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Daily Dose

Earth Day!

1:15 to read

Earth Day is this week and what better time than now to plan some family time celebrating our Earth while teaching our children about the need to keep our planet healthy.  The discussion about our planet and the changes that are happening can really begin very early, as you and I both know, you have the smartest child around…(I already know my 20 month old grand daughter is a genius as I discuss carbon emissions with her while trying to teach her to say Sue-Sue).

Kids of all ages will be discussing a wide variety of topics this year at school, so why not continue that conversation at home?  You know I always talk about “model the behavior”, and this is another great opportunity.  In fact, the Earth Day campaign this year, “Trees for the Earth”  continues to promote the planting of 7.8 billion trees over 5 years, in anticipation of celebrating the 50th anniversary of Earth Day. How about planting a tree with your kids. It can be at your house, school, church, or even park and while digging discuss how trees help us to breathe clean air by absorbing pollutant gases, as well as helping climate change by absorbing excess CO2.  “We” actually planted this TINY oak tree almost 25 years ago for a Cub Scout project with one of our sons. I can remember how hastily we planted the “little oak” right before heading to the Cub Scout meeting, you know the drill…..totally forgot it was supposed to be done prior to the meeting so he got a shovel and voila..planted and badge earned.  Well, who knew that he planted it too close to the house…it was 6 inches tall….look at the picture I am posting with this…soars above the house now and as the arborist says…”it really needs to be moved, but that entails digging up the neighbors driveway”…oops. Stay tuned for what we will end up doing, as it has huge sentimental value,  is helping our planet absorb those gasses, but not much help to our roof! 

I am planning on planting a tomato plant with our grand daughter and also with a few of my patients that live nearby as we have been talking about gardens and vegetables.  I am sure my grand daughter will think it is a fun project as what toddler doesn’t like a bucket, shovel and dirt?   The other little girls are so excited too…as they are older and want to decorate the pot, order lady bugs to keep the plant healthy and plan on having SO MANY tomatoes that they will “sell them” with lemonade from their front yard stand….early entrepreneurs!

This is such a perfect time of year to celebrate our planet and to try and keep it healthy for the generations to come… even if it is one tree or plant at a time.

Daily Dose

Bathing Your Baby

The end of summer baby “boom” is still going on and new parents are coming in with all sorts of questions…including how do I bathe my baby?  As many mothers and their babies are being discharged from the hospital after 24 hours, they really don’t have the opportunity to “practice” new parent skills, including giving their baby a bath.

Bathing your baby is really fun and is a good bonding experience for parent and child.  The bath also keeps your baby clean and smelling “sweet”.  I was convinced that it would also help them to relax and to sleep longer (not scientific at all - but it works for us right?).  At any rate, you can bathe your baby every day or every 2-3 days, or even once a week. It is really personal preference…but that wonderful “after bath smell” makes me smile.

Many people buy infant bath tubs and there are tons to choose from. I like the the “Puj Tub” or the “Tummy Tub” as you can easily put them in the kitchen sink (grandparent friendly), but you want to make sure that there are no sharp edges or places where a baby might get bumped or injured when you put the tub in the sink.  Some people use a folding tub (be careful not to pinch the baby) or inflatable tub  these may collapse), because they are easier to store if you have limited space.

The number one rule for a bath - NEVER leave your baby alone in the tub, not even when they can start sitting up. A baby may drown in an inch or two of water…so never even turn around to check your phone or check an email.  You should also make sure that the water temperature is correct and every new parent should check the hot water heater and lower the temperature to 120 degrees F, so prevent burns. Regardless, always check the water temperature before you put the baby into the tub.

I am also a fan of using mild soaps..including Cetaphil, Cerave, Aveeno, and Aquaphor  baby wash. If your child tends to have sensitive skin it is best to avoid fragrances and harsh chemicals.  I also like to moisturize the infant after a bath with baby lotions from these same companies. New data is showing that frequent moisturizing (twice a day) may also be important in preventing allergies later in life…. so why not enjoy some baby massage…and keep watching for more information on this issue.

 

 

Daily Dose

Staying Heart Healthy

1:30 to read

With it being heart month it seems like an appropriate time to discuss sudden cardiac death (SCD) in children. Thankfully, sudden cardiac death is rare in children with estimates somewhere between 0.6-6.2 deaths /100,000 in children in the U.S.  

