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Daily Dose

Strong Moms Empower

1.30 to read

I just participated in the StrongMoms Empower™ program sponsored by Similac® in New York. I had the privilege of speaking to a group of mothers (along with my new best friend Dr. Michele Borba) about the judgement that mothers feel they face every day.  This campaign urges moms to create a more supportive and less judgemental environment with the goal to empower moms to feel confident in their parenting decisions.

I know first hand that mothers are feeling stressed and anxious and this was affirmed by a study, “The National Motherhood Decision Survey”.  Whether this feeling of being judged and graded on their mothering is real or perceived, it is causing a lot of emotions. Mothers admitted to both physical and emotional effects.   Stress, anxiety, insecurity and inadequacy are common complaints of today’s mothers.

But this stress on mothers is also causing a “trickle down effect” on their children.   A study done by the American Psychological Association on Stress in America revealed that 4 in 10 children reported feeling sad when their parent is stressed or worried.  Young children pick up on their parents stress, I see this is my practice every day.  Even that cute 4-5 month old child who smiles when you smile, can be brought to tears by a sad, frowning face.

Increased family stress, and specifically maternal stress may have a negative impact on the health and well being of our children as well.   This may present as behavior problems, self esteem and confidence issues and physical complaints. Children have headaches, tummy aches and sleep problems, just like adults. 

But there seems to be a “stress disconnect” as well. Parents don’t realize the impact that their own emotions play in their children’s sense of well being.  Almost 70% of parents said that their stress had only a slight or no impact on their children, yet 91% of children reported that their parent is stressed.  STRESS is not a word that young children should even understand!

So...what can mothers do?  Moms do a better job raising their children when they feel supported.  They feel more confident, more relaxed, happier and fulfilled. in other words, “when mom is happy, everyone is happier”.

Mothers need layers of support and this should come from their most trusted inner circle of friends and family and not anonymous mothers who weigh in from social media, friends of friends etc. Trust your instincts and try not to “second” guess every decision. Don’t judge others either without knowing their circumstances. Remember, “people in glass houses shouldn’t throw stones”.

Use your pediatrician as your partner in parenting and look for advice from experts and professionals when you are facing tough questions and decisions. 

Lastly, be confidant and trust your “momtuition”. Share your ideas and values in a positive manner and support one another.  

The StrongMoms Empower™ Mission is to keep doing what works best for your and your family.  All moms want to raise confident, capable and caring children.  We are all in this together!  For more information go to www.strongmomsempower.com

Daily Dose

Breast-feeding is ‘On the Job Training’

So many of my mothers breast feed their babies and enjoy the experience. I think it is a little harder to breast feed in the early days after the your-baby is born, as your milk "comes in" and you deal with sore, full breasts as well as little sleep. Even with a well-prepared mom who has read all of the books, and practiced with dolls in different holds, real breast-feeding comes from "ON THE JOB TRAINING." But, over the next few weeks as the milk supply is established it will become much easier to breast feed and both mother and your-baby get the hang of nursing.

Saying this, it is not always possible for every mother to be successful at breast-feeding and not every mother wants to breast feed her your-baby. Although breast milk is ideal for an infant, formula works well too. The most important thing for your your-baby is for you to be a happy mother. Numerous studies have corroborated this fact, and if mother is happy, your-baby will thrive on breast milk or formula. When I discuss this with many mothers who are unhappy nursing, or are not making sufficient milk to provide enough calories for their your-baby to gain weight, there is such a sense of relief. Guilt is part of being a parent (seems especially so in us moms) but to start off your parenting feeling this way is not good for anyone. Do what is best for you and your child, and don't feel pressured by family, friends or coworkers. Lastly, there are all sorts of ways to successfully provide both breast milk and formula for your your-baby, so discuss your options with your doctor before feeling like a failure or stressing out. Just like babies, moms are all different too. That's your daily dose, we'll chat tomorrow.

Your Toddler

Hitting & Biting

A normal part of develop with a young child is for them to experiment with hitting and biting. Child neuropsychologist Dr. Kristy Hagar says it’s normal and the hitting and biting comes out as a front-line reaction during the course of normal play. Dr. Hagar says it is important for parents to intervene every time they see their child hit or bite. “First thing is not to hit or bite back to teach them a ‘lesson’. It sends the wrong message.” Dr. Hagar recommends telling the child “no” in a firm voice and then do a consequence, like a time-out to reinforce the message.

“It’s a parents role, and teachers role too, to make sure the message is given back that it’s not an appropriate behavior,” Dr. Hagar says. But there is good news for parents worried that their child may turn in to a life-long hitter or biter. The behavior normally stops by age three, when a child’s language skills start to develop more.

Daily Dose

Happy Mother's Day!

1.00 to read

So, what if you were given a second chance as a mom? I know this is supposed to be a short blog, but I may need several pages to get this all out. 

As a mom, I know I have made many mistakes over the years while raising our three sons. They are adults now, but will always be “my baby boys”.

