways that technology has made life easier and better, the internet has brought knowledge to our fingertips and connections that span the world — and as a physician, I am grateful for all the life-saving discoveries of the past few decades.

However, when it comes to parenting, not all the changes have been good.

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Managing autoinflammatory diseases in children

Yoga and relaxation can be beneficial to children with autoinflammatory diseases

Autoinflammatory diseases are a group of rare illnesses that cause recurrent episodes of fever and inflammation resulting from inappropriate activation of the immune system. While some have unknown causes, autoinflammatory diseases are often caused by genetic mutations. Symptoms include acute episodes of fever and other symptoms such as joint pain, rash, sores in the mouth, enlarged glands or abdominal pain, depending on their underlying illness.

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Esophageal atresia: Sorting fact from fiction

esophageal atresia

Will a diagnosis of esophageal atresia affect my child’s weight? Are recurrent respiratory infections normal? How long should my child stay on proton-pump inhibitors?

As the patient coordinator for the Esophageal and Airway Treatment Center at Boston Children’s Hospital, Dori Gallagher, RN, fields questions like these every day from patients around the world concerned about their children with esophageal atresia. In this condition, a baby is born without part of the esophagus (the tube that connects the mouth to the stomach). Instead of forming a tube between the mouth and the stomach, the esophagus grows in two separate segments that do not connect. Without a working esophagus, it’s impossible to receive enough nutrition by mouth. Babies with esophageal atresia are also more prone to infections like pneumonia and conditions such as acid reflux.

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Stroke in kids: What’s different?

pediatric stroke
Illustration: Fawn Gracey

Every May, we recognize National Stroke Awareness Month to honor everyone who has experienced a stroke — and to raise awareness of this disease. That awareness is especially important for pediatric stroke, which is more common than you might imagine. “Stroke occurs throughout childhood, from birth through 18 years of age, and more commonly than people think,” says Dr. Michael Rivkin, co-director of the Stroke and Cerebrovascular Center at Boston Children’s Hospital. “In fact, among newborns, its occurrence is very nearly that of its occurrence in older adults.” Here, he shares four facts parents need to know about pediatric stroke — and how it differs from that in adults.

No1
Kids aren’t immune.

Despite the misconception that stroke is a disease of the elderly, anyone can experience one — including infants and children. Babies can even have strokes while they are still in their mother’s womb. All told, strokes occur in an estimated 1 in 2,500 live births and affect nearly 11 out of 100,000 children under age 18 every year. The risk of having one is highest in a child’s first year of life, particularly during the few weeks before and after birth.

No2
Kids can have different risk factors.

Most of us are familiar with the factors that can raise the risk of stroke in adults, such as cardiovascular disease, an irregular heartbeat, obesity, diabetes and smoking. But children are more likely to experience a stroke for different reasons, says Dr. Rivkin. Common risk factors for pediatric stroke include congenital heart disease, blood vessel abnormalities (such as arterial dissection and moyamoya), disorders that increase the blood’s tendency to clot (such as sickle cell disease), infection or inflammation.

No3
Kids can have different symptoms.

In adults, we’ve been taught to look for the most common warning signs — classic symptoms such as facial drooping, arm weakness or numbness and speech difficulties. Although these signs can also be used to help identify the problem in children, kids can exhibit other symptoms as well. Newborns and young children may be extremely sleepy, use only one side of their body and experience seizures. In children and teenagers, severe headaches, vomiting, dizziness and trouble with balance and coordination, as well as seizures, may signal a stroke.

No4
Kids tend to recover better.

Because children’s brains are still developing, they tend to recover better than many adults. Indeed, the problems that result from the stroke (such as weakness and numbness) can often improve over time with therapy. A team approach to pediatric stroke — including child neurologists, hematologists, neurosurgeons, interventional and neuroradiologists, physical and occupational therapists, speech and language therapists, neuropsychologists, educational specialists, and physical and rehabilitation medicine physicians — is optimal. “We understand that a multidisciplinary and intensive approach to care of children with stroke provides the best route to recovery,” says Dr. Rivkin.

Learn about the Stroke and Cerebrovascular Center.

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