Ashley Lowery, Deseret News
Tracy Karp, a neonatal nurse practitioner, will answer hotline and e-mailed questions today.

Questions answered on pediatric, neonatal care

The July Deseret News/Intermountain Healthcare Hotline focused on children's health issues, from before birth through childhood. It featured Dr. Peter Lindgren, a pediatrician, and nurse practitioner Tracy Karp, who specializes in neonatal care.

Recently, the hotline introduced a new feature, inviting readers to submit questions by email in addition to phoning in during the hotline to talk one-on-one with a specialist. Those questions were passed onto the experts. Here they are, along with their answers.

The hotline tackles a different topic each month.

· · · · ·

Question: I am about 18 weeks along and am doing everything I can to have a successful pregnancy. It's my first. Are there certain things I should be sure to do/avoid doing?

Answer: Three of the most important things are to think positive, have an good relationship with good communication with your obstetrical provider and listen to your body. Prenatal care is one of the most powerful tools to maximize your chances of having the best possible outcome. The next thing is to identify and meet with a medical provider for your baby before the baby is born. This will also maximize your chances of success. (Tracy Karp)

· · · · ·

Question: My son complains a lot about leg aches and cramps. He's 10 and I suspect they're growing pains, but am not absolutely certain. Should we be concerned? He doesn't have them all the time, but quite often. It's only been going on this time for about four weeks. Sometimes it makes it hard for him to get to sleep. Any suggestions?

Answer: Growing pains occur commonly in preschool and school-aged children. Oddly enough, "growing pains" are not caused by growing. Pain is typically in the lower extremities; it can be crampy, and can often be severe enough to make a child cry. Pain is typically in the evening and may even interrupt sleep. Pain can be relieved by massage, heat, or analgesics — acetaminophen or ibuprofen.

If there are systemic symptoms (eg, unexplained fever, weight loss, decreased activity), persistent pain, or unilateral pain, pain during the day, limp or localized findings (decreased range of motion, warmth, tenderness, swelling, redness), then it is time to have a thorough exam by your child's physician. (Dr. Peter Lindgren)

· · · · ·

Question: If a preemie seems to be doing pretty well, are there still long-term complications that can show up later for the first time? If so, what are they and how common are they?

Answer: Congratulations if the baby is doing pretty well. While there are many individual factors such as how early the baby was, here are some things I tell the parents of patients I care for.

First, be positive, it makes a major difference. Next, provide enrichment activities as you are able, and use the available resources such as the Early Intervention program. A very powerful and simple tool is to read to your child. Read anything you like. Studies show that various enrichment activities such as reading and music exposure do improve long-term development.

Some general counseling is that major motor or muscle problems usually show up by 2 years of age. There is an increased risk of learning disabilities and the need to repeat a grade in very early preterm infants. There also is a slight decline in the rate of high school graduation compared to full-term infants, but many preterm infants do very well and go on to college.

One other interesting fact is that as a group, preterm infants seem to have less antisocial behavior. Finally, I encourage you to have an open dialog with the medical provider for your baby so they can follow the baby's progress and address your concerns. (Tracy Karp)

· · · · ·

Question: My daughter, 12, gets headaches a lot. I'm not sure what we should be giving her for them. Are headaches common in kids?

Answer: Headache is a very common complaint; 90% of school age kids will complain of headache. Migraine is the most frequent acute-recurrent headache syndrome in childhood. It is a little hard to recommend treatment for headache without evaluating a child. So again, this is something that is probably best left to discussing with your child's physician. (Dr. Peter Lindgren)

· · · · ·

Question: Is there a legitimate reason not to have my baby vaccinated? I'm not sure which is scarier, the vaccine or the diseases they're supposed to prevent.

Answer: As pediatricians, we firmly believe in the effectiveness and safety of vaccines. Vaccinating children is probably the single most important intervention in promoting the health of your child.

Having personally cared for children who have died from vaccine-preventable diseases including chicken pox (varicella), hepatitis B, pneumococcal and meningococcal meningitis, and have suffered from vaccine-preventable diseases such as pertussis (whooping cough), rotavirus, and hepatitis A, I cannot really think of great reasons not to vaccinate. It is much scarier to not receive vaccines.

The decision to vaccinate needs to be carefully thought out. There are minor risks with having vaccines. Most of us don't like having needles stuck in us, and particularly don't like having our children experience any discomfort. It is, however, much safer to vaccinate. Vaccines do not cause autism, nor do the preservatives in the vaccines. (Dr. Peter Lindgren)