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Are Premature Babies Delayed?

The term premature refers to any infant that was born earlier than 37 weeks of gestation. Premature births occur in 10% of all live births. Premature babies (“preemies”) are at risk for multiple health problems, including breathing difficulties, cerebral palsy, learning disabilities, and delays in their gross and fine motor skills.

Premature baby

Why are babies born pre-term?

The cause of premature labor is not fully understood. However, there are certain risk factors that can increase the likelihood of premature labor: a woman that has experienced premature labor with a previous birth, a woman that is pregnant with multiples (twins, triplets, etc), and a woman with cervical or uterine defects. Certain health problems can also increase the risk of premature labor, including diabetes, high blood pressure and preeclampsia, obesity, in-vitro fertilization, and a short time period between pregnancies.

What are the effects of being born pre-term?

In addition to multiple medical complications, a baby that is born before 37 weeks of gestation is at risk for developmental problems in gross motor skills, fine motor skills, sensory integration, speech and language skills, and learning. The baby may take longer to reach specific developmental milestones or need help to reach those milestones. The earlier babies are born, the more at risk they are for having delays. Each child is different as well, and no two preemies will be delayed in exactly the same manner.

If you or your pediatrician suspects that your baby is developmentally delayed, there are a variety of professionals that can assist your child in achieving his or her full potential. A physical therapist can help facilitate development of gross motor milestones such as sitting, crawling, walking, running, or jumping. An occupational therapist can help develop fine motor skills such as object manipulation, hand-eye coordination, and reaching, as well as sensory integration. Speech therapists can help improve language skills and articulation.  Consult with your pediatrician or talk with one of our Family Child Advocates to receive more information on setting up an evaluation with a skilled therapist at NSPT.

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Weight Issues: What Effects Do Overweight And Obesity Have On Our Kids?

As of 2008, the prevalence rate for childhood obesity was almost 20% in kids 2-19 years old (1). Obesity is diagnosed by a single measure, which is the Obese ChildrenBody Mass Index (BMI) percentile on the growth chart. BMI is calculated as a proportion of weight to height, and reflects how much weight a person carries for their height. BMI is categorized differently for children and adults.

For children, these are the Obesity parameters:

BMI greater than 85th percentile is diagnosed as overweight.
BMI greater than 95th percentile is diagnosed as obese.

Pediatricians or other healthcare professionals should be measuring and plotting BMI for all kids over the age of 2 at regular visits. If a child’s BMI plots higher than the 95th percentile, action needs to be taken. It is the position of the American Academy of Pediatrics as well as the Academy of Nutrition and Dietetics that obese kids need intervention to achieve a healthy weight status. Studies have shown that the most effective treatment is a multi-disciplinary, family based approach with regular, frequent visits.

The reason why it is important to seek help is because obesity is a chronic health problem. There are several comorbitities, or associated health risks, that can develop during childhood as a result of obesity:

  • High blood pressure (hypertension), which is correlated with heart disease and stroke.
  • High cholesterol (hyperlipidemia), which is correlated with heart disease and stroke.
  • Type 2 diabetes, which was previously called “adult-onset diabetes” since it used to only be diagnosed in adults. Type 2 diabetes can lead to other health issues such as heart disease, stroke, neuropathy, kidney problems, and more.
  • Non-alcoholic steatohepatitis (NASH)- the liver is inflamed and has excessive fatty deposits in the tissue, which affects function
  • Gallstones and gallbladder disease.
  • Acanthosis nigricans- darkening of the skin, especially in the back of the neck, hands and knees.
  • Difficulty breathing and asthma- the entire cardio-respiratory system is decompensated due to less ability to do physical activity, and more weight bearing on the heart and lungs.
  • Sleep apnea- Kids (and adults) with sleep apnea have brief periods where they stop breathing several times throughout the night. The excess weight and distribution of fat on the chest and neck contribute to this. These kids to not get the benefits of sleep, and therefore are more fatigued during the day, have more difficulty concentrating in school, and may have mood and behavior disturbances due to lack of sleep.

These comorbidities can last into adulthood and impact quality of life and lifespan. Data from an NHANES follow up survey and the Bogalusa Heart Study show that 50-60% of school-age kids will be obese as adults. But for obese kids, the social issues they face during childhood are even more devastating.

