Grand Rounds -- Short Stature

Blog Author — Thu, 17 Jan 2008 15:45:47 GMT

The Medical City Pediatric Grand Rounds lecture this week was given by Dr. Ellen Sher, Pediatric Endocrinologist. Her topic was short stature. She discussed the various causes and possible treatments for short stature. The most important factor that determines a child's final adult height is genetics. Unfortunately, a child can't help it if their parents are short, too! My favorite quote from this lecture: "Apple trees make apples. Pear trees make pears. We can't expect an apple tree to make a pear!" Nutrition and chronic illnesses also play a role in determining adult height, and underlying endocrine conditions such as growth hormone deficiency are much more rare. She also gave the most accurate equation for predicting a child's adult height. It is a little more complicated than some other estimates, but here goes:

[ (Height of opposite sex parent +/- 5 inches) + (Height of same sex parent) ] divided by 2

(In the fiirst part of equation: For boys, add 5 inches to the mother's height; for girls, subtract 5 inches from the father's height)

An example: Little Billy's mom is 5' 3", and dad is 5' 10" -- the equation goes like this: [ (5' 3" + 5 inches) + (5' 10") ] divided by 2 = 5' 9". Thus, little Billy has a 90% likelihood of being within +/- 2 inches of 5' 9" tall.

Grand Rounds -- Pediatric Dental Advice

Blog Author — Tue, 25 Sep 2007 17:34:22 GMT

Dr. Brian Collins, Pediatric Dentist at Medical City spoke today regarding "Practical Dental Information for the Pediatrician." Highlights of his talk:

- First dental visit is recommended after the first tooth erupts, or by 12 months of age at the latest. (Historically, we have waited until age 3, but this is a fairly recent change in the recommendations.)

- Once the teeth have erupted, kids do need fluoride in their drinking water or toothpaste. The simplest approach is to provide 4-8 ounces of fluoridated drinking water (regular tap water or bottled nursery water) each day. Call us if you think your child does not get enough fluoride.

- Dietary factors are the largest contributors for cavities in babies and toddlers. Prolonged and frequent bottle use causes cavities. We recommend discontinuing the bottle completely by 15 months of age. Liquids and snacks should be offered at specific mealtimes; constant grazing can lead to cavities, too.

- Get in the habit of massaging the gums even prior to tooth eruption. Regular, supervised dental hygiene after tooth eruption is very important.

- Thumbsucking and pacifier use do not usually affect the permanent teeth unless a child is still agressively sucking beyond age 3-4. Most kids usually stop on their own between age 2-4. By kindergarten, you can provide positive reinforcement to encourage a child to choose not to suck their thumb before the permanent teeth come in. The dentist can help with appliances if a child's permanent teeth are getting affected.

- Average age for the first tooth: 7 months

- Average age for the first permanent tooth: 6 years

- Average age for a child to lose all of their "baby teeth": 12 years