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Parenting

Parents, Encourage Your Child to Stand Up to Bullying!

2:00

We’ve all read the stories about how a crowd of bystanders have not intervened or called the police for help, as someone was being bullied, attacked or beaten. It’s a horrible thought that if you need assistance, no one will respond.

When children grow up in a home that encourages standing up to bullying, they are more likely to step up to the challenge than kids who’ve been taught to stay out of it, according to a recent U.S. study.

About one in 10 children are victims of bullying, and many anti-bullying programs are focused on getting bystanders to intervene, researchers note in the Journal of Clinical Child and Adolescent Psychology. While previous research has linked certain parenting practices to higher odds that kids will be victims or perpetrators of bullying, less is known about how parents impact what children do as bystanders.

Researchers surveyed more than 1,400 fourth and fifth graders about how their classmates responded in a bullying situation. On average, the kids participating in the study were 11 years old.

They also interviewed parents at home and gave them hypothetical bullying scenarios, asking them how they would advise their children to respond.

In school, kids whose classmates said they might intervene to stop bullies and to comfort victims were more likely to have parents at home who told them getting involved was the right thing to do, the study found. At the same time, kids whose parents told them to stay out of it were both less likely to help victims and more likely to become perpetrators. 

“We were surprised to find that when parents told children not to get involved, children were actually more likely to join in the bullying,” said lead study author Stevie Grassetti, a psychology researcher at the University of Delaware. 

Based on the study results, it makes sense for school anti-bullying efforts to involve parents and endeavor to give children consistent messages about prevention in both settings, the authors conclude.

One limitation of the study is that during school visits; researchers didn’t define what constitutes bullying the authors noted. With home visits, researchers assumed parents gave kids the same advice about the hypothetical incidents that they would offer in real life, which might not always be the case, the researchers also point out.

Parents are role models for how children learn to respond to life’s unpredictable situations. They see and absorb everything their parents say and do. To teach your child compassion and courage, start by being a good example of both and letting them know that standing by and doing nothing to remedy the situation is not an option.

Story source: Lisa Rapaport, http://www.reuters.com/article/us-health-children-bullying-parents-idUSK...

Daily Dose

National Safety Month

1:30 to read

June is National Safety Month…just in time for summer! It is a good reminder for all of us to try and prevent any injuries in our children. I do know from my own pediatric office that we see more injuries during the summer months. Whether it is from falls, bike accidents, pool incidents, household poisonings or burns, our phones stay busy.

 

So..this is the perfect time to re-think child proofing your home. Make sure that stairs are gated, both top and bottom. Cabinets need to have child proof latches to protect children from getting into breakable or sharp objects as well as medicines or household products that may be poisonous.  Put the number for Poison Control in your phone….1-800-222-1222. I am often surprised that a parent calls our office about a child who has “gotten into “ a possible poison…the first call should be to Poison Control. Keep the number posted in the house as well so a babysitter may also have it if necessary.

 

Learning to ride a bike a is “life skill” for sure….but that also includes learning to wear your helmet. I see most young children in our neighborhood who are still under the eye of a parent with a bike helmet, but once they are older I often see kids without helmets. Just saw a neighbor’s child ride down the street this evening..no helmet!!  Bike helmets are like a seat belt…not optional. Many “tween” boys will “debate” with me during their check ups about the need for a helmet,  as they tell me “ I am a great bike rider and don’t have wrecks”. Teach your children what the word ACCIDENT means and that just like a car…you never know what “the other guy may do”.  Accidents are NEVER planned and a bike helmet protects the head and brain. We can “fix” the broken arm or stitch a leg…but cannot “fix” a brain injury.

 

Texting and driving is unsafe and may even be illegal in your state. Texas just passed a law prohibiting texting and driving….but teens (and adults)  need to be reminded on a regular basis that texting is not allowed!!  Texting while driving is a leading cause of accidents and I just saw a mother who is pregnant, and was in the office with her 1 year old…she had just been involved in accident that totaled her car.  She was hit from behind by a teen who had been texting and never slowed down.  Fortunately both mother and child were buckled up and were not seriously injured.  If your child is found to be texting while they are driving you should have some serious consequences with both revoked driving privileges and no phone for a while. 

