Thank you for voting me to the Metro Parent’s 2012 Mom Approved Docs! I received the following comment from one of the parents:
Dr. Strumba is very empathetic. Being a new mom, I have all kinds of worries and concerns, but she never makes me feel silly or brushes off questions I might have. Plus, she is a certified lactation consultant, which is a HUGE bonus, since I am a full-time nursing mom! My 11-month-old daughter has also not cried once while in her care. -– Sarah, Livonia
The patient was a seven-year-old boy, who came to see me with his mom. She said that he complained of sore throat two days prior and was “spitting up” the “phlegm”. She denied any fever, cough or vomiting up food. She was concerned that her son was not able to eat or drink anything for past two days. The boy was seen on the previous day by a different doctor who examined him and took a throat swab, which showed no strep. During our conversation the boy was sitting on the exam table with a paper cup constantly spitting his saliva in it. He was not coughing and did not appear to be in pain. It looked like he was not able to swallow his saliva. “Does he have an abscess in his throat?” I thought. To my surprise his exam was absolutely unremarkable. He mentioned that his “neck hurts”, and pointed to the front of the neck. I asked the youngster if he remembered choking on something, but got no response.
I advised mom to take him to get X-Ray of his neck and chest immediately, on a suspicion of a foreign body. She did and a quarter was found is his food pipe! The quarter was uneventfully removed by a surgeon at the University of Michigan Hospital.
The lesson that can be learned from this story? — Even older children are capable of doing silly things; if you are dealing with a little child, a possibility of a foreign body should be very high on your list.
Expected Frequency. Can be up to ten times a day in a breast-fed newborn; passing of the stool by a newborn is a sign of a good food intake. Babies should have at least one stool a day. There may be occasional healthy infant (not a newborn) that may have one stool in five days; this child is not constipated if he still acts happy and his bowel movements are soft and do not cause pain. When to worry? If your newborn baby (under one month of age) did not have a bowel movement for 48 hours; or, if your child does not have daily stools in general. What to do? It depends on your child’s age:
If you have a newborn with no bowel movements for 48 hours, see your pediatrician: your baby may be suffering from poor food intake rather than from constipation.
For an infant you can use a glycerin suppository (get it over the counter) cut in half: put it in your baby’s rectum and hold the butt cheeks together for a moment.
If an older child is constipated, you may try a glycerin suppository as well, or in tough cases a pediatric enema (also available over the counter). That will help you to relieve your child’s discomfort and help him pass the stool on that particular occasion, but it does not prevent future episodes. So it is strongly recommended to see your pediatrician and among other things discuss a change in your child’s diet you need to implement.
Normal Consistency. The stool is usually liquid with some “seeds” in a newborn and couple months after. If your child is older than 6 months he should be eating some solid food daily and his stools should be soft but not liquid. When to worry? Pellet-like stools in an infant. Older children should not have hard large caliber stools or watery stools. What to do? See a doctor.
The rule of thumb is: if your child eats well and is active during the day, there should not be any issues with his stool.
A joke goes: “Mothers of teenagers know why some animals eat their young.” But all the jokes apart, raising a teenager can be a stressful and psychologically draining experience. I know it first hand. I am in no way an expert on this matter, just want to share some thoughts.
In some way having a child between the age of 12 and 16 is alike to having a newborn. They keep you up at night, you are worried for their well-being at every moment and you feel exhausted. The difference between taking care of a baby and raising a teen is that with newborns, though they are fragile creatures, a lot is in your power to protect them, with teens you sometimes feel helpless to prevent a problem. Your exhaustion is physical with a newborn, and mental and emotional with a teenager.
Your child, who was mostly sweet and aiming to please the parents before, turns into a creature with sharp fangs. Moods go up and down, happy moments are followed by “disasters” on a daily basis. You feel that you are riding a roller coaster, just hold on tight.
What are the parents to do? Rule number one: have faith in good outcome. Believe in goodness of your child. Despite those cutting words that you heard from your youngster this morning, remember that she is your child. She may not look small anymore, but her brain is still a brain of a child. She depends on you in many ways. So be noble enough to forgive her and continue being a loving, patient and helpful parent. In no way I am advocating for letting the child behave rudely and do what she pleases. That is not what parenting is about. Teach her to be polite, to control herself, and to be a good person. Do it with respect as if you are speaking to a colleague at work. It takes a lot of strength to control your anger, but this is your job.
