Need to Know: Pediatric Healthsource

Staff Writer
Columbus Parent

This time of the year we always hear that we're supposed to keep kids from getting overstimulated with the holidays coming up, but how exactly do you do that? What exactly is overstimulation and what can you realistically do as a parent?

Overstimulation refers to your child being exposed to more activity than usual - to the point where he or she is overwhelmed by all that is happening. Too much of a good thing isn't always a good thing.

While parents become aware of the need for a nap when they notice irritability in their toddler, they may not appreciate a similar problem when their pre-school or school-age child also behaves irritably. The excitement of so many activities - special holiday activities, visits from relatives, special meals or other treats all occurring within a day or a few days - can overwhelm a child's ability to make choices or to settle down.

Parents can try to limit holiday activities to one or two a day. They should also try to space activities out as much as possible and allow for some "down time" to recover and relax before moving to the next activity.

Setting time limits in advance ("we can stay for one hour") can help both parents and children prioritize what they want to do in the allotted time and avoid activities that may promote conflict or tantrums.

Dr. Daniel Coury is Chief of the Section of Developmental and Behavioral Pediatrics at Nationwide Children's Hospital. Coury's research interests include developmental and behavioral pediatrics, medical education, attention deficit hyperactivity disorder and autism.

I'm hearing about celiac disease more and more. What is it and what are the signs?

People who have celiac disease have a disorder that makes their bodies react to gluten. Gluten is a protein found in wheat, rye and barley - grains that are in many everyday foods.

In kids with celiac disease, gluten damages villi, the finger-like projections in the small intestine responsible for absorbing nutrients from food. When the villi are damaged, the body can't absorb nutrients the body needs to grow. If that happens, a child can become malnourished.

Celiac disease can lead to a wide variety of symptoms in different people. Infants may fail to gain weight and height as expected. In older kids, the condition can cause diarrhea,constipation,abdominal pain and bloating, weight loss, fatigue or anemiathatpersists despite taking iron supplements.

If celiac disease is diagnosed, the doctor will give you guidance on which foods your child can eat and which to avoid. Because these changes will greatly affect your family's everyday life and your child's diet, the doctor may suggest that you meet with a nutritionist for additional advice.

To avoid gluten, it's important to carefully read the labels of all foods before you buy them or let your child consume them. And help your child learn to do it too. When in doubt, the safest thing to do is to assume the product contains gluten and leave it out.

Dr. Jolanda M. Denham is an attending physician in the Division of Gastroenterology, Hepatology and Nutrition and Nationwide Children's Hospital. Denham's clinical interests involve all aspects of pediatric gastroenterology, with a special interest in nutritional disorders.

My child was born four weeks early. Thankfully, we're both home now and doing very well. Should I be concerned about long-term development delays? How can I ensure my child is developing at a normal pace?

Regular immunizations, medical care and evaluation are important for premature infants, as 50 to 70 percent can experience issues that affect long-term development.

During examinations, doctors will measure an infant's hearing, sight, nervous system development and motor skills development. They will also measure speech and behavioral development, as some infants may require speech, occupational or physical therapy as they age. The Neonatal Developmental Clinic at Nationwide Children's Hospital provides developmental screenings for infants up to two years following their hospital stay.

Apnea - or pauses in breathing - is common among premature infants and is usually diagnosed before discharge. It generally goes away on its own. Some preemies may develop bronchopulmonary dysplasia (BPD), which involves scarring and inflammation in the lungs. Supplemental oxygen and medications may be necessary after discharge.

Premature infants are particularly vulnerable to respiratory syncytial virus (RSV), an infection in young kids that is often mistaken for a cold or the flu. Infants born at less than 32 weeks and those born from 32 to 35 weeks that attend day care, have contact with multiple children or are exposed to second-hand smoke may be able to receive a vaccine for RSV.

Dr. Mary Ann Nelin is an Assistant Professor of Clinical Pediatrics at The Ohio State University and works in the Division of Neonatology's Neonatal Developmental Clinic at Nationwide Children's Hospital. She has been with Nationwide Children's Hospital since 2003.

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Tip of the Month

Holiday Hazards

Holiday gatherings, though fun, can pose a risk for children, particularly when they're not at a child-proofed home. Stay alert to potential dangers and keep the following out of your child's reach to ensure a safe holiday season:

Holly, mistletoe, evergreens and poinsettias: They can be poisonous depending on the quantity ingested.

Purses or bags: They may contain medications, cigarettes, alcohol or other dangers.

Decor: Beware of decorations that are choking hazards, broken ornaments and trees that children may pull on.

Leftovers: Clean up immediately - even a couple of ounces of alcohol left in a glass can be fatal to a curious toddler, and food can be a choking hazard.