Sunday, November 25, 2012


"Ang tunay na lalaki ay marunong maghintay." Such brave words and an unexpected response from a modern teenager as viewed in a television commercial of a well known noodle product. No wonder the proud parents are all smiles as they partake the meal before them. Despite all the conveniences and easy access to everything including premarital sex, it is heartening to know that there are still those who value human dignity and respect for oneself and for others.

How do you describe a young Filipina Lady? To borrow the lines from a famous old Filipino Folk Song written by Jose Corazon de Jesus...

"Ang Dalagang Pilipina" 

"Ang dalagang Pilipina, parang tala sa umaga
 Kung tanawin ay nakaliligaya
 May ningning na tangi at dakilang ganda
 Maging sa ugali, maging kumilos
 mayumi, mahinhin, mabini ang lahat ng ayos
 Malinis ang puso maging sa pag-irog
 may tibay at tining ng loob."

"Bulaklak na tanging marilag, ang bango
 ay humahalimuyak
 Sa mundo'y dakilang panghiyas,
 pang-aliw sa pusong may hirap.
 Batis ng ligaya at galak, hantungan ng
 madlang pangarap.
 Iyan ang dalagang Pilipina, karapat-dapat
 sa isang tunay na pagsinta."

I wouldn't be surprised if some parents would raise their eyebrows or even admonish their kids when they see such topic as sexual awareness being read online. One of the reasons I wanted to discuss such a controversial topic among teenagers stems from an inquiry my best friend had about his teenager son who has a young girl friend. Another eye opener for me was when I met a nineteen year old girl who contracted a sexually transmitted disease caused by the Human Papilloma Virus (HPV) at a very young age. She had her first sexual experience at 15 years old with a 40 year old married seaman. Lest you think that it only happens in Manila, think again, the lady hails from Mindanao and is the youngest in a brood of 12 children but whose parents are involved in a religious cult.

How can we help our youth so that they will learn how to wait?

Allow me to quote some Scriptures from the greatest book ever written, i.e., the HOLY BIBLE, which has all the answers to the questions we seek especially regarding sexuality.


"This is the will of God, your holiness: that you refrain from immorality, that each of you know how
to acquire a wife for himself in holiness and honor, not in lustful passion as do the Gentiles who do not know God; not to take advantage of or exploit a brother in this matter, for the Lord is an avenger in all these things, as we told you before and solemnly affirmed. For God did not call us to impurity but to holiness. Therfore, whoever disregards this, disregards not a human being but God, who [also] gives his Holy Spirit to you."
                                                                1 Thessalonians 4:3-8

"...The body, however, is not for immorality, but for the Lord, and the Lord is for the body, God raised the Lord and will also raise us by his power. Do you not know that your bodies are members of Christ? Shall I then take Christ's members and make them the members of a prostitute? Of course not! [Or] do you not know that anyone who joins himself to a prostitute becomes one body with her? For "the two, " it says, " will become one flesh." But whoever is joined to the Lord becomes one spirit with him. Avoid immorality. Every other sin a person commits is outside the body, but the immoral person sins against his own body. DO you not kow that your body is a temple of the Holy Spirit within you, whom you have from God, and that you are not your own? For you have been purchased at a price. Therefore, glorify God in your body."
                                                                1 Corinthians 6:13-20

In the book "boy meets girl" written by Joshua Harris, a best selling author and the senior pastor of Covenant Life Church in Gaithersburg, Maryland, he enumerated practical ways on how boys can be men and girls can be ladies. He said that men should have the following qualities, namely: 
1. Assume the responsibility of leading and initiating in their relationships with women.
2. Be a spiritual leader in their relationships with women.
3. Do little things in their relationships with women that communicate their care, respect, and desire to protect.
4. Encourage women to embrace godly femininity.
Whereas, the women should posses the following traits:
1. Encourage and make room for men to practice servant leadership in their relationships with godly men.
2. Be a sister to the men in their life.
3. Cultivate the attitude that motherhood is a noble and fulfilling calling.
4. Cultivate godliness and inward beauty in their life.

