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9 year old girl body odor

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  2. my 9 year old daughter has body odor, any deodorant suggestions for children? should we be concerned? Answered by Dr. Jay Bradley: Deodorant: I would recommend standard women's deodorant and being sure..
  3. In general, puberty starts between the ages of 8 and 13 for girls, and 9 and 14 for boys. But some kids start experiencing signs (like budding breasts, body odor, acne, and developing pubic and underarm hair) before those ages. The technical term for that is precocious puberty
  4. It's within the normal range of development for a girl to get body odor at age 8 and for boys, it's a little later at age 9. It's a sign that the body is maturing and the hormones are changing, Dr. Jennifer Shu, a pediatrician and author of Baby and Child Health, told BabyCenter
  5. Body odor signaling the start of puberty can start as early as age 7 for girls and age 9 for boys, said Dr. Kathryn Schaus, a Marshfield Clinic pediatrician. If body odor starts before age 7-9 or smells strange, make an appointment with your child's pediatrician
  6. Body odor in children is normal starting with early puberty, which is when kids generally start using deodorant. But the presence of body odor in children and toddlers who aren't yet at the typical age for puberty — 8 to 13 for girls and 9 to 14 for boys, typically — could signal that it's time to talk to a pediatrician
  7. But, if your child develops body odor before the age of 7-9 years, is smelling strange, or has an excessive odor, then you could consider making an appointment with your child's pediatrician, says Dr. Kathryn Schaus, a pediatrician at the Marshfield clinic (4)

Easier said than done, because you have to pay attention and establish a pattern, but this can help decrease offending smells. It's not unreasonable to start a 9 or 10 year old wearing deodorant once their body odor is noticeable. It will not harm them, and the earlier that they start ingraining good hygiene habits, the better Phenylketonuria is inherited and is a metabolic disorder that causes a musty odor in the child's body. This disorder can cause intellectual and developmental disabilities due to the body not being able to process a portion of the protein phenylalanine. This protein is in most foods, such as Typically, body odor can begin to develop as early as 7 years old in girls, 9 years old in boys, as the body hits puberty. Suddenly, your child is beginning to sweat more and sweat specifically from what are called the apocrine sweat glands, glands in the armpit and groin region

Why does my 9 year old daughter have body odor Answers

  1. That tends to skew younger for girls (about 8 to 11 years old), than it does for boys (about 9 to 14 years old), says Maguiness. Typically, you'll begin to notice more pronounced body odor after..
  2. New details about the 1984 cold case murder of a 9-year-old San Francisco girl were released this week, following a new break in the case Authorities say Mei 'Linda' Leung was raped, stabbed and..
  3. gs, a pediatric endocrinologist at IWK Health Centre in Halifax. The onset of puberty is happening earlier for many girls — according to Cum

When Is It Normal For Kids To Start Having Body Odor And

So body odor in a 5 yo girl, the cute baby sweat that we love starts changing its odor when the adrenal glands kick in, sometime between age 6 (it sounds frightening! but usually around age 8 when the earliest pubic hair may be noted). If she is not having rapid growth (height) and she has no pubic hair, or axillary hair it is doubtful that. I have a nine-year-old daughter who is beginning to go through puberty. The hormonal changes have made her body odor uncontrollable. Needless to say, this makes her self-conscious and embarrassed. We have taken every measure we know of to keep this under control, but it doesn't seem to be working This hormone also causes body odor and sometimes mild acne. This part of puberty is called adrenarche. Adrenarche is usually normal in girls who are at least 8 years old, and boys who are at least 9 years old Sometimes a body odor smelll sets into the underarm of shirts and continues to smell despite washing. When your teen's clothing smells, it will smell offensive, even when the teen is actually clean. Once the smell is set, the bacteria will be reactivated with body heat. If this is a consistent problem for your teen, you may have no choice but.

