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Toilet Training: Common Questions and Answers - American Family Physician

Oct 15, 2019 - Toilet training is a significant developmental milestone in early childhood. Most U.S. children achieve the physiologic, cognitive, and emotional development necessary for toilet training by 18 to 30 months of age. Markers of readiness for toilet training include being able to walk, put...

American Family Physician : Article

https://www.aafp.org/afp/2019/1015/p468.html

Hand-Foot-and-Mouth Disease: Rapid Evidence Review - American Family Physician

Oct 1, 2019 - Hand-foot-and-mouth disease is caused by human enteroviruses and coxsackieviruses. Outbreaks can occur in the spring to fall and are common in North America, and most cases occur in patients younger than 10 years. Hand-foot-and-mouth disease is transmitted by fecal-oral, oral-oral, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p408.html

Otitis Media: Rapid Evidence Review - American Family Physician

Sep 15, 2019 - Acute otitis media (AOM) is the most common diagnosis in childhood acute sick visits. By three years of age, 50% to 85% of children will have at least one episode of AOM. Symptoms may include ear pain (rubbing, tugging, or holding the ear may be a sign of pain), fever, irritability, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p350.html

Croup: Diagnosis and Management - American Family Physician

May 1, 2018 - Croup is a common respiratory illness affecting 3% of children six months to three years of age. It accounts for 7% of hospitalizations annually for fever and/or acute respiratory illness in children younger than five years. Croup is a manifestation of upper airway obstruction resulting...

American Family Physician : Article

https://www.aafp.org/afp/2018/0501/p575.html

Well-Child Visits for Infants and Young Children - American Family Physician

Sep 15, 2018 - The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. A complete history during the well-child visit includes information about birth history; prior screenings; diet; sleep; dental care; and medical,...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p347.html

Knee Pain in Adults and Adolescents: The Initial Evaluation - American Family Physician

Nov 1, 2018 - Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p576.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.html

Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones - American ...

May 15, 2019 - Apophysitis and osteochondrosis are common causes of pain in growing bones but have differing etiologies and required management. Apophysitis results from a traction injury to the cartilage and bony attachment of tendons in children and adolescents. Most often it is an overuse injury in...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p610.html

Recurrent Abdominal Pain in Children - American Family Physician

Jun 15, 2018 - Recurrent abdominal pain (RAP) in children is defined as at least three episodes of pain that occur over at least three months and affect the child’s ability to perform normal activities. RAP is most often considered functional (nonorganic) abdominal pain, but an organic cause is found ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p785.html

Adolescent Substance Use and Misuse: Recognition and Management - American Family ...

Jun 1, 2019 - Adolescent use of illicit substances imposes an enormous burden on individuals, families, and communities. The types of illicit substances adolescents are using have changed drastically over the past decade with decreases in alcohol use (including binge alcohol use) offset by increases ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p689.html

Neonatology/Newborn Issues - American Family Physician

Aug 15, 2019 - This collection features AFP content on neonatology and newborn issues and related topics, including breastfeeding, circumcision, jaundice, newborn examination, newborn resuscitation, newborn screening, premature infant care, postpartum counseling, and well-child visits. This collection...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=18

Febrile Seizures: Risks, Evaluation, and Prognosis - American Family Physician

Apr 1, 2019 - A febrile seizure is a seizure occurring in a child six months to five years of age that is accompanied by a fever (100.4°F or greater) without central nervous system infection. Febrile seizures are classified as simple or complex. A complex seizure lasts 15 minutes or more, is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p445.html

High Blood Pressure in Children and Adolescents - American Family Physician

Oct 15, 2018 - High blood pressure in children and adolescents is a growing health problem that is often overlooked. Children should be screened for elevated blood pressure annually beginning at three years of age or at every visit if risk factors are present. In children younger than 13 years, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p486.html

Health Maintenance in School-Aged Children: Part I. History, Physical Examination, ...

Aug 15, 2019 - The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. During the visit, the physician should address patient and parent/caregiver concerns and ask about ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p213.html

Gastroenteritis and Diarrhea in Children - American Family Physician

Mar 1, 2019 - This collection features AFP content on gastroenteritis and diarrhea in children and related issues, including dehydration, foodborne illnesses, probiotics, and rotavirus vaccination. This collection features AFP content on gastroenteritis and diarrhea in children and related issues, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=9

Health Maintenance in School-Aged Children: Part II. Counseling Recommendations - ...

