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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.

Daily Dose

Over The Counter Products

1:30 to read

So, if you have read my daily doses you are aware that my “news watching” comes from morning TV while I am getting ready for work!!  I often find myself talking to the TV, especially when it is a medical segment which includes pediatrics.  While I am excited that morning TV is covering health topics, some of the information may be a bit “misguided” when a pediatrician is not the one discussing a pediatric topic.

I “heard” another example of this the other morning when the morning shows were discussing the “top pharmacist picks for over the counter products”.  It seems they surveyed pharmacists  and then compiled a list of “favorite” name brand OTC products in numerous categories - I don’t  think there was much science behind this. At any rate, we all have our “favorite” go to “OTC” products which for one reason or another we prefer. Does that actually mean they are better?

So, here are a few that I had issue with:

Allergy medications: They picked Claritin, but why not Zyrtec or Allegra?  They are all second generation anti-histamines and there is not a great deal of data that one is better than another. If push came to shove and I could only pick one antihistamine it would be Benadryl (diphenhydramine) - despite its sedating properties it is still a great drug.

Topical antibacterial medication: They picked neosporin and I would pick polysporin. Neosporin contains neomycin which may cause an allergic contact reaction. Other than neomycin they are quite similar and both contain topical lidocaine for pain relief.  Guess what -  they are made by the same company!!  

Pain relief:  They picked Advil, but why not Motrin or generic ibuprofen.  I am frugal and buy whatever is on sale, same drug.  I always remind parents of this as sometimes they get confused and say, “Advil didn’t work so I gave them Motrin” double dosing them with same drug. Be careful.

GI complaints:  Pharmacists picked Pepto-Bismol. I do not recommend Pepto-Bismol to  children as it contains  bismuth subsalicylate which is related to aspirin and has been associated with Reye’s Syndrome.  The bottle is labelled “do not use under the age of 12 years” due to this concern, but parents may not read the fine print. There is a Children’s Pepto that contains only calcium carbonate and may be given to children as young as 2 years….really important to read the labels as there are many choices with similar names.

Lip balm: Their choice was Carmex. I do not recommend lip balm/gloss that contains menthol or camphor as it may actually damage the lips and cause more drying…so you apply more then it is a vicious cycle.  You want to use lip balm with bees wax or petrolatum and no fragrance. I like Aquaphor, Burt’s Bees and Vaseline.  

Formula: Their choice was Enfamil.  I recommend any of the formula brands including Simliac and Gerber as well as some Organic Formulas if my patients desire.  I don’t know why they would pick only one brand…no data on that either.

Sunscreen:  Their choice Neutrogena, which I also love. They make good products that are hypoallergenic and PABA free, and they have many different vehicles (spray, lotion, stick) to choose from. I am also a fan of Cerave products and they now have sunscreen for babies.  But the most important fact is to use a sunscreen of any brand with an SPF of at least 30 and one that contains zinc or titanium dioxide and no PABA or oxybenzone. 

Those are just a few of my comments and favorites.

 

Daily Dose

Waiting for the Doctor

1:30 to read

I just read a really good article from The Huffington Post that was written by a young woman from the UK.  She was discussing the issue of waiting for a doctor. She herself had been waiting for her doctor when she noticed another patient who was being very loud and quite verbal about waiting. He engaged her in conversation and said, “I bet that doctor is back there having a cup of tea”. He must have been stunned when she replied, “well, I certainly hope so”.  She knew that the doctors had recently seen her as an emergency when she began bleeding during her pregnancy. She knew that they had dropped everything to attend to her and her unborn baby and for that she was eternally grateful.  

I also “hate to wait” when I am seeing my own doctor, but I do know that he or she is not “back there eating bon-bons".  I also know that many patients have waited for me, sometimes for up to an hour.  I promise you that I know that I am running late and it makes me very anxious. But at the same time, I am doing the best that I can to treat each and every patient as if they were my own child or family member.  Sometimes a patient comes in with a more complicated or urgent problem and the time taken with that patient is much longer than was expected. Or, a child arrives wheezing and in respiratory distress without even having an appointment….they to will be “worked on” in front of everyone else…as they need a doctor immediately. 

The article continued to re-count how many times during her pregnancy that she had needed to be seen as she continued to have issues with bleeding, and each and every time, the doctors were there, no wait and no questions….they just did their job.

It is difficult to explain why doctors run late and I understand how patients are frustrated when they wait. But at the same time, how do you schedule the appropriate amount of time for a patient who calls for an appointment because their child is sick with a fever and a sore throat. But, while you are seeing their child they break down in your exam room and tell you that they have found out that their husband is “cheating on them” and that “he wants a divorce”.  As their pediatrician, do you tell them that you don’t “have the time” to listen to their problems. Do you just deal with their child’s sore throat and ignore the mother’s anguish. In my case, I choose to spend time with the mother, to empathize with her, and hope to help her.  I know that this reaction will make me late….but it is what I need and want to do for my patients and families.

