Twitter Facebook RSS Feed Print
Daily Dose

Digital Technology & Your Children

1:30 to read

I somehow stumbled upon a recent article in the UK Mirror in which Bill Gates was being interviewed. It caught my eye as it began with “As you wrestle the tablets from your square-eyed kids for the 10th time today, it might be reassuring to hear the king of Silicon Valley shares your worries”.

 

The discussion surrounding our children and the use of cell phones and the appropriate age to give a child a phone always brings up various opinions. Some parents feel that their 6 -8 year old elementary school child “needs a cell phone for safety reasons”. Other parents think that their child “doesn’t need a phone until they drive.” Lastly, there are parents who think their child gets a cell phone when “they can pay for it”.  These are only a few of the various responses I have heard from my own patient’s parents….I am sure there are a million more. 

 

Well, it seems Bill Gates, one of the greatest technology innovators of all time, “banned his kids from having mobile phones until they were 14 years old”.  During the interview he also stated that he “forbids cell phones at the dinner table”.  It sounds like Bill Gates runs a pretty tight ship in his own home..with some well founded rules,  while weighing the pros and cons of the use of electronics with his children.

 

Many parents tell me that all of these electronics are necessary for homework and social media also allows their child to stay in touch with their friends…which again is quite true. At the same time Bill Gates commented that he and his wife “often set a time after which there is no screen time…which also helps his children (now ages, 20, 17 and 14) get to sleep at a reasonable hour”. It sounds as if Bill Gates has been reading the studies about screen time and sleep…and how the two may actually affect one another and is a believer!

 

So I now think that I will quote Bill Gates and “suggest” to parents that they not rush to buy their child a cell phone until they are around 14. It also makes a great deal of sense to monitor their usage and to continue to make sure that family time, including dinner time is a “cell free zone”. He emphasizes that using it to an excess, for any reason, is just not a good idea.

 

He is also a big believer in vaccines!!! Go Bill Go!

 

 

 

Your Baby

Moms Getting Poor Advice on Baby’s Health Care

2:00

Moms are getting conflicting advice on infant and child care from family members, online searchers and even their family doctors a recent study found.

Oftentimes, that advice goes against the American Academy of Pediatrics (AAP) recommendations for topics such as breast-feeding, vaccines, pacifier use and infant-sleep, researchers say.

"In order for parents to make informed decisions about their baby's health and safety, it is important that they get information, and that the information is accurate," said the study's lead author, Dr. Staci Eisenberg, a pediatrician at Boston Medical Center.

"We know from prior studies that advice matters," Eisenberg said. Parents are more likely to follow the recommendations of medical professionals when they "receive appropriate advice from multiple sources, such as family and physicians," she added.

The researchers surveyed more than 1,000 U.S. mothers. Their children were between 2 months and 6 months old. Researchers asked the mothers what advice they had been given on a variety of topics, including vaccines, breastfeeding, pacifiers and infant sleep position and location.

Sources for information included medical professionals, family members, online searches and other media such as television shows. Mothers got the majority of their advice from doctors. However, some of that advice contradicted the recommendations from the AAP on these topics.

For example, as much as 15 percent of the advice mothers received from doctors on breast-feeding and on pacifiers didn't match recommendations. Similarly, 26 percent of advice about sleeping positions contradicted recommendations. And nearly 29 percent of mothers got misinformation on where babies should sleep, the study found.

"I don't think too many people will be shocked to learn that medical advice found online or on an episode of Dr. Oz might be very different from the recommendations of pediatric medical experts or even unsupported by legitimate evidence," said Dr. Clay Jones, a pediatrician specializing in newborn medicine at Newton-Wellesley Hospital in Massachusetts. He said inaccurate advice from some family members might not be surprising, too.

Mothers got advice from family members between 30 percent and 60 percent of the time, depending on the topic. More than 20 percent of the advice about breast-feeding from family members didn't match AAP recommendations.

Similarly, family advice related to pacifiers, where babies sleep and babies' sleep position went against the AAP recommendations two-thirds of the time, the study found.

"Families give inconsistent advice largely because they are not trained medical professionals and are basing their recommendations on personal anecdotal experience," Jones said.

Less than half of the mothers said they used media sources for advice except when it came to breastfeeding. Seventy percent reported their main source of advice on breastfeeding came from media sources; many of these sources were not consistent with AAP recommendations.

