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Pediatrics is that field of medicine which deals exclusively with patients from infancy to 21 years of age, although some countries put their cut-off to as early as age 14. The word pediatrics comes from the Greek words paidi, meaning child, and iatros, meaning doctor. Accordingly, it caters to the physical, mental, and emotional aspects of the growth and development of a child.
The field of pediatrics is concentrated on ensuring a child’s normal growth and development. Just as importantly, it also deals with the management of all the diseases that may affect a child from conception to maturity. One of the thrusts of pediatrics is that children cannot be treated medically as miniature adults. This is because, aside from the apparent differences in size, children’s bodies have different proportions and some dissimilar physiologic processes, particularly in neonates and infants. Also, children may be affected by congenital anomalies, genetic defects and decreased immune function, which render them more prone to mortality and morbidity as compared to adults.
It must also be emphasized that social factors play a very big role in pediatrics. A highly important and prominent issue in pediatrics is guardianship, essentially because children are minors and thus are considered to be incapable of making decisions for themselves. Therefore, in almost all jurisdictions, procedures cannot be done on a pediatric patient without the informed consent and/or the presence of a parent or guardian. Similarly, the social aspect of development is recognized to be a key and crucial factor in the care and management of children. A specific example would be adolescent medicine, wherein features such as life at home, education and so-called risky behavior such as sexual activity and vices are always looked into.
Like adult medicine, pediatrics has subspecialties dealing with specific organ systems or groups of diseases. Most of these reflect their counterparts in adult medicine. Examples include pediatric cardiology, pediatric neurology, pediatric infectious diseases, pediatric gastroenterology, pediatric allergology and immunology, pediatric oncology, and the like. However, some subspecialties are exclusive to pediatrics, such as neonatology, genetics, and adolescent medicine.
Because childhood is the stage wherein the most progress in growth and development takes place, it takes more than general medical training to handle this crucial period in a person’s life. Internship and residency training programs in pediatrics range from 3 to 4 years, and can be taken only after finishing medical school. In the United States, for example, one has to take a year of internship in pediatrics, after completing 4 years of medical school. This is then followed by 2 more years of residency training. A general pediatrician who then desires to practice a pediatric subspecialty then goes into fellowship, which may take a few months to about 2 years.
The specialty of pediatrics is considered relatively young, compared to the rest of medicine in general. References to specific childhood diseases and their management have been found in ancient texts such as the Ebers Papyrus and the writings of Hippocrates, Galen and Avicenna. Also, the first significant book on children, entitled De Morbus Pusiorum and written by Hieronymus, was printed in 1583. However, the field of pediatrics as it is known today only began to emerge as recently as 200 years ago. By this time, a greater number of authors began publishing articles related to the medical management of children. Prominent figures include Thomas Sydenham, who wrote on scarlet fever, measles, smallpox, epilepsy, rickets, teething fever, scurvy and St. Vitus Dance, and Edward Jenner, who invented the smallpox vaccine and fathered immunization, considered one of the best medical advances of all time.
The father of pediatrics as it is known today is Abraham Jacobi, a German pediatrician who went to live and practice in the United States, specifically in New York, in 1853. He published numerous articles, and focused on the nutrition and hygiene of children. Other notable personalities include Luther Emmett Holt, J. Forsyth Meigs, and William McKim Marriott, who all contributed significantly to growth of pediatrics as a field of medicine.
Most pediatricians belong to an association. Examples are the American Academy of Pediatrics, the American Board of Pediatrics, the Canadian Pediatric Society, the Royal College Of Pediatrics and Child Health, Norsk barnelegeforening (The Norwegian Society of Pediatricians), the Indian Academy of Pediatrics, and the Philippine Pediatric Society.
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