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Your Child

Kids and Holiday Stress

2:00

Adults know that the holidays are most likely going to include several stressors such as never enough time to get everything done, family gatherings, money woes, traffic and gift shopping.

Kids feel stress too during the holiday frenzy, but sometimes they don’t have enough life experiences to know how to handle it or what to call some of the overwhelming feelings they may have.

During the holidays, there are lots of fun activities and events going on, both at home and at school. And while that can be a good thing, the reality is that all that hustle and bustle means schedules are often out of whack, bedtimes get pushed back, and routines are disrupted.

As a result, it’s inevitable that kids may feel some degree of holiday stress.

There are ways you can help your child glide through the holidays with less stress. Number one is to be an example of what you want to child to be. So, being calm is not only going to benefit you, but your child as well. This requires mindfulness about what is actually going on around you, what expectations you have and what you are projecting. As with so many situations, the way parents handle an issue can set the tone for how their kids will behave. If you let holiday stress get to you, your kids will definitely pick up on it, and child anxiety is more likely to be a problem in your house. To minimize anxiety in children during the holidays, take steps to handle your own stress and anxiety.

Overstimulation, tiredness and hunger can cause children to stress-out. It’s hard even for grown-ups to deal with noise and lots of stimulation when they’re not feeling their best; kids get hungry more often and become tired more easily, and may understandably have a tough time being on their best behavior. They are more likely to experience holiday stress when they’re exhausted or hungry. Take healthy snacks with you and schedule breaks to sit, relax and re-group when visiting malls or holiday celebrations.

Children like routine. The holidays can disrupt routines that are comforting and reliable, causing kids to feel anxious. To minimize holiday stress in your kids, try to get routines back on track once an event or party is over. For instance, if a school holiday concert or a church gathering goes past your child’s bedtime, try to stick to quiet, calm activities the next day and get your child to bed on time the next night.

Let’s face it; we all overindulge during the holidays. Too much sugar and simple carbohydrates can play havoc with our moods and weight. Kids are particularly sensitive to these food interruptions. Whenever possible, offer healthy snacks, such as air-popped popcorn or apple slices with cheese and crackers and limit cookies and candy to after-snack treats.

One way for kids to beat stress is to get moving. Fresh air and exercise are essential for boosting mood and re-setting the spirit, which can alleviate holiday stress and anxiety in children. Make sure you schedule some time to get your child outside to run around and play.

If your child is old enough, ask him or her to join in with decorating and holiday tasks. If you have to shop, ask your child to help you look for an item at the store (fun stocking stuffers for cousins, for example). Giving your child a task will not only boost his or her self-esteem, it’ll help by offering a beneficial distraction.

Creating a little quiet time during the holidays is helpful to parents and kids alike. Find a quiet corner and read a book with your child or create holiday pictures for grandma and grandpa. Take a walk outside in nature, away from noise and crowds and obligations.

A great antidote for holiday stress and the bloated commercialism of the season is helping others, whether it’s by shoveling a neighbor’s sidewalk, volunteering or by wrapping presents for needy kids at your local church. The season of giving takes on more meaning when the giving is your time and love.

Story source: Katherine Lee, https://www.verywell.com/holiday-stress-and-anxiety-in-children-620516

Daily Dose

Holiday Gifts

1:30 to read

Despite it being a busy “sick” season in my office, it is also a fun time of year. The office is decorated for the holidays and it is a great time to talk to my “verbal” patients about what they want for Christmas or Hanukkah. 

Discussing gifts serves two purposes, #1 it lets me get an idea of a child’s language and articulation and #2 it keeps me in the loop as to what to  buy for my nieces and nephews!!   (they always think I get the best gifts...they don’t know I have a bit of help from hundreds of patients).

So...the most interesting thing is that not ALL children want electronic toys and gifts.  There are still a number of patients who are telling me they want American Girl dolls, Tonka trucks, Thomas the Train sets, Legos of all kinds and for all ages, books (yes one 9 year old told me she has a list of 35 books she wants to get so she can get an award at school), Elsa and Ana dolls, and Transformers. ( wish I had kept all of that stuff my boys had...everything makes a comeback!)

There are also kids who tell me that they want an iPad (yes, even a 5 year old), iTouch, IiPhone, (I guess pretty much anything Apple sells), Minecraft games, Nintendo and XBbox, talking dolls and remote control drones.

So...what to get this holiday season?  

