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Daily Dose

Five Minutes for Mom

1.15 to read

I’m doing a lot of check ups this summer and a lot of questions surrounding behavior.  I have had many a parent lately who keeps asking me, “what is wrong with my 2-3 year old, they used to be so sweet but they are driving me crazy!”  It is a statement that has been uttered by most parents at different times while dealing with toddlers and young children. As I have said before, this is typically NOT an easy stage, but it is so important in terms of child development, behavior modification and early discipline. It requires a great deal of PATIENCE as well. 

For most of the parents it is just a matter of being reassured that: 

  1.  Their child is not “possessed”

B.   They are not the only one going through this

C.   This too shall pass 

One of my fondest memories while dealing with my own children during these years was of a very cute book that I would read to them after a long day! They loved the book, as did I, as it is written for both a parent and child to enjoy. 

The book is entitled “Five Minutes Peace” by Jill Murphy.  I found my hardback copy (I haven’t saved much from my boys early childhood, but did keep a good book collection for future use) and opened it to find that it had an inscription.  It had been given to my oldest son

for his 3rd birthday. The inscription read, “have mommy read this to you and I bet she will enjoy it as much I hope you will”.  The mother who had brought it for a birthday gift had 3 children and her youngest was the same as age my oldest. She was a wonderful mother and she used to give me such sage advice.  This book kept me sane many a day and then I went on and bought several other books about The Large Family. They are all very special books. I recommend you get on Amazon and buy one and see for yourself. 

And guess what?  I am now taking care of this same mother’s 3 most adorable grandchildren and yes, they too have a copy of “Five Minutes Peace” for their mommy to read to them. 

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

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.

 

 

 

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

 

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Flu

Fight The Flu

Parenting

Health Official: Zika Outbreaks Likely in U.S.

2:00

The United States can expect to see outbreaks of the Zika virus says Dr.Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.

While the U.S. has already seen more than 350 cases of people who were infected abroad and returned to the country, there haven’t been any recorded cases of someone infected within its borders. But those days may be limited, said Fauci.

"It is likely we will have what is called a local outbreak," he said on Fox News Sunday with Chris Wallace.

Since being detected in Brazil last year, the virus has spread through the Americas. It has been linked to thousands of cases of microcephaly, a typically rare birth defect marked by unusually small head size, which often indicates poor brain development. The World Health Organization declared a global health emergency in February.

Zika, which is spread by mosquitoes and through sexual contact, can give adults the paralyzing Guillain-Barre syndrome. The Aedes aegypti mosquito, which primarily transmits disease, is already present in about 30 U.S. states.

While Fauci does expect someone to be bitten by the mosquito here in the States, he does not expect a large number of people to become ill.

"It would not be surprising at all - if not likely - that we're going to see a bit of that," he said. "We're talking about scores of cases, dozens of cases, at most."

He also raised the prospect that other neurological ailments could be eventually linked to Zika, which he called "disturbing."

"There are only individual case reports of significant neurological damage to people not just the fetuses but an adult that would get infected. Things that they call meningoencephalitis, which is an inflammation of the brain and the covering around the brain, spinal cord damage due to what we call myelitis," he said. "So far they look unusual, but at least we've seen them and that's concerning."

Fauci has pressed the administration’s case for budgeting $1.9 billion dollars in emergency funds to fight the virus.

"We have to act now," he said. "I can't wait to start developing a vaccine."

Still, Fauci refrained from recommending that U.S. women avoid becoming pregnant because of fear of giving birth to a baby with microcephaly.

"Right now in the United States they should not be that concerned. We do not have local outbreaks," he said.

According to the Centers for Disease Control and Prevention (CDC), no vaccine currently exists to prevent Zika virus disease. The mosquito that carries the Zika virus mostly bites in the daytime.

The CDC recommends following typical mosquito bite preventions such as:

•       Wear long-sleeved shirts and long pants.

•       Stay in places with air conditioning and window and door screens to keep mosquitoes outside.

•       Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from mosquito bites.

•       Use Environmental Protection Agency (EPA)-registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breast-feeding women.

◦       Always follow the product label instructions.

◦       Reapply insect repellent as directed.

◦       Do not spray repellent on the skin under clothing.

◦       If you are also using sunscreen, apply sunscreen before applying insect repellent.

•       To protect your child from mosquito bites:

◦       Do not use insect repellent on babies younger than 2 months old.