 

Lastly, this is a good month to remember to check your medicine cabinet and throw away any expired or unused medication.  There are some pharmacies that are having events where you can bring in expired medications and they will dispose of them properly. The number one place that  teens find drugs is in the home…keep all narcotics locked up and dispose of any unused medications!! I have had more than several parents who have told me that “drugs” had disappeared from their medicine cabinets after their own kids had had a lot of friends over…and who knows who may be “seeking” prescription medications. Locks on medicine cabinets and liquor cabinets are a must for families. 

What about taking a family first aid course at your local YMCA or Red Cross and spend a day getting your own family first aid kit together.  This is a great way to spend some time together and a productive activity. Have a fun and safe summer!!

Daily Dose

Hot Car Deaths

1:30 to read

Did you know that heat stroke is the second leading cause of non-traffic fatalities among children, with the first being backover deaths.  As the summer temperatures are rising these tragic accidents become all too frequent.  

My home state of Texas leads the country in child vehicular heat stroke deaths, followed by Florida and California.  But children who are trapped in vehicles have died in milder climates as well. The temperatures outside may be as low as 60 degrees, but the inside of a car heats up quickly, with 80% of the increase in temperature happening in the first 10 minutes. The reason for this is due to physics.....the sun’s short-wave radiation is absorbed by dark dashboards and seats...the heated objects including child seats then emit long wave radiation which heats a vehicle’s interior air.  All of this leads to tragedy.

A child’s thermoregulatory system is not the same as an adult’s, and their body temperatures will warm 3-5 times faster.  When a child’s body temperature rises to about 107 degrees or greater, their internal organs begin to shut down.This scenario can then lead to death. If you see a child who has been left in a hot car call 911...every minute matters.

The greatest percentage of these tragic deaths are totally unintentional.  These parents are not “bad parents” or “child abusers”, they are loving, good parents who simply forgot that their child was in the car. On average there have been around 37 deaths per year due to vehicular heat stroke and in most cases this is not due to reckless behavior but simply to forgetfulness.  Parents and caregivers both admit to “just forgetting” a child was in the car.  It truly can happen to anyone.

So, how can you remember that your precious, quiet, sleeping child is in back seat. Make it a routine to always look in the back seat before you lock and leave the car.  Try putting your purse, briefcase, or cell phone in the back seat as a reminder to look for your child.

Lastly, if your child is in childcare, have a plan that the childcare provider will call you if you have not notified them that your child will not be coming to school,  and they don’t show up.

Daily Dose

Dog Bites

1:30 to read

I am a dog lover and we have always had a dog in our house….even before we had our children.  But, some dogs will bite and unfortunately there are more than 800,000 people every year who receive medical care for a dog bite…more than half of these are children.

 

Children are also more likely to be severely injured from a dog bite…and I was reminded of this today when I saw a very serious dog bite to a child’s face.  The child was brought to my office by his nanny after being bitten on his cheek by the family’s dog.  It was one of the worst bites I have ever seen! He was severely injured and should have actually gone straight to the ER….the good news is that he will ok, but he had to undergo surgery to repair the bite and will probably require another small surgery at some later date. 

 

In this case as in most, the dog bite occurs when a child is interacting with a familiar dog, and in this case it was the family pet. The little boy is a toddler with a twin sister and they were playing when he was bitten.  The dog had been around the children since they were born…and it is unclear what precipitated the bite.  Sometimes a dog becomes aggressive if they are bothered while they are eating or sleeping…and you know toddlers, they can “bother” anyone. 

 

One of my “boys” is also a dog bite statistic.  He was raised with dogs (my sweet lab Maggie is at my feet as I am writing), so I was totally caught off guard one night when the phone rang. My son had been spending the night at a friend’s house (he was about 10 years old) and the voice on the other end of the phone was the father of the friend (he too a doctor), informing me that my child had been bitten by their dog.  It seemed the boys were laying on the floor on blankets watching a movie and eating popcorn and for some “unknown “ reason the dog bit my son on his face.  The bite was not precipitated by anything…they had not been playing or rough housing with the dog and the dog had not been known to be aggressive. The next words out of the father’s mouth…”do you know a good plastic surgeon?” Not words you want to hear from another physician.

