Entries in Toddlers (14)


Toddlers Struggle with Juvenile Arthritis

Courtesy Kim Pruden(PHOENIX) -- Campbell Pruden was only 19 months old, just beginning to talk, when she developed a limp and begged to be carried. The only way she could express her pain was to tell her parents, "It's too tight."

In 2011, the once energetic toddler was diagnosed and hospitalized with systemic juvenile idiopathic arthritis. At one point, she was taking eight daily medications. She was so afraid of the frequent steroid injections that she had to be put under anesthesia to keep her still enough for the procedure.

"In the beginning when there were all those unknowns, we knew we had to get to the bottom of it," said her mother, Kim Pruden, a 35-year-old speech pathologist from Phoenix. "But at the same time, we had to keep that poker face with her to give her the confidence that, 'You are OK and you are going to be OK.'"

The couple has their "breakdown" moments after Campbell goes to bed at night.

One of the greatest misunderstandings about arthritis is that it affects only adults. More than 300,000 children in the United States are living with the disease, according to the Arthritis Foundation, which has launched a new public awareness campaign to debunk the myths of arthritis during the month of May.

In addition to swelling in the joints, children can suffer muscle and soft tissue tightening and bone erosion that affect growth patterns.

Symptoms may include a non-contagious fever and rash. Inflammation can affect the spleen or the membranes that cover the lungs and heart.

It's important to recognize the symptoms of arthritis early, as many forms of arthritis can cause irreversible joint damage, often within the first two years of the disease. There are more than 100 types of arthritis and knowing what type you have makes a difference in how it is treated.

Now three years old, Campbell gets intravenous injections of powerful immune-suppressant medicines known as biologics, but office visits can last anywhere from two to five hours long. She calls the tiresome procedures her "stupid tubes."

Pruden laughs that the ordeal is like "going to Disney World for kids to get poked with needles."

Pruden and her husband John take a positive approach with their daughter whose joints are always aching.

"We keep her moving, we keep her active and we take one day at a time," she said. "When she is not feeling well, we respect that, but it's important not to make that a crutch or an excuse."

Arthritis is an umbrella term used to describe the many autoimmune and inflammatory conditions.

One family hard-hit by the disease recently moved from rainy Seattle to Charleston, S.C., for the warm climate, which is easier on the aching joints of sufferers.

Sisters Amelia, 5, and Liberty, 3, have juvenile idiopathic arthritis, which affects their joints "from head to toe," according to their mother, Lisa Schultz, who was recently diagnosed with rheumatoid arthritis.

Their father has had gout since he was 20, which is also a form of arthritis.

Amelia was diagnosed in April 2010 when she was nearly 2. She suddenly stopped walking and reverted to crawling.

"She started limping in the morning and wanted to be carried," said Schultz, 37 and a stay-at-home mother. "She would cry when I changed her diaper, too. I would lift her up and she would say her toes hurt when I put on her socks. Her second toe was almost the size of her big toe and her knees were the size of oranges."

Amelia's younger sister was just 15 months old last November when she, too, developed juvenile arthritis. Like her sister, she had painful joints; both stopped growing. Just recently, Liberty has developed inflammation in her right eye related to her arthritis and takes drops six to eight times a day. Untreated the condition, uveitis, can cause blindness.

"One day in the tub I saw that one knee was way bigger than the other knee, but I thought there is no way possible I would have two kids with it," said Schultz. So far Liberty is "in better shape" than Amelia. The family has a son, 7, who shows no signs of arthritis.

Both girls had tried anti-inflammatory and steroid medications, often the first line of defense for treating arthritis.

In the last decade, there have been significant advances in the treatment of arthritis, especially for those who do not respond to conventional drugs. The most important has been the development of a group of drugs called biologic response modifiers or biologics.

Now, like Campbell Pruden, the girls take biologics, known as TNF (tumor necrosis factor) inhibitors that suppress the inflammatory response seen in arthritis. So far, neither of the Schultz girls has any joint deterioration. But their mother worries about potential side effects with these powerful biological medicines -- one of which is lymphoma.

"It's scary," she said. "But we don't have a choice. Years ago kids were in wheel chairs and crippled. Now, with the medicines, you wouldn't be able to tell they have arthritis."

