The care of children is fundamental to the survival of humanity.
That was the belief of an 18th century London physician named George Armstrong, although he said it this way: “But certain it is that the human species can only be preserved by taking proper care of the infant race.”
Dr. Armstrong, who devoted his life to the care of children, to learning about them and documenting their illnesses and their behavior and development, is considered one of the parents of pediatrics. For that reason, every year at the Pediatric Academic Societies (PAS) meeting a lecture is given in his honor. This year, the PAS meeting was in Boston and the lecture was given by Boston Children’s Hospital’s own Judy Palfrey, MD. Palfrey, who has been the president of both the Academic Pediatric Association and the American Academy of Pediatrics, is the T.Berry Brazelton Professor of Pediatrics at Harvard Medical School and the director of the International Pediatric Center at Boston Children’s.
In Armstrong’s time, one in two children died—and medicine, as Palfrey pointed out, had not much more than leeches to offer. But Armstrong did some remarkable things. He started a clinic that cared for 35,000 children. He kept careful records, some of the earliest examples of population data and quality improvement. He built collaborations with influential people, even did outreach to the Queen, in his attempts to get children what they needed. He understood, long before most, that advocacy is crucial for health—especially the health of children, who can’t advocate for themselves. Full story »
The Boston Globe recently ran a story about a young Boston Children’s Hospital patient who came to the hospital from Palestine. Coordinating his care was a combined effort of many people, crossing geological and political borders.
Yahya at Boston Children's
When Yahya Ahmad Masalma was born in a small village in Palestine, Israeli doctors diagnosed him with posterior urethral valves (PUV), a congenital and chronic condition that compromises the kidneys and urological system. In Yahya’s case, his kidneys and bladder were unable to properly function, causing serious problems, so doctors in Jerusalem began performing regular dialysis—a process that takes the blood out of the body, filters it through a machine and puts back into the body.
But a person—especially a child—can only undergo dialysis for so long before the body begins to revolt. After five years, Yahya’s blood vessels were damaged and failing and he would soon be unable to undergo any more of the life-sustaining treatment.
Without dialysis, Yahya’s condition would worsen quickly, and the only way he could survive was to get a kidney transplant.
Michael Agus, MD,director of Medicine Critical Care Program Boston Children’s Hospital had heard about Yahya’s case through his Israeli colleagues, and made William Harmon, MD, chief of Boston Children’s Division of Nephrology, aware of the situation. Although the Israeli Hospital has performed kidney transplants in small children before, Yahya had very low blood pressure and they felt that it would not be safe to do so for him. The Israeli physicians could not find a transplant program that was willing to accept Yahya. Full story »
Tree climbing can be dangerous and should only be done under close supervision
The warm weather is finally here, which means many kids will be spending more time outside. Playgrounds are a great way for children to get exercise, but while there they should be watched closely to make sure the running and climbing doesn’t end in injury. To keep kids safe while playing outside:
Make sure an adult is always watching
When possible, visit playgrounds built on a soft surface like rubber, bark chips or sand
Dress them in safe play clothes. Scarves, hood draw-stings, necklaces and other dangling accessories can get caught on play equipment. Also, helmets should only be worn during the activity it was designed for. Playing and running with a helmet could cause an accident because it could limit the child’s range of vision.
Riding a bike, skateboard or scooter is another great summer activity, but only when done safely. Most accidents involving children and bicycles, in-line skates and skateboards happen because the child broke a traffic or safety rule. If your child uses a wheeled toy be sure he or she:
Knows the rules of the road:
Always ride on the right side of the road, going the same direction as traffic
Use hand signals to let others know which way he is turning
Stop at all stop signs and red lights
Look both ways before crossing a street or sidewalk Full story »
Having blood drawn can be a very anxious thing for a child with autism. Ellen Hanson and her colleagues have developed an educational kit that they hope will make blood draws easier on kids, parents, and their doctors.
Raising a child with autism is challenging, to be sure, but some situations can be more challenging than others. Take trips to the doctor, for instance – especially if the child has to get shots or have blood drawn. “Anything with a needle can be a real stumbling block for families,” says Ellen Hanson, a researcher in Children’s divisions of developmental medicine and genetics. “It’s completely out of the routine, and children may have had a bad experience in the past or general anxiety about going to the doctor that make it really difficult.