◦       Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.

◦       Dress your child in clothing that covers arms and legs.

◦       Cover crib, stroller, and baby carrier with mosquito netting.

◦       Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.

◦       Adults: Spray insect repellent onto your hands and then apply to a child’s face.

•       Treat clothing and gear with permethrin or purchase permethrin-treated items.

◦       Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.

◦       If treating items yourself, follow the product instructions carefully.

◦        Do NOT use permethrin products directly on skin. They are intended to treat clothing.

Story sources: Diane Bartz, http://www.reuters.com/article/us-health-zika-usa-idUSKCN0XE0UV

http://www.cdc.gov/zika/prevention/

Parenting

Sharing Too Much About Your Kids on Social Media

1:45

In a few days from now, your social media site of preference will be flooded with pictures of young children in cute Halloween costumes out for an evening of trick or treating.  It’s safe to say, online landscapes have replaced the old hard-cover family album. Relatives, friends and even strangers are just a click away from viewing your child’s most significant moments.

While many parents often keep a watchful eye on their kids social media use, they might want to think about how much personal information they are sharing about their family.

"This is all so new. Our parents didn't deal with this," said Dr. Bahareh Keith, an assistant of pediatrics at the University of Florida College of Medicine, in Gainesville.

Before social media, parents might embarrass their kids by showing old photo albums to a few family members and friends.  Now, the things parents disclose online -- the good and not so good -- leave a lasting "digital footprint," Keith explained.

The researchers cite an astonishing statistic in their review: Studies have shown that 92 percent of 2-year-olds in the United States have an online presence, and about one-third make their first appearance on social media within 24 hours of their birth.

Not only do parents share the “Hallmark” moments in their children’s lives, but some parents also share personal information about their child’s struggles with behavioral issues that can end up in the public domain. Social media outlets such as Facebook allow friends of “friends” to view your posts. You may or may not know who these people are. Public information about your child’s personal behavior, Keith points out, can have psychological repercussions for kids.

On a more sinister note, public information about your home life can help thieves and pedophiles link together a profile on your family - such as where your child attends school, when you are at work or on vacation, your child’s most vulnerable tendencies and a host of other things you’d rather strangers not know.

According to Keith, there has been little research on the issue, probably because it's so new. Her team did a review of the medical and legal literature on the subject, to come up with some guidelines for parents.

For now, she offered some advice on how to post wisely:

·      Never share pictures of your child in "any state of undress."

·      Be careful about posts that give your child's precise location.

·      If you are going online for help with your child's behavioral issues, keep any information sharing anonymous.

Be sure to understand the privacy policies of the sites you post on. Simply limiting your Facebook posts to "friends" is not enough, Keith said. If someone else is tagged in a photo, for example, the friends of that person may see it.

Keith says the review is not to scare parents from sharing family photos or bragging about their children’s accomplishments online, but to use caution in what you share and when.

"We're not saying 'don't share,' " she said. "Just share wisely."

That's not only to keep kids safe, but to respect their privacy, according to Keith.

With older kids, she said, always ask if it's OK to post a photo or share a story.

With younger kids, try to think ahead. "Look forward," Keith said. "Ask yourself, at the age of 14, will my child be OK with this? If you're in doubt, don't post it."

It's natural for parents to focus on their kids when they're using social media, said Dr. David Lloyd-Hill, chair of the AAP's Council on Communications and Media.

"If you're a parent," he said, "the most important and exciting things in your life are probably centered on your kids."

But while those posts may be well meaning, Lloyd-Hill agreed that parents should think before they share and take some sensible precautions.

The bigger concern, he said, is children's privacy, and whether the images and information parents choose to share will hurt their child in some way -- now or years down the road.

"Yes, we need to be monitoring our kids' social media posts," Lloyd-Hill said. "But we also need to look at our own."

Keith is scheduled to present her findings at the annual meeting of the American Academy of Pediatrics (AAP), in San Francisco this Friday. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

Story source: Amy Norton, https://consumer.healthday.com/health-technology-information-18/misc-computer-health-news-150/what-not-to-post-online-about-your-kids-716055.html

 

Parenting

Does Time Spent With Dad Make Babies Smarter?

1:30

A new study suggests that not only do dads play an important role in a baby’s social development; time spent with dad may actually increase baby’s I.Q.

