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Ask Dr. Bob
 

Make sure your child’s blood pressure is checked regularly

This column originally appeared in the March 24, 2008 issue of the St. Louis Post-Dispatch.

 

High blood pressure is most commonly found in adults.  But children, even babies, are also susceptible to this condition that can lead to heart disease and stroke in adulthood.

Among the email questions I receive from parents and grandparents, I sometimes hear from people asking about high blood pressure, or “hypertension,” in children.

Pediatric high blood pressure is most common in children who are overweight, African American, or who inherit the condition from one or both parents.  Heart or kidney disease can also contribute to high blood pressure, although it may go away once the primary disease is treated.

All children age 3 years and older should have their blood pressure checked at least once a year, during routine visits to the pediatrician. Catching high blood pressure early improves your chances of effectively treating the condition and reduces medical complications later.  A special diet and regular physical activity may lower blood pressure, especially for overweight children. Taking medication is the best route for some other children.

In any case, the best approach is to be sure your child’s blood pressure is checked regularly by his or her pediatrician. Here are some other questions from readers:

 

Dear Dr. Bob:
My grandson is seven weeks old and has acid reflux.  They have him on Nutramigen  lipil formula. This is the third different kind he has been on. But he cries so bad some times and screams and stretches his little legs out.  I am so worried about him; I do not think he should be going through such pain. He spits up sometimes, about an ounce. They give him some kind of medicine for this acid reflux but it makes him sleepy. I guess he is worn out from fighting sleep. Any suggestion you can give me I will deeply appreciate.

                         
Gastroesophageal reflux (GER) is common in healthy infants, but it certainly can be concerning to parents and can sometimes be a serious condition. More than half of all babies experience reflux in the first 3 months of life, but most stop spitting up between the ages of 12 and 24 months.

GER occurs when stomach contents reflux, or back up, into the esophagus (the tube that connects the mouth to the stomach) during or after a meal. GER can also occur when babies cough, cry, or strain. The good news is that only about 5% of infants carry this condition into childhood.

Your grandson’s acid reflux certainly appears to be severe. Have the doctors tried thickening his feeds with rice cereal and sitting him up in a pumpkin seat or holding him upright after feeds? There are also other positions that work.  You say that they are trying a medicine for acid reflux and this should help.  It is very important to communicate with the doctors if he isn't improving so they can try something different.

You can find more information on acid reflux in infants at these Web sites: http://digestive.niddk.nih.gov/ddiseases/pubs/gerdinfant/index.htm and http://www.webgerd.com/GerdInInfants.htm

 

Dear Dr. Bob,
I just had my son seen by a doctor for Gastroenteritis.  He was very sick and dehydrated and couldn’t keep anything down for three days. Now my almost 2-year-old has it and also has diarrhea. He was also just diagnosed with an ear infection. I was wondering how long I should wait to bring him to the hospital. We have been giving him sips of water and Pedialyte, but he can’t keep it in. I don’t want to overreact but I also don’t want him to get as bad as my oldest. Please Help!

Viral gastroenteritis is an intestinal infection caused by several different viruses. Highly contagious, viral gastroenteritis is the second most common illness in the United States. It causes millions of cases of diarrhea each year.

Anyone can get viral gastroenteritis and most people recover without any complications. However, viral gastroenteritis can be serious when people are unable to drink enough fluids to replace what is lost through vomiting and diarrhea.  Infants and young children are among the most vulnerable to these complications.
If your son isn't keeping Pedialyte down, he needs a medical evaluation from his pediatrician. It’s almost always best to start there.  If your doctor isn't available I would come in to the emergency department.  I hope he gets a lot better soon.

 

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine.

3/24/2008 
 
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