“At the same time,” she continued, “these things are part of good medical care.” Blood draws are also essential for the genetic studies that researchers like Hanson are conducting into the root causes of autism spectrum disorders (ASDs). “Some of the families that we’ve reached out to for our studies have been reluctant because of concerns about how their child will react to the blood draw.”
So how can we make this easier on everyone: doctors, researchers, families, and, most importantly, the children? Recognizing that there was little guidance in the literature about making blood draws easier for children with ASDs, Hanson and her colleagues sat down to create what they call a blood draw intervention program – essentially, a method and kit for helping parents and doctors prepare children for blood draws so that the actual event is as painless as possible. Full story »
Sarah Pastore was born with bright blue eyes, a beautiful smile and a single, failing kidney. She fared well in her first few months, but by the time she approached her first birthday her prognosis was clear: without a kidney transplant the little girl from North Reading, Mass., was sure to die.
Her parents, Nancy and Robert, were screened to see if they could be potential donors, but neither was a good match. Because Sarah’s brother John Paul is under 18, he wasn’t eligible to donate. It looked like the next stop was the organ donor list.
But before her name could be submitted to the list, her uncle, Anthony Pastore, was tested to see if he and his niece would be compatible for transplant. As luck would have it, they were, and the 32-year-old Woburn man quickly offered one of his kidneys to save her.
With the live donor identified, Sarah was well on her way to better health. But how exactly do doctors fit an adult kidney in a toddler’s body? Full story »
TheBoston Globe featured a study last week associating frequent dental X-rays with benign brain tumors called meningiomas. Despite the findings, says Man Wai Ng, DDS, MPH, Boston Children’s chief of Dentistry, you should still focus more on your child’s teeth than his or her brain when they’re in the dentist’s chair.
That’s because it’s unlikely that most children will have dental X-rays frequently enough to raise their tumor risk. The American Academy of Pediatric Dentistry (AAPD), the American Dental Association and the Food and Drug Administration all offer recommendations and guidelines for dental X-rays in children, with a big focus on minimizing X-ray exposure. Full story »
We’re not the only ones who enjoyed the record-setting mild winter—ticks and mosquitoes have too. While normal winters produce hard freezes that kill off these pests or make them dormant, unseasonably warm temperatures allowed adult mosquitoes and ticks to live through it, creating early arrival and a potential population boom for some types of bugs.
So how can you prepare your family for the early onslaught of ticks and mosquitoes?
“Prevention is key,” says Catherine Lachenauer, MD, director of Infectious Diseases Outpatient Practice at Boston Children’s Hospital. “Avoid areas at the edge of the woods with long grasses. Also, wearing long, light-colored clothing helps keep ticks from getting on the skin and makes it easier to recognize one on your body.” Full story »
Taylor West was suffering from terrible headaches, but they came and went so fast neither she nor her parents were too worried at first. But as the headaches got worse, doctors became worried. A CT scan revealed a large tumor in Taylor’s brain, and less than 10 days later she was undergoing surgery at Boston Children’s Hospital and waiting to find out if the tumor was cancerous.
When Taylor West of Tecumseh, Oklahoma, started complaining of headaches, her mother Lori’s first thought was that she was trying to get out of school: The headaches were worst early in the morning, but by noon Taylor would be up and running around.
“People thought the headaches were just because of stress, but I knew they weren’t,” says Taylor, age 10. “It felt kind of like an electric shock.”
When Taylor began getting sick to her stomach and throwing up, Lori thought perhaps she had a flu bug that was going around. But as weeks and then months went by, she became concerned, and so did the doctors. A neurologist sent Taylor for a head CT scan.
“That evening we got a call saying, ‘get her to the hospital tonight,’” Lori said. Full story »
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The care of children is fundamental to the survival of humanity.
We’re not the only ones who enjoyed the record-setting mild winter—ticks and mosquitoes have too. While normal winters produce hard freezes that kill off these pests or make them dormant, unseasonably warm temperatures allowed adult mosquitoes and ticks to live through it, creating early arrival and a potential population boom for some types of bugs.
“That evening we got a call saying, ‘get her to the hospital tonight,’” Lori said. 