In a small British study, researchers looked at how 128 fathers interacted with their infants at 3 months of age. When the kids turned 2, the researchers measured their mental development.

They found that infants whose fathers were engaged and active during play time, within the first few months of the baby’s life, did better on thinking skills tests at age 2 than other infants.

Many factors have a major influence a child's development, and this study wasn't designed to prove a cause-and-effect relationship. But these findings suggest that father-child interactions at a young age are an influencing factor, the researchers said.

Researchers noted that dad’s interactions had a positive influence on thinking skills for both boys and girls.

"Even as early as 3 months, these father-child interactions can positively predict cognitive development almost two years later, so there's something probably quite meaningful for later development, and that really hasn't been shown much before," study leader Paul Ramchandani said in an Imperial College London news release. He is a professor at the school's department of medicine.

Study co-author Vaheshta Sethna said, "We also found that children interacting with sensitive, calm and less anxious fathers during a book session at the age of 2 showed better cognitive development, including attention, problem-solving, language and social skills." She's with the Institute of Psychiatry, Psychology & Neuroscience at King's College London.

"Our findings highlight the importance of supporting fathers to interact more positively with their children in early infancy," Sethna said.

While dads may not always garner the attention moms and babies do, the positive impact that devoted and engaged fathers have, is immeasurable on their little one’s life.

The study was published recently in Infant Mental Health Journal.

Story source: Robert Preidt, https://consumer.healthday.com/kids-health-information-23/child-development-news-124/does-dad-time-with-infants-boost-babies-iq-723168.html

Your Teen

Are Today’s Teens Avoiding Adulthood?

2:30

Are today’s teens riding a slow boat to maturity? Compared to teens in the 1980s and 90s, this generation of teenagers are not in any hurry to grow-up, according to a new study.

In some ways, that’s a good thing. High school kids today are less likely to drink alcohol or have sex, compared to their counterparts a couple of decades ago.

However, they are also less likely to go on dates, have a part-time job or learn to drive – all conventional steps to adulthood.

Are these changes in development good or bad?  Actually, they are both, researchers said.  It depends on how you look at it.

Jean Twenge, a professor of Psychology at San Diego State University, said there are “trade offs’ to each path.

"The upside of slower development is that teens aren't growing up before they are ready," she said. "But the downside is, they go to college and into the workplace without as much experience with independence."

Being unprepared for work or college is definitely a problem for many of today’s adolescents, according to one specialist in teen mental health.

"I think if you ask any college professor, they'll tell you students these days are woefully unprepared in basic life skills," said Yamalis Diaz.

Diaz, who was not involved in the study, is a clinical assistant professor of child and adolescent psychiatry at NYU Langone Medical Center, in New York City.

Today's students may be sharp academically, Diaz said -- but they often have trouble with basics like planning, time management and problem solving.

The findings, published online in the journal Child Development, are based on nationally representative surveys done between 1976 and 2016. Together, they involved over 8 million U.S. kids aged 13 to 19.

On the upside, many of today’s teens aren’t attracted to activities that can be destructive such as drinking alcohol, drug and tobacco use and having sex at an early age. Those are important changes that bode well for young adults and make parents happy.

So why the change in attitude and priorities? It’s complicated. Technology has altered how many people, particularly teens, communicate. Many are spending less time in face-to- face conversations, choosing to text or post on social media.

Parenting styles have also seen a transformation. The “helicopter” or “hovering” parental style has gained in popularity. Some parents are involved so heavily in their kids’ lives that they make all the decisions for them and try to keep their kids from experiencing any type of failure.

In recent years, Diaz said, parents have become much more "child-centric," compared with the days when parents would send their kids outside with instructions to be back by dinner.

And while that is well-intended, Diaz said, kids today may have few chances to deal with relationships, work through their own problems -- and otherwise "stand on their own two feet."

"On one hand," Diaz said, "today's parents should be commended for sending their kids the right messages about what's appropriate for their age."

But, she added, "sometimes parents want to keep doing everything for their kids."

Diaz suggests that parents give kids the space they need to develop necessary skills, like problem-solving, time management and the ability to hold down a part-time job. She also advised parents to create some "no phone" time every day at home -- and to encourage their kids to do the same when they're with their friends.

Story source: Amy Norton, https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/are-today-s-teens-putting-the-brakes-on-adulthood-726634.html

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.    

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