I would suggest that if you have a child who is 6 or younger you resist the urge to buy ANYTHING that requires batteries! This means that you go to the back of the toy store, past all of the new and “cool” children’s electronics and head for puzzles, blocks, books, Lincoln Logs, Tinker Toys, crafts to make jewelry, crayons, coloring books, board games.....dolls, push toys, Brio train sets, Matchbox cars, puppets and paints and easels.  The list of wonderful “old fashioned”, hands on creative toys is quite long. Toys that allow a child to use their imagination and create their own story, rather than one told to them on an electronic screen. 

There will be plenty of time for I-pads, Nintendo, remote control cars an dolls, but early childhood should still be about child’s play.

Good luck...I know you can do this!  Many of these toys will last a lifetime and no tears when the batteries don’t work!

 

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.   

Daily Dose

Lead Testing

1:30 to read

Lead exposure is young children may lead to long term consequences. Therefore, blood lead level testing has been recommended for all children at their 1 and 2 year check ups. Most doctors offices either prick a child’s finger or heel to draw the blood for testing, and many use an in office machine to perform the test.  

 

Some of the blood testing is performed by Magellan Diagnostics and the F.D.A. just announced that the 3 minute test run in many doctor’s offices could “yield inaccurate results when used on blood drawn from a vein”.  The F.D.A. went on to say “that there was no evidence at this point that the finger and heel prick methods have provided inaccurate results, and for some reason only venous blood has been associated with inaccurate readings”. 

 

I have already been getting some calls and emails from concerned parents wondering if their child needs to have repeat testing performed.  Fortunately, in our office we have routinely used capillary blood from a finger stick. We test that specimen for both lead and also a hemoglobin test to look for anemia.  You would probably remember a “venous blood draw” as it requires finding a vein (usually in the crook of the arm) and actually using a needle and syringe to draw the blood sample…a lot more difficult than a finger stick, especially in a squirming toddler.

 

We are all exposed to some lead in our environment, and lead levels under 5 mcg/dl as being “safe”.  If a child’s screening lead level is higher than 5, then most doctors will draw a venous sample to confirm the elevated levels and to then try to determine if the lead exposure is coming from the home, school, or environment. Infants and young children are especially vulnerable to the effects of long term lead exposure and lead poisoning, especially during periods of rapid brain growth and development. High lead levels may lead to long term effects on IQ and performance as well as affecting other body systems.

 

If your child is under the age of 6 years and you are concerned about the accuracy of their lead testing, you should call your doctor’s office and inquire if they had testing done on venous or capillary blood.  If there are concerns it would be appropriate to draw another sample from capillary blood or sent to an outside lab.  It is estimated that most of the testing performed in a doctor’s office was done on Magellan equipment which is used by about 10,000 pediatricians throughout the country.

 

Daily Dose

Playing with Your Children

Are you your child's playmate? It;s hard to entertain kids all day. FInd a balance for you and your child. It's healthy for everyone!On my day out of the pediatric office, I was able to catch up with one of my favorite daytime TV shows “The View”. The hot topic was a lively discussion about parents who are their children’s playmates.

The whole conversation started when Sherry discussed letting her son have a tantrum because she wouldn’t play a game with him while they were in an electronics store.  She had taken him with her while shopping for a computer cable and he wanted her to play a game. When she said no, he had what I term a “meltdown”. I know we have all been there before!  But it really seems as if more and more parents are faced with the dilemma that their children think that their parents are their full time playmates. I know as a working mother that I often “felt guilty” if I didn’t spend all of my “down time” playing with my children. But, as the boys got to be a little older, and I guess I got busier, I realized that my “job” as a parent was not to be their full time playmate. That is not to say that I didn’t play with them, I did.  And I also enjoyed every minute of it. But the reality of any parent having the time or energy to play tea party or superhero, all day every day, quickly goes away for most parents.  Being a full time playmate leaves very little time for a parent to do the myriad other jobs that parenting requires.  In other words, there has to be a balance. I think it is very important for parents to play with their children. That playing begins in infancy with just talking to your baby, which can actually be any sort of conversation. The best thing about a baby is that they just love to hear their parent’s voices, they don’t care what you are talking about. Enjoy this stage, as later on that precious infant will become an older child who probably tells you that your conversation is “boring”. As your child gets older, playtime involves putting puzzles together, building blocks, playing house or playing with train sets.  This doesn’t need to be an all day long project. It is often appropriate to start the puzzle and then let your child have some time alone to work on the puzzle, or begin the train track and let them use their imagination to complete the track. This kind of play takes practice and encouragement, as your child may continue to insist that you play for hours.  You as the parent can participate in play while at the same time teaching a child how to play independently. As a child gets older they can play for longer periods of time independently. Older children need to have playtime with their parents too. Often parents with older children have to convince their children to “play”.  Family time playing board games, cards, or charades encourages children to stay involved with their families.  Family game night or movie night works for all ages of children and can become a weekly or biweekly event.  Put the date on the family calendar and make sure everyone attends. Staying engaged with older children is equally as important as it is when they are little. Playing with your children is about balance.  Don’t be a constant playmate in the early years and remember to continue to play with your children as they get older.   It’s good for everyone! What do you do for fun and games in your house? Would love to hear your comments! That's your daily dose for today. We'll chat again tomorrow.