SCD is defined as “a death that is abrupt, unexpected, and due to a cardiovascular cause”. It is also defined as a death that occurs within 1 hour from the onset of cardiovascular symptoms, and in the pediatric population death typically occurs within a few minutes of symptoms.  The majority of these tragic sudden deaths occur during sports (20-25%), and in many cases there have been no previous warning signs.

While congenital heart disease is the most common cause of SCD, there continues to be a great deal of research into this subject.  It is now known that there are genetic risk factors involved for many of the disorders that lead to heart disease, arrhythmias and SCD.  Hypertrophic cardiomyopathy ( enlargement of the heart) is the most common cause of SCD in children and adolescents and is due to a genetic abnormality as is prolonged QT syndrome.

Since sport participation has been associated with an increased risk of SCD in children, it is now recommended that athletes are pre-screened for risk factors associated with SCD. A good history is always important, with questions directed towards the heart - including chest pain with exertion, recurrent syncope (fainting) or syncope with exertion.  While many children may not be symptomatic a detailed family history of sudden early unexplained death may be a clue to provoke a further work . The physical exam is equally important including blood pressure readings with the patient both supine, sitting and standing. A good cardiac exam is necessary to listen for murmurs as well as any physical findings suggestive of Marfan’s syndrome. 

Routine ECG (electrocardiogram) screening for all athletes is currently not recommended, although this is the recommendation in several other countries ( Italy has a lot of data on this topic). Unfortunately, an ECG alone does not diagnose all abnormalities and there are frequent false positive results as well, which may lead to unnecessary testing.  An echocardiogram is also necessary to diagnose some abnormalities, and again is not routinely recommended and requires a pediatric cardiologist to read it. 

The most important treatment for SCD is early cardiopulmonary resuscitation (CPR) and to have an AED (automatic external defibrillator) available.  It is estimated that early CPR/AED use could prevent about 25% of pediatric sudden deaths.  If we increase the number of people ( including older children)  who have been instructed in CPR and feel comfortable knowing the correct way to use an AED the statistics for survival may even become more favorable.  There have been anecdotal reports of children performing CPR successfully simply due to the fact that they had seen CPR performed on TV shows or the internet.  Taking CPR/AED training into middle and high schools may be one way to insure this. For children that have been found to have a genetic abnormality which puts them at risk for SCD, or for those who have survived a sudden cardiac event, there are treatments available including medications and in some cases implantation of an internal cardioverter and defibrillator ( almost like your own AED).  Evaluation and treatment by a pediatric cardiologist with expertise in this area is preferred.  

So…with it being heart month a good family activity might be CPR training…who knows when you just might save a life!

Daily Dose

Parenting is Hard Work!

1:30 to read

Being a mom (as well as a dad) is one of the hardest jobs in the world....and as many a person has pointed out, it pays a lot less than minimum wage.  But, it is also the best job in the world.

I have the privilege of seeing a lot of mothers everyday. From the time they come in with their brand new infant until their children have graduated from college....mothers worry about the “job” they are doing.  For a new mother who is already hearing that voice in her head...”am I doing this right?”, 

it is very reassuring for her to hear me say, “you can’t mess this up yet!” Your baby loves you unconditionally, just like you do them.

But as your child gets older it takes a great deal of self-esteem to sometimes feel as if you are “doing it right”.  Children of all ages can sometimes bring us to our knees...how can a small child know just the right thing to say, and that teenager...well, enough said.So, I like to tell them my own stories about raising children and my days of feeling like a failure, or at the least an inadequate mother....especially as your children point this out to you.

When my oldest and very verbal son was about 6, he was riding in the front seat with me (crazy huh) and I stopped the car in front of our neighbor’s house where our 4 year old son was heading to play. I rolled down the window to give the 4 year old some instructions when the eldest son leaned over and started telling his younger brother what to do. So. in my best “mommy voice” I tell the 6 year old that I am the mother and will handle this, to which he doesn’t miss a beat and responds ”if you were doing a better job of being a mommy I wouldn’t have to help you!”  Enough said.

It takes a lot of self esteem and true grit to be a mom. Hang in there.  We all have those days when we know we are doing our best and our kids disagree. 

Daily Dose

Keeping Family Secrets

1.30 to read

How do you explain to young children the idea of “keeping family secrets”.  It is a slippery slope for parents for sure, as I know I told my children “you don’t keep secrets from mommy and daddy” and then days to weeks later I turned around and said, “this is a family secret, so don’t tell!” 