Rule number two: set clear rules and stick to them. Set limits for sleepovers and Internet use. Get to know your child’s friends and their parents. Find out what rules they have. It helps to have everybody on the same page. That is the only way to survive the teenage years. You will be surprised to see that kids find comfort in having limits and knowing what to expect. For example, in my family we discuss the destination where my driving teenager is going, who will be there and time of her return before she starts driving. Thank G-d she is honest with us. Maybe it is because we trust her, maybe it is just our luck.
Rule number three: stay positive while dealing with your teen. Praise what can be praised however small the reason is, trust them to do the chores and give the praise for that, keep fun family traditions — having meals together, playing board games or going berry picking. Pay attention to their words and wishes, listen, provide comfort, create a warm and loving home. And stay informed on what is going on in their lives. The only way to do it is through love and respectful communication, not prying or spying.
And the last advice is: pray. It helps you and your child in many mysterious ways. Good luck!
A 20 month old boy presented in my office with a chief complaint of refusing to fall asleep in his crib. The parents said that whenever they put him in his bed and try to leave the room, he starts screaming until he works himself up to the point of vomiting. They heard many different suggestions from family, friends and their former pediatrician on how to handle the situation, and tried them all: from taking their child out of the crib after every sound he made to not coming into his room and letting him cry. Neither approach worked. By the time they they came to my office, their son was spending every night in their bed and the parents could hardly get a wink of sleep.
The method of “letting him cry” never worked for me as a mother, so I do not recommend that to the parents of my patients.
All people, children and adults alike, have periods of superficial sleep through the night, when they wake up and fall asleep again. They learned as infants the skill of putting themselves to sleep. This is the skill you want to teach your child by giving reassurance and comfort of your presence — not rocking him to sleep but letting him do it on his own.
This particular situation was aggravated by vomiting: parents were afraid that the child will vomit from crying and just did not put him back if he did it once. Their son was a smart little boy and quickly figured out what he had to do to end up in the parent’s bed. “What do we do if he starts crying and vomits again?” they asked. I recommended to wash his face, clean the mess and put him right back in his crib, but not to leave the room.
I suggested putting the child to bed when he is still awake and staying in the child’s bedroom next to his crib for a little while and either quietly talk or sing to him without taking him out of the crib. It’s OK to hold his hand or rub his back, but resist the urge to pick the child up: this sends the message that the crib is a bad place to be in, that he needs his mommy or daddy to “save” him. And he will demand it again next time.
Three weeks later the same patient came back for an unrelated reason. His mother said excitedly that all the sleep problems are gone. “We did what you said and he is a different child now!” she told me.
It’s the second year in a row that Anna Strumba MD, a West Bloomfield/ Novi pediatrician and lactation consultant, has been recognized as one of America’s Most Compassionate Doctors. The award is based on patients’ reviews. “While physicians generally receive positive feedback from their patients, only a select few receive praise about the compassion that accompanied their care… Of the nation’s 720,000 active physicians, less than 3% were accorded this honor by their patients in 2011,” Vitals.com, who tabulates this award, says.
When a man becomes a father, he may feel lost and awkward about the task of caring for the baby. As much as he wants to be useful, the new dad does not know where to start and what to do. Considering that a new mom may not feel very upbeat and energetic after delivery and may be in pain or just sleep deprived and emotional, the first two weeks may be tough for the whole family. So what can dads do to make it easier for everyone [Continue reading...]
Over the past two weeks I have noticed unusually frequent cases of pneumonia among children coming to my practice. Pneumonia has to be promptly treated with antibiotics: a recent study showed that in critically ill children with pneumonia, delays of even a few hours to treatment with the correct antibiotic increase risk for severe complications .
What is pneumonia and when should you suspect it? Pneumonia is an infection in the lung (or both lungs). It usually starts acutely with high fever and cough. Children with pneumonia look sick, they have decreased energy and appetite, they may vomit from cough and their breathing is fast and labored. Also pneumonia happens more often in kids who have history of asthma, since [Continue reading...]
You are expecting a baby. Congratulations! This is such a special time in your life. You may have researched a wealth of books and online resources about what to expect after baby’s arrival. You probably feel more and more excited, and anxious, as you get closer to the due date.
I am always happy to meet expectant mothers or couples coming to my office for a first interview. The fact that you took the time to come and meet me shows that you truly care about the future baby. I will highlight some practical points that may be important to you in the first weeks after birth:
We started displaying ads on this site. Running a website costs money, all coming from my family’s budget. I am not reimbursed for these expenses by my employer or anybody else. One way to offset the costs is to display paid ads on the site, so the ads are here to stay.