On today's episode, we welcome back Matthew Greenhawt, MD, to discuss non-IgE related food allergies, including Food Protein-Induced Enterocolitis Syndrome (FPIES). Dr. Greenhawt is an associate professor of pediatrics and allergy at the University of Colorado School of Medicine.

In this episode:

• How non-IgE mediated food allergies most commonly presents in children
• The fact that non-IgE food allergy symptoms appear more slowly
• Identifying the various presentations and triggers of dietary protein-induced enterocolitis
• The benefits of using extensively hydrolyzed infant formulas or amino acid-based infant formulas
• Treating atopic dermatitis with a topical steroid versus allergy screening
• Creating awareness of eosinophilic esophagitis in the primary care discipline
• The importance of identifying family history patterns to diagnose allergies
• How the presentation of FPIES differs between environments globally

With us today is Matthew Greenhawt, MD, associate professor of pediatrics and allergy at the University of Colorado School of Medicine. Dr. Greenhawt discusses hot topics surrounding food-related allergies, including the early introduction of peanuts.

In this episode:

• What initial steps to take before referring patients to an allergist
• The importance of getting a complete patient history to diagnose food allergies
• Tools primary care providers can utilize in the diagnostic process
• Why the presence of IGE may not be an effective marker for a food allergy
• Understanding the cross-reactivity between different allergies
• How to implement a food allergy action plan
• Methods and recommendations for early introduction of the peanut
• Where providers can find resources for on-going food allergy education
• Recommendations on prescribing epinephrine

Links from today's episode

• Food allergies
• Research on how to avoid food allergies
• UpToDate

In this episode we discuss attention-deficit/hyperactive disorder (ADHD) medication management with Marissa Schiel, MD. Dr. Schiel is the Medical Director of the Outpatient Psychiatry Program at Children's Colorado and an assistant professor of child psychiatry at the University of Colorado School of Medicine. Also joining us is Danielle Stutzman, R.Ph., a clinical pharmacist at Children's Colorado with a special interest in psychiatry medication.

In this episode:

• The importance of getting a detailed history when assessing a child for ADHD
• Understanding the spectrum of ADHD symptoms and how they affect a child's function
• How to approach the medication management conversation when it comes to ADHD
• The most common side effects that are associated with stimulants or psychotropic medication
• Management strategies for dealing with potential medication side effects
• The importance of screening a child for cardiac concerns before prescribing stimulant medications
• Understanding the functional benefits of the two different classes of stimulants
• The ideal target doses for specific ADHD medications
• A recommended follow-up regime and titration strategy for patients
• How to counsel families on medication management as the child ages
• Medication recommendations to consider when trialing the non-stimulant class
• Techniques to use in therapeutic relationships with ADHD patients

Our guest for this episode is Marcy Yonker, MD. We discuss headache and migraine management in primary care, including their prevalence, triggers and treatment options. Dr. Yonker is the Director of the Headache Program at Children's Colorado and visiting professor of pediatrics at the University of Colorado School of Medicine.

In this episode:

• The prevalence of headaches and migraines in children
• Creating a differential headache diagnosis
• When imaging should be used
• Common medications prescribed for migraine headaches
• Newer treatments for headaches and migraine
• Natural remedies for headaches and migraines
• Triggers for migraines in children and teenagers
• The influence of family history on migraine prevalence
• The role of psycho-psychology in migraine diagnosis
• Other uncommon migraines
• Using Botox as treatment for migraines

In this episode Taizo Nakano, MD, discusses the most common vascular anomalies in the primary care setting. Dr. Nakano is the Medical Director of the Vascular Anomalies Center at Children's Colorado and assistant professor of pediatrics, hematology and oncology and bone marrow transplant at the University of Colorado's School of Medicine.

In this episode:

• Common presentation of a vascular anomaly
• The two major categories of a vascular anomaly
• Defining the genetics lesions
• Lab testing for vascular anomalies
• Vascular emergencies and the features of a lesion that can be detrimental
• Top 10 things to be concerned about with a vascular anomaly

In this episode, Sean O'Leary, MD, discusses vaccine safety and hesitancy from parents. He also suggests motivational interviewing techniques to use when talking with your patients and families. Dr. O'Leary is a pediatric infectious disease specialist at Children's Colorado and associate professor pediatrics and infectious diseases at the University of Colorado School of Medicine.

