pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

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Puberty: Tanner Stages – Girls

Growth, development and maturity begin at a wide range of ages

The original study of childhood growth and maturity done by Dr. Tanner at the Harpenden orphanage in England during WWII has been replicated and verified many times since then.
Read more→

Childhood Immunizations In A Nutshell: Links

Preschool boy receiving immunizations against life-threatening diseases

I’ve noticed that there are a lot of blog posts on the internet with outdated information about childhood immunizations. Even the links on a whole lot of physicians web pages fail or point to outdated material.

It’s really not surprising due to the many new ‘official recommendations’ published recently following the frequent recurrences of diseases we thought we had eradicated. Un-immunized children are making new epidemics Read more→

Puberty: Tanner Stages and Growth

Doctor James Mourilyan Tanner, originator of scales to measure growth and development in children

Pretty much the second question you field from a parent during your pediatric clerkship in medical school (right after “what’s this yukky looking rash”) is: “Do you think (insert name here) is growing well enough?” or, some equivalent question.
Read more→

Puberty Series: Intro/Index

growth boy when did that happen?

It’s hard to believe but less than eighty years ago humanity didn’t even have a clue about nutrition let alone what constituted adequate nutrition for a child!

During the war, there were developing so many refugee children that needed to be cared for by institutions that Great Britan decided to undertake a simple study about what “growth” looked like in children. Nothing was known about that of substance either.

Dr. James Mourilyan Tanner was asked to take over a nutrition study of institutionalized children with the intent of seeing to it that the children still grew well—whatever “well” looked like. He agreed to do it, used the scientific method, devised what is now still the definitive study on growth and puberty (the Tanner Scale) and the rest is history.

This series of posts is all about that. What it is, how it came to be, how it’s used and what we know about the study of puberty.

9 Posts in "Puberty Talk" Series

  • Puberty, Tanner Series: Intro/Index – 11 Jul 2015
    Puberty and the Tanner Scale, it's development, rationale and use in adolescent medicine, intro and index

  • Tanner Stages and Growth – 12 Jul 2015
    An explanation of the "five stages" of puberty that Dr. James Tanner developed, the physical characteristics and issues.

  • Tanner & Growth - Girls – 20 Jul 2015
    The physical stages of "Puberty" for girls as explained by the "Tanner Stages" one through five: it's characteristics and issues.

  • Tanner Stages - Boys – 28 Jul 2015
    The physical stages of "Puberty" for boys as explained by the "Tanner Stages" one through five: it's characteristics and issues.

  • Puberty: Psychological Stages – 5 Aug 2015
    Part one of the explanation about the psychological issues experienced in the first four Tanner Stages of pubertal development.

  • Puberty: Psychological Stages - Part 2 – 13 Aug 2015
    Part 2 of the discussion about the psychological states of puberty dealing with the last two "Tanner Stages" of development.

  • Doctor's Talking About Puberty and Sex to Patients – 28 Aug 2017
    This post is about a study I found where researchers examined how well doctors do at teaching and helping patients with sexual related issues.

  • FAQ - Boxers, Brief's or Commando – 28 Aug 2018
    A preliminary answer to a puzzled teens online question to his doctor after being embarrassed by girls at a party who asked him "what do you wear, boxers, briefs or commando?" He asked, "is there a best?" and his doctor asked if I'd take a crack at answering him.

  • Boys Underwear: Boxers, Briefs or Commando - explanation, recommendations – 22 Sep 2018
    A probably way too exhaustive post giving an answer to an embarrassed teens question: "Is there a 'best' one: boxer, brief or commando?"


If you’d like to read a bit more about historical medicine, you’d do well to peruse the Top 50 Doctors of All Time series as well.

Measles: The Real Evidence

Unimmunized child with measles

This year (2015) the U.S. has suffered a huge increase in Measles. An increase unlike any other in recent years! The blame for much of it has been directly placed at the feet of California residents who exercised a “personal belief” exemption in the state’s childhood immunization requirements.
Read more→

10 Scary Issues About Concussions

Concussion: Not an easy fix

I saw a 5-year-old purple-faced dragon at Sam’s Club trying to go ingognito. She was wearing the lace-up pink boots that everyone knows is what frogs wear when they want to go out on the town. She couldn’t fool me!
Read more →

Internet Vaccination Advice Nearly Killed Their Son

Parents "philosophical" decision not to immunize nearly cost this boy his life

I ran across a poignant article while researching the difficult topic of how parents should use the internet to gain medical information – truly, it sounds simple BUT IT’S NOT.

There is a mind-blowing amount of information exposed by a search on Google for about any medical condition! Unfortunately, there is also an incredible amount of crap exposed in that same search!
Read more →

10 Travel Diseases to Consider – Part 2

Multigenerational family vacation

We’re talking about ‘travel diseases’ which should be considered before taking a trip ‘abroad’ either with or without the family in tow. Yes, from the standpoint of living in the U.S. most of these seem vague and ‘out there somewhere’ but not associated with our daily worries.
(more…)

Ten Travel Diseases: Intro/Index

This post begins the series of TEN Travel Diseases you shouldn’t forget to consider if you’re lucky (and brave) enough to be taking a vacation this year which involves some degree of traveling – especially across some borders. And remember, the more borders you cross, the more of these you should consider.

You may or may not have even heard of them (hence writing these posts) but be assured, they are still alive and well in the world. And many still here in parts of the United States!

Here is the index to the Ten Travel Diseases series:

3 Posts in "Travel Diseases" Series

  • 10 Travel Diseases: Intro/Index – 7 May 2015
    The Intro/Index to the Ten Travel Diseases Curated Posts Series

  • Ebola, MERS, CHIKV, Measles, Polio – 7 May 2015
    You traveling this year on your vacation? There are a few things we ought to keep in mind – medically speaking – in order to avoid experiencing a vacation that just “keeps on giving” long after you’d like it to be over. I'll list 10 of them, this post containing the first five: Ebola, MERS, CHIKV, Measles and Polio.

  • Cholera, Bird Flu, TB, Malaria and Yellow Fever – 11 May 2015
    Here are the second five (of the ten) travel diseases I'm discussing. Things that you might want to take into consideration, especially when you're crossing borders. Cholera, Bird Flu, TB, Malaria and Yellow Fever.

Tonsillectomy – part two

Nonexudative pharangitis, normal tonsils

Due to editing and space constraints, my (newspaper) article on tonsillectomy two weeks ago did not present the entire picture of how physicians feel about this surgical procedure… and generated several additional questions – which we will cover here.
Read more→

Tonsillectomy – Risks and Benefits

sore throat, germs eye view

I have been asked several times this week about tonsillectomy – whether or not a child should have their tonsils taken out by surgery.  Usually the question is in response to a sore throat of some kind, whether or not there is an infected tonsil.

There are just so many variables (i.e. whether it is acute or chronic, allergic or contagious etc.) that my reply must be largely individualized; so, a short article cannot adequately cover the topic.
Read more→

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