Obese kids are at higher risk for:

  • Low self-esteem, which can lead to poor school performance; higher likelihood to engage in “risky” behaviors; etc
  • Depression
  • Bullying
  • Discrimination

One study asked kids with a variety of serious diagnoses to rate their quality of life. The obese kids reported a lower quality of life than kids with cystic fibrosis, epilepsy, cancer, type 1 diabetes, kidney transplant, irritable bowel disease, and healthy kids (2). This shows how much kids struggling with obesity need our help.

In the presidential race, two hot topics, as always, are healthcare and federal spending. The fact is, as big as these issues are now, they are going to become exponentially bigger as America’s youth carry health issues into tomorrow. That is, unless, we help take away that burden for our kids. At North Shore Pediatric Therapy, we have a multi-disciplinary team of experts who can dedicate time to your family’s health. Call to schedule an appointment today.






1. Ogden CL. JAMA 2006;295:1549-1555, Ogden CL JAMA 2008;299:2401-2405, Ogden
CL. JAMA 2010;303(3):242-249.
2. Ingerski et al J Pediatr 2010;156:639-44.

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CRUNCHING THE WEIGHT GAIN NUMBERS: A MATHEMATICAL PERSPECTIVE ON OBESITY

I found this article from the New York Times (published 5/14/12) to be very interesting. It is an interview with Carson Chow, an applied mathematician from the National Institute of Diabetes and Digestive and Kidney Diseases, who used mathematical equations to analyze the etiology of the rise in obesity rates over the past 20-30 years. Through his applied mathematical analysis, Chow reports that his results indicate that a surplus of food supply, starting from the 1970s when the government began encouraging farmers to grow as much food as possible, is one culprit in rising obesity rates since then. He argues that in general, the amount of physical activity Americans do really hasn’t changed in the past 20-30 years. He further explains that with this surplus of food, came cheaper food prices and more marketing from food retailers and restaurants, which in turn encourages people to eat more. Since it is affordable and convenient, fast food is even more appealing to today’s busy American consumer.

Even more interesting, he found through mathematical analysis that the more overweight a person is, the easier it is for them to gain weight. Also Chow states, “huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.” This insight rings especially true for those “yo-yo dieters” or others who do dramatic diets that only produce temporary results. In addition, he touches on the idea that our body has a “set point” of body weight, which is a weight that our body tends to hover around despite variations in eating day to day. This set point can be “reset” though, both in a negative way (in the case of excessive intake over time resulting in overweight status that becomes the new set point), or a positive way (in the case of weight loss). However, it takes time for our body to reset, so when weight is lost, it must be maintained for a long time, 1-3 years, before that new point is set.

To me, Chow’s findings demonstrate two things:

  1. We have to be smarter food consumers and aware of what the human body actually needs in terms of nutrition to sustain normal growth and health. This includes listening to our hunger and satiety cues, knowing what is a healthy body weight for stature (i.e. normal BMI), and knowing how to put together healthy meals.
  2. Weight management is a long term journey. It is a lifestyle change that really involves changes in all areas of life. It may mean cooking more at home, grocery shopping differently, adjusting the family budget, incorporating more physical activity into your day, and making food and health a priority in life. These are not easy changes, but if it is important to you or your family member to achieve weight management goals, meet with a registered dietitian to make a plan.

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A Healthy Start to 2012: Featuring Expertise from a Pediatric Physical Therapist

With a new year just around the corner, many people are likely reflecting on the past year and thinking ahead to goals and resolutions for the next. One important topic to consider is physical health. What better time to begin a fresh fitness regime for the whole family than the start of a new year?boy eating hamburger

Childhood Weight Statistics:

The rate of obesity has tripled in adolescents in the United States over the last 20 years. 16-25% of children 6 to 19 years of age in the United States are overweight, and 7-19% are obese. Rates are even higher in economically disadvantaged ethnic minority groups. Furthermore, between 70-80% of obese adolescents will become obese adults. Many families have expressed concerns about their children’s weight and physical health and have asked about ways to address these issues. Lucky for them, North Shore Pediatric Therapy is a multidisciplinary team in which therapists from various fields collaborate to provide holistic services for children. To delve deeper into the topic of how to ensure and maintain a healthy lifestyle, I consulted Jesse Coffelt, PT, DPT, of our pediatric physical therapists.

How do you talk to your children about your concerns about their weight in a straightforward, yet sensitive manner?