Whenever I am talking to prospective patients I am perfectly honest when they ask me, “will I ever have to wait?”.  My response has changed over the years as I have come to realize that there will be times when they do wait….but it is not because I ever want to “run late” or make my patients wait. It is because, I have decided that my practice has just as many flaws as my parenting, not perfect. But similar to my children, at times one will need me more than another, and when they do I will spend more time with the one that needs me the most.  It may not seem “fair”, but how do you make it always be “fair”?  I hope that at the end of the 23-25 years I spend with these families they come to realize…it all evens out in the end…there are times that I spent too much time with them and then there are times that they waited.  But, just like parenting, you do the best that you can.  I will continue to practice that way as well. I promise, if you are waiting I am not having tea and bon-bons!!!   

Daily Dose

Flu Cases Rising

1:30 to read

Flu season is definitely upon us and unfortunately it is hitting just in time for the holidays!  I have been on call for the last 2 weekends and I can assure you, flu is everywhere. You name the place and you are probably being exposed somewhere.  That includes the mall (where people are shopping whether sick or well), grocery stores, churches, synagogues, restaurants, day care, schools, airports...the list is endless.   I am saying this because patients continue to ask, “where do you think I got this?”.  

To compound the problem families are gathering for the holidays, so it makes it an even better time for the respiratory viruses to spread.  Those viruses just love this time of year.

Fortunately, despite the flu vaccine not being a “good match” for the Influenza A (H3N2) that is widely circulating, the children I am seeing with the flu (and yes, I myself have already seen 100’s) are not terribly sick.  They do have the typical fever, cough, sore throat, headache and body aches that typically comes with flu, but they are typically only running fever for 1-3 days and when the fever is down they are playing video games, watching TV and baking cookies. I have not seen anyone that has had a serious complication....I am hopeful that this continues.  

Many patients are wondering about using Tamiflu (which is advertising heavily right now). I am using Tamiflu for children who are high risk (under 2 years, have underlying illnesses, are immunocompromised, have significant asthma etc).  For most children the flu can be handled at home with the usual symptomatic treatment, fever control, fluids, rest and parental TLC (tender loving care).  I would always watch for any respiratory distress and make sure your child stays hydrated. In most cases I bet the fever is gone in a day or two and they are left with a nasty cough (same goes for the parents).  I always warn parents to watch for any re-occurence of fever later in the illness, which makes me worry about a secondary infection which would require a visit to the doctor.

Best prevention right now is to continue to get a flu vaccine....some protection is always better than none. Wash your hands, eat healthy, get plenty of sleep and if you are sick- please stay home!!  We’ve got several more months of flu....winter is just really starting.

 

 

 

Daily Dose

New Sleep Guidelines for Your Baby

1:30 to read

I am sure that many of you heard about the latest recommendations on infant sleep that the American Academy of Pediatrics has released. The latest policy statement from the AAP recommends that all infants sleep in their parents room, but not in the parents bed,  for at least the first 6 months of life and preferably for the first year!!  This is big news and quite a change from the previous sleep recommendations which were published in 2011.

 

All of the latest recommendations regarding sleep are intended to help to reduce the incidence of SIDS (Sudden Infant Death Syndrome), which is the leading cause of death for children under the age of 1 year. SIDS in one of the greatest fears of all parents. While “the back to sleep” campaign has reduced the incidence of SIDS, there are still over 3,500 babies in the U.S. who die suddenly and unexpectedly every year while sleeping. (this includes some from suffocation and strangulation and not SIDS).

 

In addition, the recommendations re-iterate that the baby should not co-sleep with their parents, but should be in a crib or bassinet with a firm sleep surface, in the parents’ room. These new recommendations, may be driven by the reality that breast feeding mothers are exhausted and often fall asleep while nursing their baby. If the mother is sitting in a chair or on the couch and falls asleep the baby may be at risk of suffocation if they roll into a cushion or fall down between pillows. If the mother is in bed breast feeding and accidentally falls asleep at least the baby is on a firm surface - make sure when you do breast feed your baby in bed to remove all loose blankets and pillows in the area around your baby prior to feeding - just in case.

 

Although it has been a long ago, I always put our infants in their own cribs to sleep -  you might say I was obsessed. One night, shortly after the birth of our 3rd child I found myself on my hands and knees looking under the bed. When my husband was awakened and asked me “what are you doing?” I replied…”looking for the baby!” He then reminded me that I had put the baby in his crib in the nursery right after I had finished breastfeeding him.  I truly had no memory and thought he had fallen under our bed!! This, from someone who had previously stayed up for 36 hours during residency working in the hospital and thought I could handle sleep deprivation- clearly not true!! I just remember the feeling of being frantic! 