I still don’t know how you begin to explain the difference about secrets, but it has to start when your child is fairly young.  It typically starts when your 3 or 4 year old overhears you say something which you had not planned on happening. Suddenly they are telling anyone they can, “my mom is having a baby!”, or “my dad doesn’t like his boss!”. Oh dear, out of the mouth of babes, right? 

So now you are telling them that we have to keep some things secret. But not secrets about them, really just “our family secrets”.  All of those secrets and comments about neighbors, teachers, friends and even distant cousins that seem to come up over the years.  It is really the beginning of understanding social graces as well. All of these topics are so difficult to explain, especially to young, inquisitive children who just say whatever comes to their mind.   

I vividly remember this issue with our youngest child. Of course he had two  big brothers who would talk about many topics at the dinner table, some of which were probably not meant for little ears.  So, one day we went to a basketball game with big brother and baby brother says to everyone, “My mom doesn’t like the coach of this team!”  Of course he had heard this at our house.....but really?   

So, when we would talk about keeping family secrets with our children we came up with the idea of a filter. Instead of blurting out, “don’t talk about that, it is a secret”, we would say “filter”.  Even with adult children, we still sometimes have to remember “secrets” and when someone starts to slip the family says, “filter!” and every one bursts out laughing.  

Good luck with this topic at your house.  Make sure your children don’t keep their secrets from you, but that they know how to “filter” the family secrets. Can someone say AWKWARD!

Daily Dose

Read To Your Kids

1:30 to read

I know that there seems to be a “national” day for almost everything these days…we just celebrated National Dog Day! (who doesn’t love a dog…but not all families want, have space or  extra income to care for a dog). But there is one thing all parents can do and celebrate very day regardless of socioeconomic background, ethnicity, or geographic location…they can read to their child in the first 5 years of life (and maybe even longer!) 

Try reading to your child 15 minutes a day. The benefits are endless!  Seems like an easy enough “to do” and something that all parents can start from the time their baby is an infant. Newborns need to hear their parents voices and  language early on as a baby’s brain grows exponentially and will actually double in size in the first year of life alone.

A recent study conducted by You.Gov for the Read Aloud Campaign found that only about 46% of parents read aloud with their child every day and only 34% do so for the recommended 15 minutes.

The American Academy of Pediatrics (AAP) has also recommended that all children, beginning at birth, are read to every day. In another survey while six in 10 ( 62%) of parents admit to receiving advice to read aloud to their child only 8% actually followed through.  When asked why they have not read to their child parents site “I can’t find the time in the day”, while over half of the parents surveyed say “their child watches TV or uses a tablet at home rather than being read to”. Some parents say, “their child won’t sit still” to be read aloud to.  But if you realized the head start you are giving your child….could you find the time?

Scientists know that a baby’s and toddler’s brain is making huge connections among the 100 billion neurons they are born with.  By the age 3 there will be about 1,000 trillion connections between those neurons.  These are also the critical years in the development of a child’s language skills.   A child will quadruple the number of words they know between the ages of 1 and 2 years.  Yes, they will mimic everything….even words you wished they had not heard so be careful.

Reading aloud is one of the single most important things a parent or caregiver can do to help a child prepare for learning.  Children who have been exposed to books while listening and reading daily with a parent get a head start in language and literacy skills.  Unfortunately,  more than one in three children begin kindergarten without the necessary skills of listening and learning.  Some are at such a disadvantage that they may not be able to “catch up”.

So, I find myself giving books as baby gifts more and more these days - as who doesn’t have a favorite book or two that make timeless gifts (that may even be passed on to the next generation).  Nursery rhymes, Good Night Moon, Pat the Bunny are a few of my favorites as well as all books by Dr. Seuss and Eric Carle. 

So make it a new habit whether your child is 1 day, 1 month, 1 year or older….read aloud 15 minutes a day and before you know it your child will be reading to you!!!

Daily Dose

Epi Pen Controversy

1;30 to read

I have more than several patients who have had serious allergic reactions (anaphylaxis) to a variety of things…including insects (fire ants, bees) as well as foods (peanuts, tree nuts, fruits, shellfish). All of these children need to have epinephrine auto injectable pens (EpiPen) on hand in case of “accidental” exposure to the allergen and a subsequent life threatening allergic reaction.  These medical devices are seldom used ( thank goodness), but need to be replaced every 12-24 months and should always be readily available in case of an emergency.

