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Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

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Nội dung chi tiết: Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2n the tightly controlled insurance reimbursement climate in the U.S. However, despite the challenges, preventive care remains a major focus in pediatr

ic integrative medicine.In the U.S. there are typically 32 well child visits, including the prenatal visit, with the majority occurring before rhe age Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

of 5 years. These offer an important opportunity to reinforce a lifelong foundation of health. The integrative medicine model can be used to enrich t

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

hese visits by introducing more derailed information on nutrition, selected dietary supplements, stress management tools, physical activity, and sleep

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2nt stage, an estimated 20% of pediatric office visits are due to behavioral or mental issues, highlighting the importance of addressing nurturing rela

tionships, family and peer connections, self-regularion skills, self-efficacy, effective behavior change, and development of empathy and compassion fo Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

r others—skills that are routinely taught in integrative medicine.The Bright Futures resources through the American Academy of Pediatrics provides a f

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

oundation of rich resources on traditional pediatric health and health screening, and continues to serve as a classic blueprint for those caring for c

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2screening annually from age 11-21. Screening for dyslipidemia is now recommended for patients between 9 and 11 years old, screening for HIV between 16

and 18 years old (Geoffrey et al. 2014).This chapter includes a discussion and checklist of proposed integrative anticipatory guidance suggestions by Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

age. Ideally these guidelines would be introduced and consistently reinforced in an integrative medical home that supports child, family, and clinici

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

an health. Some opportunities to influence rhe health of rhe newborn begin long before birth. As in any practice of medicine, cultural considerations

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2 rhe model presented here fully supports the use of routine immunizations. Despite historic and ongoing controversy, the protective benefits are enorm

ous against illnesses that continue to be prevalent around the world. Although a polarizing topic, no child is well served when adults take extreme po Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

sitions in this218 Integrative Pediatrics: Art, Science, and Clinical Applicationdebate. No family should be dismissed from a practice for refusing to

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

vaccinate, just as no family should be encouraged to rely on “herd immunity,” relying on high vaccination rates on other children as a protective mec

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2d for medical reasons, or children who did not get a full immunologic response at real risk of exposure to serious illnesses (Buttenheim 2012).Some pa

rents resist vaccinations on moral or religious grounds, or due to underestimation of real risk to their children. Others fear triggering of autism or Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

other serious neurological disease, or have deep skepticism that vaccines can actually prevent illnesses. Of concern, vaccine refusal rates are incre

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

asing in the U.S. which tracks with increasing prevalence of outbreaks of measles and pertussis (Omer et al. 2009).One of the early spikes in anti-vac

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2he article was published in Lancet in 1998 and later retracted (Editors of The Lancet 2010).Author Wakefield and his two co-authors were charged with

professional misconduct and falsifying research. Wakefield was eventually banned from the practice of medicine. Despite rhe serious professional fallo Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

ut to Wakefield, rhe ripple effect from his erroneous work has been far reaching. Rates of immunization remain impacted in the U.S. and in other devel

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

oped countries despite a range of large well-designed studies disproving the association between vaccines and any partem of serious neurodevelopmental

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2n the first 24 months of life. Again, no established correlation between this schedule and serious neurodevelopmenral or immunological outcome has bee

n reported. The American Academy of Pediatrics encourages practitioners to encourage open and respectful dialogue with parents about vaccines, and to Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

work with rhe parents to be sure every child is fully vaccinated (Gilmour et al. 2011).Airhough rhe rerm “alternate vaccine schedule” is popular, stud

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

ies show that rhe majority of families using this approach are following informal recommendations from family, or picking and choosing vaccines based

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2le (Dempsey er al. 2011).Ideally, striking a balance between mutual respect, trust, flexibility, and collaboration and using evidence-based educationa

l tools will help rhe parent-clinician ream provide rhe best protection from what in many cases are 100% vaccine-preventable illnesses (Glanz, Kraus, Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

and Daley 2015).Studies have shown that clinicians who are willing to listen, and who manifest openness with eye contact, receptive body language, and

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

mindful presence in rhe room are most likely to connect successfully with parents and be able to fully understand their fears and concerns (Leask er

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2sory Group of Experts as being influenced by “complacency, convenience, and confidence.” Efforts are underway to improve educational approaches and re

sources and to support global efforts ro best protect children from preventable illness (Kumar et al. 2016).An Integrative Approach to Preventive Heal Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

th 219Lifestyle Foundations: Maternal HealthNutritionMaternal diet is important to fetal health, and accruing research offers more derails on best app

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

roaches. A ‘‘prudent" diet inclusive of vegetables, fruits, oils, whole grains, water as primary beverage, and liber rich bread was shown to be associ

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2n” diet that included salty and sweet snack foods, white bread, processed meats, and desserts. The traditional diet in this study consisted of potatoe

s and fish and was also associated with reduction in risk of preterm delivery compared to a ‘‘Western" diet (F.nglund-Ogge Ct al. 2014).Weight Managem Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

ent: Obesity RisksMaintenance of healthy weight throughout pregnancy has long-term implications for fetal and infant health. The 2013 American College

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

of Obstetricians and Gynecologists Committee Opinion No. 549 on Obesity in Pregnancy recommends that preconception counseling should review the feral

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2eight retention. Fetal complications have also been widely reported and include: prematurity, stillbirth, higher rate of congenital anomalies—includin

g neural tube defect, and large for gestational age which predisposes to childhood and adolescent obesity. The report recommends that nutrition counse Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

ling and encouragement to begin an exercise program should be offered to all overweight or obese women. Maternal obesity has also been shown to reduce

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

initiation and success at breastfeeding (American College of Obstetricians and Gynecologists 2013).Dietary SupplementsSimilar to folate, docosahexaen

14 An Integrative Approach to Preventive HealthTime available for pediatric preventive care in clinical visits has become more and more constricted in

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2hird trimester when rhe feral brain approximately doubles in size (Makrides 2013).D11A is also needed for development of rhe rods and cones of rhe ret

ina, sperm, and testicles (De Giuseppe, Roggi, and Cena 2014). Adequate DHA has also shown a significant association with prolonging gestation and red Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

ucing rhe risk of preterm delivery at less than 34 weeks gestation in both low-risk and in high-risk pregnancies (Mozurkewich and Klemens 2012).Matern

Ebook Integrative pediatrics - Art, science, and clinical application: Part 2

al consumption of omega-3 fatty acids during and post-pregnancy may also confer a protective effect against allergy by lowering allergen specific 1112

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