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Daily Dose

A Better Night's Sleep

1:15 to read

What is it about sleep and parenting? Babies never sleep enough and teenagers sleep too much!! Why can’t “we” get this right? While sleep patterns definitely do change with the age of the child, good sleep habits can begin in infancy and continue throughout adolescence.

Even from the beginning,  you should try to teach your child to fall asleep on their own and to self-console by either sucking on their fingers or a pacifier. But remember, this sleep thing is new and babies really do have to learn how to do this.  Think of it as if you were teaching your child to read, it doesn’t happen overnight, but evolves with practice, patience and repetition. Sleep is the same way.

After the early years of teaching your child to fall asleep on their own, the toddler, preschool, and elementary years are usually fairly easy to establish good sleep patterns if you follow a routine, with a set bedtime, reading to your child before bed and hugs and kisses and lights out. This is the age for occasional nightmares, or fears, but also for regular nights of uninterrupted sleep.

With the tweens and teens and hormone changes of adolescence comes a new sleep clock that is set to stay up too late and not wake up in the morning. Even teens need a good nights rest, so a bedtime should be encouraged and enforced unless there is a test of special event. There is not a reason I can think of for teens to be up past 11 pm on a school night, homework should be finished, and all of the accessories such as cell phone, computer and all other electronic gear put up before bed. The older you get the more you understand a good night’s sleep , but someone has to teach the basics along the way and before you know it the whole house will be on that schedule too. That's your daily dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue now!

Daily Dose

Pregnancy & Sleep

1:15 to read

Why is it that as you get further into your pregnancy you sleep less?  I am sure that it is just a factor of being “bigger” and as one mother said to me, “having another human inhabit your body”. It is often hard to find a comfortable position to sleep in, and even if you do, the baby may not want to stop moving when it is your bedtime.

But, I also really think this is all in God’s plan to get a mother (and father who often says his wife keeps him up) ready to be new parents. It is just foreshadowing of the weeks to come when you bring that newborn home from the hospital.  You have already learned to “survive” with less sleep.

The first few weeks at home with that most precious baby is really just about survival. I don’t care what you read or how many classes you take...there really are no “rules” or “tricks” to get thru the first 6-8 weeks of being a new (or seasoned) parent.  

I tell my parents the only “rule” is that the baby MUST sleep on their BACK..other than that try to do the feed, play, sleep routine that you think will just happen, but know at times your baby just does not want to go to sleep when you want them to!! They are not abnormal and you are not a “bad” parent.....they are just newborns with developing brains and sleep cycles. I promise, this too shall pass and longer sleep cycles will come.

So, if you are awake one night toward the end of your pregnancy and reading this, look at the bright side.  Your body is just getting you even more prepared to be a “great” parent....you already know how to survive with interrupted and less sleep.      

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

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!!!

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Health

Parenting News You Can Use

Your Teen

Teens Waiting Longer For Sex, But Still Taking Risks

"Fifteen- to 19-year-olds have the most sexually transmitted diseases. Even though they are waiting, they are having risky sex and not taking precautions," Weller said. According to Weller, it's important to provide sex education at a young age. "The younger one receives sexual education, the less likely you are to engage in risky sex," she said. Teenage girls in the United States are more likely than boys to have unprotected sex during their first sexual experience, new research indicates.