As for Campbell Pruden, she is now in a "holding pattern," doing well as doctors have cut back on her medications. Her parents keep her off red meat and dairy, part of an anti-inflammation diet.

"She can have some sort of remission, but it will be in her body for the rest of her life," said Pruden. "You never know when there is going to be a flair up. Right now, we just hope it stays dormant.

Nowadays, Campbell joins her parents hiking and on other outdoor activities. "She's a trooper and wants to do everything we do," said her mother.

Just recently Campbell got a fever and her parents worried she was taking a downward turn. "Doctors ruled out a flair-up [of her arthritis] -- it was an early version of the flu," said Pruden. "If it's flu, I'll take it."

The Prudens' greatest reward comes from helping others with the disease.

"I make it my mission to raise awareness," she said. "These children live in pain every day and can't even wake up and go to school because of the pain in their body. We need to find a cure, to find a way for these kids to lead strong, happy lives."

Copyright 2013 ABC News Radio


Breath-Holding Tots Terrify Parents, Hold Them Hostage

iStockphoto/Thinkstock(NEW YORK) -- When 3-year-old Rozalynn Cevetto has at least two things wrong -- she is hungry, tired, hurt or just not getting her way -- she looks as if she is going to cry but never takes the "big breath."

The first breath-holding incident occurred when Rozalynn was only 14 months old.

"She would start crying, but then appear to take a big breath, but really, she was just sitting there with her mouth agape until she passed out from not breathing," said her mother, Sarah Cevetto, 31, a mother of four from Niles, Ohio.

"It was frightening, at first," she said.  "Her eyes would roll back, her lips would turn blue and her face would get really tight."

Cevetto herself was a breath holder when she was little, as was her father.  In the 1980s, doctors treated her with medication for seizures, diagnosing her as an epileptic.

But Rozalynn's doctors tell her to just wait, the toddler will outgrow it.

"Breath-holding spells are pretty common in the toddler set," said Ari Brown, an Austin, Texas, pediatrician and author of the book, Toddler 411.  "However, they are not harmful in healthy children because if the child actually holds his breath until he passes out, the body's natural mechanism to breathe -- just like when you are sleeping -- kicks in and overrides the child's forced breath-holding."

Even so, many parents and some child psychologists worry that the incidents are not physiological but behavioral, and worry that a child will take advantage of their parents' terror and learn to be manipulative.

"Bottom line," said Brown.  "Don't let your toddler's breath-holding hold your parenting discipline strategy hostage."

Brown estimated "1 in 100 or 1,000, but not 1 in 20,000" children are breath-holders.

The only time these attacks deserve a medical evaluation is if they occur on a regular basis or happen more frequently.  A small number of children actually have an iron deficiency that can cause the incidents.

According to the Baby Center, one of the largest online resources for childbirth and parenting, breath-holding spells usually happen in response to pain, fear, frustration, anger or surprise.

Sometimes trauma can trigger an attack.  It can happen rarely or up to several times a day.  Sometimes, a child will turn blue and behave as if having a seizure.  Most outgrow breath-holding by the time they are 8.

"While these spells sometimes occur with tantrums, they're not willful," according to Baby Center.  "Your child is not holding her breath on purpose."

Copyright 2012 ABC News Radio


Loud, Persistent Snoring in Toddlers May Be Cause for Alarm

Hemera/Thinkstock(CINCINNATI) -- Aside from being a nocturnal annoyance, a new study confirms snoring in young kids can have implications for their behavior later on.

Previous research has shown that poor sleep quality in children, including snoring, is linked to hyperactivity.  However, little is known about "how much" snoring is too much, and whether the behavioral effects last over time.

The link between snoring and effects on behavior may be related to hypoxia, or decreased oxygen delivery to the brain.  Snoring may be a sign that not enough air is going through a person's airway -- a situation many doctors believe occurs frequently with sleep-disruptive breathing disorders.  Less oxygen delivery to the brain can mean inflammation, and even changes in the brain tissue itself.

"Many preschool children snore for brief periods, [for example] when they have a cold," says Dean Beebe, a neuropsychologist at Cincinnati Children's Hospital Medical Center.  "But loud snoring that lasts for months or years is abnormal and may signal a sleep-related breathing problem that could affect a child's behaviors during the day."