 

Thankfully, I did know a good plastic surgeon who I awakened after his long day in the OR….and he got out of bed and met us to suture my son’s face with over 20 stitches. Luckily it only involved his nose, cheek and chin, just barely missing his left eye. I am sure I cried more than my son.  He still has a scar across his nose..which only bothers his mother.  Incredibly, he never “blamed” their dog, went back to play at their house, and still loves his own dogs more than anything.  My brother who is a vet still thinks that any dog that bites without provocation should not stay in the home with children…but that is one vet’s opinion. 

 

It is especially important to teach your children never to approach a dog to pet it without first asking the owner if it is okay.  Children should learn to move slowly and let the dog “sniff” them first and to stay away from their face and tail. Teach your child how to gently pet an animal and to always be gentle.  If they are around a dog who is behaving in a threatening manner by growling or barking, they should slowly back away from the dog and try to avoid eye contact with the dog. If they are ever knocked over by a dog they should curl up in and ball and protect their face with their arms.

If your child is bitten and it is superficial it will probably just require care with soap and water. For bites that break the skin you should check in with your pediatrician.  Make sure you know the rabies vaccination status of the dog that bit.  You also need to make sure that your child is up to date on their tetanus vaccination. In some cases your child may also need an antibiotic.

Daily Dose

Pool or Trampoline? The Safety Debate

1:15 to read

Do you have a pool or trampoline in your yard? Both pools and trampolines are fun for children, and both pose dangers as well. I saw a patient today who asked me my opinion of trampolines. It seems that she and a friend, both of whom have elementary school age children, are having a "discussion" about trampolines. My patient is totally against having a trampoline in her yard, although she has a pool. Her friend says that it is safer to have a trampoline than a pool. And so their debate continues.

Both pools and trampolines are fun for children, and both do pose dangers. But as my own children often told me "according to you Mom, everything that is really fun, is dangerous!" The biggest issue surrounding children playing in pools and jumping on trampolines is parental supervision. When children are taught safety and are given rules to follow that are then enforced, they may have fun and be safe at the same time. Pools are fenced, and gated. Parents watch their children swim. This is usually the party line. But trampolines also require the same amount of supervision and many parents don't realize this.

Most trampoline injuries occur when children are unsupervised. Many serious trampoline accidents occur when children of disproportionate weights are doubling jumping and the smaller child becomes a missile and is thrown from the trampoline when serious neck injuries may occur. Trampolines are also safest when they are buried in the ground or have safety nets on the side. Letting children jump unsupervised is as dangerous as swimming alone.

So, I can't resolve this friendly discussion, but I do know that both pools and trampolines require parental supervision and strict safety rules to ensure the safest possible experience. And yes, they are both fun! That's your daily dose, we'll chat again soon.

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

A Little TLC Goes A Long Way

Just what is TLC and how can it help your child feel better quicker?I can tell that I am aging!!  Not by the new “character lines” I see popping up (hate that), but rather by the way that language and jargon continues to change. I really have tried to stay up with new acronyms such as LOL, or POS, or even “keep it on the DL”.