For the longest time it was not a “big” issue (cost wise) to write prescriptions for these allergic children and to make sure that they had several EpiPens on hand. This included having them available at home, school, in the mothers purse or in the car or in the gym bag…many people also wanted “extras” to have at the grand- parents house or at the lake house…etc.  So….I would write a script for the EpiPen 2 pack and the family might get 4-5 sets to disperse to the appropriate people. Prior to 2009 the cost was less than $100/two pack. 

It was several years ago that a few families started talking to me about the expense of these devices and also how quickly they seemed to expire…in fact we started asking the pharmacist to look at the expiration dates and to try and dispense the ones that had the longest expiration, in hopes of saving some expense.  At that time there were also two companies that were making the epinephrine devices.  

Then in the last year parents started calling me complaining that the EpiPens were becoming cost prohibitive and “did they really need to keep filling them?”….especially seeing that they had never needed to use one?  Of course I replied that “by the grace of God” and their vigilance they had not needed one, but YES, they indeed needed to continue to have them on hand.  In many cases families reduced the number that they bought and tried to make sure that they handed them off if their child left home….terribly hard I would think to keep up with.

This issue came into view most recently as parents across the country started complaining to not only their physicians, but to the pharmacy, their insurers and the drug maker Mylan Pharmaceuticals….why in the world had the price jumped to over $600? In retrospect, the price had been raised 15% twice a year over the past 2 years!  ( It was also pointed out that this was a 6 fold price increase in the past decade).

I do know that epinephrine has been around for a long time and the drug itself is not that expensive, and is used everyday in hospitals around the country….but the EpiPen auto injector which allows “anyone” to inject the medicine into a muscle without any measuring etc. has become cost prohibitive for many families, even some of those with insurance. It seems that Mylan Pharma  is setting prices “based on whatever the market may bear” and not on the fact that the drug is new or expensive to produce…

This is one of the times that all parents with children who need to carry an EpiPen need to contact their representatives in Congress, as well as their insurers to see if the public can be influential in trying to remedy this situation.  The public will have to let their concerns and voices be heard…

Just as I am writing this, Mylan has announced an “instant savings card” for those people who are paying out of pocket and help for those who do not have the means to buy the EpiPen….but this does not correct the problem as a whole. While the discount may be helpful for some, but not all, it is not the answer to the ever growing problem of exorbitant drug costs in this country. I have several families who are going to try and buy the EpiPen while on trips to Mexico and Canada. I have no idea of the costs there…but worth a try.  

Your Child

Sexting and Internet Safety Increase as Health Concerns for Children

2:00

With more and more young kids using cell phones and surfing the web, parents are increasingly concerned about children ‘s sexting and Internet safety according to a new poll.

Internet safety rose to become the fourth most commonly identified major problem in the 2015 C.S. Mott Children’s Hospital national poll on children’s health, up from eighth the year before, with 51 percent of adults this year citing it as a top concern.

Sexting, meanwhile, was cited by 45 percent of adults and advanced to number six on the list of most pressing problems this year, from 13th place in 2014.

 “The public is well aware of the potential risks to children and teens of Internet activities and sexting, such as cyber-bullying and predatory behavior,” poll director Dr. Matthew Davis of the University of Michigan in Ann Arbor said by email with Reuters.

“Children’s use of the Internet continues to grow, so it makes sense that growing use, without much evidence of greater safety, would lead to higher levels of public concern,” he added.

The poll was taken of 1,982 adults age 18 and over and took place in May.

Smoking and tobacco use, usually rated near the top of the list, dropped from fourth to seventh place, which may reflect a declining number of children who have this habit, the researchers note.

School violence ranked number eight, followed by teen pregnancy and stress.

The top 10 health concerns in the poll also highlight a need for parents to foster open communication with children and teens and monitor not just their comings and goings but also their activities online, said Kathleen Davis, director of pediatric palliative care and ethics at the University of Kansas Hospital.

“Parents must take on a greater ‘hands on’ approach to parenting, knowing what their child is texting, emailing, Snap chatting, Facebooking and blogging and with whom they are communicating in those fashions,” Davis, who wasn’t involved in the poll, said by email.