Beebe and colleagues explored these issues in a new study published Monday in the journal Pediatrics.  Their goal was to focus on younger children and "follow kids over time to get a sense of what happens when snoring persists," he says.

Researchers looked at 249 mother/child pairs at 2 and 3 years of age and asked parents how frequently they heard "loud snoring" coming from their child's bedroom.  Children were characterized as "non-snorers" if they snored less than once per week, "transient snorers" if they snored more than two times per week at age 2 or age 3, or "persistent snorers" if they snored more than two times per week both at age 2 and at age 3.

The same children were also assessed for behavioral problems -- including hyperactivity, aggression, depression and inattention -- based on a validated questionnaire known as the Behavior Assessment System for Children.

The results of this study demonstrated that the persistent snorers had significantly worse overall behavioral functioning at age 3, specifically in the areas of hyperactivity, depression and attention, compared to the transient snorers and the non-snorers.  In fact, 35 percent of persistent snorers were found to be at risk for behavioral problems.

Pediatric sleep specialists say they are enthused by the findings.

"In my opinion, this study is very important," states Dr. Frisca Yan-Go, a neurologist from UCLA, "because it gives data to support clinicians in emphasizing that habitual snoring is not normal at any age."

Yan-Go explains that if a sleep-related breathing disorder disrupts a child's sleep, "[It] definitely will affect the child's daytime function, including behavior, learning and development."

Sleep experts say parents who have kids who snore loudly and persistently should inform their pediatricians as soon as they can.

Copyright 2012 ABC News Radio


Is Early Potty Training Harmful?

Ryan McVay/Photodisc/Thinkstock(WINSTON-SALEM, N.C.) -- As soon as toddlers are able to walk and communicate their needs, many parents rush to get their kids potty trained.  But the hard and fast recommendation by many experts to get children out of diapers before age 3 is a myth and can even be dangerous for some children, according to one expert.

"Children under age 3 should not manage their own toileting habits any more than they should manage their college funds," wrote Dr. Steve Hodges, a pediatric urologist at Wake Forest University Baptist Medical Center, in an article on the parenting website

Many mothers begin training because of a variety of life factors, including the need to have a child potty trained so they can go to day care programs or school.

But preschools and facilities that require children to be potty trained by age 3, "are harming kids," according to Hodges.

A child's bladder, which continues growing to its standard size until age 3, grows stronger and faster when it's filling and emptying uninhibited, said Hodges.

"When you train early, you're interrupting that process," he told ABC News.

Training a child too early can lead to toilet accidents because the bladder may not be strong enough.  It may also lead to constipation, kidney damage and even urinary tract infections, said Hodges.  Mainly children are holding in their bowel movements longer than they should, he said.

These conditions may also be signs of forced training, according to some experts.

To prevent medical complications, children should be allowed uninhibited elimination until they are ready, Hodges said.

Age doesn't matter when it comes to potty training, according to many experts.  Some children are ready earlier than others.

A child's social, cognitive, and physical skill sets should dictate whether a child is ready to train, said Dr. Stephanie Hines, pediatric developmental and behavioral specialist at Beaumont Hospital's Center for Human Development.  

"At their age, they have control over sleep, eating, and going to the bathroom," said Hines. "So this is one of the few areas of their life they have control over."

Hines said the control should stay with the child.  If the child is resisting potty training, parents shouldn't force it, she said.

Copyright 2012 ABC News Radio


Bottles, Sippy Cups Pose Injury Risks to Babies

Jupiterimages/Pixland/Thinkstock(COLUMBUS, Ohio) -- Every four hours a child under the age of 3 is treated in the Emergency Department for an injury caused by a bottle, pacifier or sippy cup.  Previous studies had focused on choking and burns caused by these products.  But a new study published Monday in the journal Pediatrics has shown that a range of injuries can occur, especially injuries to the mouth.

