Ask the pediatrician: How has pediatrics changed over the past 50 years? [column] | Food + Living

This year, Lancaster Pediatric Associates will celebrate our 50th anniversary. Started in 1970 by Dr. Charles Kurtz, Dr. Clark McSparren and Dr. William Boben, the practice has grown tremendously and has seen monumental progress in pediatric medicine.

As with most fields, some things have changed, and some have stayed the same. In honor of this anniversary, Dr. Boben, my mentor, adviser, comic relief — and, by the way, my father — is taking over this column to highlight some of the changes in pediatrics, kids, parents and Lancaster in the last 50 years.

Decades of perspective

Greetings everyone, I am grateful and honored to have been a part of so many families in Lancaster.

Many things have changed in pediatrics since 1970, but one has remained the same: Our children are the most precious thing we have.

Protecting and guiding our kids is a mandate for all pediatricians and parents, and fortunately I have had the privilege to work in a community that has placed its children as a top priority. Here are some highlights of the way things have changed, and a few that have stayed the same.

Antibiotics

Penicillin was the best antibiotic choice for infections. It was dosed four times a day and tasted like dirt. The alternative was a shot in the buttocks that made it hard to sit down for three days. This would guarantee in the future that the child would not tell parents about an earache or a sore throat unless it was extreme.

With the arrival of amoxicillin, pediatricians were thrilled to have a twice-a-day medicine that tasted good! The pharmaceutical company promoted its development by distributing lollipops that were amoxicillin flavored to emphasize how good it tasted. Imagine: medicine-flavored candy!

25 is the new 35

Weeks that is. Babies who were born extremely premature were kept warm and comfortable until they passed away.

Now, with the advent of the specialty of neonatology, and all the advances within that field, extremely premature babies not only survive but thrive. Lancaster welcomed its first neonatologists in 1984, and with that change has come many “NICU grads” who go on to do amazing things.

Rare father sightings

There were only rare father sightings. Dads who were hands-on were pretty unusual back then. Only 30% to 40% of women worked outside of the home, so it was typically the mother who brought the child into the office. Even if Mom was employed, it was still usually the mother who was responsible for health care concerns.

If the Dad did bring the child in, he would say, “child is sick, please fix,” with no further details available!

Lack of technology

Technology was not something that was really a part of medicine, except in research fields. A microscope and an otoscope were about as fancy as we got. Today doctors use computers in so many ways. Yet, where it has affected us the most is the way parents and children use them.

Having that much information so accessible has proven to have benefits and disadvantages.

One of our new roles is helping our patients, and their parents, navigate all this information. I find it ironic that the computerization of medicine and parenting has made the human connection even more critical. And I like that no one complains about my handwriting anymore.

Vaccines make diseases rare

Diseases such as pneumococcal meningitis, measles encephalitis, heamophilis epiglotitis, and varicella (chicken pox) pneumonia were common enough that we all had lost patients to them, and kept those diagnoses in the forefront of our minds every time we saw a sick child.

Thanks to vaccines these diseases are very rare and parents (and pediatricians) do not live in fear of them.

ADHD

Attention deficit hyperactivity disorder first came to pediatricians’ attention in the 1960s. The first medications for this disorder were often very sedating, which meant kids felt foggy and tired.

There also were many theories on ADHD, including that the child was brain damaged, or that the problem was caused by exposure to food additives. Today, around 10% of children are diagnosed with some type of attention disorder, and while the number of children with this diagnosis has more than tripled, thankfully the amount of safe, effective treatment options has also grown.

Discipline

Corporal punishment, or physical discipline such as spanking, was an accepted practice both at home and in schools in the 1970s and ’80s. Most of us felt from the beginning that not only was it an ineffective way to discipline a child, but that it often led to further behavior and emotional problems.

However, society norms did not agree with us, and in fact, in 1977 the Supreme Court upheld a school’s right to practice corporal punishment. I can still see the way principals would threateningly display a paddle in their office.

It was not until 1998 that the American Academy of Pediatrics issued a policy condemning physical discipline tactics. Pennsylvania banned corporal punishment in schools in 2005. Today we know that there are better ways to discipline children, and we advocate for positive reinforcement instead of emphasis on negative behavior.

Balance, science

Pediatrics and parenting, just like hemlines and necktie widths have had extremes, and I quickly learned to be wary of them. Aspirin on the gums for teething, DDT for lice and high-dose vitamins all have come and gone with most pediatricians greeting them with healthy skepticism.

As with life, pediatrics must be approached with balance, science and, of course, humor. I do not know what the next 50 years will bring, but as long as we keep advocating for the health and welfare of our children, the future will be bright.

Dr. Pia Fenimore and her father, Dr. William Boben, are both members of the team at Lancaster Pediatric Associates. Fenimore answers questions about children’s health. You can submit questions at [email protected]