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Diabetes Risk

Your Teen

Young Male Athletes, Parental Pressure and Doping

1:45

When 129 young male athletes, whose average age was 17, were asked what would make them consider “doping” as a way to boost their athletic ability – the majority said parental pressure.

A new study from the University of Kent in England asked the young male athletes about their attitudes on "doping" -- the use of prohibited drugs, such as steroids, hormones or stimulants, to increase athletic competence.

These substances, sometimes called performance-enhancing drugs, can potentially alter the human body and biological functions. However, they can be extremely harmful to a person's health, experts warn.

The study group was also asked about four different aspects of perfectionism. The areas were: parental pressure; self-striving for perfection; concerns about making mistakes; and pressure from coaches.

Only parental pressure was linked to positive feelings about doping among the athletes, the study authors found. Although the study was small, it did point out how important demanding expectations from parents can be to kids. 

Lead author of the study, Daniel Madigan, a Ph.D. student in the university's School of Sport and Exercise Sciences, said the findings suggest that parents need to recognize the consequences of putting too much pressure on young athletes in the family.

"The problem of pressure from parents watching their children play sports is widely known, with referees and sporting bodies highlighting the difficulties and taking steps to prevent it," Madigan said in a university news release.

"With the rise of so-called 'tiger' parenting-- where strict and demanding parents push their children to high levels of achievement -- this study reveals the price young athletes may choose to pay to meet their parents' expectations and dreams," Madigan added.

The researchers only focused on young men for this study but plan to investigate if the same result will occur with young female athletes, and if there are differences between athletes in team versus individual sports.

The study findings are scheduled for publication in the April print issue of the Journal of Sports Sciences.

Story source: Robert Preidt, http://teens.webmd.com/news/20160229/young-athletes-pressured-by-parents-may-resort-to-doping

 

Daily Dose

Toddler Constipation

1:30 to read

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

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

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

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

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

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

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

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Daily Dose

Breast Feeding Woes

1:30 to read

I recently read an editorial in The New York Times entitled “Overselling Breast Feeding”. It was written by Courtney Jung who is a professor of political science at the University of Toronto.  It was quite interesting to me as she stated “the moral fervor surrounding breast feeding continues unabated, with a steady stream of advocacy and education campaigns”.  The WHO (World Health Organization) developed “ten steps to successful breast feeding” in hopes of increasing breast feeding initiation and duration around the world. Hospitals have been designated “Baby-Friendly”  (aren’t they all supposed to be?)  if they adhere to these steps as well. But the United States has done well with breast feeding rates as 79% of mothers initiate breast feeding.

Most, if not all of the new mothers I make rounds on are proponents of breast feeding. They have read the books, gone to classes and are determined to be successful at breast feeding. But, in my experience over the last several years, I have actually seen more and more new mothers becoming over-wrought and wary of breast feeding fueled by the “rules” that they are being required to follow. With that being said, having someone “tell you that you must breast feed your baby in the first hour after birth”, and that “your baby must remain in your room 24 hours a day“, and that they “may not have a pacifier”, “and should “breast feed on demand” is actually anxiety promoting and leaves many a new mother exhausted and tearful within a day or two of having a baby. 

While breast feeding is “natural” it also requires some practice and the only practice is really “on the job” training.  Some babies just latch on quickly and are pros immediately, but not all babies will become proficient at breast feeding in the first day or two. The mothers are told to “let the baby nurse on demand” and some mothers have had their babies at the breast for hours on end and are exhausted, with sore and bleeding nipples. I have walked in to too many hospital rooms with a mother in tears and a fretful baby, and a “helpless” new father.  Some feel as if “they are failures” as mothers before they even are discharged, and at the same time are having serious doubts about continuing to breast feed.  They are sure that their baby will catch serious illnesses and have a lower IQ if they don’t breast feed, but how can they maintain this constant breast feeding and no sleep and never put a pacifier in their baby’s mouth??? Is there only one way to be successful at breast feeding?

I loved breast feeding but it was a long time ago and we were instructed by caring nurses “to just go home and put the baby to the breast every 2-3 hours”. While that may not have been the best education has the pendulum swung too far?  Will giving the baby one bottle when a mother is having postpartum anxiety and sleeplessness really harm the baby?  Should a mother have to sign an order allowing her baby to have a pacifier??   While guidelines for breast feeding are helpful should they be so rigid that a mother “gives up” on breast-feeding because she can’t follow 10 steps in the first 24-48 hours?   

