Change in a Boy

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 [Continue reading…]

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Raising Teenagers Roller Coaster

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 [Continue reading…]

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When a Toddler Refuses to Sleep in His Crib

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 [Continue reading…]

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Welcome to the Expectant Parents

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:

Your baby will be seen by a pediatrician who will come to the hospital [Continue reading…]

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Dr. Strumba Is Now an IBCLC

Hurray! I have achieved a certification and a title of an International Board Certified Lactation Consultant (IBCLC). My full name became a bit longer: Anna Strumba MD, FAAP, IBCLC.

One may wonder, “why would a doctor want to become a lactation consultant?” In my work as a pediatrician I frequently have to take care of the babies that are breastfed. In fact, in most situations that means to take care of both: baby and mother. For the baby to be growing and thriving, the mother has to know how to latch and nurse in a proper [Continue reading…]

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Breastfeeding Counseling and Supplies Free under Affordable Care Act

A symbol of a mother nursing a child

The U.S. Department of Health and Human Services (HHS) announced the new guidelines that require health insurance plans to cover women’s preventive services such as breastfeeding support, well-woman visits, domestic violence screening, and contraception without charging a co-payment, co-insurance or a deductible. New health plans will need to include these services without cost sharing for insurance policies with plan years beginning on or after August 1, 2012.

What a great news! The visits to the Providence Park Hospital’s Breastfeeding Clinic will become most affordable for all mothers.

Coincidentally and very appropriately, the announcement has been issued on the first day of [Continue reading…]

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Toddlers Should Ride Rear-Facing to Age 2

The American Academy of Pediatrics released the new, 2011 policy on car seats. The biggest change from the previous policy is that parents are now advised to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. The recommendation is supported by new research showing that children under age 2 are 75 percent less likely to die or be severely injured in a crash if they are riding rear-facing.

The previous policy, from 2002, cited age 12 months and 20 pounds as a minimum to ride forward-facing. As a result, many parents turned the seat to face the front of the car when their child celebrated his or [Continue reading…]

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Starting Solid Foods

To many new mothers feeding babies anything but the breast milk or formula can be a difficult task. Parents often have questions regarding what to start with and how much to give and how often and what to stay away from.

In reality it is not as complicated as it seems to be. Here some simple rules.

You may start solids between 5 and 6 months of babies age. Pick the time of the day when your baby has the best disposition and appetite, and give solids BEFORE you give the bottle or your breast. Start with a single ingredient food: powdered rice cereal mixed with breast milk or formula that your baby is used to. If your baby has a [Continue reading…]

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Breastfeeding: Unveiling the Truth

While meeting parents before their baby is born or speaking to the mother of a newborn at the hospital, I am amazed at how many mothers have a totally distorted view on breastfeeding. From “I was fed formula, so I will feed my babies the same” to “I do not want to do it because it hurts”. These mothers do not realize that they are the victims of the culture, formula-feeding culture that is. Our country is probably unique: the formula industry totally changed the approach to feeding the baby, and breastfeeding is often viewed as an anachronism or inconvenience. We have lost the community/family knowledge about this process because for many generations babies were fed formula only. Where will the [Continue reading…]

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Breastfeeding Clinic to Open at Providence Park Hospital in Novi

I recently had a pleasure to speak at the pediatric department meeting where I announced the opening of a Breastfeeding Clinic at Providence Park Hospital. I will start seeing patients there in July 2010.

The clinic will be Michigan’s second pediatrician-led breastfeeding clinic. The big advantage of such an arrangement over the private lactation consultations is not only the evaluation will be provided by a doctor, but also the fact that the services will be covered by most insurance plans.

Each mother-baby couple will be given 45 to 60 min appointment with a team consisting of a pediatrician and a lactation consultant. Our intentions are to help mothers to achieve their goals, whether it is exclusive breastfeeding or partial breastfeeding, to [Continue reading…]

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