Young girls and infants may have normal vaginal odor. Diapers and urine may make the smell a little stronger. However, if your daughter has a smell, redness, itching, and may complain that it hurts when she pees, it's probably vulvovaginitis. This is very common in young girls before puberty, and it is caused by soap residue in concentrated urine Teens go through various bodily changes after puberty. Body odor may be one of them, and teens usually complain about it. A teen may be concerned, but there is no need to worry. It is normal for teenagers to develop body odor (1)

Body Odor in Almost 8 Year Old Daughter. Hi...my daughter is starting to get major body odor under her armpits. It is very noticeable when I pick her up after school. And this weekend, on Saturday, we were barely gone from home when she mentioned she was hot (we were outside walking) and her pits smelled (to put it bluntly) Is Body Odor in kids normal? Most of the times your child emit some kind of body odor which is noticeable. That is why children below 8 years do not normally emit body odors. However, teenagers along with your preteen children who are entering puberty do tend to emit distinct odor

Bad Body Odor Causes and Remedie

Had the odor problem for 5 months before she began getting her arm pit hair. My cousin's daughter had the odor problem for a year before she started other signs of developement and my 11 year old grandson started using deordorant a year and a half ago and just started getting arm pit hair about two months ago. Natural course of aging We do not consider it early when this process happens to girls after the age of 8. And in the case of boys, this process usually happens after the age of 9, says Céline Huot. Yes, it seems early, but it's normal. For your 6-year-old child, it's not really puberty but rather, premature adrenarche Limit Pungent Foods. If your tween seems to struggle with body odor despite wearing deodorant and practicing good hygiene, you may want to try limiting their intake of pungent foods. Foods like garlic, onions, and fish can increase body odor in some people. 3 Even eating large amounts of red meat has been linked to an increase in body odor. 4 Body odor in 6-year-old girl May 2006 . My 6 year old sometimes has body odor under her arms after vigorous activity. I'm probably the only one who can smell it- because I get up so close to her but it seems so young to me! She is definately not near puberty in any other observable way While the first signs now typically start around age 9 or 10, 7- to 8-year-olds are on the early end of the range. Even if your child isn't showing any hints of puberty yet, this is still the.

In boys, the signs of precocious puberty before 9 years of age include: enlargement of the testicles or penis. rapid height growth (a growth spurt) In girls and boys, some of these can be signs of possible early puberty, but sometimes are normal: pubic, underarm, or facial hair development. voice deepening. acne 8 year old girl with body odour. Very odd but the past two days my daughter's come home from school really quite wiffy. This has come out of the blue, never happened before. I don't think she's been excessively hot at school, it was really cold on Tuesday so I don't know what's up For a Boy. The physical changes of puberty for a boy usually start with enlargement of the testicles and sprouting of pubic hair, followed by a growth spurt between ages 10 and 16 — on average 1 to 2 years later than when girls start. His arms, legs, hands, and feet also grow faster than the rest of his body A 28-year-old female asked: My daughter is five years old, and has a few pimples on her forehead and nose and at times a blackhead. l've always put aques cream on her body and face after she had a bath, and I had and still do at times have acne The fact that your child has body odor doesn't mean he'll be shaving anytime soon. True, his body is maturing — but it's a very slow process. Later on, probably sometime after age 8 or 9, your child will experience a more significant hormonal change. This is when you can expect to start seeing signs of puberty

Hi, I have a 6 year old daughter who I have been trying to teach to shower, she has a very strong body odor and I have tried helping her wash herself, I have tried different approaches and nothing works, she will stand in the shower for an hour if More I allow her and she will not scrub, wash her hair or anything. her dad tells me that is my. When bacteria on the skin mixes with sweat, the result is an unpleasant odor, even in young kids. Body odor isn't the only problem -- maturing too early can lead to shorter adult height and emotional strain and embarrassment due to breast development and early periods in girls or increased sexual libido in boys

My 8 year old daughter has body odor! 10 answers / Last post: 13/08/2012 at 2:30 pm. Ash99lkm. 11/08/2012 at 8:58 am. Ive just noticed that my 8 year old daughter smells of sweat under her arms. Can anybody tell me if this normal or if i should perhaps take her to the docs?? She just seems a bit to young for this to be happening Odor Shield™ eliminates 99.9% of odor-causing bacteria in the fabric and stays put for at least 70 wash cycles. Managing your sweat can also help you combat B.O. effectively. Try our best-selling sweat proof undershirts for men and women to stop body odor and sweat marks in their tracks Though there is not specific age at which it happens, body odor at age 9 or 10 is not unusual now, particularly given that tweens are entering puberty earlier than previous generations did Hello, I appreciate your post as I am looking for a cure for my 9 year old daughter for months now. I did take her to the dermatologist but was told that this aweful odor is normal! At my insistence they tested her but for fungus only (which I already knew she doesn't have) and of course it came negative. The odor is there right after the. In girls, the signs of precocious puberty are: Breast development. Pubic or underarm hair. Rapid height growth - a growth spurt. Acne. Adult body odor. Vaginal discharge or bleeding. Talk to your doctor if your daughter is less than 8 years of age and shows any of these signs