Fr. Adolf Faroni, SDB, in his book entitled, "How to Love for Teenagers and above", wrote "THE TEN COMMANDMENTS FOR A MODERN GIRL", namely:
1. Observe moderation in the use of cosmetics. If you use make-up, do so sparingly.
2. Exercise moderation also in the sphere of amusements, in order to allow yourself time to pursue other interesting hobbies like music, embroidery,sketching, and the like.
3. Don't patronize places like bars, where unseemly steps and poses are tolerated, or where there is no kind of supervision, or where intoxicating drink is sold. Use discretion in your choice of partners.
4.Don't stay out late at night except on special occasions and with the consent of your parents or
5. Listen with respect to the good advice of your elders.
6. Don't accept jewelry or expensive gifts from men friends.
7. Go without, rather than borrow money. Don't spend beyond your means.
8. Don't allow yourself to be picked up by any smartlooking "Romeo" who happens to come into your line of vision.
9. Don't have a boy friend just because other girls have one.
10. Remember that the best and holiest of souls cannot remain virtuous without the help of Divine
...If you are prudent with your power of attraction.
...If, by your behavior, you give value to others.
...If you know which is the door where temptation can come easily to you and avoid it.

Sunday, September 30, 2012


Jaundice is defined as a yellowish discoloration of the sclerae and/or the skin due to high levels of bilirubin in the blood.


Bilirubin is a yellow pigment that is created in the body during the normal recycling of old red blood cells. The liver helps break down bilirubin so that it can be removed from the body in the stool. Before birth, the placenta, the organ that nourishes the developing baby, removes the bilirubin from the infant so that it can be processed by the mother's liver. Immediately after birth, the baby's own liver begins to take over the job, but this can take time. Therefore, bilirubin levels in an infant are normally a little higher after birth.

Causes of jaundice in the Newborn:

Physiologic jaundice usually appears after 24 hours of life and peaks between the third and fourth day of life and disappears after 2 weeks. It usually happens during the breakdown of fetal red blood cells at birth that are not adequately handled by the liver of the newborn resulting in a higher bilirubin level but causes no problems.

Breast milk jaundice occurs when a metabolite in breastmilk (3-alpha-20-beta-pregnanediol) inhibits an enzyme (USPGA glucoronyl transferase) which is responsible for the conjugation and excretion of bilirubin. This usually happens in some healthy, breastfed babies after one week of life, and usually peaks during the second and third week of life. It may last at low levels for a month or more.

Breastfeeding jaundice is seen in breastfed babies in the first 3-7 days of life when baby does not get enough breastmilk and is dehydrated and has infrequent bowel movement. Without bowel movement, bilirubin is not excreted.

Conditions that increase the number of red blood cells that need to be broken down, and can cause more severe newborn jaundice:

1. Abnormal blood cell shapes
2. Blood type incompatibility between the mother and the baby
3. Cephalohematoma (bleeding underneath the scalp) due to a difficult delivery
4. Deficiency or lack of certain important enzymes
5. Higher levels of red blood cells, which is more common in small-for-gestational-age babies and some twins
6. Infection

Conditions that make it harder for the baby's body to remove bilirubin may also lead to more severe jaundice:

1. Certain medications
2. Congenital infections, such as rubella, syphilis, and others
3. Diseases that affect the liver or biliary tract, such as cystic fibrosis or hepatitis
4. Hypoxia
5. Infections (such as sepsis)
6. Many different genetic or inherited disorders


The earliest indication of jaundice is yellowish discoloration of the sclerae. The main symptom is a yellow color of the skin. The yellow color is best seen right after gently pressing a finger onto the skin. The color sometimes begins on the face and then moves down to the chest, abdomen, legs, and soles of the feet. Sometimes, babies with significant jaundice have poor activity and poor suck.

Signs and tests

Any infant who appears jaundiced especially in less than 24 hours of life should be worked up right away. The tests include the following:

 Complete blood count
 Coomb's test
 Reticulocyte count
 Bilirubin levels, (direct, indirect and total)

Doctors, nurses, and family members will watch for signs of jaundice at the hospital. Some hospitals use probes that can estimate the bilirubin level just by touching the skin. High readings need to be confirmed with blood tests.

After discharge, the parents are advised to monitor for signs of jaundice. If significant jaundice is observed after 24 hours, more so if accompanied by other signs and symptoms like vomiting, poor suck or poor activity, the infant should be brought back to the hospital right away and be tested.


Treatment depends on the cause, age of the baby, day of life of occurrence, level of bilirubin and how fast the level is rising so a serial monitoring may be needed. Physiologic or normal causes of jaundice usually need no treatment but only reassurance. However, a baby who was born prematurely even with low levels of bilirubin, or a term neonate with a very high level of bilirubin or with a level that rises rapidly may require hospitalization and treatment.

Treatment regimen may entail use of phototherapy and in severe case of jaundice, it may require an exchange transfusion and giving of intravenous immunoglobulin.