In addition, more than a quarter of the mothers who got advice about vaccines from the media received information that was not consistent with AAP recommendations.

"Mothers get inconsistent advice from the media, especially the Internet, because it is the Wild West with no regulation on content at all," Jones said.

The possible consequences of bad advice depend on the topic and the advice, Jones said.

"Not vaccinating your child against potentially life-threatening diseases like measles is an obvious example," he said. "Others may result in less risk of severe illness or injury but may still result in increased stress and anxiety, such as inappropriately demonizing the use of pacifiers while breast-feeding."

Mothers who look for information online should stick to sources such as the AAP, the American Academy of Family Physicians or the U.S. Centers for Disease Control and Prevention, Eisenberg suggested.

Even though some advice from doctors did not follow AAP recommendations entirely, Eisenberg and Jones agreed that doctors are the best source for mothers on the health and care of their children.

"While our findings suggest that there is room for improvement, we did find that health care providers were an important source of information, and the information was generally accurate," Eisenberg said. "But I would encourage parents to ask questions if they don't feel like their provider has been entirely clear, or if they have any questions about the recommendations."

The study was published in the July edition of the journal Pediatrics.

Source: Tara Haelle, http://www.webmd.com/parenting/baby/news/20150727/new-moms-often-get-poor-advice-on-baby-care-study

 

Daily Dose

PU: Body Odor

1.00 to read

I received an email from a mother who asked if her 5 year old son, an avid athlete, could wear deodorant?  It seems that his arm pits “smell like a grown man”.  I have actually been asked this on occasion in my office and I have even noticed body odor (BO) during exams on some 5-8 year olds.   

Most children start to “stink” as they begin to enter puberty, but there are occasional children that for unknown reasons, develop BO without any signs of puberty. If it seems that your child is entering puberty at an early age, you do need to talk to your doctor.  If your child happens to be one of those kids who are just odiferous, there are several things that you can do.

Number one, make sure that your child is bathing/showering everyday, and that they wash their armpits well. Some little boys (and I bet a few girls) just pop in and out of the shower without touching soap on most of their bodies.  (I used to smell my boys hair when they came out of the shower, sometimes still smelled sweaty, no soap!).

If daily bathing does not do the trick, it may be time to use a deodorant, which just masks the smell. This often works for younger kids who are really stinky rather than sweaty.  An anti-perspirant actually stops and dries up perspiration and may not be needed until an older age.

There are numerous deodorant products available, some of which are natural as well. Head to the store and read labels to decide which one you prefer.

Parenting

Spring-Cleaning Kid’s Stuff!

2:00

Traditionally, spring is when we review what is needed and what needs to go. Clutter that has been growing throughout the years is viewed with fresh eyes once the season of renewal begins.

Along with typical household items, all the extraneous, broken and outgrown kid’s stuff can begin to take a toll. It takes up a lot of space and requires constant picking up. Clothes are beginning to look like a small mountain made of material, buttons and zippers.

Organization and prioritizing are the keys to making the job of spring-cleaning work.

When you’re ready to tackle the kid’s stuff- make them a part of the process. From arts and crafts to toys and clothing – get their input and give them choices. You, however, make the final decision on what stays or goes.

Here are a list of items to start with and how kids can have input:

1. Artwork. Kids love to create things, but not everything is a masterpiece. Encourage your child to pick out a few drawings, paintings or pottery works that are their favorites. Consider framing those pieces and putting them up in their rooms. For the other works of art that you like or they are having trouble letting go- take photos and store them on your computer, so you have a record of their creations! If your child is old enough, ask them to be the photographer.

2. Clothing. Sometimes getting rid of clothing is harder (for sentimental reasons) on the parents than the kids. I admit to being guilty of this. I still have several pieces of clothing from when my adult daughter was a toddler or baby. They are stored in a chest of memories. For all the rest, sort clothing that is likely to be passed on to either family members or friends, and ones that are ready for donation. Torn and stained clothing needs to be tossed out. Family homeless shelters always need good, clean children’s clothes.