What's that smell? Body odor means puberty is starting

Adrenarche is the onset of androgen-dependent body changes such as growth of axillary and pubic hair, body odor, and acne. Menarche is the onset of menstruation. Normal Puberty. Normal puberty begins between ages 8-12 years in girls and 9-14 years in boys. Tanner stage 2 breast development in girls; Tanner stage 2 testicular enlargement in boy Body odor is one of the earliest signs of puberty. Due to hormonal changes, children begin to sweat profusely as their sweat glands start pumping out more moisture. But sweat alone does not a smelly child make—indeed, sweat itself is odorless salty water. The stench comes from specialized sweat glands located under the arms and in the groin.

Body Odour in my 9 year old DD (19 Posts) Add message | Report. 3 of the girls in DDs primary class started their periods at 9 and at least half the girls in the class had started before leaving for secondary school. I would assume from that they all had BO and body hair well before that time. yip , get deodorant . I have to spray my 9. Question: My 7 yr old son smells like onions. He has recently developed body odor, but in the past few days has had an onion odor.He bathed last night, but has the odor this morning

Pubic hair typically appears after age 8 years in girls and after age 9 years in boys. Changes in the hormones made by the adrenal gland lead to the development of pubic hair, axillary hair, acne, and adult-type body odor at the time of puberty. When these signs of puberty develop too early, a child most likely has premature adrenarche. The key. Question for Dr. Leia: My 5 year old has the worst body odor under her arms. I don't understand how it can be so bad in a little girl & so young. This has been going on since she was about 4 and she seriously smells like a man that's been working outside in 90 degree weather ALL day without deodorant on The academy pointed to a few signs that a child's development might be out of the range of normal: testicular enlargement in a boy younger than 9 and progressive breast development in a girl younger than 8. Kohn said rapid growth in pubic hair or acne at a young age are also possible warning signs Early Puberty in 6-year-old. May 2006. My 6 year old kindergarten daughter has been referred to a pediatric endocrinologist. She has begun growing pubic hair and has a strong body odor when exercising (dancing, P.E., etc). Has anyone out there had similar experiences. So far, the bone x- ray indicates a normal 6 year old structure They will likely mention body odor, hair growth or breast development, for girls. You can draw all these things on the image, or write keywords nearby on the paper. This can be your opening to talk about: Deodorant: Armpits are an area that may need attention. Some teens, mostly girls, may choose to shave

The first pre-pubescent signs

I want my 9-year-old daughter to be prepared for her first period, but she's so young! When should I start talking to her about periods? In general, most girls get their periods an average of 2 - 2 ½ years after the development of breast buds. The development of breast buds is a great opportunity to talk more about body changes yet to come Since body odor is linked to puberty, it's important to determine if your child has started puberty already. Girls typically start puberty between the ages of 8 and 13, while boys usually start when they're between 9 and 14 years old.   In a cross-sectional study involving 17,077 girls, striking differences were detected in pubic hair development between black and white girls. At 6 years of age, 9.5% and, at 8 years of age, 34.3% of black girls had at least Tanner stage 2 pubic hair, whereas 1.4% and 7.7% of white girls, at these ages, had pubic hair a population of 8- to 16-year-old girls designed to be representative of the entire US population.2 In a more recent study,3 using a sample of white, black, and Hispanic girls in New York City, Cincinnati, and San Francisco, breast development was assessed by palpation, allaying the concern (one of the problems with the PROS study) that lipomasti

The average age of menstruation for girls is 12, Why I threw my 11-year-old daughter a period party. When having the body odor conversation, your tween will likely laugh, want to walk. On average, girls start puberty between the ages of 8 and 13, but some will start to develop breasts, pubic hair, or body odor before age 8. The technical term for this is precocious puberty. Girls are more likely than boys to develop precocious puberty. Watching your daughter become a woman can be an emotional roller coaster under normal. Confessions of a Stinky Girl: 4 Tips to Naturally Control Body Odor. follow 34 Followers. 0 Boost Score Kimberly Lo (55,235) #34 Contributor - see top 100. Facebook Twitter. 171k. 1. 2.1k Share on Facebook Share on Twitter Link: 28. I was in the in sixth grade when I first became aware that I had a not-so-fresh-fragrance

Specialist Answers On Pediatric Concerns. Q1. Two years ago, I noticed that one of my daughters, now 15 years old, had developed stretch marks from her knees to her thighs. She has not been. 4. Facial and Body Hair. Hair in unwanted places is a common side effect of puberty. Body odor and excess body hair often tend to go together, says Alderman. Girls get hairy arms or hairy upper lips, and it can be embarrassing.. You can do certain things to help minimize the appearance of your body hair Kids start puberty at different ages, with many girls beginning between the ages of 9 and 13 and many boys between 10 and 15, according to the Centers for Disease Control and Prevention (CDC. That said, there are some girls who start their pubertal changes a little differently. Most girls have breast development first and then they develop pubic hair, underarm hair, and odor. But about 10 percent of girls start with the hair and odor first, and the breast development comes a little later Precocious puberty is when a child's body begins changing into that of an adult (puberty) too soon. When puberty begins before age 8 in girls and before age 9 in boys, it is considered precocious puberty. Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body's ability to reproduce

Recently I noticed that my 5 year old girl has relatively strong BO. I didn't think it was possible at such a young age and had never investigated the source of this smell until a few days ago. The fact that despite all this baby/child beauty and body products out there, there is no such thing as child deodorant My six year old wakes in the middle of the night - every night! Nic18mnd. 04/08/2008 at 5:46 am. In the meantime, you could look into mineral deodorants which prevent the growth of the bacteria that cause the smell as a more natural way. Boots sell them, and though there are others, one make is PitRock

A 6-year-old white girl comes with her mother for evaluation of her acne, breast buds, axillary hair, and body odor. What information should the nurse explain to them? 2. Encourage the girl to dress and act appropriately for her chronological age. An infant is born with ambiguous genitalia. Genetic testing and an ultrasound are ordered Precocious puberty is defined as the onset of true puberty before 7 to 8 years of age in girls or 9 years of age in boys. (Isolated breast development which doesn't progress to the rest of puberty is called premature thelarche, and is a different, benign condition). Precocious puberty is 10 times more common in girls than in boys Polyester clothing exacerbates body odor and doesn't help those with excessive sweating issues. Synthetic fabrics don't allow the skin to breathe well. Cotton is breathable and won't trap odor causing bacteria. 9. Add Herbs to Your Diet. While natural foods like garlic and onions can contribute to body odor, certain herbs can help deflect it Causes of body odour. Things that can make body odour worse include: exercise. hot weather. hormonal changes. being overweight. having a condition like diabetes, kidney disease or liver disease. certain types of medicine, such as antidepressants. Body odour may also be linked to excessive sweating and smelly feet Normal puberty begins between eight and 14 years of age in girls and between nine and 14 years of age in boys. Pubic hair distribution is used to stage puberty, along with breast size and contour.

How to Tell if a Little Kid's Body Odor Is Cause for

Body Odor In Children: Causes, Treatment And Home Remedie

Type 1 diabetes in children is a condition in which your child's body no longer produces an important hormone (insulin). Your child needs insulin to survive, so the missing insulin needs to be replaced with injections or with an insulin pump. Type 1 diabetes in children used to be known as juvenile diabetes or insulin-dependent diabetes There comes a certain age when our kids start to smell and sweat like teens. For most adolescents, this is a temporary phase that will improve with age. A few will struggle with hyperhidrosis (excessive sweating) and osmidrosis (foul-smelling sweat) for their whole lives. Don't worry- with just a few tricks and the right antiperspirant, READ MOR Body odor happens when sweat and bacteria mix. We sweat to maintain our body temperature and that sweat is water-based. Kids, of course, sweat from physical exertion, night sweats and fever. Most kids begin to experience body odor around the age of 9, and typically girls before boys. If a younger child is experiencing body odor, it might need. Body odor usually becomes evident when puberty hits. Discuss the difference between deodorant, which controls bacteria while adding fragrance, and antiperspirant, which is supposed to stop or limit sweating. De-Grease Hair. Many preteens find their hair gets oilier as they grow. Encourage a thorough washing every day or two