The finding was a surprise to researcher Nicole Weller, an Arizona State University graduate student working on her doctoral degree in sociology. "I'm looking at the interaction between sexual education and how it impacts young adolescent sexual behavior. This in particular was an interesting finding because males usually report that they are having more sex than females," Weller said in a university news release. Her analysis of data from the National Survey of Family Growth also found that young people are waiting longer than in the past to have a first sexual encounter, but they are contracting sexually transmitted diseases (STDs) earlier than in the past. "Fifteen- to 19-year-olds have the most sexually transmitted diseases. Even though they are waiting, they are having risky sex and not taking precautions," Weller said. According to Weller, it's important to provide sex education at a young age. "The younger one receives sexual education, the less likely you are to engage in risky sex," she said. But the type of sexual education provided in U.S. schools is inconsistent -- from abstinence to STD awareness, and from birth control to pregnancy awareness. "It varies in school districts and from state to state," she added. According to Centers for Disease Control surveys, Texas teens have unprotected sex far more often than the national average. In states and cities with "abstinence-plus" teaching policies, the rate of unprotected sex drops below the national average. Houston, for example, has an abstinence-plus teaching policy, and CDC surveys show Houston teens as below the national average for unprotected sex. Research also shows that younger children seek their parent's advice more than adolescents, who tend to depend more on their friends and the media. Take advantage of the opportunity to talk to your young children about issues of sexual health. Talking to your kids about issues like dating and relationships, STDs, and HIV can leave a lasting impression. This will help you provide your children with information that is accurate and reflects your personal values and principles.

Daily Dose

Timeout!

1.30 to read

When I am seeing toddlers for their check ups, the topic of behavior is usually at the top of both the parent’s and my list for discussion.  Once a child is walking and beginning to talk, all sorts of new behaviors seem to occur! 

Parents ask, “how do I stop my child from hitting or biting?”  “What about misbehaving and not listening?”  The toddler years are challenging for behavior as a child is gaining independence, and testing as well.  Toddler and teens have some of the same attributes and it is important to begin behavior modification during the toddler years. 

Time out is the most commonly used behavior modification and not only will parents use this method at home, but preschool and day care teachers begin using this technique as well. This is the age that children begin to understand rules and consequences. 

So how do you “do” time out and when?  I usually start using time out when a child is between 15 -18 months of age. While I try to ignore and distract tantrums, I use time out for biting, hitting and those age appropriate yet inappropriate behaviors. 

I pick a chair in the house (we had a small set of table and chairs which seemed perfect) and every parent needs a kitchen timer to use for time out.   It is important to get at your child’s level when disciplining them as well. Tell them why they are going to time out and then have them sit in the chair for 1 minute per year of age.  (Trust me a minute sometimes feels like forever!)  

Here is the trick, if your child will not just sit in the chair (and many won’t), go behind them and hold them in the chair as if you were a human rope.  In most cases the child will be crying and trying to get up out of the chair, but you calmly hold them in the chair from behind. No eye contact!  Once the timer goes off, you let go of them, go back around so that you make eye contact again, get down to their level, and explain once again that they had to sit in the chair because they (fill in the blank).  

Time out takes time and patience.  If you are consistent about using time out for misbehaving, your child will learn to sit in the chair.  For some it may only take 1 time and others are more head-strong and it may take months of “human rope” before they decide to sit alone. 

Don’t give up!!!  This is a very important lesson for children to learn and you will use time out many times, not only in that little chair, but in other venues as your child gets older.    

Your Child

Unnecessary X-Rays for Kids

1:45

Too many children are receiving unnecessary x-rays for symptoms such as vomiting, feeling ill and fainting says a new study from the Mayo Clinic.

"Chest X-rays can be a valuable exam when ordered for the correct indications. However, there are several indications where pediatric chest X-rays offer no benefit and likely should not be performed to decrease radiation dose and cost," said study author Dr. Ann Packard, a radiologist at the Mayo Clinic in Rochester, Minn.

Researchers looked at the reasoning behind 637 chest x-rays given to children from newborns to 17 years- old between 2008 and 2014. They found that 88 percent of the x-rays given to children did not have an impact on treatment they receive.

What kinds of symptoms were children displaying when they were given an x-ray?  Kids and infants had chest pain, fainting, dizziness, cyclical vomiting, and a general feeling of being unwell or under distress (spells). Another problem stated was a condition called "postural orthostatic hypotension," in which blood pressure drops suddenly when a person stands up after sitting or lying down.

X-rays are often given when a physician suspects someone may have pneumonia or a bronchial infection.