3. Collections. Many kids are collectors, everything from bugs to superhero gadgets to valuable sports cards. Whatever your child chooses to collect is a symbol of their unique personality and interests. Managing collections provide early lessons on personal responsibility and organizing. Take an interest in what your child is collecting and find a way to honor the collection while respecting the space available to store it. It’s enriching for children to learn about limits and become comfortable making decisions to live within them. It’s also a time to learn about boundaries for collecting stuff. Many a hoarder began with a specific collection and moved on to collecting everything – unable to let go of anything. Have your child pick one collection to focus on and explain what they like about it.

4. Stuffed animals. Because they are so darn cute, stuffed animals seem to multiply like rabbits (particularly stuffed rabbits!) Culling these furry creatures can be difficult for parents and kids. Lots of children receive many more stuffed animals than they can play with or use. Overtime, they outgrow the attraction they once felt towards certain ones. Give your child a number that they can keep and let them make the decision of what stays and goes. Again, this is an area where other children can benefit from and enjoy the gifts donated by your child.

5. Arts and Crafts. If you have a child, then you’ve also got crayons, coloring books, paper, dried up markers and pens that don’t work. Grab a doodle pad and bring all the supplies to a table. Have fun sorting with your kids while making quick decisions about what’s worth keeping and what’s not. If you haven’t got one, consider creating a travel pack of supplies for use in transit. Extras in great shape can be donated. Use for birthday party decorations and activities.

6. Sports equipment. This is an area a lot of parents don’t think too much about but these things can fill a closet or garage in a few short years. Equipment that will be used next year should be cleaned and stored in a bin. Some sports items in good condition can be sold, put on consignment, passed on or donated to leagues.

7. Toys. Ah yes, toys… the biggest space eater of all. Kids these days have a tremendous amount of toy options. Between marketing, fads, peers and commercials there is an endless push for the latest, greatest new toy. How many of these once “gotta-haves” are now just filling up space and providing objects to trip over? Most of the same rules from above apply here. If it’s broken- it’s gone. If it’s not played with any longer- it’s gone. If it’s become a pet chew-toy- it’s gone. Organization is particularly important for toy collections. Bins can provide a good storage option if they used, but they can also become trash cans where all toys go even if they are just pieces. Its time clean them out.

Have your child pick out their favorite toys and decide which ones he or she would like to donate or throw out.

Sort and assign a bin by type. Good toys that your child has simply outgrown can be gifted to nieces and nephews and friends of your child. Intact toys that can still be played with can be donated. Broken toys should be trashed. For certain types of materials, you might want to check on finding a recycling bin.

During this cleaning expedition, you may need to gently point out a toy’s condition to your little one, “I know that play oven was one of your favorite toys, but it doesn’t stand anymore and the front door is missing. Maybe it’s time to let it go.”

And then there’s always Ebay, might as well make a little back on the thousands you’ve spent, especially on video games!

Spring-cleaning is a good time to re-evaluate what needs to stay and what needs to go. I think we’re all aware that it’s time-consuming, but clearing out the clutter not only gives you more space and organization, but also feels great when it’s done!

Story source: Clare Kumar, http://www.todaysparent.com/family/activities/spring-cleaning-with-kids/

 

Daily Dose

Toddler Constipation

1:30 to read

I get so many questions about toddlers and constipation.  Constipation relates to stool frequency and consistency.  It is important to understand that everyone has different bowel habits and not all children will have a stool every day.  While some children will have several stools a day another may have a stool every 2 -3 days. Both of these scenarios may be normal and not an indicator of problem.  At the same time, stool consistency is important. If your child has  hard, dry, pebble like stools ( rocks rather than softer snakes or blobs ) this may be an indicator of constipation. Everyone will occasionally have a hard stool, but this should not occur consistently. Lastly, it should not be painful to pass the stool. While toddlers may grunt or push, or even start to “hide” to poop, it should not cause real pain.

With all of that being said, it is not uncommon for toddlers to become constipated as they often are also becoming picky eaters. Due to this “phase”,  some young children will drink too much milk in place of eating meals and this may lead to constipation. Your toddler should be drinking somewhere between 12 -18 ounces of milk per day.  Many children also load up on other dairy products like cheese, yogurt and cottage cheese, which while healthy, may also lead to too much dairy intake and contribute to constipation.

Water intake is also important to help prevent constipation. If your child is drinking too much milk, substitute some water as well.  It is a balancing act to make sure your child is getting both milk and water. If necessary I will also put the smallest amount of apple or prune juice in the water. By the age of 1 year, your child should no longer have a bottle as their main source of nutrition is no longer in the liquid form!