If I could re-play anything, I would advise moms to enjoy and embrace every stage of parenting as it all goes by too quickly. I always remember looking at other families and thinking, “when will I get to that stage?” as it always looked like the next milestone would be easier or more rewarding or more anything. But in reality, every single stage of parenting has its ups and downs and you can only realize that in retrospect. I was guilty of looking ahead too much rather than enjoying whatever present situation we were in. The old adage of “live in the moment” is never so true as while you are a parent. I say enjoy playing blocks with your baby, reading to your children every night, playing games in the yard, trips to the pool or long chats with your teens about their friends and making good choices. For each of these things goes by so quickly and cannot be replayed except as special memories in your mind. I would also remind you to take more pictures, and videos, as these are the things that will jog your memory later in life.

All of the memories that are hidden away in some remote spot in a mom's aging brain become clearer when you see a picture of an event. This was evident when I was trying to pull together our family pictures for our oldest son’s wedding. Why is it that I took pictures of everything when our oldest son was little, and by the third child, the pictures are fewer and farther between? He was no less important for sure, but the time issue just didn’t seem to allow it to happen. I should have made the time!! How long could it have taken to take a picture of kids playing together in the yard, or eating dinner at the table together or doing homework? Those are the memories I long to have, the “normal” family times. Most family pictures are of “events”, which is fine, but documenting the simple things too, for they are the most special memories.

Lastly, I asked “my boys” about a re-do, and they all said, “You should have let us wrestle more!” How funny is that! Seems like such a simple thing, but I was always breaking up those boys for fear of them hurting one another. The louder it got, the more I was sure it would only lead to trouble, so I was the “girl” in the middle pulling them off of one another. My advice to young parents, enjoy the ride and try to live in the moment that you are given. You never know what lies ahead, and some of the hardest times in parenting may actually help you appreciate the wonderful times even more. I am continuing to give myself that advice as I am learning about parenting grown sons and now a grandmother! Thankfully, parenting never ends! 

Daily Dose

Advice from My Mom

1.15 to read

I have been visiting my mother for an “early Mother’s Day” celebration and she and I spent an evening reminiscing about all of the advice she has given me over the years. The funny thing is that I often catch myself talking to my own children, and even my patients, and say, “I am sounding just like my mother”. The reason being is that she has given me a lot of good advice. 

The best advice which has stood the test of time is “do the best that you can and you can be anything you want.” Both she and my dad told me that, while they continued to support me as I pursued a career in medicine. Boy, was I lucky or what? 

She also told me “you should also always be able to take care of yourself.” That has also been great advice and something I have told my own children. The good news for me is that my children have listened to me (to date) and I am so proud of their work ethic, their integrity and their goals. They have made it easy to parent them. 

Another good piece of advice remains as true today as it did 40 years ago;  “never chase a boy (they always had to call first) and all of your dates must come to the door to meet your parents.” As a mother of sons, I told my boys how important it is to go to the door, make eye contact with the girl’s parents, introduce themselves, and to let the parent know that they are responsible gentleman and will always respect their daughter. This advice is timeless.  I saw it first hand when our oldest son went to ask his now father-in-law for his daughter’s hand in marriage. It made me so proud to hear how responsible and respectful he had been. (He listened!) 

Here are a few more “Jeanne-isms” worth remembering: 

-No white shoes before Easter or after Labor Day

-Stand up straight and hold your shoulders back 

-If you can’t say something nice, don’t say it at all  

I know you too have memories of wonderful mothers’ advice worth sharing. Keep passing them on to your children. Many are timeless, no matter what we used to think. 

Happy Mother’s Day to all!

Daily Dose

Is Your Child Ready for Kindergarten?

Parents often ask me about their child’s readiness for kindergarten. It seems more common in different parts of the country to “hold back” younger five-year-olds rather than sending them on to kindergarten. In other words children who will be five over the summer, just in time to start school by the September 1 cut off.

I am often confused as to why it is becoming more common to “hold a child back”, as someone is always going to be the youngest in a class, just as someone is the smartest, the tallest, the loudest etc. At the same time, I know that there are circumstances when a child may not be deemed to be “kindergarten ready” but those cases should be looked at individually. I do not think that the birth date alone should not be the deciding factor. All of a child’s experiences leading up to kindergarten are educational in some manner and help to promote school readiness. The R’s of reading (which I think should be started by parents while their child is still an infant), rhyming and playing (which probably does not include video games), setting routines, rewarding success (from potty training to learning to write their name), and lastly relationships are important factors in school readiness. Most children have developed these skills from some combination of family life, day care or preschool, church and friendships. The cumulative experiences of early childhood are the stones on the road to future learning. The most significant developmental markers that predict success in kindergarten are both social and emotional. The importance of embracing a school community, respecting teachers, becoming self-sufficient while at school, and enjoying new friendships in combination with the love of learning are the developmental milestones to be achieved during the kindergarten year. Not every five-year-old is ready to read, and some are more fidgety than others, while some will write their full names and addresses on the first day. But kindergarten is still the “entry level” job and everyone needs to start there on the road to being a CEO. Unless there are “red flags” as to specific learning issues I would not recommend “holding “ your child back simply due to being young. That’s your daily dose, we’ll chat again tomorrow.

