History of Pediatrics
- Child-specific medical problems mentioned in the Hippocratic Corpus and the Sacred Disease
- Greek philosophers and physicians discussed specific illnesses affecting children
- Traces of pediatrics found in Ancient India
- Ayurvedic texts like Sushruta Samhita and Kashyapa Samhita contain information about pediatrics
- Byzantine physicians and Islamic Golden Age writers contributed to the field
- Term 'pediatrics' introduced in English by Abraham Jacobi in 1859
- Jacobi is considered the father of American pediatrics
- The first pediatric hospital, Hôpital des Enfants Malades, opened in Paris in 1802
- Similar institutions established in Berlin, Saint Petersburg, Vienna, Breslau, and London
- First pediatric hospitals in Scotland and the US
- Autonomy is traceable to ethical theory and law
- Hippocrates highlighted the importance of patient autonomy in healthcare
- Ancient societies did not prioritize pediatric medicine or children's rights
- In the twentieth century, emphasis on children's rights increased
- Best Interest Standard of Child developed to prioritize children's rights and best interests
- The history of pediatrics dates back to ancient times, with early physicians recognizing the importance of specialized care for children
- Soranus of Ephesus, a physician in Roman times, is considered one of the fathers of pediatrics
- Pediatric care has evolved over centuries, influenced by cultural, social, and medical advancements
- The establishment of pediatric hospitals and the development of pediatric organizations have played a significant role in the advancement of pediatric medicine
- The field of pediatrics continues to evolve and improve, with ongoing research and advancements in medical technology
- Nestlé Nutrition Workshop Series, Vol. 22, provides a comprehensive history of pediatrics during the period of 1850-1950
- There is an official history site (in French) that focuses on nineteenth-century pediatric hospitals in Paris
- The Mason Brown Lecture in August 1999 discussed the role of Scots in pediatric surgery during this time
- 'Pediatrics in the United States' by Howard A. Pearson, published in 1991, explores the development of pediatrics in the United States during this period
- Commentaries by Edwards A. Park in the journal Pediatrics shed light on important aspects of pediatric practice
Differences between adult and pediatric medicine
- Physiological differences between infants/children and adults
- Congenital defects, genetic variance, and developmental issues are of greater concern in pediatrics
- Children are not simply little adults
- Pediatric physiology affects drug pharmacokinetics
- Continual research needed to understand medication decisions in pediatrics
Medical Care
- Pediatrics involves medical care of infants, children, adolescents, and young adults
- Age limits for pediatrics vary worldwide and have been trending upward
- Pediatricians work in various settings including clinics, research centers, and hospitals
- Some pediatric subspecialists continue to care for adults up to the age of 25
- Pediatricians specialize in different areas like neonatology
Pharmacokinetics
- Neonates and young infants have increased stomach pH, affecting drug absorption
- Acid is essential for degrading certain oral drugs, so absorption is greater in children due to decreased breakdown
- Children have an extended rate of gastric emptying, slowing drug absorption
- Drug absorption affected by factors like gastric pH and gastric emptying rate
- Percentage of total body water and extracellular fluid volume decrease as children grow
- Pediatric patients have larger volume of distribution than adults
- Dosing of hydrophilic drugs like ampicillin needs to be adjusted in children
- Infants and neonates have fewer plasma proteins
- Highly protein-bound drugs have fewer opportunities for protein binding in infants and neonates
- Drug metabolism occurs via enzymes in the liver
- Phase I and Phase II enzymes have different rates of maturation
- Enzyme capacity, clearance, and half-life contribute to metabolism differences between children and adults
- Drug metabolism can differ within the pediatric population
- Neonates and infants have slower kidney maturation, affecting drug metabolism
- Drug elimination facilitated via liver and kidneys
- Infants and young children have increased renal clearance
- Preterm neonates and infants have slower kidney maturation
- Diseases affecting kidney function impact drug elimination
- Lower doses and greater dosing intervals may be necessary for certain populations
Education and Training
- Aspiring medical students need 4 years of undergraduate courses at a college or university
- After college, future pediatricians must attend 4 years of medical school and later do 3 more years of residency training
- High school students interested in becoming pediatricians should take basic science classes such as biology, chemistry, physics, algebra, geometry, and calculus
- It is advisable for high school students to learn a foreign language, preferably Spanish in the United States
- In medical school, student courses will focus on basic medical sciences like human anatomy, physiology, and chemistry
- The training of pediatricians varies across the world and can take from 4 to 11 or more years depending on jurisdiction and specialization
- In the United States, medical school graduates specializing in pediatrics must undergo a 3-year residency composed of outpatient, inpatient, and critical care rotations
- Subspecialties within pediatrics require further training in the form of 3-year fellowships
- Entry-level degrees are common to all branches of the medical profession in most jurisdictions
- Junior medical doctors may need to undertake generalist training before specializing in pediatrics
- Subspecialties within pediatrics include critical care, gastroenterology, neurology, infectious disease, hematology/oncology, rheumatology, pulmonology, child abuse, emergency medicine, endocrinology, neonatology, and others
- Pediatric subspecialties require additional training and expertise beyond general pediatrics
- Pediatric subspecialists focus on specific medical conditions and provide specialized care to children
- Subspecialists work closely with general pediatricians to provide comprehensive care for pediatric patients
- The availability of pediatric subs
Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the age of 18. The American Academy of Pediatrics recommends people seek pediatric care through the age of 21, but some pediatric subspecialists continue to care for adults up to 25. Worldwide age limits of pediatrics have been trending upward year after year. A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word pediatrics and its cognates mean "healer of children", derived from the two Greek words: παῖς (pais "child") and ἰατρός (iatros "doctor, healer"). Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties (e.g. neonatology requires resources available in a NICU).
 A pediatrician examines a neonate. | |
| Focus | Infants, Children, Adolescents, and Young Adults |
|---|---|
| Subdivisions | Paediatric cardiology, neonatology, critical care, pediatric oncology, hospital medicine, primary care, others (see below) |
| Significant diseases | Congenital diseases, Infectious diseases, Childhood cancer, Mental disorders |
| Significant tests | World Health Organization Child Growth Standards |
| Specialist | Pediatrician |
| Glossary | Glossary of medicine |
From Ancient Greek παῖς (paîs, “child”) + -iatrics.