Aug 15, 2019 - School-aged children (five to 12 years) are establishing patterns of behavior that may last a lifetime; therefore, during health maintenance visits, it is important to counsel families on healthy lifestyle practices. Children should eat a diet high in fruits, vegetables, whole grains, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p219.html

Type 2 Diabetes Mellitus in Children - American Family Physician

Nov 1, 2018 - The prevalence of type 2 diabetes mellitus in children and adolescents has increased worldwide over the past three decades. This increase has coincided with the obesity epidemic, and minority groups are disproportionately affected. The American Diabetes Association recommends screening ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p590.html

Lead Poisoning in Children - American Family Physician

Jul 1, 2019 - Asymptomatic lead poisoning has become more common in children. Blood lead levels of less than 5 µg per dL are associated with impairments in neurocognitive and behavioral development that are irreversible. Risk factors for lead poisoning include age younger than five years, low ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p24.html

Conduct Disorder: Recognition and Management - American Family Physician

Nov 15, 2018 - Conduct disorder is a psychiatric syndrome that most commonly occurs in childhood and adolescence. It is characterized by symptoms of aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules. Risk factors include male sex, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1115/p584.html

Nutrition in Toddlers - American Family Physician

Aug 15, 2018 - The establishment of eating practices that contribute to lifelong nutritional habits and overall health begins in toddlerhood. During this time, children acquire the motor skills needed to feed themselves and develop preferences that affect their food selections. Classifications for ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p227.html

Poststreptococcal Illness: Recognition and Management - American Family Physician

Apr 15, 2018 - Group A beta-hemolytic streptococcus can cause several postinfectious, nonsuppurative immune- mediated diseases including acute rheumatic fever, poststreptococcal reactive arthritis, pediatric autoimmune neuropsychiatric disorders, and poststreptococcal glomerulonephritis. Except for ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0415/p517.html

School Absenteeism in Children and Adolescents - American Family Physician

Dec 15, 2018 - Frequent school absenteeism has immediate and long-term negative effects on academic performance, social functioning, high school and college graduation rates, adult income, health, and life expectancy. Previous research focused on distinguishing between truancy and anxiety-driven ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p738.html

Right Care for Children: Top Five Do's and Don'ts - American Family Physician

Mar 15, 2019 - Underuse and overuse of medical interventions, failure to use interventions known to be effective, and provision of tests or interventions in which benefits do not exceed harms are types of low-value care. The Lown Institute’s Right Care Alliance Children’s Health Council identified ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p376.html

Childhood Bullying: Implications for Physicians - American Family Physician

Feb 1, 2018 - Childhood bullying is common and can lead to serious adverse physical and mental health effects for both the victim and the bully. In teenagers, risk factors for becoming a victim of bullying include being lesbian, gay, bisexual, or transgender; having a disability or medical condition ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p187.html

General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues - ...

May 15, 2018 - Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p642.html

Attention Deficit/Hyperactivity Disorder: Screening and Evaluation - FPIN's Help Desk ...

Jun 1, 2019 - The Conners Abbreviated Symptom Questionnaire has the best combination of positive and negative likelihood ratios.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0601/p712.html

Screening for Elevated Blood Lead Levels in Children and Pregnant Women: Recommendation...

Oct 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/1015/od1.html

Thickened Feedings for Infants with Gastroesophageal Reflux - FPIN's Help Desk Answers ...

Oct 1, 2019 - Bottle-fed infants with gastroesophageal reflux should be given thickened formula feedings.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/1001/p437.html

Laboratory-Based Prediction Model Can Rule Out Serious Bacterial Infections in Febrile ...

Oct 1, 2019 - In febrile infants up to 60 days of age, the combination of a normal urinalysis result, an absolute neutrophil count of less than 4,090 per mL (4.1 × 109 per L), and a serum procalcitonin level of less than 1.71 ng per mL is accurate at ruling out serious bacterial infections.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440.html

Maintenance Intravenous Fluids in Children: AAP Provides Recommendations - Practice ...

Aug 15, 2019 - The American Academy of Pediatrics has created an evidence-based guideline recommending the use of isotonic fluids for patients 28 days to 18 years of age to reduce the risk of developing hyponatremia.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0815/p251.html

Infantile Hemangioma: AAP Releases Guideline for Management - Practice Guidelines - ...

Aug 1, 2019 - Infantile hemangiomas are the most common benign tumors of childhood, occurring in up to approximately 5% of infants. These benign vascular tumors are small, self-resolving, and do not require treatment.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0801/p186.html

Vaccines for Preventing Influenza in Healthy Children, Healthy Adults, and Older Adults...

Aug 1, 2019 - Influenza vaccination reduces rates of laboratory-confirmed influenza and symptomatic influenza-like illness in healthy children, healthy adults, and older adults. There is no consistent evidence that influenza vaccination reduces school absenteeism in children, parental absenteeism ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0801/p143.html

Chronic Cough After Acute Viral Bronchiolitis: Suggestions from the ACCP - Practice ...

May 15, 2019 - To address the high prevalence of bronchiolitis, the effects of chronic cough on patients' quality of life, and adverse effects from inappropriate use of medications, an expert panel from the American College of Chest Physicians performed systematic reviews to develop several ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0515/p654.html

Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: Recommendation Statement - ...

Aug 15, 2019 - The USPSTF recommends prophylactic ocular topical medication for all newborns to prevent gonococcal ophthalmia neonatorum.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0815/p236.html

Skin-to-Skin Contact for Improved Duration of Breastfeeding - FPIN's Help Desk Answers ...

Aug 1, 2019 - Skin-to-skin-contact in the immediate postnatal period should be recommended to all mothers because it is associated with a higher likelihood of exclusive breastfeeding at hospital discharge and for up to six months afterward (number needed to treat [NNT] = 5 to 8).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0801/od2.html

Interventions to Prevent Child Maltreatment: Recommendation Statement - U.S. Preventive...