Daily Dose

Supporting Moms in Their Quest to Breastfeed

A recent article in Archives of Pediatrics reviewed pediatrician's attitudes, knowledge and practices surrounding breastfeeding. They looked at surveys pediatricians completed in 1995 and 2004 and compared the results. It was interesting that in spite of increased knowledge and even personal experience with breastfeeding, pediatrician's attitudes toward breastfeeding have deteriorated between 1995 and 2004.

But, concurrent with the drop in pediatrician's attitudes, breastfeeding rates in the U.S. have actually been on the rise. This may be due to other factors such as hospital policy and support for nursing mothers. The American Academy of Pediatrics recommends that infants be exclusively breastfed for the first six months of life, and recommends continuing breastfeeding along with solid foods, until one year of age. The take home message for me is that we pediatricians need to continue to support new mothers in their quest to successfully breastfeed. For some mothers (I was not one of these) breastfeeding just happens, and is easily established, but for others it is "on the job training" and requires a village to get the your-baby to the breast. My friends who already had babies laughed at me when I "wondered if my milk was in?" as this is not something you learn in medical school or residency. They were all correct; you will know when it does! But practice, practice, practice will usually get even the most stubborn your-baby to the breast and for most mothers breast feeding gets going and all is well. That being said, there are mothers who do not feel comfortable breastfeeding, or have inadequate milk supply and the your-baby is not gaining weight, or have post partum complications that impede breast feeding. In my opinion, it is my job as their pediatrician, to support new parents (and I guess in this case, specifically the mother) in her decision to breastfeed or not. The most important factor for any newborn is maternal-infant bonding. That bonding comes with a sense of maternal well-being, and a mother should NOT be "guilted" into breastfeeding if she chooses otherwise. Parenting is a long haul, and this issue is just the first of many that does not have a 100% right answer. One size does not fit all. That's your daily dose, we'll chat again tomorrow.

Daily Dose

Many Parents Still Confused About the Flu

Here we go again, but I found myself repeating this over and over again today to many parents who are still confused about the flu this year.

  1. Influenza is not the same thing as "tummy flu" where you have vomiting and diarrhea. Unfortunately the flu vaccine does not prevent gastro intestinal disorders which are usually due to other viruses. People just call this a stomach flu and it is a misnomer. Winter is the time of year for MANY viral infections, so you are being bombarded with exposure to many things, not only influenza. The only good thing (if that adjective is appropriate at all) about the stomach bug is that it doesn't last as long as influenza and you usually get over it in 12 - 48 hours.
  2. Influenza, which is a viral infection, is just beginning to rear its angry head around the country. This is the typical time of year for this and influenza infections will most likely continue to rise over the next four to six weeks. There are two different types of influenza, A and B. It is important to distinguish which type you have as the antiviral medications that we had previously used to help treat influenza A and to prevent its spread in household contacts is resistant to the oral medication Tamiflu. I have seen more than several parents who have spoken with a physician by phone and started Tamiflu for "presumed influenza". If you think you have influenza, "the real flu" you need to have a test to see whether it is A or B and then be put on the appropriate antiviral. I would not use Tamiflu alone in Influenza A infections.
  3. Flu vaccine will not "give you the flu" The shot is a killed virus and will not give you flu. You may still get a cold or a stomach flu, but hopefully not the climb in your bed, have chills and fever, cough out your lungs influenza that makes you wish you had gotten the vaccine. The kids I am already seeing look sick, like they have the flu, and if they are old enough already say they don't want to be this sick again.

I know this is repetitive information but people keep asking. Stay tuned for further developments as we get further into this flu season.

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Daily Dose

Pregnant? Get Your Flu Shot

1.45 to read

If you are pregnant, know someone that is pregnant, or are even thinking about becoming pregnant, you need a flu vaccine!!  (That is not to say that we all need to be thinking about flu vaccine’s right now!)

A study out of Duke University showed that of 1,600 women who delivered during the 2009-2010 flu season, those that had received a dose of flu vaccine delivered more term babies and also delivered babies who had higher birth weights. Women who received at least one flu vaccine during the season were also less likely to require a doctor’s visit for flu prior to delivery and they had lower hospitalization rates.

Another study out of Wake Forest University which was recently published in the Journal of Obstetrics and Gynecology looked at women who had received flu vaccine during their pregnancy.  This study showed that infants born to mothers who received flu vaccine while pregnant were 50% less likely to be hospitalized with flu than infants born to mothers who had not received flu vaccine. This was a study conducted over the years 2002-2009 (before H1N1) Impressive!

Flu vaccine is recommended for everyone 6 months of age and older. Infants 6 months of age and younger have the highest rate of hospitalization for flu related illness among all children.  The only reason that flu vaccine it is not given to younger infants is that the vaccine is not effective. How do we protect those babies, by protecting the mothers who are carrying the child? 

So…bottom line, pregnant women who get their flu vaccines not only protect themselves, they are protecting their newborn infants as well. A mother’s job of protecting her children is life long, but it begins even with a baby in utero. Go get that vaccine, as flu season is upon us!  

That’s your daily dose for today.  We’ll chat again tomorrow.

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