Car Seats Done Right (Article)

Cars can be dangerous for children, especially considering the vast amount of time they spend in and around them. This fact is borne out by statistics, year in and year out. In 2011 for instance, 148,000 children were injured in automobile accidents. A third of these children were not restrained by a car seat or seatbelt at the time of their injury. Amazing. Intoxicated drivers, poorly installed car seats, and simple carelessness make injuries and death of children in cars mostly preventable. Continue reading

Understanding Newborn Diaper Rash (Pedcast)


Anyone who has been around a new baby and tasked with changing diapers knows about common phenomena, diaper rash in the first few weeks of life. It is so common as to be almost normal. But why? Why does this happen and more importantly, how can it be avoided? Well, today I am going to try and explain the biology and chemistry behind this phenomena, and maybe even save some babies from having a very sore bum, and you from having to console a very distraught newborn. That’s a big task but I think we can do it. Continue reading

Hearing Loss (Pedcast)

Good evening, and welcome to another addition of, the home of Portable, Practical, Pedcasts dedicated to parents and children. Today we’re going to take on a topic that probably has not been on your radar: the problem of acquired hearing loss in children. There are risks to your children’s hearing in everyday life, and I feel that parents need to know the basics about sound, noise, and hearing loss in order to protect their children during childhood. So, let’s take the plunge and find out more, shall we?

First, a little trip down what I call Science Lane. We’re gonna do a little basic science about noise and sound and how it’s measured. Sound can be measured in two ways: first in terms of volume, how loud the sound is. This we measure with units called decibels. This is a logarithmic scale, so 100 decibels is a LOT louder than 50 decibels. The threshold of human hearing is about 15 dB…very quiet. And we begin to get into the damage zone for a child’s hearing at about 80 dB, certainly above 100 dB. So, that’s volume. The second way we measure sound is in terms of the frequency of the sound. Speech is a low frequency sound, and certain musical instruments like the flute produce high-frequency sounds. Speaking softly is a low decibel, low frequency sound, whereas listening to a flute is a high volume, high frequency sound. Got it?

The most common hearing loss that pediatricians see in children comes along with cold and ear infections. This is a low-frequency sound loss and fortunately is temporary until the child’s ear infection clears up. As we age, we lose our hearing very slowly. Older people and those exposed to a lot of noise tend to lose high-frequency hearing first. If you don’t remember anything else from this lesson on hearing, I want you to remember this: noise exposure that can damage hearing comes in two forms, first being very brief but very loud noises like shooting a gun, the second type being moderately loud noises, in the range of  80 decibels and higher, that go on for long periods of time. Either of these types of noise exposures can eventually lead to hearing loss. More on this in a minute.

So, as I said before, I want to make you aware that noise can damage your children’s hearing. I want you to do everything you can to protect your kids during childhood. This is important. They may not get the hearing loss until they are adults, but it’s still very important to their overall health and well-being. Now, the number one cause of hearing loss in United States is shooting guns such as shotguns and handguns and yes, children do this as well or they are around when this is being done. Additionally, few people seem to know that power tools like nail guns can also permanently cause hearing loss. These devices produce extremely loud noise, in the 120-140 decibel range, but the noise is so brief, our brains can’t perceive just how damaging this kind of noise can be.

And here are some other kinds of loud noises that have the potential to damage your child’s hearing: lawnmowers–a lot of kids run lawnmowers, and use hairdryers, and those teenage girls love t0 dry their hair every day, sometimes multiple times a day, and certain types of musical instruments like in a very loud wind instruments, and recorded music–especially when delivered with their ear bud devices very close to a child’s eardrum, and motorcycles and farm equipment–All these things have the potential to damage your child’s hearing. I think you should insist that your children wear hearing protection when they are around any of these noise generators and limit their exposure. You need to insist on it. You are the adult in the room!