Saturday, September 29, 2012



Sepsis in the newborn or neonatal sepsis is any infection affecting an infant during the first 28 days of life or up to 2 months of life according to some authors. Neonatal sepsis is also known as "sepsis neonatorum." It is an infection that spreads throughout the baby’s body. Sepsis occurs in less than 1 percent of newborns (1 out of every 100), but accounts for up to 30 percent of deaths in the first few weeks of life. Infection is 5-10 times more common in premature newborns and in babies weighing less than 5½ pounds than in normal-weight, full-term newborns.

The infection may be systemic or globally or may be local or limited to just one organ like the lungs, heart,and others. It may be acquired prior to birth (intrauterine sepsis) or after birth (extrauterine sepsis) and maybe due to different causes like Viral (such as herpes, rubella [German measles]), bacterial (such as group B strep) and more rarely fungal (such as Candida). It can either be an early onset sepsis  or late onset sepsis depending on the onset of signs and symptoms.


During pregnancy, it is important to constantly monitor the health of both the pregnant woman and her fetus for any signs or symptoms that might indicate sepsis. There are many indicators that can signal if a potential infection is developing even before delivery. Pregnant Women are screened for infectious diseases ideally on the first pre-natal visit. Some of these include the TORCHS infections like toxoplasmosis, rubella, Chlamydia, herpes, hepatitis B, HIV and syphilis and other sexually transmitted diseases like gonorrhea. Sometimes even immunity to chickenpox is also being checked and between the 35th and 37th week of pregnancy, screening for group B strep is commonly performed.

Some signs and symptoms like a slower than anticipated fetal growth may be a subtle indication of threatened fetal well-being. This can be monitored by measuring the uterine size via the traditional tape measure or ultrasound examination of the uterus, placenta, and fetus. During every prenatal visit, it is important to monitor the actual fetal heart rate at rest as well as the infant's cardiac response to a mild stress like uterine contraction or do a biophysical scoring system for risk assessment which includes taking note of the fetal heart rate, fetal movement and fetal tone. Maternal fever at anytime during her pregnancy should be evaluated and treated if it indicates presence of infection like UTI. The onset of premature labor or premature rupture of the amniotic sac (termed "premature rupture of membranes") may also put a newborn at increased risk of infection.

During labor, several risk factors may indicate the possibility of developing neonatal sepsis. Abnormalities of fetal heart rate, maternal fever, premature separation of the placenta from the uterine wall, or foul smelling/cloudy amniotic fluid all indicate a high-risk labor and delivery. These would require prompt consultation with the pediatrician or neonatologist regarding the potential for delivery and/or postpartum complications.

A neonate who fails to make a smooth transition from intrauterine to extrauterine life should be considered at high risk for sepsis. It is very crucial to closely monitor the vital signs (heart rate, respiratory rate and effort, skin color, temperature, and activity) and see the trending to anticipate such an occurrence.

Early-onset neonatal sepsis occurs within six hours of birth in over half the cases and within 72 hours in the great majority of cases. It is usually due to either prenatal factors as mentioned previously or during labor. Sepsis that begins four or more days after birth is called late-onset sepsis, and is probably an infection acquired in the hospital nursery (a nosocomial infection). In both types of neonatal sepsis, the infection may be only in the bloodstream, or may spread to the lungs (pneumonia), brain (meningitis), bone (osteomyelitis), joints, or other organs in the body.

Typical symptoms of a newborn with sepsis include: CRAFTS

     CARDIAC symptoms (bradycardia, tachycardia)
     unusual RASHES
     poor ACTIVITY or listlessness (a very sleepy baby)
     poor FEEDING
    a high OR low TEMPERATURE    jaundiced SKIN

Other symptoms include: GIJRS

     GASTROINTESTINAL symptoms (repeated vomiting, projectile vomiting, diarrhea, abdominal distention)
    excessive JITTERINESS 
    RESPIRATORY symptoms (difficulty of breathing, rapid breathing, apnea or when the baby stops breathing)


To arrive at a diagnosis of neonatal sepsis, it is important to take a complete history (including pregnancy, labor, and delivery) and perform a thorough physical examination. Various laboratory tests are also requested annd done which include:
     Blood tests:

            CBC (Complete blood count) with White Blood Cell Count and Differential, platelet count, toxic granules

             When an infant is fighting an infection, their  white blood cell count may increase, as the infant’s body produces more  infection-fighting cells, or it might also decrease if the infant has used up all of  their white blood cells fighting the infection and can no longer keep up with  their production of white cells. Another change that is seen when an infant is  fighting an infection is an increase in the percentage of immature white cells.  This is due to the increased production rate of white blood cells, such that  more immature white blood cells are being released into the blood stream.  This higher percentage of immature white cells is sometimes referred to as a  “left-shift,” and is one of the things that can tell the doctors that the infant has an infection. The presence of toxic granules may also indicate infection.

             CRP (C-Reactive Protein)
             This is a laboratory test that measures a protein that is a  non-specific marker for inflammation and therefore infection. If the infant has  two normal CRP levels measured 24 hours apart, then there is a 99% chance  that the infant does not have an infection. Therefore, this test is  most  useful in ruling out an infection.

            Blood chemistries (blood sugar, kidney- and liver-function tests, CPKMB)

             A random blood sugar (RBS) or Hemoglucose test (Hgt) that is below normal may indicate infection. Increased levels of renal function test with urinary tract infection may signify acute renal failure and give a bad prognosis. An elevated liver function test levels may indicate the need to decrease dosages of the antibiotics and sometimes may require a more invasive approach to treatment like exchange transfusion if coupled with marked jaundice unresponsive to the usual regimen. Sometimes, persistent bradycardia despite adequate antibitoic therapy may warrant a request for CPKMB.   

       Cultures of body fluids (blood, urine, CSF [cerebrospinal fluid])

             Positive cultures will help identify the cause of sepsis in the neonate as well as guide the antibiotic therapy. Only small samples of blood and other body fluids are taken so that sometimes no organism is found. However, the infant may still be treated if other laboratory studies or the infant’s clinical appearance strongly suggest an infection.

             A spinal tap, or lumbar puncture will be performed if meningitis is suspected, especially more common if something has grown in the baby’s blood culture. It allows the doctor to obtain a small amount of cerebrospinal fluid (CSF), which is the protective fluid that surrounds the brain and the spinal cord. The CSF can then be cultured to determine if the bacteria has spread to the nervous system.

       Radiological studies (chest and abdominal X-rays, ultrasound studies)

       Two-dimensional echocardiography (2D echo), if with elevated CPKMB levels


Neonatal sepsis is treated with antibiotics given intravenously. Antibiotics are often started ideally after all the necessary blood work ups are requested and done and even before laboratory and culture results are available. The empiric choice of antibiotics depends on the prevailing or common cause of neonatal infection. The doctor may then shift to a different antibiotic that is more specific to the baby’s infection once the results of laboratory tests are back. The duration of antibiotic treatment varies depending on the infant’s clinical status, laboratory test results, and kind of infection. If blood cultures and other laboratory tests are all negative, antibiotics may be discontinued after 48 hours of treatment. If the cultures are positive, or if the laboratory tests and clinical status are suggestive of infection, the treatment with antibiotics may range between 7-14 days. When appropriately treated with antibiotics and cared for in the intensive care unit, the great majority of newborns with sepsis live without any long-term sequelae.

The treatment of sepsis in the newborn involves correcting any abnormal vital signs as well as directed antibiotic therapy. A very sick infant will commonly need IV fluids and may require medications to support blood pressure and heart function. Since many of these infants are very weak and too sick to feed, nutritional support will commonly involve administration of either breast milk/formula via a tube passed through the oropharynx into the stomach or rely solely on IV mixtures of proteins, carbohydrates, and fats. For some critically ill neonates, assisted ventilation (via a tube passed into the larynx) may be necessary.

Prevention of sepsis in the newborn is still the key to a good neonatal outcome. It requires a timely and focused prenatal care, close observation during labor and delivery and detailed monitoring of the newborn after birth in the nursery and even at home after discharge.


Friday, September 28, 2012


The Advisory Committee on Newborn Screening (ACNBS) has approved the inclusion of Maple Syrup Urine Disease (MSUD) in the current newborn screening panel of disorders. This expanded newborn screening now includes six congenital disorders, instead of five diseases. The ACNBS has passed Resolution No. 2012-001 which allowed the offering of the additional test to all newborns at no additional cost.  The ACNBS resolution will be fully implemented in the different areas according to this schedule: NSC-NIH, July; NSC-CL, August; NSC-Visayas, October; and NSC-Mindanao, December.

Newborn screening (NBS) is a simple procedure to find out if your baby has a congenital metabolic disorder that may lead to mental retardation and even death if left untreated. Most babies with metabolic disorders look normal at birth. One will never know that the baby has the disorder until the onset of signs and symptoms and more often ill effects are already irreversible. NBS should be done on the 24 to 72 hours after birth, except for sick and premature babies who must be screened by the 7th day of life regardless of weight and age of gestation. It is available in participating health institutions (hospitals, lying-ins, Rural Health Units and Health Centers). If babies are delivered at home, babies may be brought to the nearest institution offering NBS. The results are available within seven to fourteen ( 7 - 14) working days after the newborn screening samples are received in the NSC.

A negative screen means that the result of the test indicates extremely low risk of having any of the disorders being screened.

A positive screen means that the baby is at increased risk of having one of the disorders being screened.

Babies with positive results should be referred at once to the nearest hospital or specialist for confirmatory testing and further management. Should there be no specialist in the area, the NBS secretariat office will assist its attending physician.

The disorders tested for newborn screening are:

(1) Congenital Hypothyroidism (CH)

(2) Congenital Adrenal Hyperplasia (CAH)

(3) Galactosemia (GAL)

(4) Phenylketonuria (PKU)

(5) Glucose-6-Phosphate-Dehydrogenase Deficiency (G6PD Def.)

(6) Maple Syrup Urine Disease (MSUD)

Below is the list of the G6PD Confirmatory Centers all over the country:

MCU-FDTMF Hospital
EDSA Caloocan City
Tel.             +63 2 365.4868       / 367.2031 loc 1136
 Fax. +63 2 365.4868

 National Institutes of Health Central Laboratory
 NIH Bldg., University of the Philippines Manila
 625 Pedro Gil St., Ermita, Manila
 Tel.             +63 2 525.5171

Our Lady of Lourdes Hospital
 46 P. Sanchez St., Sta Mesa Manila
 Tel.             +63 2 716.3901       loc 513/229/287
 Fax. +63 2 714.7495

University of Perpetual Help Dalta Medical Center
 Alabang Zapote Rd. Pamplona, Las PiƱas City
 Tel.             +63 2 874.8515       loc 175/204

Mariano Marcos Memorial Hospital and Medical Center
San Julian, Batac, Ilocos Norte
Tel.             +63 77 792.3133       or 792.3144
 Fax. +63 77 6171517 or 792.4978


Cagayan Valley Sanitarium and Hospital
Mabini, Santiago City, Isabela
Tel.             +63 78 682.8486       or 682.6908/09
Fax. +63 78 682.8548


Angeles University Foundation Medical Center
Mac Arthur Hi-way, Angeles City
Tel.             +63 45 625.2999     
Fax. +63 45 625.2924


Batangas Regional Hospital
Kumintang Ibaba, Batangas City
Tel.             +63 43 723.0165       or 980.1733
Fax. +63 43 980.1738


Polymedic Medical Plaza
National Highway, Kauswagan, Cagayan De Oro City
Tel.             +63 88 858.5242     
Fax. +63 88 858.4185

Mayor Hilarion A. Ramiro Sr., Regional Training
Maningcol, Ozamiz City
Misamis Occidental
Tel.             (088)5210440     
Fax (088)5210022


Tagum Doctors Hospital
Highway 5A, rabe Subd., Tagum City
Tel.             +63 84 400.1353     
Fax. +63 84 210.2309


Dr. Pablo O. Torre Sr. Memorial Hospital (Riverside Medical Center)
B9 Aquino Drive, Bacolod City
Negros Occidental
Tel.             (034)4337331     
Fax (034)4345532
Here is a video of the newborn screening from the Newborn Screening Site:

Thursday, September 27, 2012


                                                (November 27, 1911 - August 6, 2011)

Dr. Fe Del Mundo, has been the epitome of a true pediatrician who had spent most of her life taking care of Filipino children as well as educating and training future pediatricians who would be armed with the knowledge, wisdom and skills in whatever area they choose to practice. The English translation of her full name, “Faith of the World”, would signify her belief in the capabilities of Filipino pediatricians to excel worldwide.
Born on November 27, 1911 in Manila, Dr. Del Mundo has lived with her family right across the Manila Cathedral. She was christened Fe. She graduated valedictorian at the University of the Philippines in 1933 and received the award as the "Most Outstanding Scholar in Medicine”. She went to the United States and completed her Pediatric courses A, B and C at Harvard Medical College in 1937 through a Fellowship Grant from the Commonwealth of the Philippines. She is the first Filipino woman, and the first female, to be enrolled at Harvard Medical School. She also studied and trained at Columbia University, University of Chicago, Boston University and Massachusetts Institute of Technology. She earned an M.A. degree in Bacteriology from Boston University in 1940.