“Be sensitive, but be an adult.” Jesse suggests a balance between talking to children about their weight and physical fitness in a gentle way, while acting as the head of the household through concrete decision making. One way Jesse suggests talking to children is to check in with them about their perspectives. For example, if your children used to play sports at school but no longer seem to enjoy them, you can say, “I notice you don’t run around as much with your friends as you used to. Why is that?” Jesse explains that most children will answer that they cannot keep up. This, then, is a great entry point to talk to your children about their fitness goals (ex. “Would you like to be able to play on the soccer team this spring?”) and how to get there (ex. “To play on the soccer team, we will have to make some changes so that you feel more confident and prepared. I know you can do it!”).

As a therapist specializing in mental health, I would also suggest anticipating your children’s reactions. All children are different and receive constructive feedback in various ways. If you know that your children will have a challenging time with specific language (ex. “I notice that you’ve gained a few pounds”), think of ways to help your children respond positively so that they will actively participate in a new fitness regime!

How do you know there is an obesity/weight issue?

“The best method to determine whether your children’s height, weight, and body fat are in a healthy range is to calculate their Body Mass Index (BMI). Check out these 2 helpful websites (http://www.bcm.edu/cnrc/bodycomp/bmiz2.html) ( http://kidshealth.org/parent/growth/growth/bmi_charts.html?tracking=P_RelatedArticle)  BMI calculators and additional information. The Center for Disease Control and Prevention defined overweight as between the 85th to 95th percentile of BMI for age and obese as at or above the 95th percentile of BMI for age.”

 How do you implement a family fitness regime?

  • “Avoid extremes.” Jesse suggests that one simple, yet effective way to implement a new health regime is to reassess the family diet. Cutting out sugary juices and soda in place for water, for example, is a simple way to decrease the number of unhealthy calories and increase the intake of water (health fact: did you know that half of your body weight is the number in ounces of water you should drink per day?). Jesse also warns against extremes (ex. No more desserts forever) and instead recommends healthy alternatives. Click here for a fun, child-friendly, holiday snacking guide!
  • “Have fun with it!” Creating a fitness regime can be fun! Involve the entire family and take family classes at the local gym (ie. Family Zumba is a great option for an energetic dance class open to all ages and levels), spruce up daily walks (ie. Make it a scavenger hunt), engage in friendly competitions (ie. Click here for indoor gross motor activities), and once in awhile, treat your children to creative outings involving physical activity! The president’s challenge is an excellent program and resource with tips and strategies for maintaining a physically active and healthy lifestyle for children and adults!
  • “Don’t get discouraged.” Jesse explains that it takes at least six weeks to increase muscle mass and that you may not recognize changes in body composition. Set goals and keep a log of everyone’s weight so you can really track your success!

Happy 2012! Please share with us your family’s health and fitness goals for the new year!

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Recess And Behavior: Why Movement Matters

Children need movement on a daily basis! There are so many benefits of allowing children time to engage in physical movement and heavy work activities that to me, it is almost a crime to prevent children from having their physical play time.

Allowing Children To Move Benefits Everyone

Children learn and grow through movement. They refine gross motor and sports skills and they increase their motor control, coordination, and muscle strength through movement. In addition, movement promotes cognition, organized behaviors, self esteem and self confidence, self Happy Boy On Monkey Barsregulation, a calm body, and attention.

When children sit for longer than 15 minutes at a time, their attention and concentration is reduced, and discipline problems begin to increase. When this happens, children are less available to learning, more energy is spent on behavior management by the teacher/parent and the children, and nobody wins.

All children benefit from a break in their mental focus. Recess provides opportunities for unstructured physical play, which allows kids to “blow off steam”, and reduces stress. Recess increases attention and on-task behaviors, and decreases fidgety behaviors.

Additionally, we have an epidemic of childhood obesity in our country, which is heavily impacted by a lack of physical activity. Physical activity during recess promotes the health of our children now and in their future. In general, the goal should be a minimum of one hour of exercise daily by the time your child reaches elementary school and thereafter.

Removing Or Skipping Recess Can Increase Undesired Behavior

One of the biggest mistakes a teacher or other adult can make is to keep a child inside for recess, especially if the reason is as a consequence for misbehavior, tardiness, or something the child did not do. Sometimes, a class cannot go out for recess because of weather. In this case, it is definitely best to allow the children to use the gym instead. If the gym is not available, doing animal walk races, yoga, or some other kind of movement based activities in their classroom will benefit everyone.

Requiring children to sit for longer periods of time without allowing relief through movement breaks is contradictory to what adults are asking children to do in terms of academic achievement, physical health, and emotional health. Their brains and bodies need breaks in order to achieve greater academic success.