Children's Health

Growth and development

A healthy child's development actually begins before conception with the parents' health and their genetic legacy. It continues on to conception and through the prenatal period. During this time, there is naturally considerable overlap between pediatric concerns for the fetus and obstetrical concerns for the mother.

Once the baby is delivered, there are new and important matters to ponder, such as breastfeeding, newborn screening tests and sleeping safety. All too soon, there are health-care appointments to be kept, for example, for well-baby checkups and immunizations. These are followed by other challenges, such as when to introduce solid foods and to start toilet training.

The field of pediatrics recognizes classic stages in growth and development, but these are artificial since a child's growth and development constitute a continuum. A baby changes at an astonishing rate during the newborn period and early infancy. Before you know it, the baby becomes a toddler, next a child and, after a little more than a decade, is already a teen. It is a busy, challenging period.

Children's illnesses

Unfortunately, even the healthiest baby can get sick. It is worth knowing the signs and symptoms of the common childhood illnesses as well as the treatment and prevention of these illnesses. There are a number of common childhood conditions such as ear infections and even tonsillitis, which may be unavoidable. But children are also subject to serious infectious diseases, some of which can be prevented by immunizations.

Children may be born with health problems. For example, a cleft lip or palate is evident at birth. But some equally common birth defects, such as heart malformations, may not be immediately apparent. Birth defects of all kinds are a consequential concern for children and their parents. It is estimated that between 2%-3% of all children are born with birth defects.

Children's injuries

It may not be possible to prevent a specific birth defect or an illness, but it should be possible to protect a child from an accident and injury, such as from common cuts and burns. Considerable progress has been made in the safety arena, for example, in the rapid recall of dangerous toys. The mandated uses of car seats, safety belts, and bicycle helmets are also examples of advances in child safety.

But other major areas of safety concern remain -- such as the all-too-frequent drownings of children in swimming pools, their accidental swallowing of household cleaning products, their being burned by a hot stove or heater, or being accidentally shot with a firearm. The list is endless. All of us must exercise continued vigilance and make every effort to be sure that a child's environment is made as safe as it possibly can be.

Children's behavior

In addition to a child's physical well-being, there are also concerns about a child's behavior and emotional health. Major challenges include autism, Asperger's syndrome, learning disorders, and ADHD (attention deficit hyperactive disorder).

But children may also be plagued by nightmares, sleeping difficulties, and irrational fears. Many children have trouble expressing their anger in an appropriate fashion. A major area of study is the effect on children of watching violence on television and playing violent video games.

As children get older and more independent, their chances of developing eating disorders such as anorexia and bulimia increase, especially among girls who worry about being overweight. The specter of drug and substance abuse appears. Smoking also often starts in response to peer pressure. And then there are those tattoos and body-piercing.

Children's mental illness

Suicide is now the second leading cause of death during the teen years. Major depression and bipolar disease may underlie suicide attempts and suicide.

It was once thought that children were not subject to these mental illnesses because children had not yet developed the ability to feel hopeless and helpless about the future. That is clearly untrue. It is now widely acknowledged that children are susceptible not only to major depression and bipolar disease but also to anxiety disorders, phobias and posttraumatic stress disorder. Here again the treatment must be appropriate for use in the pediatric age range.

Health care for children

It is important to emphasize that children are not just small adults nor should they be treated as little adults. Child health care and the specialty of pediatrics are concerned with providing optimal and appropriate care to all children; and in fact pediatrics has expanded to include not only young children but young adults as well, since a large portion of our 18-21-year-olds continue to be dependent on their parents into their 20s.

Getting appropriate, high-quality health care for a child is not always easy. Existing programs for child health are not available to all families that need them. There are serious gaps between those eligible for health care and a parent's ability to afford health care. Too many children fall between the cracks, not only in the U.S., but in the world as a whole.