But while we “mature” adults feel the need to keep up with the younger generation’s “language”, some of the older acronyms seem to be fading away.  I realized this today when I was seeing a young patient and his mother. The cute little 5 year old boy had one of those nasty winter time viruses with a fever and a cough. After finishing his exam and doing an influenza test on him (it was negative) I told the mom that the best way to treat his virus was with fever control and a little TLC.  She gave me this blank look and said, “is that a brand of cough syrup?”  I didn’t know whether to laugh or to cry. I thought that TLC was a universal acronym for all mothers (or maybe better put for parents) as even my own parents and grandparents would say, “you just need a little TLC”. For those of you who have read this far and still don’t know what I am talking about, TLC is the acronym for “tender loving care”.  What better way to treat your feverish, coughing, uncomfortable child, than with a little TLC. When my own children are sick, even now that they don’t all live at home, they still all want some TLC.  As much of a rule follower that I am, when your child is sick, the rules get broken for a while. That means that children get to sleep in their parent’s beds (I often moved after a few wild kicks and thrashing), but one parent remained with the feverish child sleeping next to mom or dad. There were all sorts of “forbidden fruits” given to a child who was sick, such as “slurpees”, ice cream and popsicles in bed, favorite foods all day long and even television without a  time limit. The homework might not get finished due to a fever and general “feel bads”, and the list of things to do just went away for a few days while a child was sick.  It was one of those lovely parenting moments when you could just “turn off the time” and snuggle with a sick child. In other words, lots of TLC. TLC has nursed many a child through numerous illnesses over the years.  I don’t think the directions for TLC have changed.  Just do anything that makes your child feel better. Games in bed, making cookies and jello to eat after an afternoon nap, and even getting to have a special TV tray to use while eating chicken noodle soup.  These “comfort foods” and pampering do make anyone who is sick feel a little bit better.  There are even studies to confirm this. So, remember TLC is not a new fancy cough syrup. It is the “tender loving care” a parent gives to a sick child. Some things never change with time and TLC is one of them.  Best of all, no need for a prescription or a copay! That’s your daily dose for today.  What’s your favorite TLC remedy for your kids? Comment below to share with all of us!

Daily Dose

Happy New Year!

1:30 to read

Happy New Year!!  So here we go again with the New Years resolutions and the “to do” list.  I  try to figure out something each year that I am going to “resolve” to do….one of which continues to be to learn how to play bridge. Somehow I have had the same resolution for two years and yet I still cannot play…at least well. I start off with a bang and just as I can “kind of sort of” play a real game, I somehow get too busy to play and here we go again…back to beginner. I need a new plan!

 

I was having dinner with my “adult children” and they were talking about their New Yea'rs resolutions and it seems they have “categories” of resolutions. In other words they have several different resolutions…which they called personal, professional, social etc. Their thought is that they are more likely to succeed if they have more than one goal??  Maybe they are correct? New approach?

 

So…with that being said let’s think about several different areas that might be good for family resolutions. 

 

Family meals:  We all vowed to try to eat out less and cook at home more often. Not only is it less expensive, it is often healthier and an important time for families to come together to discuss their day. Whether your child is 2 ,10, or 20 yrs old,  just eating together as a family has been shown to improve moods, behavior, school performance and yes, reduces obesity.

 

Electronic media:  As I am on the computer typing I am reminded about how often we all have our faces engrossed in a screen. Some of my young patients know how to “Swipe” and “Refresh” before they can even walk!!  As the world becomes more electronic we are are becoming more isolated…and this is especially true of children. Making a family commitment to limit screen time for all ages may be difficult but is important for building language, social skills and even better sleep. Texting is not talking…who needs a study to confirm that?

 

Exercise: Who doesn’t vow to get more exercise every year…well maybe not young children who long to go outdoors regardless of the weather. But for everyone else, we are becoming more and more sedentary and that is probably somewhat related to the above issue (electronic media).  Make a family plan to exercise at least 3 -4 days a week, maybe after family dinner? Walking, bike riding  (helmet please), playing soccer in the yard, shooting hoops together, or even playing tag, make it easy. Getting our children to move continues to be important for overall health.   They will sleep better, snack less and exercise also gets those good endorphins flowing.  If you keep it up you actually do “feel better”. 

 

Smoking: If you are a parent that smokes…. resolve to “give it up for your children”.  Second hand smoke is REAL, and more and more data shows how it may contribute to SIDS, asthma and other lung problems in children. Model behavior you want to see in your children.  Teen smoking continues to be an issue and many teens are experimenting with electronic cigarettes which then often lead to smoking at a later age. Giving up smoking saves a lot of money towards a fun trip or night out!!

 

OK - let me know how your family does after a few months!! I am hopeful to stay on track for all of 2017. Happy Healthy New Year!!