"Our study team was interested in doing this study because we recognized that almost every child in the U.S. uses all of these products on a daily basis at some point during infancy or early childhood," said Sarah Keim, principal investigator in the Center for Biobehavioral Health at The Research Institute at Nationwide Children's Hospital in Columbus, Ohio, and a researcher on the study.  "We noticed that there was really no research about injuries associated with these products, aside from a handful of case reports about severe burns from overheated bottles and asphyxiation or ingestion of pacifier parts."

Keim and her colleagues at Nationwide studied 20 years of data and found that around 2,000 children each year are treated in the emergency room for injuries from these products.  Children younger than 3 were usually hurt when falling while these objects were in their mouths.

If there is a silver lining, Keim said, it is that the number of injuries has been on the decline in recent years compared to years past -- though it is hard to say exactly why.

"It could be [that] children are using the products less, the products are somehow safer, or the injuries are less severe and so don't arrive at emergency departments for care," she said.

Still, the idea that bottles and sippy cups could be leading to these injuries at all may be surprising to parents.

"Everybody uses them, so we automatically assume that they are safe -- but are they really?" said Dr. Deborah Lonzer, chair of the department of community pediatrics for the Cleveland Clinic Children's Hospital in Cleveland, Ohio.  "This study shows that they may not be as safe as we think that they are."

Children around age 1 were most likely to be injured, probably because kids are learning to walk, climb and run around this time.  Boys were most likely to suffer cuts to the face, while girls were more likely to break or chip their teeth.

Lonzer said many of these injuries may be avoided if parents switch their kids over to regular cups sooner.

Copyright 2012 ABC News Radio


Some Moms Unaware Toddlers Are Overweight, Study Finds

Comstock Images/Thinkstock(BALTIMORE) -- Mothers of overweight toddlers believe their children are smaller than they actually are, according to a new study published in the journal Archives of Pediatrics & Adolescent Medicine.

Moms whose toddlers were overweight also reported being more satisfied with their children’s size, possibly reflecting the belief that heavier toddlers are normal.

Mothers whose toddlers were underweight, on the other hand, had accurate perceptions of their child’s size, but believed their children needed to be bigger, the study found.

The researchers asked 281 low-income, mostly African-American mothers of toddlers between 13 and 30 months of age to select a silhouette that they believed most accurately represented their child’s shape.  Mothers of overweight toddlers were 88 percent less likely to choose an accurate shape.

The authors had hypothesized before the study that low education level and low income, as well as being African American, were factors associated with inaccurate views of toddler weight.

“We live in this culture where people perceive overweight or chubby toddlers to be healthy infants or toddlers, and that’s been a social norm,” said Erin Hager, the study’s lead author and an assistant professor at the University of Maryland School of Medicine in Baltimore.  “We also live in a culture where there are so many overweight kids, so the overweight body type is becoming the norm.”

Parents might idealize their child as being a normal size, the authors wrote, because a heavy child is sometimes seen as a “sign of successful parenting, especially during the early years when parents are responsible for their child’s health, nutrition and activity opportunities,” the authors wrote.

But an overweight child runs the risk of numerous health problems that can persist throughout life -- from diabetes to heart disease -- which is why Hager said it’s important for parents to become more aware of what an overweight body type is.

“The best way is though pediatric visits,” she said.  “If people go to these well-child visits and we can get this dialogue going in a clinical setting about what a child’s body proportion is, parents can start to visualize what the ideal proportion is.”

Copyright 2012 ABC News Radio


Toddlers Give In to Peer Pressure, Too?

iStockphoto/Thinkstock(NEW YORK) -- Parents often warn teens as they reach junior high and high school about the negative effects of peer pressure.  But should parents start worrying about peer pressure earlier?  A new study suggests that even toddlers give in to the influence of their peers.

Researchers reported that 2-year-olds are more likely influenced to copy the actions of three other toddlers than if they saw the same actions carried out by just one other toddler, HealthDay reports.

Study author Daniel Haun, of the Max Planck Institutes of Evolutionary Anthropology and Psycholinguistics in Germany and the Netherlands commented in a release for the journal Current Biology, which also published Haun's findings, that very few people think of children this young as influenced by the majority.  "Parents and teachers should be aware of these dynamics in children's peer interactions," Haun said.

The researchers also found, according to Health Day, similarities for social learning between humans and chimps.  While chimpanzees tend to follow the group, orangutans do not.

