Bulimia nervosa is an eating disorder which involves binge eating followed by purging.  Children with bulimia often have a feeling of lack of control over eating with associated feelings of guilt, anxiety, low self esteem, and depression. Episodes of binge eating typically involve consumption of large amounts of food in short periods of time. Binge eating episodes are typically followed by purging activity which may include self induced vomiting, vigorous exercise, extreme dieting, or laxative abuse. For the diagnosis of bulimia two binge eating episodes per week must occur for at least three months. Bulimia typically creates a great deal of both physical and emotional stress for a child.  These children are often extremely concerned with their body image and food intake. Bulimia may be complicated by significant health risks.

So how much sleep does your newborn need?  How much sleep is normal in a toddler?  Does my child need naps?  Is it normal for my teenager to sleep until noon?  These are common questions for a pediatrician.  To evaluate for possible sleep disorders, parents should be aware of what is considered normal.  Children have very different sleep patterns when compared to adults.  Young infants may sleep up to 20 hours per day.  Children generally stop taking naps at about 5 years of age.  The day-night human clock creates what is called a "circadian rhythm."  This internal clock tells the body when to be sleepy and when to be awake.  This internal clock can be affected by multiple environmental clues, the most important one being light and darkness differences.  Sleep problems may occur from medications (i.e., caffeine), poor sleep patterns (i.e., staying up late and getting up early), or sleep disturbances (i.e., sleep apnea, non-peaceful surroundings).

Can supplements improve sports performance in kids?  Are they legal?  Are they dangerous?  These are the questions I'll try to address.  The best sports performance enhancers for kids are water, sugar (in moderate amounts), and electrolytes.  There is some evidence that caffeine, ephedrine, sodium bicarbonate, and creatine may increase performance however adverse effects can be dangerous.  Anabolic steroids, growth hormone, erythropoietin, and blood transfusions are illegal methods of performance enhancement.  Protein shakes and amino acid supplements are taken with the intention of increasing muscle mass, but there is little evidence that they provide any benefit.  A typical healthy diet usually contains all the protein necessary to build lean body mass.