Ear Tube Placement in Kids without Sedation

Our office routinely performs  traditional  ear tube placements in the office, without sedation, starting from the age of 12 years. For those younger than 12 years,  ear tube placement  typically requires general anesthesia, not for pain reasons, but because in order for the procedure to be performed safely, the child has to be totally still. However, a new device called Hummingbird TTS allows for the possibility for ear tube placement without sedation in younger kids. Why? The device allows …

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Lose the Juice: Sugary Drinks Linked to Reflux in Children (Guest Blog)

A guest blog by Dr. Julie Wei (pediatric ENT in Florida) Despite doctors informing the public that cigarette smoking causes lung and other types of cancer, and cause chronic obstructive pulmonary disease (COPD), emphysema, bronchitis, and other various health conditions, it took decades before the public finally shifted the stigma of cigarette smoking and started shedding light on the harmful effects. As a result, cigarette packages now come with mandatory warning labels. SURGEON GENERAL’S…

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Video of Hearing Testing in Young Children (6 Months - 6 Years Old)

In celebration of Kids ENT Health Month, our office has produced a video demonstrating the various ways a child's hearing is tested  from 6 months to 6 years old. After all, you certainly can't just ask them to push a button when they hear a beep as you would in an adult. This video shows the following different types of hearing testing done in children: • Soundfield Auditory Testing (SAT) - 6 months to 2 years old • Speech Awareness Threshold (SAT) - 2 years to 3 years old • S…

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FDA Warning For Sedation in Kids Under 3 Years and Pregnant Women

On 12/14/16, the FDA published a warning that prolonged or repeated sedation in kids under 3 years old and women who are pregnant during their third trimester may adversely affect childhood brain development. However, a single short exposure to a general anesthetic and sedation drugs in infants or toddlers is UNLIKELY to have any negative effects on the brain. Such short time exposure with minimal risk would apply to ear tube placements as well as tonsillectomy and adenoidectomy . This r…

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Is Tongue Tie Becoming More Common?

In October 2016, I listened to an interesting lecture by Dr. Ghaheri (ENT in Portland, OR) who at one point attempted to explain through genetics why clinically significant tongue tie may be increasing in frequency. After all, it seems that every year, more and more moms are reporting breastfeeding difficulty/pain as well as more infants are being diagnosed with tongue tie now than in the past. One explanation may be due to genetics. He specifically mentioned three research papers that …

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Laryngomalacia Video in an Infant with Squeaky Breathing

A video has been created showing what laryngomalacia (floppy infant airway) looks like from the inside. Both normal infant airway as well as infant with moderately severe laryngomalacia is shown including audio. Infants with laryngomalacia have what parents hear as a "squeaky" or "noisy" breathing, especially on inhalation. Although most infants outgrow this condition, some require surgical intervention (supraglottoplasty) due to failure to thrive, inadequate oxygen…

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Breastfeeding Milk Supply vs Demand in Tongue Tied Infants

There are some breastfeeding moms who have a TERRIFIC milk supply... I'm talking newborns who at times seem to be drowning in milk the supply is so great, accidental spraying of the infant's face with milk, numerous soaked nursing pads throughout the day, etc. BUT... they also have an infant with a significant tongue tie . What if anything should be done from a breastfeeding perspective? After all, milk supply is definitely not a problem... or is it??? The breastfeeding concern e…

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Baby Born Without a Nose

You may have noticed in the news about a baby born without a nose in Alabama on 3/4/15. Very cute little baby named Eli. As media noted, this condition known as congenital arhinia is extremely rare occurring about 1 in 197 million. In fact, there's only 40 known cases in the world currently. When an infant is born unable to breath thru the nose, this is a life-threatening condition because newborns are not able to breath thru the mouth. They are known as obligate nasal breathers. Beca…

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Does Tongue Tie Cause Breastfeeding Difficulties and Speech Problems?