Your Teen

Parents Need to Have the “Sex Talk” With Their Kids

2:00

Let’s face it, talking to your child about sex isn’t something a parent looks forward to, but a new study says teens who have had a serious conversation about sex with one or both parents are more likely to use condoms or birth control is they are or become sexually active.

“The take home message is that parents do matter, and these conversations do matter,” said Laura Widman, lead author of the new paper and an assistant professor of psychology at North Carolina State University in Raleigh.

While the more information you can present to your child in a way that addresses the health aspects of sexual activity is good, parents don’t have to be experts says Widman, “Just having the conversation is important,” she said. “That’s the good news.”

According to the Centers for Disease Control and Prevention (CDC), nearly half of high school students have had sexual intercourse. Almost 60 percent of high school students surveyed who have had sex said they used a condom when they last had sex, but 14 percent of sexually active teens said they did not use any birth control the last time they had intercourse.

Young people, aged 15 to 24, make up only a fraction of the sexually active population, but they bear a disproportionate burden of sexually transmitted diseases. And while teen pregnancy rates have dropped significantly, there were still 625,000 teen pregnancies in 2010, and nearly half of them –273,000 — gave birth.

Widman noted that results from the study showed that teens who communicated with their parents about were more likely to communicate with their sexual partners and to use condoms.

“We know that being able to communicate with a partner about condom use is one of the best predictors of whether teens use condoms or not,” Dr. Widman said. “So providing kids with the language they need and getting the message across that the subject is not off-limits or taboo can make a difference in their behavior.”

Some parents worry that talking about sex with their child somehow sends a message that they are approving of that behavior. However, studies have found that children who are comfortable talking about sex are actually more likely to delay sexual activity and be older when they first have intercourse.

“Parents fear that if they bring these issues up, they’re signaling that it’s okay to have sex, but that’s completely untrue – we know that parents who bring it up, and bring it up regularly, their kids are least likely to have sex,” said Vincent Guilamo-Ramos, a professor of social work at the Center for Latino Adolescent and Family Health at New York University’s Silver School of Social Work and author of an article about that topic that was published recently in JAMA Pediatrics.

Parents aren’t the only ones uncomfortable talking about sex, so are their kids.  In a 2012, half of the kids surveyed said they were uncomfortable talking to their parents about sex. Only 19 percent of the parents said they were uncomfortable having the “sex talk” with their child.

Children often think that if they ask questions, their parents “will overreact or assume they’re having sex,” said Dr. Guilamo-Ramos, who has developed some pointers on talking with your children.

If you’re wondering how to start that conversation with your child, the Office of Adolescent Health, part of the U.S. Department of Health and Human Services, has these tips:

·      Use current events, pop culture or developments in your social circle to start conversations about sex, healthy relationships and contraception. It’s not a one-time chat, Dr. Guilamo-Ramos said. “Talk to your child on a regular basis.”

·      Take on the tough topics, like birth control and sexual orientation.

·      Pay attention to a teen’s romantic relationships. Teens in intense romantic relationships are more likely to have sex, especially if the partner is a couple of years older than your child.

·      Address your child’s concerns, not just your own. “They want help with the real life pressures they’re experiencing in social situations,” said Dr. Guilamo-Ramos. “Talk with them about what a healthy relationship looks like, and help them come up with strategies and short one-liners that will help them get out of tough situations.”

·      Make sure to talk to your sons, not just your daughters. “Parents’ messages are often more directed to girls than boys,” he said. “And boys aren’t getting the information they need.”

The findings from the North Carolina State University research stem from a large analysis of adolescent health data, based on more than 50 studies involving 25,314 teens over the course of 30 years. The link between parental communication and safer sex practices, while modest overall, is strongest for girls and for teens that talked with their mothers, according to the research, published online in JAMA Pediatrics

As with most studies, the results do not prove a conclusion, only an association. 

Source: Roni Caryn Rabin, http://well.blogs.nytimes.com/2015/11/04/why-parents-should-have-the-sex-talk-with-their-children/?_r=0

 

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Why kids need to wear life jackets while boating.

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