“Hearing protection around lawnmowers and hairdryers and musical instruments Doc Smo, did I really just hear you say that?” Yes, I really just said that, and I also want you to teach your kids the “warning signs” that sound is too loud for their ears, the number one signal being that the sound hurts when you first start listening to it. We’ve all had that experience of getting in the car the radio really loud and it hurts when you first start listening. That level of sound is damaging. Signal one, the sound hurts initially. The second sign is to hear ringing after noise exposure, this almost always means that there’s been some damage to one’s hearing.

So, to summarize, I want you to be aware that either very loud brief noises repeatedly or moderately loud noise over a long period time can damage your children’s hearing. I want you to try to protect them with some kind of hearing protection, and that’s especially important if they cut the grass (95 db), dry their hair with an electric dryer (85-90 db), shoot weapons (140-170 db), are around motorcycles and loud engines (95 db), as well as any other situation that you think might warrant protecting their precious hearing. Let me tell you it’s much easier to keep your kids from losing their hearing than it is to get their hearing back after they have lost it. That’s true for parents as well. Make sure you set a good example for them, won’t you?

This is Doc Smo, thanking you for joining me and hoping you enjoyed my little chatter, about a subject that really matters. Until next time.

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Home Births (Pedcast)

Doc Smo here, your pedcast host, coming at you with another edition of, the pediatric blog that provides parents with portable practical pediatrics on your time schedule. Today, I am going to bring you some new information about a growing trend: home births. If you have ever considered this option for the birth of a one of your children, make sure to listen carefully to the details of this pedcast.

I guess it’s just human nature to challenge, rebel, and reject those things we don’t like. Take modern western medicine for instance…specifically, delivering babies in hospitals. Some mothers and families don’t like the loss of intimacy and privacy that comes with having a baby within the confines of a hospital. These families argue that humans have been having babies at home, outside hospitals, for centuries and things usually go well. Why not continue to do it that way? Besides, having a baby at home is a lot less expensive, way more private, and home births allow the entire family to participate in the birth process, right? Then these families read about babies being swapped at birth, abducted from the hospital, or acquiring a hospital infection during their stay and they say, “See, I told you so.” Then, the worry part of a mother’s brains take over, they hear about their friends having babies at home, the midwife says everything will be fine, and suddenly the risks of having a baby at home are minimized or not considered at all. Home births are all positive, right?

This is what seems to be happening in the United States in the past few years according the Center for Disease Center in Atlanta. (1) More and more families are choosing home births and unfortunately, more and more babies and mothers are starting to see some of the terrible things that their great grandmothers experienced; a greater number of babies dying during the birth process from complications, more mothers hemorrhaging to death shortly after giving birth, and more moms getting extremely sick or dying from a postpartum illness called “Child bed fever.” While home births are still a rarity in the US–around 1% of all births–the trend is growing, and growing rapidly. The problems are growing as well; check out these stats and see what you think. Depending on the year you choose to look at, when you compare the rate of death among babies born to nurse midwives in and out of a hospital, you can see that the rate of baby death is 3-6 times higher when these deliveries happen at home, despite the fact that the planned home births are generally lower risk pregnancies compared to those delivered in a hospital.
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Let’s face it, giving birth is dangerous for both mom and baby. Things can go wrong very fast, and a rapid response by the attendants of the delivery can make all the difference in the world. If a dangerous situation arises during a home birth, a midwife simply can’t provide what modern hospitals can in terms of diagnostic and therapeutic power. I’m reminded of that DocSmo pearl, “A crisis for which you are  prepared is often not a crisis at all.” Make sure you take advantage of all the preparation hospitals offer by having your next newborn in a hospital.

Thank you for joining me today. I hope I increased your pediatric IQ and got you thinking about this important pediatric topic.  Portable, practical pediatrics on your schedule is what we promise and what we deliver every week. Please take a moment to subscribe to my podcast on iTunes, and while you are there, leave a review and tell me how you think I am doing. You can also share your comments on my blog,, or share this pedcast by simply sending it to a friend or relative. This is Dr.Paul Smolen, broadcasting from studio 1E, hoping your next childbirth is only filled with mirth. Until Next time.

Smo Notes: