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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!

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Your Teen

Parents Need to Have the “Sex Talk” With Their Kids


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,


Daily Dose

Everything in Moderation

1:30 to read

How often have you heard the words, “everything in moderation”?  That was an expression that my parents taught me years ago, and I am sure that their parents used those same words.  It seems that those words hold true today as well, but unfortunately moderation seems to be “out of style” and excessive is a word that comes to my mind more and more often.

I see this so often in my own practice….beginning as soon as a new baby is brought into the world.  There are so many gadgets and gizmos available to new parents, and they are inundated with so many choices.   Hundreds of bottles, pacifiers, sleep sacks, diaper wipe warmers, not to mention state of the art video monitors to watch your child when sleeping or awake just to “ensure they are breathing”.  When you walk into a baby store there is NO moderation, and even I am confused and overwhelmed with all of the “stuff”. I honestly think this only serves to make parents more anxious….even before the baby arrives.

What about moderation and electronics?  It is very hard to keep electronics away from babies and toddlers as they begin seeing an iPhone or iPad from birth, if only for taking pictures. It isn’t too long before a baby can recognize themselves on the screen and want to look at their picture and by the time some children are 18 months - 2 years they know how to open and icon to see their family pictures.  I am not really too concerned about their use of electronics for looking at their own pictures. With that being said, sitting your baby or toddler in front of a screen for hours everyday to watch videos rather than reading them books is excessive and inappropriate. Letting your child watch 30 minutes of Sesame Street or Daniel Tiger while you get dressed for work or make dinner sounds like “life”.  I feel badly when a young mother calls me and says, “I feel so guilty I let my 2 year old watch a video today and I know I should not allow that but I am 36 weeks pregnant with twins and it is 98 degrees outside!”. What, that sounds perfectly reasonable to me….everything in moderation.  

What about eating and food choices?  I have so many parents who worry if their child “won’t eat” so they will let them dictate what they will eat.  The kids then often end up eating “only” chicken tenders, macaroni and cheese, spaghetti and pizza….but won’t try new foods or drink milk. While I like all of those “kid favorite foods” as well, only in moderation. Catering to a child’s food choices all of the time is not healthy and also does not teach your children to eat a wide variety of foods.  Excessive focus on food and worrying if your child skips a meal only makes mealtime stressful and often leads to unhealthy food choices for a long time. Moderation…one night chicken tenders and mac and cheese, another salmon and green beans. Don’t worry they won’t starve!

So…with all of this being said, you can see what I am talking about with my own patients and their families….old school, but it seems to make sense and may make a family’s life a bit less complicated.

Daily Dose

Twisted Neck?

1:30 to read

Under the heading of “continuing to learn” every day…comes a new case.


A patient of mine who is 4 years old was playing with his brother the other morning while his mother was making their breakfast. He was a “well child” and woke up in a good mood, ready to eat and go to preschool.  She could see the boys playing while she was cooking and then suddenly the 4 year old started to scream and cry that his “neck hurt”.  At first she thought “he was pretending or over reacting” as there did not overtly seem to be anything wrong. The only thing she noticed is that he refused to turn his neck and held his head in an awkward position.


He continued to cry and actually scream - so she tried to calm him down and gave him some ibuprofen as well. Despite this he would not move his neck and was unconsolable, to the point that she almost took him to the ER but instead she brought him to the office.  He was noted to be crying and seemed uncomfortable and refused to move his neck at all.  His exam was otherwise normal. Even with careful questioning there was no history of trauma. He had slept through the night before this had occurred. He had a cold several weeks before, but had since improved. He did not have a fever.


He seemed to be in such pain that he was sent for neck X-rays which were read as normal. But he continued to be miserable….so who do you call?? 


I spoke to a pediatric orthopedic surgeon and he said he really did not have any ideas. Next call, the pediatric neurosurgeon. After hearing the symptoms he immediately said that he thought this little boy had “rotatory dislocation/subluxation” of the two upper cervical vertebrae in his neck (C-1 and C-2). He explained to me that in most cases the displacement resolves spontaneously, but in some cases the child continues to be uncomfortable as there is associated spasm of the sternocleidomastoid muscle, which causes the torticollis. (twisted neck).It may be seen in children after a recent upper respiratory infection and is then called Grisel Syndrome.


Treatment for the acute condition…pain control and muscle relaxation.  This was all news to me and I had to go to textbook (online of course) to even read about the condition.  The neurosurgeon walked me through treatment and the child was sent home on a very low dose of valium and continued ibuprofen. When I spoke to the mother later that evening the child was already more comfortable and had started to move his neck. 


I called her the following morning and she said that he had not required any further valium and slept well and was actually on his way to preschool! WOW….I was thrilled he was better so quickly and that I was that much “smarter”. Wonder if I will ever see rotatory subluxation of the cervical vertebra again? I’ll be ready.

Daily Dose

Advice from My Mom

1.15 to read

I have been visiting my mother for an “early Mother’s Day” celebration and she and I spent an evening reminiscing about all of the advice she has given me over the years. The funny thing is that I often catch myself talking to my own children, and even my patients, and say, “I am sounding just like my mother”. The reason being is that she has given me a lot of good advice. 

The best advice which has stood the test of time is “do the best that you can and you can be anything you want.” Both she and my dad told me that, while they continued to support me as I pursued a career in medicine. Boy, was I lucky or what? 

She also told me “you should also always be able to take care of yourself.” That has also been great advice and something I have told my own children. The good news for me is that my children have listened to me (to date) and I am so proud of their work ethic, their integrity and their goals. They have made it easy to parent them. 

Another good piece of advice remains as true today as it did 40 years ago;  “never chase a boy (they always had to call first) and all of your dates must come to the door to meet your parents.” As a mother of sons, I told my boys how important it is to go to the door, make eye contact with the girl’s parents, introduce themselves, and to let the parent know that they are responsible gentleman and will always respect their daughter. This advice is timeless.  I saw it first hand when our oldest son went to ask his now father-in-law for his daughter’s hand in marriage. It made me so proud to hear how responsible and respectful he had been. (He listened!) 

Here are a few more “Jeanne-isms” worth remembering: 

-No white shoes before Easter or after Labor Day

-Stand up straight and hold your shoulders back 

-If you can’t say something nice, don’t say it at all  

I know you too have memories of wonderful mothers’ advice worth sharing. Keep passing them on to your children. Many are timeless, no matter what we used to think. 

Happy Mother’s Day to all!

Daily Dose

Commencement Speech Advice

1.15 to read

It is commencement season and I have recently enjoyed attending a few college graduations with a few high profile speakers. I have been privileged to hear both Condoleezza Rice at SMU and Robert Gates at University of Texas in Austin, both of whom gave excellent speeches.  

I was listening to another interesting speech given by Eric Schmidt at Boston University’s commencement which really hit home with me. Schmidt is the chairman of Google, and while much of his address was directed at the graduates and the many advantages that they would have as  “the first fully connected generation” he also made the comment that “computers, while exceptionally complicated, just don’t have a heart”.   

While he spoke eloquently about technology and connectivity and his belief that “technology can and has changed the world to be a better place”, he also realizes that being connected on line is not the same social experience as face to face discussions and interactions. 

In the middle of his commencement address he charges the students to “take one hour a day and turn that thing off!  Take your eyes off that screen and have a conversation, a real conversation. Don’t push a button saying you “like” someone, actually tell them.”  (while he is delivering the speech they are showing graduates riveted to their phones and texting rather than listening..very funny). 

Eric Schmidt and I have one thing in common, we agree on the importance of human to human contact and interaction. Turning off our computers, phones and iPads and sitting down to read a child a story or have a discussion about the world economy during a family dinner is necessary and important to stay truly connected. (Pick any topic for dinner table discussion). 

Singing a song to a child as you take them on a walk (rather than talking on the phone and ignoring the child in the stroller). Play a board game (not on line) or play cards as a family. The list is endless!! 

I encourage you to watch his commencement address and make this a topic of conversation with your children. Only 1 hour a day, but what an important hour! 

Try it and let me know what you think!

Daily Dose

Kids Say the Cutest Things!

1:15 to read

I am back post holiday with some of the cutest things I heard from my patients......this is such a great time of year to engage the little ones in conversation and they do “say the darndist things”.  

I was doing a check up on a 4 year old, precocious verbal little girl. The Christmas holidays are an easy time to chat about Santa and what a child is asking for.  When I asked this little girl she had a long, very specific list. I also asked her if she had gone to sit on Santa’s lap....she said she “had already seen him”.  Her mother added that the last time her daughter sat on Santa’s lap and he asked her what she wanted, the little girl looked right up at his sparkling eyes and said, “I just saw you last week, have you already forgotten?”.  

It is also the height of “sick” season so the office is really busy!  We also try to keep the well children away from sick patients. So, I was seeing a 6 year old for a check up and as I left the room I said, “I don’t want to see you for another year!”, to which the child looked at me wide eyed and said, “that hurts my feelings, I like to see you”.  

Do you have an “elf on the shelf”?  Why in the world did I not think of that clever idea....but as a parent you need a “year round” elf to help your children remember about good behavior.  When I asked a 5 year old little boy what he wanted for Christmas he quickly said, “an elf that I can touch and play with, my elf is boring”.  

I am thinking about a “bunny on the shelf”, what do you think? Might help change behavior for another 2 months of the a parent I think that is a great idea.



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