Dr. Patricia Helm, MD

Orthorexia is an unhealthy obsession with eating healthy. It has many tendencies that overlap with anorexia and OCD and causes great emotional turmoil for patients. It starts with a good goal of having a healthy diet but then usually overshoots, causing malnutrition and other complications.
 
Transcript: "So this question is, what is orthorexia? Orthorexia is basically an unhealthy obsession with eating healthy. And it actually was described in 1997, but really we're seeing a resurgence of this now. And it is a very common eating disorder, unfortunately. It is not technically in the DSM-5 yet, but it is very common in clinical practice. And unfortunately, with the surge of eating disorders over the last few years with the pandemic, it is one of the most common ones that I'm seeing in my practice. And really it's kids who are trying to eat healthy. So they try to eat healthy, and then they really go for it. And they way overshoot, and then they end up with some malnutrition. And unfortunately, orthorexia has many tendencies that overlap with anorexia as well as OCD. And so when kids and adults have orthorexia, what happens is that the obsession of the food is not really the quantity of the food but really the quality of the food. This can happen when people try to eat really clean, and then they overdo it and then become malnourished because they've either cut out food groups or they will only eat certain good foods or bad foods that they have designated. It causes great emotional turmoil for patients with orthorexia when they cannot obtain these foods, and they can't really deviate from the new diet. So it is a little bit insidious as it starts typically with a really good goal-- to have a healthy diet and to optimize sport performance or whatever the patient's goal is-- but then usually way overshoots and then becomes actually more difficult to treat and causes many complications including malnutrition."

Pointing is an important social and communicative skill that babies, infants, and toddlers develop between 12 and 18 months. It's a way for them to communicate what they find interesting and share it with a caregiver, which is called joint attention.
 
Transcript: "So this is a great child development question. It's on pointing and why is pointing so important. Older kids we teach them not to point-- put your finger down-- but it is a huge developmental milestone for toddlers. Usually between 12 and 18 months and sometimes sooner, kids learn to point. This is a very important social and communicative skill that babies, infants, and toddlers develop. They do it to show you they think something is important. And this is very important because as they're pointing, they're showing someone, a caregiver, that they see something and they want you to see it too. This is called joint attention. It's looking at something on purpose with intention that I think is interesting. It may be a plane. It may be a truck. It may be a ball. Whatever it is, that child is trying to communicate. They see something cool and they want you to think it's cool too and to look at it. This is very important for child development and for communication skills. Often kids learn to point about when they learn to talk but sometimes even before. And it's a very important skill that they learn very early on. So that is the big deal about pointing. It is joint attention, intentionally looking at something that the child is interested in and they're able to communicate that with the caregiver."

Swimmer's ear is an infection of the external ear canal and can be prevented by using swimmer's ear drops and drying the ear with a hairdryer after getting out of the water.
 
Transcript: "So great question about swimmers here. And how do we prevent it? Kids swim all the time. Some kids are more prone to it, some are not. A previous question asked what is swimmer's ear. And just as a reminder, it's an infection of the external ear canal called otitis externa. So not behind the tympanic membrane and not in the middle ear. It usually is treated best with antibiotic drops. The question is how to prevent it. This is tricky. You can't always prevent it. But some things that are helpful are when you get out of the water using the swimmer's ear drops that are just over the counter. If you have tubes or a perforated eardrum, please talk to your doctor first. But in general if you're ear is healthy, swimmer's ear drops can be helpful. The other thing is drying of the ear canals. So using a hairdryer actually just for the external ear here. You don't have to dry the whole head, but just getting any extra water or moisture out of the ear canal, that way helps keeps the ears dry and also may help prevent infection."

Hand Foot and Mouth is a contagious virus that can cause blisters in the diaper area, as well as the hands, feet, and mouth. It can often last a long time, and it is possible to get it more than once. It belongs to a group of viruses called enteroviruses and is caused by the coxsackievirus. It is most common in the summertime.
 
Transcript: "So, it's summer season, and there's a great question on Hand Foot and Mouth. So, Hand Foot and Mouth is a virus that is very contagious, actually. And the blisters are not always in the hands, the mouth, and the feet. They're often in the diaper area as well. It can last a long time. It seems like forever sometimes when you're a parent, because kids are contagious till that last blister appears. And the question really was, can my child get Hand Foot and Mouth more than once? And absolutely. You can get Hand Foot and Mouth more than once. Hopefully not so many times, and just once or twice, but it certainly is possible. Hand Foot and Mouth belongs to a group of viruses called enteroviruses. And specifically, Hand Foot and Mouth is caused by the coxsackievirus. Enteroviruses are very common in the summertime. So we see this virus really all year long, but most commonly in the summer. And let's hope your kids don't get it more than once."

Your child should be eligible for the COVID vaccine as soon as they've finished their 10 day quarantine period and symptoms have resolved. You can opt to wait a month or two, but it's recommended to get the vaccine as soon as eligible for best protection.
 
Transcript: "So this is a question about the COVID vaccine, and when should your child get the COVID vaccine if they've already had a clinical COVID infection. I wish there was a magic answer for this, but really there's eligibility criteria. So your child is eligible for the vaccine as soon as they've completed their 10 day quarantine period, and as soon as their symptoms have resolved. So if your child has met these two criteria, then they're eligible for the vaccine. Some families are opting to wait a month or two after to take advantage of some natural immunity, and that's reasonable. Certainly check with your doctor about specific timing for your child and their medical needs. There are some adult studies that show three months of protection. And so some families are waiting the full 90 days as well. But we are really encouraging families to opt for vaccination as soon as these criteria are met-- the completion of the quarantine and symptom resolution-- so your child can be protected from serious disease, and from complications in the future. Given the great prevalence of COVID right now, it certainly is possible that your child may have had clinical infection prior to the vaccine, and then they should still be vaccinated when eligible."

Constipation is a common complaint in kids, and can be treated by increasing fiber intake in the diet with foods such as prunes, peaches, pears, plums, and raspberries. If symptoms persist, an over-the-counter laxative may be necessary, but should be taken under the direction of a pediatrician. It's recommended that kids ages two to five get 7 to 15 grams of fiber per day.
 
Transcript: "This question is about constipation, and how to treat it in kids. Constipation is a very common complaint in children. It often presents as belly pain. It's one of the number one presenting symptoms of belly pain in the pediatrician's office. And the question is really how to treat it. So when kids are little, we know that water helps and fiber help a lot. Everybody knows about prunes, but the other P foods, peaches, pears, plums, and raspberries even, have a lot of fiber in them, and are easy to incorporate into a toddler's diet, who likely won't take a full diet of kale to maintain that colon health. So usually that helps. And what you're trying to do is titrate whatever foods you're giving your child to have one soft, but formed, bowel movement every day, or every other day. Too much or too little can often cause belly pain and then constipation. Warning signs certainly are distended belly, vomiting, diarrhea, leaking of stool. If these things are happening, please talk to your pediatrician. Some children also have issues with withholding stool due to various social and physiologic concerns. So your child should be evaluated. And sometimes an over-the-counter laxative in this case is most appropriate. But your pediatrician can guide how long the child should take it, and how much they should have. Sometimes in these cases, you need to actually reestablish colorectal tone before increasing fiber. But if your child has a normally developing GI system, and just gets a little backed up every once in a while with some belly pain, please do increase the fiber in the diet. A good rule of thumb is five more grams than the age. So if your child is two, plus five grams of fiber is kind of what you need. A good rule of thumb is 7 to 15 grams for most kids ages two to five. Hopefully, that's a good benchmark to aim for, and some helpful tips to treat constipation."