But sensitivity to peer pressure does not always have to be negative, Haun pointed out.

"The tendency to acquire the behaviors of the majority has been posited as key to the transmission of relatively safe, reliable and productive behavioral strategies," he said.

Copyright 2012 ABC News Radio 


Preschool Mouths: Dental Disaster Zones

iStockphoto/Thinkstock(NEW YORK) -- Preschoolers across the country are increasingly getting fillings and extractions for extensive dental decay, sometimes requiring surgery and general anesthesia in an operating room, pediatric dentists report.

The trend, seen in families both rich and poor, points to neglect driven by several factors. Despite decades of emphasis on eliminating tooth decay with fluoride toothpastes and frequent brushing, many parents aren’t getting the message that dental care begins when a child’s first tooth comes in, and that a child should be brushing with fluoride by age 2.

Parents of all income levels indulge young children in too many sugary snacks and sippy cups filled with sugar-laden fruit juices, dentists say. Too often, they put toddlers to bed with a bottle of juice or milk. Saliva levels go down overnight, making the mouth even more acidic and allowing sugars in the drinks to eat into tooth enamel for hours at a time.

As a result, dentists are fighting more aggressively to counter the resulting decay, often treating cavities in baby teeth before the bad bacteria can spread elsewhere in the body or harm the adult teeth forming below them in the jaw.

“The myth has been for years, these are just baby teeth, they’re just going to fall out anyway,” said Dr. Amr Moursi, chairman of pediatric dentistry at NYU’s College of Dentistry. Moursi said the need for dental operating rooms at NYU exceeds the supply, forcing dentists to compete with cardiac surgeons and neurosurgeons for operating room time, and forcing patients to wait three to six months to have their dental surgeries scheduled. In addition, he said, it’s hard to find pediatric dentists with operating room privileges, which further squeezes the ability to treat children in need.

“There’s not enough operating rooms in the country equipped to do dental work,” he said.

Severe neglect of a child’s oral health most often occurs among poor families “trying to make ends meet, pay the rent; it’s not a high priority,” Moursi said. However, dentists also are seeing a troublesome trend of lax parenting among more well-off mothers and fathers who don’t enforce brushing-after-meals rules.

As parenting styles have shifted, there has been evidence of changes that “sometimes include a de-emphasis on oral health or anything that the child doesn’t necessarily want, whether that’s bath time, or practicing the piano, or eating their vegetables,” Moursi said. “That’s when we have the conversation: You’re the parent and it’s in their best interest. We give them some techniques to make it easier.”

Just Tuesday morning, Dr. Jonathan D. Shenkin, a pediatric dentist in Augusta, Maine, found six small cavities between the teeth of a 4-year-old girl during her first-ever appointment with a dentist. The child should have been seen by her first birthday. The girl’s mother was at a loss to account for all the decay in her daughter’s mouth, telling Shenkin that she thought she had her children doing everything right: “We don’t drink soda. They brush their teeth twice a day.”

But when he asked if the family uses fluoride toothpaste, she responded that they had just started to use it.

“Brushing with fluoride toothpaste is the most important thing you can do,” he said. Next, parents must pay attention to what their children eat and drink. Numerous well-intentioned parents tell him they only give their children “all natural” products, thinking those somehow are better for their dental health. However, many fruit juices contain just as much sugar as sodas, he said.

Although dentists prefer to spend their time on prevention, a parent’s decision to wait until a child is in pre-school before making a dental appointment is too late to prevent tooth decay that already may have begun, Shenkin said. “The kids coming into our offices at this age already have it at this point. There’s no way to turn back.”

“The goal should always be to treat in the office if possible,” Shenkin said. “The last resort should be going into the operating room under general anesthesia.”

By and large, the children going to the operating room tend to be lower-income children, he said. “When we talk about tooth decay, 80 percent of the disease is in 20 percent of the population…usually the lowest income population. The need for anesthesia disproportionately affects the Medicaid population.”

Although there aren’t good statistics establishing the extent of preschoolers requiring extensive dental work, Moursi said he’s seen a dramatic rise in the number of children with “really severe decay” warranting operating room treatment.