Thirty-nine of the x-rays for chest pain were positive for pneumonia, bronchial inflammation, trauma or other conditions, according to the findings scheduled for presentation in Chicago Wednesday at the annual meeting of the Radiological Society of North America. But chest X-rays had no effect on treatment for any of the children with fainting, postural orthostatic hypotension, dizziness, spells or cyclical vomiting.

Radiation in children is a concern. Many pediatricians and experts recommend limiting the exposure to radiation in children when possible. These procedures can also be expensive for families.

"This study addresses both of these issues, which is important not only for physicians but also for young patients and their parents," Packard noted in a society news release.

"I would like this research to help guide clinicians and deter them from ordering unnecessary exams which offer no clinical benefit to the patient," she added.

Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

If a doctor recommends x-rays for your child, be sure and ask specifically why they believe the x-ray is needed and what impact they believe it will have on your child’s treatment.

Possible broken bones need x-rays, trouble breathing could need an x-ray to look for infection or pneumonia. Your doctor may have a perfectly sound reason for ordering an x-ray, but you may want to know ahead of time exactly what it will tell your physician before agreeing.

Source: Robert Preidt, http://www.webmd.com/children/news/20141203/many-kids-exposed-to-unneeded-x-rays-study-finds

Your Child

Pre-teen Football Linked to Brain Changes in NFL Players

2:00

The start of a new school year also brings after-school sports programs. Late summer and fall is prime football season for many middle and high schools. In some states, it’s a hallowed tradition that boys and girls look forward to participating in whether it’s running down the field or cheering on the team.

While school football doesn’t typically offer the same ferocious body beating and brain –rattling that are seen in the National Football League (NFL), a new study shows that brain development can still be affected by playing football at a young age.

The study looked at the possible connection between a greater risk of altered brain development in NFL players who started playing football before the age of twelve as opposed to those players who began playing later in life.  The study is the first to show a link between early repetitive head trauma and future structural brain variations.

The study was small but interesting. It included a review of 40 former NFL players between the ages of 40 and 65 who played over 12 years of structured football with a minimum of 2 years at the NFL level.

One half of the players took up football prior to the age of 12 and half started at age 12 or later. The number of concussions suffered was very similar between the two groups. All of these players had a minimum of six months of memory and cognitive issues.

"To examine brain development in these players, we used an advanced technique called diffusor tensor imaging (DTI), a type of magnetic resonance imaging that specifically looks at the movement of water molecules along white matter tracts, which are the super-highways within the brain for relaying commands and information," study author Dr. Inga Koerte, professor of neurobiological research at the University of Munich and visiting professor at Harvard University, said in a press release.

The researches believe their findings add to the growing amount of scientific evidence that shows the brain may be especially vulnerable to injury between the ages of 10 and 12.

"Therefore, this development process may be disrupted by repeated head impacts in childhood possibly leading to lasting changes in brain structure," said study author Julie Stamm, currently a post-doctoral fellow at the University of Wisconsin School of Medicine and Public Health.

Despite finding a link to the brain development window where kids are more likely to suffer brain injury by repeated head impacts, the small size of the study means the results may not necessarily apply to non-professionals.

"The results of this study do not confirm a cause and effect relationship, only that there is an association between younger age of first exposure to tackle football and abnormal brain imaging patterns later in life," said study author Martha Shenton, a professor of psychiatry at Harvard Medical School.

Because of the intense publicity about and the findings of many studies on the short and long-term dangers of concussions, many school sports programs are looking at changing how they allow students to play in games associated with head injuries.  Where it was once common for coaches to let players continue playing after a particularly rough tackle or head butting, they are more likely now to insist that a field medical professional examine the child. Some schools are also implementing no tackle policies to protect very young players.

While traditional football isn’t likely to become extinct, parents and coaches can educate themselves about brain injuries and learn how to best protect young players from the chances of long and short-term disabilities.

Source: Brett Smith,  http://www.redorbit.com/news/health/1113407634/pre-teen-football-linked-to-more-severe-brain-changes-in-nfl-players-081115/

 

 

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