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Dr. Gollup's Pediatric Housecall

Dr. Howard Gollup is a board-certified pediatrician with Aurora Advanced Healthcare in Germantown. He cares for children from birth through adolescence. Though he cannot respond to individual medical questions, he welcomes your feedback and suggestions for future topics.

Tonsils, Tonsillectomy, and Sleep Apnea in Kids

tonsils, tonsillectomy, sleep apnea, strep throat

In the last entry, I discussed tonsillitis, which is a natural segue into the question of tonsillectomy--surgical removal of tonsils.

Fifty years ago, tonsillectomy was done at the drop of a hat. My treasured  copy of Abt's Pediatrics from 1924, which I refer to for both laughs and long-forgotten insight, advocates tonsillectomy for many conditions: "A great variety of symptoms...may determine the removal of the tonsils regardless of their size or their apparent condition". It goes on to list many conditions for which we would not consider even remotely associated with tonsils today. These days, we have relatively specific reasons and rationale to recommend tonsillectomy.

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Eliminating Thumb-sucking and Other Habits

habits, thumb sucking, thumbsucking, nail biting

Parents often ask how they can eliminate a habit, such as thumb-sucking. Most parents quickly discover that reminding a child not to thumb-suck starts to look like nagging, and rapidly becomes frustrating. It just plain doesn’t work—like many habits, most of the time the child is not even aware of it. Taping the thumb to the hand is also ineffective. For a simple habit, I recommend a behavioral modification scheme that utilizes positive reinforcement of increasingly compliant behavior. If there is a way to help the child self-monitor that is even better.

Thumb-sucking isn’t generally harmful if a child is doing it at brief intervals as a self-comforting or self-soothing activity. If your child has his or her thumb in the mouth for a few minutes when settling down for a nap, or before sleep, it is not going to have any significant effect other than aesthetics. If the thumb is in the mouth a considerable potion of the day, it can impact dental structure. I’ve also seen inflamed and even infected thumbs, though not often.

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