While the new technologies may seem alien, the parenting strategies to deal with children’s online lives should be familiar, noted Lisa Jones, of the Crimes Against Children Research center at the University of New Hampshire.

“Striking the right balance with controlling technology use and access for children, or monitoring their behavior is something I think we are still figuring out and will probably be an ongoing process for parents, just like deciding how much to control what children choose to wear, who they can hang out with, and where they can go on their own,” Jones, who wasn’t involved in the poll, said in an email to Reuters as well.

“The key recommendation for parents is to keep communication open,” she said. “Make sure your children feel comfortable coming to talk to you when problems come up.”

Many teens and pre-teens aren’t aware of the dangers associated with sexting and how those photos and comments can follow you the rest of your life.  Without good guidance kids don’t truly realize that it’s become a viral universe and posts can gain speed worldwide before you know it. Also, a child may think that only the person they are sending the text to will see it- that’s not always the case and others, including pedophiles can learn where a child lives, the school he or she goes to and their daily habits by “friending” or following a child or their friends online.

Parents still need to monitor their children’s web surfing and texting as they move from childhood into adolescence. It’s not always a pleasant job, but it’s incredibly important for a child’s health and safety.

Source: Lisa Rapaport, http://www.reuters.com/article/2015/08/10/us-health-kids-internet-safety-idUSKCN0QF1X820150810

 

 

 

 

 

Parenting

New Year Resolutions for the Family

2:00

As 2015 closes its tired eyes, 2016 is ready for full steam ahead! The beginning of a new year is often the time when people take stock of where they’ve been and where they want to go. It’s a great time for families to set new goals and discuss what is important to them.

Resolutions do not need to be difficult or overwhelming. In fact, the simpler the resolution, the better.

One small step at a time and before you know it 2017 will be here and your family will have accomplished more than they thought they would!

If you’re searching for ideas, here’s a list of suggestions.

1.     Spend one day out of the week unplugged from any unnecessary electronics or social media. Cell phones and computers have become a necessity these days, but too often they are overused for texting, social media and mindless Internet searches. Set a goal of spending at least one day a month (if not per week) without your gadgets, and instead, enjoy the outdoors or have a board or card game marathon.

2.     Commit to better eating schedules and choices. Healthy eating habits provide benefits for the whole family. Ask for your kids input when planning meals and discuss ways to make everyone’s choices healthier. Positive discussions about health and food can have a big impact on a child’s lifetime eating habits.

3.     Plan family outings that involve exercise. Make it fun and easy. Daily walks, bicycling, swimming even an indoor dance party can get everyone moving without a lot of expense.

4.     Read with and to your kids. Libraries are great places for young children to experience new books and reading programs. A whole new genre of books have peaked an interest in reading for many teens. Summer is a great time to start a family book club, when the kids don’t have homework competing for their time.

5.     Spread the household responsibilities. Having a system for household responsibilities spreads out the work instead of having it all fall on one person. Try keeping a chore jar with slips of paper for kids to pick which chore they'll do that week, such as taking out the trash. Print out this chore chart and put it on the refrigerator or a clipboard to help your family stay on task.

6.     Teach and reflect kindness. Kids learn how to be kind by their parent’s example. Bring unkind or rude comments to your child’s attention. Discuss how to handle frustration or angry feelings. Most of all, exhibit kindness towards your mate and others. Teach compassion through community service when an organization needs volunteers. Children who volunteer to help others in need have a broader view of the world.

7.     Get more sleep! The fact is, you all need at least eight hours of sleep to stay healthy and productive. Some children need more than that. Make sure bedtime is quiet and computers and cell phones are shut down at least an hour before bed.

8.     Teach your children how to manage money. Have them create a budget with their allowance or gift money and help them stick to it. Again, being a good example not only helps the whole family’s budget, but also teaches children the difference between want and need.

Also don’t forget to take a little time out for just you and your spouse. The occasional date night can help you reconnect and have fun together. Being a parent is hard work – one of life’s most demanding and rewarding. Don’t forget that you need to take care of yourself emotionally, physically and spiritually to be the example you want to be.

Have a Happy New Year!

Source: Erin Dower, http://life.familyeducation.com/slideshow/new-years/67775.html

Image: http://colongan.xyz/happy-new-years-eve-2016/happy-new-years-eve-happy-holidays/

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