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Pediatricians offer advice on keeping children well

Parents always want to listen to the pediatrician when a child is sick, but what do the pediatricians want parents to hear when the goal is to keep children well?

We posed that question to three doctors — Dr. Joel B. Steinberg, professor of pediatrics at University of Texas Southwestern Medical Center and attending physician at Children's Medical Center Dallas; Dr. Chris Straughn, a pediatrician at Medical City Children's Hospital in Dallas; and Dr. David Goff, a pediatrician at Cook Children's Medical Center in Fort Worth, Texas.

Here's what they said:


Childhood obesity is easier to prevent than it is to rectify, all three doctors agree. It is one of the biggest threats to children's health today: This the first generation that is not on track to live as long as their parents.

Obesity is harmful on every level, increasing a child's chances of developing Type 2 diabetes, high blood pressure and even cancer.

Steinberg says 80 percent of kids younger than a year old regularly eat french fries — a food he'd like to see less of in children's diets along with macaroni and cheese, mashed potatoes, fried and other high-fat foods and high-sugar drinks.

Straughn also would like to see parents eliminate high-fructose corn syrup from their children's diets.

The doctors agree on the importance of exercise from the earliest possible age, which can mean playing in the park or ditching the stroller in favor of a walk. Straughn notes that a March study published in Pediatrics finds that children who eat meals regularly with their family, get adequate sleep and limit their television time to no more than two hours a day had a 40 percent reduction in obesity compared with kids who had none of these routines.


The three doctors all express concerns that too many parents are forgoing lifesaving vaccines against measles, mumps, whooping cough, chicken pox, influenza and meningitis.

Steinberg respects the anxiety that some parents express about possible links between vaccines and autism, even though no connections have been proved He suggests discussing concerns with your child's pediatrician, who should be up to speed on the latest research. Steinberg says that because autism is typically diagnosed at 18 months, he will delay some vaccinations until age 2 if parents prefer. Though it means more appointments, he will also stagger immunizations for parents concerned about multiple immunizations given at once, or offer vaccines that have no preservatives.

If cost is an issue, Vaccines for Children, a Centers for Disease Control and Prevention program (, will help make vaccines more affordable for Medicaid-eligible kids.

In addition, Straughn recommends a pertussis (whooping cough) booster for all parents and other adults who will be in contact with young infants.


Many children and adults need more vitamin D. People need to compensate for the diminished exposure current generations are getting to the sun, the doctors say; vitamin D is produced through the skin by exposure to sunlight.

Straughn notes that a vitamin D supplement is recommended for all breast-feeding infants, and a multivitamin containing vitamin D is recommended for all older kids. Check in with, a parent-friendly website produced by the American Academy of Pediatricians, for the recommended doses.


Even if you have a healthy child, don't skip scheduled doctor visits. Parents should also be checking in with their pediatrician, who should be up to date on the latest recommended schedule for their child's hearing, vision and dental exams.

Parents should also discuss their child's weight, height and body mass index growth curve, and take steps if the child's growth curve is not healthy and diet corrections need to be made. Find out whether your child is meeting developmental milestones for walking, talking and socializing, too.


Always use an approved car safety seat or booster seat for babies and young children. Keep any guns in the home under lock and key. Put up a secure swimming pool gate, and do not let a child swim unattended. Keep household drugs, medicines, cleaning supplies and knives out of reach. When children start to move or crawl, it's important to remove coffee tables with sharp edges and breakable items that they can pull down from tables or shelves.

Pediatricians offer advice on keeping children well 06/18/10 [Last modified: Thursday, June 17, 2010 5:37pm]
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