Fiber is also important so offer plenty of whole grains and limit the “white foods” that toddlers love (yes, the bread, cereal, pasta). If you always buy whole wheat pasta and whole grain breads your children will never know the difference. Stay away from processed white foods whenever possible.  It is also easy to throw flax seed or bran into muffins or smoothies (disguising fiber). I also sometimes use Metamucil cookies (they are pre made) and may even resort to dot of icing smeared on it and offer it as a cookie for snack, along with a big glass of water.

Fruits and veggies are a must…even if you think your child won’t eat them! Your toddler needs 2 servings of fruits and veggies every day and rotate what you offer them.  You will be surprised at how one day they may refuse something and they next they will eat it. Don’t give up on fruits and veggies,  it may literally take years for your child to eat peas…but if they aren’t offered a food repetitively they will probably never it eat. I know a lot may get thrown to the floor but just clean it up and persevere.  Not only will this help their stools but their long term healthy eating habits as well.

Movement is also important to help keep the bowels healthy and “moving”.  Making sure that your toddler is moving seems crazy, as they are on the go all of the time.  But with an older child make sure they are getting plenty of time for play and exercise outside or in…and not just sitting in front of a screen.

Lastly, for short term issues with constipation it is also okay to try using milk of magnesia (MOM) or even Miralax….but ask your doctor about dosing in toddlers.   

Daily Dose

Taking Your Child to the Doctor

1:15 to read

I imagine that you have heard the saying, “motherhood is the necessity of invention”?  It seems I must use this saying often as I can overhear my nurses quoting me and using the phrase as well.

 

There are many times I find myself in an exam room with a young patient and their mother when the mother says, “I forgot the……”. Sometimes it is a diaper (easily available in any pediatrician’s office), maybe a bottle (we have those too), a child’s favorite “lovie” (dire), and in many cases a pacifier.  Getting through the office visit without some of these necessities may make not only the child miserable, but also their parent.

 

Just the other day an adorable 5 month old baby and her cute mother came in because the baby had a cold and some eye drainage. Her mother was concerned that she might have an ear infection.  The first part of my exam was easy and the baby had a clear chest and no respiratory distress. She let me look at her nose and throat as well. Then it was time for the ear exam and of course the ear canals were waxy and I could not see her ear drum.  This means I have to use an instrument to remove the wax from the ear canal before I can get a good look at her ear drum.  The first ear was cleaned out and her ear drum was clear!!  But the second ear was more difficult to clean and the baby started to WAIL during this. Her mother looked frantically for something to soothe her..but she had forgotten her diaper bag with all of her stuff. So, once the ear canal was cleaned …she was pronounced ear infection free. While this was great news for the mother, the baby just continued to cry, loudly and angrily. 

 

I was trying to discuss the cold with the mother, but it was difficult for either of us to hear with the baby screaming. What to do…..? The only thing I had in the exam room was the basket of lollipops and stickers that we offer to children at the end of their exam.  I tried making a “sticker pop” on a tongue depressor to entertain and distract the baby…no such luck. The mother then looked at the lollipops, took out a grape one and unwrapped it and put in the baby’s mouth…INSTANT calm and smile on her face!!  Hysterical laughter from both of us as we took a picture to send to the father with the caption…Baby’s first food!!  Priceless. 

 

Love a mother like that…motherhood IS the necessity of invention!!

Play
2734 views in 1 year
Bug bite prevention

Bug Bite Prevention & Treatment!

Daily Dose

Twisted Neck?

1:30 to read

Under the heading of “continuing to learn” every day…comes a new case.

 

A patient of mine who is 4 years old was playing with his brother the other morning while his mother was making their breakfast. He was a “well child” and woke up in a good mood, ready to eat and go to preschool.  She could see the boys playing while she was cooking and then suddenly the 4 year old started to scream and cry that his “neck hurt”.  At first she thought “he was pretending or over reacting” as there did not overtly seem to be anything wrong. The only thing she noticed is that he refused to turn his neck and held his head in an awkward position.