The New York Times article was quite interesting and I had to agree with many of the author’s  points. Supporting a woman’s choice to breast feed is admirable and “policy changes promoting maternity leave, and flexibility” are definitely needed to encourage women to continue to breast feed. But as she states “is all of this breast feeding advocacy crossing the line?”   A mother should choose to breast feed because she wants to, and that does not mean if her baby does not breast feed in the first hour that she will never bond with her baby or be successful at breast feeding.  Some woman are unable to breast feed for a multitude of reasons and that decision should not label her as a “bad mother”.  Again, breast feeding, like a woman’s breast, is not “one size fits all”. 

 

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Daily Dose

Teaching Kids Morals & Values

1.30 to read

This is the time of year we all become very reflective, even my young patients. I love to ask them what the holiday season means to them.  Some are about “wanting” while some about “giving”. 

During a recent office visit, I was having a discussion with the mother of young patients of mine.   She and her husband had been talking about “giving rather than receiving” and how to begin to instill those values in their children.

Their children were getting to the age where they wanted an allowance for doing chores: making their beds or setting the table.  They decided to start giving their kids $1 a week for allowance.  

At the same time, they set up three different “banks” for their children with jars which were labeled: SPEND, SAVE, GIVE.  Each week, their children got to decide how to divide up their dollar, with the caveat that some amount had to go in each jar. (The parents were also clever in that they gave them the dollar in coins).

This mother was commenting on how her children were already understanding the concept of giving and saving, while at the same time learning how much to spend. She found it interesting to listen to her children’s comments while they each wrangled with how to divide up the money.  She also noted how their different personalities played into the dividing the funds. She found that their reasoning changed each week.

As Christmas and Hanukah drew closer, her children were putting more money in the GIVING jar and talking about why, as well as what, they wanted to do that money.  Each of the children had specific ideas of how to GIVE their money and to whom.

I love this idea and think that it is such a clever way to start teaching children about how we all have to “divide” up our money. It doesn’t matter what amount you start with or what age children you have, it works for all!  Teaching the basic premise of money management with SPEND, SAVE, GIVE is a lesson for all and what better time of year to discussing GIVING.  

That's your daily dose for today. We'll chat again tomorrow. 

Daily Dose

When Parents Date

1:30 to read

I recently saw some patients of mine who are now teens. They were brought in for their check ups by their father who i had not seen in some time.  He has a boy and a girl about 16 and 14 years old.  I knew that there had been some “issues” within their family, but is had actually been several years since i had seen them.

As it turns out the parents had divorced, the mother had some problems with addiction and the father now had custody of the children. He was trying to get “everything back on track”, including visits to the pediatrician.  

After seeing each of the kids alone and talking to them, they actually seemed to be doing extremely well. They had seen a counselor during some of the more tumultuous times and were happy to be in a “stable” environment and had “less family stress” as they put it. They were both doing well in school, had lots of friends and were involved in different sports and school activities.  They said that their sad had been instrumental in getting things “back to normal”, or back to a “new normal”.  

I also visited with the dad and he told me he had a new concern.  He was really happy about how well his children were doing, all good.   It seems that he had just started dating agiain, and he was not quite sure how to handle the subject with his kids.  He told me that he had had several dates and his kids wanted to know....what’s next?

I had to laugh a bit, as we had just discussed his children dating and going to Homecoming. My response was,  “be honest with them”.  If you asked your teen after 2 dates “where is this going?”, they would probably reply, “dad, who knows, we’ve only had 2 dates...I’m not getting married!”.

I told him I would tell his children the same thing,  in a manner of speaking. I would acknowledge that I was enjoying dating, that I had no plans to get married any time soon, and did not even know if i was ready to be “exclusive” ( is that the adult version of Facebook official?) with anyone at this point.  

I would also make it clear that I would keep them updated if and when things changed, but in the meantime they did not need to worry. Their dad would be there everyday to get their breakfast, have dinner with them and continue their “new normal”. It was just such a good feeling seeing all of them happy!

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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