Kids Stink Dear Dr

Just like a plant grows in phases, the human body also grows in different steps. You must have heard that gender is decided after 20 weeks of pregnancy. While your body has all of the external sex organs, puberty is their time to work. Thus, the associated release of hormones is achieved during puberty. Your body becomes ready for sexual. Read on below for a list of various odors that may be a sign of a health problem. 1. Sweet Smelling Breath. It's one thing to have bad breath in the morning, but something else entirely to. Stage 2 marks the beginning of physical development. Hormones begin to send signals throughout the body. Girls. Puberty usually starts between ages 9 and 11 Time Frame. Many young grade schoolers require deodorant, notes pediatrician Jennifer Shu. Although a 5-year-old is unlikely to develop body odor, a child older than the age of 8 is a candidate. Shu further notes that it is entirely normal for children between 8 and 12 years of age to develop a need for deodorant Why does our six-year-old have BO? It is not unusual for parents to be concerned about their child's body odour, particularly if she is a girl. Usually there is nothing to worry about; the smell.

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The Cause of Body Odor in Young Children Healthfull

Body Odor in Kids: Is It Normal & What to Do About It

Underarm body odour in children Last updated 23.04.2014 This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses During puberty, an adolescent's body begins to change. Along with outward physical differences, an adolescent may notice a discharge from their vagina and become concerned. It is normal and healthy for young people's bodies to produce clear or white discharge from the vagina. The mucus is produced normally from the cervix (see illustration) So if your 12 -year old sends a whiff of bad odour, it is simply a sign of the onset of puberty. If your girl sweats and smells like an adult at around eight and your boy at around nine, then there is no need to worry. But if your 3-8 year old is getting smelly, then it is a cause of alarm and must not go unnoticed

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Teacher claims she faces dismissal over unshaven armpits

Age of puberty onset varies, and may be from 8 to 14 in girls and about 9 to 15 in boys. These are broad averages, and body odor production does not necessarily begin at the very first signs of puberty. In the first few years of puberty, body odor may not be prominent, and if a child showers daily, deodorant may not be needed MD. My 7 yr old son smells like onions. He has recently developed body odor , but in the past few days has had an onion odor. He bathed last night, but has the odor this morning. View answer. Answered by : Dr. Robert Galamaga ( Hematologist Fish odor syndrome Trimethylaminuria, better known as fish odor syndrome, is a rare disorder that causes a person's bodily emissions to smell like fish. The odor can arise from the saliva, sweat. So if your 9-year-old has begun developing breasts, this is not early puberty. However, if signs of puberty begin before the age of 7 or 8, then it is considered to be early puberty or precocious puberty. This is relatively rare - only 1 in 5000 girls are affected Deep Moisturizing Body Wash - up & up™. 3 out of 5 stars with 182 ratings. 182. $3.49 - $6.29. Spend $20 get a $5 gift card on select beauty care items. Only ships with $35 orders. Free 2-day shipping with $35 orders. In stock at Bedford Park. Ready tomorrow with pickup

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A Mom's Guide to Puberty Books for Kids. 2/9. Amazon. It's Not the Stork!: A Book About Girls, Boys, Babies, Bodies, Families and Friends. Part of a trilogy that also includes It's Perfectly Normal and It's So Amazing, this sex-ed book is recommended for kids as young as kindergarten, and gets high marks from parents for providing accurate. Five-year-old girl reportedly already has breasts and her periods, faces menopause. A mother is pleading for help after claiming her five-year-old daughter allegedly started her a period a year. Bromhidroisis, a condition in which sweat is malodorous and offensive, is caused by decomposition of products from the apocrine, eccrine, and sebaceous glands. 2 Apocrine bromhidrosis, which begins after puberty with a characteristic acrid or sweaty odor, results from a combination of short-chain fatty acids, ammonia, androgenic steroids, hexanoic acid, and saturated ketones and indoles. 2.