 

The AAP continues to recommend that the crib be essentially bare - in other words, no bumpers, no blankets, no stuffed toys, just the fitted crib sheet. The baby should always be placed on their back to sleep…once your baby learns to roll from back to front ( which typically happens after they have learned to roll tummy to back), they may be left to sleep on their tummy. Even with a baby in your room you cannot get up all night to keep trying to keep them from rolling over!  

 

The AAP does recommend using a pacifier for sleep times ( I am a huge pacifier fan as you know). The only problem with a pacifier is convincing The Parents that it is time to “get rid of the paci” once their baby is over a year old….. sometimes hard to sell that concept.

 

Lastly, the APP reiterated that they do not support the use of any of the devices sold to new parents to help “prevent”  SIDS. In other words, all of the technology being marketed including  “anti-SIDS mattresses, home cardiorespiratory monitors, and even fancy video monitors.  While many a well intentioned parent will invest a lot of unnecessary money and time trying to make the baby safe during sleep, the mantra “less is more” is now the best way to ensure safe sleep for your baby. I remind parents that there will be plenty of ways to spend that money  - start the college savings!

 

 

 

 

Your Child

Safety Recalls: Finger Paints, Baby Bathtubs, Strollers and More

2:00

The American Academy of Pediatrics’ (AAP) online Gateway issue has listed several children’s products that have been recalled due to health and safety concerns.

The list includes

·      Sargent Art tempera finger paints, Lil’ Luxuries Whirlpool, Bubbling Spa & Shower

·      Peg Perego’s 850 Polaris Sportsman ATV-style ride on toy

·      Mamas & Papas’ Armadillo Flip and Armadillo Flip XT strollers

·      Fiddle Diddles LullaBelay adjustable car seat strap system

·      Chimparoo brand Trek baby carriers

Sargent Art tempera finger paints: About 2.8 million units of paint have been recalled. The paint can contain harmful bacteria, putting children with weak immune systems at risk of serious illness. Those with healthy immune systems may not be affected.

Recalled are 13 types of Sargent Art tempera and finger paints. All colors and sizes of the following types of paints are recalled: Art-Time brand of tempera paint, washable finger paint, washable fluorescent finger paint, washable fluorescent tempera paint, washable glitter finger paint, washable paint and fluorescent tempera paint.

Sold at: Hobby Lobby, Wal-Mart and other stores nationwide and online at Amazon.com and ShopSargentArt.com from May 2015 to June 2016 for $1 to $8.

Stop using the paints and contact the company for a refund at 800-827-8081 or visit www.sargentart.com.

Lil’ Luxuries Whirlpool, Bubbling Spa & Shower: About 86,000 units have been recalled. Fabric slings can come off the infant bathtubs, and infants can fall or drown.

Lil’ Luxuries Whirlpool, Bubbling Spa & Shower is a battery-operated whirlpool bath with motorized jets intended for use with children from birth to 2 years. The product has a fabric sling on a plastic frame onto which the infant is placed for bathing. The fabric sling on the tub does not have a white plastic clip to attach the headrest area of the fabric sling to the plastic frame. Recalled bathtubs have numbers 18840, 18850, 18863 or 18873 with date codes starting with 1210, 1211, 1212, 1301, 1302, 1303, 1304, 1305, 1306, 1307 or 1308, which stand for the two-digit year followed by the two-digit month, on the fabric sling.

The products were sold at Toys R Us/Babies R Us and other juvenile product specialty stores nationwide from October 2012 through October 2013 for about $60. The tubs also might have been sold secondhand.

Stop using the fabric sling in the tub, and contact the company for a replacement sling with a white plastic attachment clip. You can call 844-612-4254 or visit http://bit.ly/2f1wQNG.

Peg Perego’s 850 Polaris Sportsman ATV-style ride on toy, About 3,000 toys were recalled. A relay on the circuit board can fail causing the vehicle’s motor to overheat and catch fire.

Recalled are Peg Perego’s 850 Polaris Sportsman ride-on, 24-volt battery-operated toy vehicles for children ages 5 to 7 years. The ATV-style vehicles for two people are silver, red and black and have four wheels, a flip-up backrest for the back passenger and a front and rear luggage rack. Vehicles with date codes 651016, 651017, 651020, 651021, 651022, 651023, 651024, 651027, 651028, 651029, 651030, 660304, 660305, 661123, 661124, 661125 and 661130 are recalled. The date code is under the vehicle seat. Sportsman Twin and 850 EFI are printed on the side and Polaris is on the side of the seat.

Items were sold at online retailers including Amazon.com, Cabelas.com, Target.com, ToysRUs.com and Walmart.com from October 2014 through April 2016 for $500 to $600.