Jul 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0715/p110.html

Screening for Adolescent Idiopathic Scoliosis: Recommendation Statement - U.S. ...

May 15, 2018 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for adolescent idiopathic scoliosis in children and adolescents aged 10 to 18 years.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/0515/od1.html

Child Passenger Safety: AAP Updates Best Practice Recommendations - Practice Guidelines...

Apr 15, 2019 - There has been an increase in scientific evidence supporting the use of child safety and booster seats. The American Academy of Pediatrics (AAP) has updated best practice recommendations on child passenger safety based on this evidence.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0415/p525.html

Mild TBI in Children: Guidance from the CDC for Diagnosis and Treatment - Practice ...

Apr 1, 2019 - Mild traumatic brain injury in children is a major problem in the United States. Based on a systematic literature review, the Centers for Disease Control and Prevention (CDC) released recommendations specific to children with Glasgow Coma Scale scores of 13 to 15.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0401/p462.html

Pulse Oximetry Screening for Critical Congenital Heart Defects in Newborns - Cochrane ...

Apr 1, 2019 - Pulse oximetry is an accurate screening test for critical congenital heart defects in newborns. Pulse oximetry is simple to use, widely available, and has moderate sensitivity (76.3%) and good specificity (99.9%). However, the prevalence of critical congenital heart defects is low, and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p421.html

Smectite for Acute Infectious Diarrhea in Children - Cochrane for Clinicians - American...

Mar 1, 2019 - When compared with placebo, smectite decreases the duration of diarrhea by about a day, with a mean difference of 24.4 fewer hours of diarrhea (95% confidence interval [CI], 17.9 to 30.9 hours). Smectite also decreases stool output by 11.4 g per kg (95% CI, 0.8 to 22 g per kg).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0301/p294.html

Digital Media Use Associated with ADHD Symptom Development Among Adolescents - POEMs - ...

Feb 1, 2019 - High school students who reported a high frequency (many times per day) of digital media use (e.g., social networking, streaming movies or music, texting) were significantly more likely to self-report symptoms of ADHD over two years of follow-up (10% higher symptom reporting rate).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p189.html

Depression in Adolescents: AAP Updates Guidelines on Diagnosis and Treatment - Practice...

Oct 1, 2018 - These updated recommendations from the American Academy of Pediatrics aim to address the identification and diagnosis of all forms of depression in adolescents, defined in this guideline as those 10 to 21 years of age.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/1001/p462.html

Nebulized Hypertonic Saline for Bronchiolitis - Medicine by the Numbers - American ...

Jul 1, 2018 - Despite reported benefits associated with the use of hypertonic saline for bronchiolitis, we have chosen a yellow recommendation because the more recent trials and systematic reviews have shown either much smaller effect size or no benefit at all compared with the older trials. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0701/p23.html

Hyperpronation Method for Reduction of Nursemaid's Elbow - Medicine by the Numbers - ...

May 15, 2018 - Although data are limited, the results have consistently shown a higher rate of success with first attempt reduction of nursemaids' elbow when the hyperpronation method was used. For other outcomes, including pain and adverse effects such as bruising, no conclusions could be drawn ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0515/od2.html

Feed Thickener for Newborn Infants with Gastroesophageal Reflux - Cochrane for ...

Sep 1, 2018 - Feed thickeners decrease the number of reflux episodes in full-term formula-fed infants. Additionally, full-term formula-fed infants with GER who are given thickeners are more than twice as likely to be asymptomatic compared with infants not receiving thickeners at one to eight weeks of...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0901/p275.html

Counseling Parents and Adolescents About Marijuana - Editorials - American Family ...

Jul 15, 2018 - Physicians are increasingly likely to be asked by adolescents or their parents whether recreational marijuana use is safe. Although many adults view marijuana as benign, there are major concerns about its use in adolescents because all illicit drug use, including marijuana, may have ...

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0715/p80.html

Interventions for Increasing Fruit and Vegetable Consumption in Children Five Years and...

Oct 1, 2018 - Child feeding interventions are effective in the short term (i.e., less than 12 months) for increasing a child's intake of fruits and vegetables, but only by less than 5% of the recommended daily allowance. Conversely, parental nutrition education and multicomponent interventions, such ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1001/p419.html

Interventions for Treatment of Overweight and Obese Children - Cochrane for Clinicians ...

Aug 1, 2018 - Interventions that include combinations of diet, physical activity, and behavior changes may reduce weight, body mass index (BMI), and BMI z-score (equivalent to BMI-for-age percentile) in overweight and obese children six to 11 years of age.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0801/p151.html

Antibiotics for Otitis Media in Children - Medicine by the Numbers - American Family ...

Jun 15, 2018 - This meta-analysis concludes that the risk of a prolonged course of antibiotics was twice as high for children younger than two years with bilateral acute otitis media than for children two years and older with unilateral acute otitis media, indicating that antibiotics might be ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0615/od3.html

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