 

He continued to cry and actually scream - so she tried to calm him down and gave him some ibuprofen as well. Despite this he would not move his neck and was unconsolable, to the point that she almost took him to the ER but instead she brought him to the office.  He was noted to be crying and seemed uncomfortable and refused to move his neck at all.  His exam was otherwise normal. Even with careful questioning there was no history of trauma. He had slept through the night before this had occurred. He had a cold several weeks before, but had since improved. He did not have a fever.

 

He seemed to be in such pain that he was sent for neck X-rays which were read as normal. But he continued to be miserable….so who do you call?? 

 

I spoke to a pediatric orthopedic surgeon and he said he really did not have any ideas. Next call, the pediatric neurosurgeon. After hearing the symptoms he immediately said that he thought this little boy had “rotatory dislocation/subluxation” of the two upper cervical vertebrae in his neck (C-1 and C-2). He explained to me that in most cases the displacement resolves spontaneously, but in some cases the child continues to be uncomfortable as there is associated spasm of the sternocleidomastoid muscle, which causes the torticollis. (twisted neck).It may be seen in children after a recent upper respiratory infection and is then called Grisel Syndrome.

 

Treatment for the acute condition…pain control and muscle relaxation.  This was all news to me and I had to go to textbook (online of course) to even read about the condition.  The neurosurgeon walked me through treatment and the child was sent home on a very low dose of valium and continued ibuprofen. When I spoke to the mother later that evening the child was already more comfortable and had started to move his neck. 

 

I called her the following morning and she said that he had not required any further valium and slept well and was actually on his way to preschool! WOW….I was thrilled he was better so quickly and that I was that much “smarter”. Wonder if I will ever see rotatory subluxation of the cervical vertebra again? I’ll be ready.

Daily Dose

Pink Eye

1:30 to read

This is another time of the year that I see a lot “pink eye”.  Any time the eye is pink..you have “pink eye”, which mothers seem to be quite confused by!!   They often comment…”this is pink eye?” , to which I respond, “well, the child’s eye (conjunctiva) is pink (red), so yes…this is pink eye”.  The term is just a description of the eye….but then you need to determine why the eye is “pink”.

 

Conjunctivitis is one of the most common causes of a pink eye….and there are many different types of conjunctivitis.  As with any condition the history is really important in helping to determine why a child’s eye is inflamed.  Several of the most common causes of the “pink eye” are bacterial, viral and allergic conjunctivitis.

 

Bacterial conjunctivitis often shows up in younger children and they have lots of matting of the eye lids and lashes and a mucopurulent discharge (gooey eyes). Some moms say that the “goo of gunk” comes as quickly as they can wipe it.  The child often has a lot of tearing and will rub the eyes as they feel that something is in their eye and it is irritated.  Bacterial conjunctivitis will typically resolve in 8 -10 days on its own, but antibiotic eye drops are used to shorten the course  of the pink eye and also reduce the contagiousness.  It seems as if every child in a day care class room will get conjunctivitis as they constantly rub their eyes and touch toys!!  Hand washing helps….but you can’t wash a child’s hands every time they touch their eyes.

 

Viral conjunctivitis usually occurs in combination of with systemic viral illness. Sore throat, fever and bright red eye are often seen in older children and teens and is due to adenovirus.  While the eye is red, the discharge is typically watery and matting is much less common. These patients are contagious for up to 12 days so it is important to practice good eye/hand hygiene, especially in the household. Artificial tears may help the feeling of eye irritation, but antibacterial eye drops rarely help except in cases of a secondary infection.  I get many phone calls from parents saying, “we tried prescription eye drops and they are not working”. I make sure to tell my older patients to take out their contacts and wear glasses for 7-10 days.

 

At this time of year I am also seeing a lot of seasonal allergic conjunctivitis.  These children have intensely itchy and watery eyes, as well as swelling of the eyelids and area surrounding the eyes. They look like they have been crying for days as they are so swollen and miserable. Many also have a very watery nasal discharge. They do not have fever. Using over the counter medications for allergy control, such as nasal steroids and anti-histamines will help some of the allergic symptoms. There are also over the counter eye drops (Zaditor, Patanol) that help when used daily.  During the worst of the season I make sure that the child has daily hair wash and eyelash and eyebrow wash with dilute soapy water to make sure the pollen is removed after they have been playing outside. It is nearly impossible to keep a child indoors for the 6 or more weeks of allergy season!

 

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

The best ways to cope with seperation anxiety.

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.