Remedy is to Contact Peg Perego for a replacement circuit board with instructions, including shipping. Call 877-737-3464, email 850recall@pegperego.com or visit https://us.pegperego.com/cs/recalls/.

Mamas & Papas’ Armadillo Flip and Armadillo Flip XT strollers: About 3,000 strollers have been recalled. A loose latch on the stroller can cause the infant in the seat to tip back unexpectedly and possibly fall out when facing the parent.

Recalled are Mamas & Papas’ Armadillo Flip and Armadillo Flip XT strollers. All models are folding strollers for one infant. They come in black, teal and navy and weigh about 22 pounds. Lot number ranges for recalled Armadillo Flip strollers are 00814 through 00416. Lot number ranges for the Flip XT are 01214 through 00416. The number is printed on the sewn-in label on the stroller.

Strollers were sold at Albee Baby, Babies ‘R’ Us, Buy Buy Baby and other stores nationwide and online at www.mamasandpapas.com and www.amazon.com from December 2014 through July 2016 for $500.

Stop using the strollers and contact the company for a repair at 800-309-6312 or visit www.mamasandpapas.com/us.

Fiddle Diddles LullaBelay adjustable car seat strap system: About 250 units have been recalled. The carabiners attached to the strap system have small parts inside that can come loose and be swallowed and choked on by young children.

The Fiddle Diddles LullaBelay adjustable car seat strap system with model number LB1001 includes two fabric straps, carabiner hardware, a mesh car seat cover and a tote bag. The carabiners are used to hang a car seat from a shopping cart. The model number is printed on the straps.

They were sold at Amazon.com from November 2015 through June 2016 and Fiddlediddles.com from May through June 2015 and at Zoolikins stores in Arizona from November 2015 through June 2016 for about $40.

You can contact the company for a repair kit with three new carabiners. Call 888-741-2957, email info@fiddlediddles.com or visit http://fiddlediddles.com/replacement-kit.html.

Chimparoo brand Trek baby carriers: About 130 units are being recalled. The carriers’ side strap can loosen unexpectedly from the buckle, and the child can fall out.

Recalled are Chimparoo brand Trek baby carriers that allow the user to carry a baby tummy to tummy, on the hip or on the back. The 100% twill fabric carriers were sold in 18 solid, striped and pattern color combinations. The carriers attach to the wearer’s body with adjustable straps made of polypropylene webbing and plastic buckles. “Chimparoo” is printed on the upper right hand corner of the carrier. “Trek” is embroidered on the belt.

The carriers were sold at Children’s boutique stores, such as Granola Babies, of Costa Mesa, Calif., Eat/Sleep/Play, of Summerville, S.C., and Top to Bottom, of Omaha, Neb., and online at www.Amazon.com and www.Chimaparoo.ca from May through July 2016 for about $170.

Contact the company for a replacement buckle for the baby carrier’s side-buckle. Call 855-289-5343, email safety@Chimparoo.com or visit www.Chimparoo.ca/en/recall.

Story source: Trisha Korioth, at http://www.aappublications.org/news/2016/11/17/HealthAlerts111716

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

Your Child's Sitter

1.15 to read

Do you ever leave your child with a babysitter or caregiver? Weird question right? But some parents never want to leave their child with someone else....and I am not sure that is healthy for either parent or child.   

I recently had this discussion with parents of a 3 year old child who was having a terrible time with separation anxiety. While many children go through stages of separation anxiety, by the time a child is 3-4 years they are typically past this stage. When I was talking with this family they told me their child had never been left with anyone.  

I guess as a working mother I was incredulous. What? Had the parents never gone out to dinner or to a party, a concert, lecture  or even on a night away for some much needed “couple” time?  They told me that they would occasionally call in grandparents but typically took their child everywhere with them.  (I think there are many places such as movies, adult restaurants, and other venues that might not want the 2 year old in tow).   I suppose some would say the child was fortunate, but I really believe that as a child reaches age 2ish they need to begin learning to separate from their parent. Not for days or weeks, but for either a play group, a pre school program, the gym nursery or something where the child is learning a bit of independence.   

While some parents are quite fortunate that they don’t have to leave their child to go to work every day, the concept of leaving your child for any hour or two with a trusted babysitter should not cause anxiety for the parent and ultimately not the child. Separation is an important milestone, as your child learns that while you may leave for an hour or two, you always return. There is security in that knowledge. They will also learn how to interact with  other adults and children, which is often different than they do with their own parents.  (Ask any teacher about that phenomena). 

Autonomy and independence are typically traits that parents desire for their children.  Parents also need to have some autonomy as well.....I think this makes for a better parent child relationship in the long run.  Little steps in separating become bigger steps as a child grows older....starting with a babysitter or nursery for an hour or two on occasion is often the beginning. 

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!

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DR SUE'S DAILY DOSE

A few life lessons & fun with Elf on the Shelf!

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