During an interview, he said he’d just received a phone call from an NYU pediatric dental resident who had examined a 4-year-old with several cavities, including one that had caused major facial swelling. “The infection had gone through the tooth, down into the surrounding bone of the jaw and spread up into the face under the eye,” Moursi said.

The child was going to be treated with powerful antibiotics, but might still require a trip to the operating room to extract the tooth, he said. In rare cases, such dental infections can spread to the brain, or into the heart and lungs, he said.

“When you have a 6-month wait to get into the O.R. and they’re all 3-year-olds, we know we have a problem,” Moursi said.

Copyright 2012 ABC News Radio


The 25 Words Your Toddler Likely Knows

Kraig Scarbinsky/Digital Vision/Thinkstock(VANCOUVER) -- If your toddler is having trouble building her vocabulary, you’ll want steer her toward the word “dog” rather than, say, “aardvark.”

It may be common sense, but now there’s a growing body of scientific research to back it up, says psychology professor Leslie Altman Rescorla.

Rescorla, the director of the Child Study Institute at Bryn Mawr College, presented research on late talkers in the United States and around the world this past weekend in Vancouver, British Columbia, at the American Association for the Advancement of Science‘s annual conference.

Rescorla said that recent studies of children’s language development in Greece, the Netherlands and South Korea echo findings she published in 2001 -- that whether a child is slow to learn language or learns language at an average rate, there are certain commonly used words that she is likely to know.  And when working on language intervention for late talkers, Rescorla said, it’s good to focus on such words when building a basic vocabulary.

Based on her own research and that of collaborators in other countries, Rescorcla compiled a list of the 25 most commonly used words and expressions by children at age 2.  They are:

-- mommy
-- daddy
-- baby
-- milk
-- juice
-- hi/hello
-- ball
-- no
-- yes
-- dog
-- cat
-- nose
-- eye
-- banana
-- cookie
-- car
-- hot
-- thank you
-- bath
-- shoe
-- hat
-- book
-- all gone
-- bye bye
-- more

Rescorla said children are considered late talkers when they say fewer than 50 words at the age of 24 months. Such delays may be symptomatic of hearing problems, an autism spectrum disorder or another developmental disability.

Her research on children with language delays -- and no other disabilities -- showed that late talkers were, “functioning at the normal range” by about age 4 or 5.

“The important point is they’re not learning language in some very unusual way, they’re just learning it later,” she said.

A long-term study by Rescorla of late talkers in affluent Philadelphia suburbs found that by age 17, the teens’ performance was at or above average, though they still lagged behind the language skills of their privileged peers.

Copyright 2012 ABC News Radio


Toddlers Hear Their Own Words Differently, Says Study

Hemera/Thinkstock(COPENHAGEN, Denmark) -- Ever wonder why toddlers just can’t seem to get the pronunciation of some words just right?  Science may now have an answer.

People subconsciously monitor their voices to ensure the sound they are producing is the one that is intended.  If it is different, we are able to change that tone, but new research found that toddlers do not monitor their voices in the same way.

“Surprisingly, 2-year-olds do not monitor their auditory feedback like adults do, suggesting they are using a different strategy to control speech production,” lead author Ewen MacDonald of the Technical University of Denmark told ABC News.

MacDonald said monitoring one’s voice is similar to musicians playing music.  For example, violinists adjust their fingers to bring a note that is out of tune, in tune.

In the study, published in the journal Cell Biology, a group of adults, 4-year-olds, and 2-year-olds said the word “bed” repeatedly while simultaneously hearing the word “bad” through a set of headphones.  Everyone was able to adjust their speech to continue to say the word “bed,” except for the youngest age group.

The findings are surprising because infants can detect small changes in the pronunciation of familiar words in their native language, MacDonald said.  By the time American children reach age 2, they have an average of 300 words in their vocabulary.

One reason for the findings may be due to the way children communicate with their caregivers, researchers noted.

“One possibility is that the 2-year-olds may rely on the person they are talking to instead of monitoring their own voice,” said MacDonald.  “If you look at interactions between young toddlers learning to speak and their caregivers, you will often hear the caregiver repeating or reflecting back what the child has just said. It may be this interaction that is helping children judge their accuracy in producing speech.”

Copyright 2011 ABC News Radio

ABC News Radio