In 1957, Dr Del Mundo returned home and established the Children’s Memorial Hospital on Banawe, Quezon City which is the first Pediatric hospital in the Philippines. The hospital was later renamed Fe del Mundo Medical Center Foundation, where she served as the hospital president and chief pediatrician for more than 50 years.
Dr. del Mundo was founder of Children's Home in Manila and the Institute of Maternal and Child Health. She was the first Filipino Diplomate of the American Board of Pediatrics, the first lady president of the Philippine Pediatric Society, the founder and first president of the Philippine Woman's Medical Association, the first woman to be elected president of the Philippine Medical Association in it's 65-year history, and the first Asian to be voted president of the Medical Woman's International Association.
She was also the first Filipina national scientist to be recognized due to her invention – a makeshift incubator. The innovative incubator was made of bamboo which was used in rural areas without electricity, a cloth-suspended scale to weigh infants and a radiant warmer made of bamboo to maintain the baby's body temperature. It consisted of two native woven baskets of different sizes usually used for keeping laundry. The smaller basket was placed inside the larger one. During a biographical interview in 2007, Del Mundo said, “I put in hot water bottles all around between them. I put a little hood over the entire contraption and attached oxygen for the baby,” she says. “We had to do with whatever was available.”
Dr. Del Mundo was also the recipient of numerous awards during her lifetime and beyond. She received the Elizabeth Blackwell Award for "outstanding service to mankind" and the Ramon Magsaysay Award for outstanding public service in 1966 and 1977, respectively. She also received the 15th International Congress of Pediatrics award as most outstanding pediatrician and humanitarian in 1977. President Benigno Aquino III conferred the Order of the Golden Heart with the rank of Grand Collar posthumously on National Scientist Fe del Mundo on August 11, 2011.
This petite pediatrician, barely 5 feet tall was married only to her career, which is taking care of children, and never had a family of her own. She has a big heart for the sick and even chose to practice until she died in her sleep on August 6, 2011. She was more than 99 years old, actually less than 3 months shy of 100. .She was finally laid to rest in the Libingan ng mga Bayani, where she rightfully belongs because she was a hero.


Friday, September 21, 2012


"Conduct yourselves wisely toward outsiders, making the most of the opportunity. Let your speech
always be gracious, seasoned with SALT, so that you know how you should respond to each one."
                                                                                Colossians 4:5-6

Parents and other caregivers like the grandparents, aunts, and other relatives and friends of my patients may be unseasoned because their knowledge and skill are limited to what they read in the newspapers, hear in the radio and surf in the internet. These information may either be lacking or inaccurate so it is my job to be the seasoning like salt that adds flavor to a bland meal.

When the parents of my patients seek consult for an illness or wants new information on how to raise their children, may I provide them wisdom and knowledge through God, the Holy spirit, so that they may be gifted with a family who follow God's commandments.  I will attain this by applying the keys to a good physician.

 What are the  keys to a good physician? SALTP


In talking to the parents, I will use SIMPLE LANGUAGE. If I am able, I will try to speak their
dialect so I can be better understood.

In trying to decipher what worries them or what ails their children, I will ASK checking QUESTIONS. I will get a complete history and do a thorough physical examination. In doing so, I have to make sure that my patient is comfortable and my parents aren't ill at ease.

Although I need to probe every detail to come up with a correct diagnosis, I will LISTEN CAREFULLY to the answers of the mother, father or any of the child's caregiver. Sometimes, what I seek is not the direct answer to my question but what lies hidden in their eyes and words.

Eventhough it means I have to spare a few more minutes, I will TAKE TIME to talk to the mother or
caretaker. I will not hurry off to the next patient when I haven't gotten all the information I need
so I can manage my patient well.

I will bring a smile and encouragement to my patient's parents and caretakers through PRAISE and
ADVISE them on things that matter, especially regarding family relationships and dynamics.

What are the different patient/parent education strategies that I can utilize so I can better serve
my patients and relatives?

One strategy is to inform the parents about the importance of  newborn screening and immunizations. Another strategy is demonstrate or show by illustrations the different steps to bathe a baby safely. A third strategy is to provide resources like hand-outs on simple home remedies for common ailments. It is also important to ask open-ended questions. In order to give new information, a practicing pediatrician should update oneself on latest evidenced-based evaluation and management of diseases or other ailments affecting the different age groups. Finally, it is part of a physician's task to seek family perspective and provide positive feedback on basic health care.