Top Pediatrics Trends 1999-2009

The last decade has produced some amazing changes in child health. Recently, I consulted some of the top pediatricians in the country to figure out where we’ve come from and where we are going next.  Some of these changes may surprise you, so hold on to your seat!

1. IMMUNIZATIONS HAVE REDUCED DISEASE AND CHANGED PEDIATRIC CARE

Hands down, immunizations have been our number one advancement in child health. As Carden Johnston, MD, FAAP, past American Academy of Pediatrics President, put it:

“Immunizations… (have) changed the way we practice medicine” by dramatically reducing the amount of incurable and devastating diseases.

2. GENERAL HEALTH CARE OF INFANTS IS BETTER

Dr. Johnston also pointed out that simple interventions have dramatically improved infant health:  “How about folic acid (for pregnant moms) and its impact on neural tube defects. The back to sleep campaign has had a tremendous change in [infant mortality rates]. “

3. PARENTING IMAGE AND CONFIDENCE IS SHAKY

American Academy of Pediatrics Member and Seattle pediatrics Don Shifrin, MD, FAAP, noted that parents are not portrayed very positively by Hollywood compared to years past:

“On the screen most parents are portrayed as absent, ineffective, clueless, or just plain mean. No more Cosby shows, Growing Pains, or that ilk. Just check the Disney Channel for examples daily.”

This erosion of a strong parental image may be what is behind the shaky parental confidence so many of us are observing in our offices and the dramatic rise in emergency room visits for relatively simple issues. Elizabeth Murray, MD, FAAP, Fellow, Pediatrics Emergency Medicine notes:   “During my training, I have lived and worked in 4 different parts of the country (and) one thing that seems to be on the decline is tolerance of a sick child.I think families are busier (with) moms often on their own.  They do not have an experienced grandparent to show them the ropes.”

4. YOUTH SPORTS INJURIES ARE ON THE RISE

Kids are simply playing sports too young and too hard with injuries occurring at younger ages such as Tommy John surgery that simply shouldn’t be occurring. Don’t count on your town’s league to do the right thing by your young athlete.  You must get more informed and be your child’s best advocate!

5. OUR KIDS ARE OVERSCHEDULED…AND DON’T NEED TO BE!

Dr. David Elkind wrote his famous book “The Hurried Child” in 1981. Today, in 2008, 27 years later, the situation is markedly worse than his famous book predicted.  The impact on our kids is increased stress with poor self-esteem. Studies are crystal clear on two fronts that our kids need more free time and more play.

Dr. Alvin Rosenfeld calls what we are doing “hyper-parenting” and suggests we all need to schedule our kids less so we can be as a family more.  The National Family Night movement came from his call to action that we’re truly pushing our kids in teh wrong direction and over parenting.

6. DR. GOOGLE

Many parents often turn to the web for information instead of calling their child’s pediatrician. This is a dangerous practice, as pointed out by Mark Rosenberg, MD, FAAP, a pediatrician from Chicago, Illinois:

“As recently as two generations ago, when a parent needed advice on the care and raising of their child, the trusted source of information was a grandparent or other close relative.  Now the ‘trusted’ source of information is the internet and the various information services available on line. While we owe a great deal to the information revolution online, there is much to be wary of.  Information may be posted by literally anyone, who then becomes an instant expert. “

7. BODY IMAGE

Visiting the McCord Museum at McGill University recently, I stumbled upon a fashion exhibit,  Reveal or Conceal?, that looked at trends in woman’s fashion from the 1900s to now. Click here to see the slide show of the exhibit.

Clearly, we show more skin and our clothes have much less material than even a decade ago.

Kids are looking too much like young adults and too many adults are trying to look like older kids. And, way too much skin is being shown on all ages.

Fashion can still be trendy with a bit more modesty and it is up to us to help our kids understand that and to lead by example.

8. THE FUTURE: TECHNOLOGY

According to Dr. Carden, “ Providers (in the next 10 years) will do more “eyes on hands off” care (where) monitors for the chronically ill will be connected to the physicians office so then they can use their cell phones (and computers) to look at each other, saving trips to the office and  (avoiding) many trips to emergency departments during evening hours.”

9. …AND GENETICS

Utilizing our new and growing understanding of the genetics of illness, it won’t be long before we see new and very high tech treatments of disease that utilize this knowledge and go after the imperfections in the genetic code that are resulting in disease.  This won’t be a comfortable situation for everyone initially but in many ways no different than the shock many people felt when vaccines were introduced. That was considered revolutionary way back when.  Dr.Johnston agrees.  “…the ethics, technology, science and entrepreneurism of genetics will confuse parents and providers alike”, he told me. “By 10 years we should be working through those issues…Challenges facing parents and providers will be almost as big as they were in the 40s and 50s with polio.”

10. A LOOKING GLASS INTO THE FUTURE

In a snap shot, what we are doing is not working out so well.  We must reclaim those values from the past that worked do well for kids and families and learn to move forward with social and scientific progress without losing them…again.

(Originally posted October 2008; updated December 2009)

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