Although there is both objective and subjective evidence that tongue tie contributes to breastfeeding difficulties and speech problems, when it comes to quality evidence-based research, the data is a bit lacking. And because of this sparseness, tongue tie release is actually considered a controversial topic with both supporters and detractors (personally, I am a supporter of this procedure). Among the detractors, tongue tie release is considered unusual and unnecessary... even bizarre. To…

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Early Exposure to Peanuts May Reduce Peanut Allergies, but Choking Risks Remain!

Image from Wikipedia In response to peanut allergies and children being in the news this week (Feb 2015), the American Academy of Otolaryngology—Head and Neck Surgery is cautioning parents and caregivers about choking risks especially posed to young children and infants by peanuts, tree nuts, and nut fragments. The 2015 NEJM study on peanut ingestion and allergies in children suggested that exposing infants to peanuts before age 1 (even as young as 4 months) actually helped prevent pea…

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Top 10 Myths in Diagnosing and Treating Tethered Oral Tissues (Tongue Ties and Lip Ties) in Breastfeeding Infants (Guest Blog Post by Dr. Kotlow)

Dr. Chang's Note: Dr. Kotlow is a pediatric dentist who has done much to advance the understanding of infant factors leading to breastfeeding difficulties. This is a guest blog post by Dr. Kotlow. by Lawrence Kotlow, DDS www.kiddsteeth.com "Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public …

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Save a Choking Baby Video

A cute video demonstrating what to do if a baby is choking... Of course, basic and advanced life support for an infant has many more and other steps, but for a conscious baby who is choking with an ineffective cough, the video does pretty much sum it up!

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Young Girl from 0 to 14 Years Old in 4 Minutes

We all have seen an abbreviated version of this video on TV commercials, but here's the complete video showing a beautiful young girl go from age zero to 14 years in 4 minutes. This time lapse video was taken by filming her for 15 seconds every week from the day she was born. Simply amazing!

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Video on Breastfeeding Problems: Infant Factors

A  new video  has been uploaded to show infant factors that may lead to breastfeeding problems. Video goes over  tongue tie ,  upper lip tie , and  posterior tongue tie . Check it out!

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Video on Upper Lip Tie Release

A  new video  has been uploaded to show how  upper lip tie  is treated. Check it out! Unlike  "regular" tongue tie , upper lip tie is when the upper lip is tethered to the gum causing breastfeeding difficulties. For more information, click  here . For related info on tongue tie, click  here .

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Ultrasound of Breastfeeding Baby

Ever wonder what breastfeeding looks like inside an infant's mouth? What does the tongue do exactly? Does it move up and down or is it more back and forth? How far does the nipple go into the mouth exactly? Well, using ultrasound , researchers were able to exactly see what happens during breastfeeding inside an infant mouth. The key learning point discovered from the ultrasound images is that milk expression is due to a vacuum created within the infant mouth that occurs from the …

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Infant Sound Machines for Sleep May Cause Hearing Loss

As a father of two young kids who still use a sound machine to help them sleep, I was quite curious about a recent paper that warned that such devices may cause permanent hearing loss. Researchers compared a total of 65 sounds produced by 14 machines and measured the maximum sound level at a distance of 30 cm (crib-rail placement), 100 cm (beside crib placement), and 200 cm (across room placement). Why is placement important? When it comes to risk of hearing loss due to loud noise exp…

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Why Do Babies Hate Getting Their Nose and Face Wiped???

I have often been asked this question by parents... and even more so by my wife as we try to clean the snot off our little kids' noses as they shriek as if we're torturing them. Given it seems ALL young kids have this nose-wiping aversion across cultures and racial ethnicities, it would seem that this reflex reaction is hard-wired into human babies. But why would evolution favor this reaction? I tried to find an answer to this question to see if any bright researchers actually stu…

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Does Removing the Adenoids Decrease Risk of Ear Infections? Yes...

A recent meta-analysis has determined that risk of recurrent ear infections is significantly reduced if adenoidectomy is performed in combination with ear tube placement as opposed to ear tube placement alone. When stratified by age, removing the adenoids was found particularly helpful in children older than 4 years of age. Combining results from over 15 studies containing over 71,000 children, the estimated rate of repeat ear tube placement for recurrent ear infections in children who…

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