Trimethylaminuria (TMAU) is an uncommon condition that causes an unpleasant, fishy smell. It's also called fish odour syndrome. Sometimes it's caused by faulty genes that a person inherits from their parents, but this isn't always the case Boys start developing at around age 9-14. The pituitary gland also sends hormones, but the hormone that is sent is different than for girls. Testosterone begins to be released and the male organs begin to develop. Along with the beginnings of male organ development, a boys will start to grow pubic hair and body odor 4. Have good dental hygiene. Brush your teeth, floss, and use mouthwash at least twice a day - after breakfast and before bed. This decreases tooth decay, gum disease, and bad breath. Try to use toothpaste or mouthwash with fluoride. If you have braces or aligners, you may want to brush after every meal If body odor is a problem for you, you can do a few things to help manage it: Try a solution of hydrogen peroxide and water to fight body odor. Use 1 teaspoon of peroxide (3%) to 1 cup (8 ounces.

Recognize body odor. When you go through puberty, your hormones are in overdrive and your sweat glands start becoming more active. Your sweat will start to mix with bacteria, which will cause body odor. Luckily, there are many things you can do to get rid of this unpleasant odor, including: Take a shower or bath every day This 100% plant based deodorant eschews the nasties (aluminum and parabens) for activated charcoal, which purportedly draws out bacteria and combats odor. The coconut oil and water base gives this roll-on a silky feel and beach-y scent. It won a coveted Allure Best of Beauty Award in 2018 and sells out quickly online. $12 AT AMAZO Pains related to periods, including period pain and ovulation pain. Tumours in the abdomen: these are rare. Weight loss and night sweats are other common symptoms. Inflammation of the pancreas: pancreatitis is very uncommon in children but it can result from abdominal injury, some illnesses and some scorpion bites Asperger's Syndrome, a form of Autism Spectrum Disorder, is a developmental disorder. Young people with Asperger's Syndrome have a difficult time relating to others socially and their behavior and thinking patterns can be rigid and repetitive. They also may have trouble understanding body language

Decreased body temperature. The normal temperature for healthy cats is 100 - 102.5°F or 37.7 - 39.1°C. (An ear thermometer is an invaluable tool for the pet owner to monitor the cat's temperature.) Cool extremities. In the active phase of dying your cat's ears and paws may feel cool due to decreased blood circulatio I know my 11 year old hasn't started puberty yet and the doctor said to be on the lookout for body odor as one of the first signs. She is more active than the 9 year old, but not as active as the 11 year old. I just started noticing it, but it also just started getting hot out. Maybe that has something to do with it. It's body odor for sure though My 15 year old daughter has had to shower/bath every day of her life. She started showing herself at age 9. To this day, if I'm not here to watch her, she will not do a sufficient job 9-year-old autistic boy's body found in Flint-area lake 6 days after he went missing Child Protective Services report says Omarion Humphrey, his siblings were living in filth with biological parent This 98.9%-natural shampoo and body wash is a perfect go-to shampoo for your kids, especially if they have sensitive skin. The natural blend features soothing aloe, oat flour, and soy proteins. The mostly natural ingredients keep your kid's eyes sting- and tear-free

Ages 18-24 months: The child has a conscious sensation of bladder emptying. Ages 2-3 years: Most children develop the ability to voluntarily stop urination and develop appropriate toileting skills. Ages 3-5 years: Most children have achieved urinary control and are dry both day and night. Although there are many factors that contribute to. Check out for more information:(Lemon for Body Odor) Turmeric. Get a glass small bowl, blend 5 teaspoons of new lemon juice with enough turmeric to make a glue. Apply the glue equitably to your armpits. Allow to dry for 30 minutes, wash away with warm water. Coconut oil. Back-rub a couple of drops of coconut oil onto your armpits. For 15. Five to 10 minutes is long enough. Use a non-drying soap. Whether you prefer a bar or liquid body cleanser, choose one labeled as moisturizing. Use soap only on select areas of the body. Limit lather to those prone to odor—armpits, groin, buttocks, feet, and between the toes. Be gentle The primary care pediatric nurse practitioner is performing a well child examination on a 12­year­old child who was diagnosed with type 1 diabetes at age 9. The child had a lipid screen at age 10 with an LDL cholesterol 100 mg/dL Case 1: Abdominal Distention, Bloating, and an Intrauterine Device in a 19-year-old Girl R. Claire Roden , Erin R. McKnight , Elise D. Berlan Pediatrics in Review Sep 2020, 41 (9) 481-484; DOI: 10.1542/pir.2019-007

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