In this episode:

• How to help families identify the good information from misinformation regarding vaccines
• The prevalence of vaccine resistance
• Effectively and efficiently delivering vaccines information to parents
• Using motivational interviewing techniques when talking with parents about vaccines
• How to pivot the conversation when a parent is resistant to a care plan
• Why asking permission is a key component to motivational interviewing
• Understanding the differences between a recommended and alternate vaccine schedule
• Techniques for communicating relative risks about vaccines
• Working with parents who are vaccine resistant
• Vaccines that receive the most resistance and hesitancy

In this episode Sumeet Garg, MD, discusses back pain management, including identifying characteristics and the relationship between scoliosis and back pain. Dr. Garg is a pediatric orthopedic surgeon at Children's Colorado and associate professor of orthopedics at the University of Colorado School of Medicine.

In this episode:

• The incidence of back pain in kids, especially adolescence
• Identifying what to look for on physical examination
• When to obtain imagining
• The challenge with MRI in younger kids
• Suggestions for talking with patients and families about back pain
• Tight hamstrings and weak core abdominal muscles as an underlying driver of back pain
• What type of patients should see an orthopedic surgeon for back pain
• The relationship between scoliosis and back pain in pediatric and adolescent patients
• Bad posture as a habit and not a deformity
• Scoliosis and what families can expect over time

In this episode, Maya Bunik, MD, discusses common challenges and myths surrounding breastfeeding management and how to support new moms in your practice. Dr. Bunik is an executive committee member of the American Academy of Pediatrics (AAP) section on breastfeeding, Medical Director of the Child Health Clinic at Children's Colorado and a professor of pediatrics at the University of Colorado School of Medicine. Dr. Bunik is also the author of the AAP's breastfeeding telephone protocols and advice.

In this episode:

• Why breast is best
• Approaches to working with a new mom who is struggling with breastfeeding
• Identifying reasons why a mom is struggling with breastfeeding
• Impacts of sleep deprivation on new moms and their milk supply
• How to know whether a baby is getting enough milk
• The importance of babies' weight checks
• Ways to boost milk supply through milk removal
• Power pumping
• Indication of needing a lactation professional
• When a mom should start pumping after delivery
• Why breastfed babies need Vitamin D
• Common myths associated with breastfeeding
• Impact of cleft lip and palate with breastfeeding

In this episode, Amy Brooks-Kayal, MD, discusses acute seizure management. The conversation includes the importance of gathering a detailed history of a seizure event, identifying provocations of a seizure and options for anti-seizure and rescue medications.

Dr. Brooks-Kayal is the Chief of the Pediatric Neurology, Co-Director of the Translational Epilepsy Research Program and past president of the American Epilepsy Society.

In this episode:

• Responding to a patient's first seizure
• Importance of a detailed history of a seizure event
• Identifying provocations of a seizure
• Neurological examination
• Focal onset versus a generalized seizure
• Chances of seizure reoccurrence
• Anti-seizure and rescue medications
• Managing the anxiety of families
• Basic seizure safety
• Current research into pediatric epilepsy

In this episode, Duncan Wilcox, MD, talks about acute scrotum management. The conversation includes the most common indications of acute scrotum and how to differentiate an incarcerated hernia and a hydroceles scrotal trauma.

Dr. Wilcox is the Chair of Pediatric Urology and Surgeon-in-Chief at Children's Colorado. He is also a professor of surgery at the University of Colorado School of Medicine.

In this episode:

• The most common indications of acute scrotum
• The role trauma plays in acute scrotum
• How to treat testicular torsion and urgent treatment
• Differentiating an incarcerated hernia and a hydroceles scrotal trauma
• Why an incarcerated hernia needs to be treated rapidly
• The three groups of acute scrotum patients
• Long-term outcome for patients living with one testicle