Parenting

Bedwetting Causes and Coping Tips

2:00

Most children will go through a bedwetting stage and though some kids get through it rather quickly, others take longer before they have consistently dry nights.

Bedwetting can also be a symptom of an underlying disease, but not typically. In fact, an underlying condition is identified in only about 1% of children who routinely wet the bed.

Bedwetting is not only difficult for the child, but it can strain a parent’s patience as well. It’s important to remember that a child that wets the bed doesn’t do it intentionally. Children who wet are not lazy, willful, or disobedient. Bedwetting is most often a developmental issue.

Did you know that there are 2 types of bedwetting? They are called primary and secondary. A child with primary bedwetting has episodes of bedwetting on a consistent basis. Secondary bedwetting is bedwetting that starts up after the child has been dry at night for a significant period of time, at least 6 months.

So, what causes primary bedwetting? It’s usually a combination of factors:

  • The child cannot yet hold urine for the entire night.
  • The child does not waken when his or her bladder is full.
  • The child produces a large amount of urine during the evening and night hours.
  • The child habitually ignores the urge to urinate and put off urinating as long as they possibly can. Parents usually are familiar with the leg crossing, face straining, squirming, squatting, and groin holding that children use to hold back urine.

Secondary bedwetting may occur because of an underlying or known medical condition or emotional problems. The child with secondary bedwetting is much more likely to have other symptoms, such as daytime wetting.  Reasons for secondary bedwetting can include:

  • Urinary tract infection: The resulting bladder irritation can cause severe pain or irritation with urination, a stronger urge to urinate, and frequent urination. Urinary tract infections in children may indicate another problem, such as an anatomical abnormality.
  • Diabetes: People with diabetes have a high level of sugar in their blood. The body increases urine output to try to get rid of the sugar. Having to urinate frequently is a common symptom of diabetes.
  • Structural or anatomical abnormality: An abnormality in the organs, muscles, or nerves involved in urination can cause incontinence or other urinary problems that could show up as bedwetting.
  • Neurological problems: Abnormalities in the nervous system, or injury or disease of the nervous system, can upset the delicate neurological balance that controls urination.
  • Emotional problems: A stressful home life, as in a home where the parents are in conflict, sometimes causes children to wet the bed. Major changes, such as starting school, a new baby, or moving to a new home, are other stresses that can also cause bedwetting. Children who are being physically or sexually abused sometimes begin bedwetting.

If your child suddenly begins to wet the bed after months or years of dry nights, talk to your child about it and your pediatrician. Your doctor may want to do an examination and bloodwork to rule out any health conditions. 

Most children do not stay dry at night until about the age of three.  And it's usually not a concern for parents until around age 6.

Bedwetting can be embarrassing for children. Be supportive and reassure your child that they won’t always wet the bed. Bedwetting often runs in families. If you want to share your own personal story, your child may see that people do outgrow it.

To help your child make it through the night dry, make sure he or she isn’t drinking a lot of liquids before bedtime. Make using the bathroom just before they get in bed part of a bedtime routine. Also remind them that it's OK to get up during the night to use the bathroom. Nightlights can help your child find his or her own way when they need to go.

Some parents wonder if they should wake their child up during the night to go. That’s a personal choice, however, keep in mind that if you deprive your child of rest and sleep, you may increase his or her level of stress. Stress can be a bedwetting trigger. Some children may also have a difficult time getting back to sleep once woken.

If your child wets the bed, you might consider getting a plastic bed cover to help protect the mattress.

If accidents do happen, try these tips to remove the smell and stains from linens, clothes and the mattress.

  • Try adding a half-cup to a cup of white vinegar to your wash to remove the smell from their sheets and clothes.
  • If you need to clean urine from a mattress, first use towels to blot up as much as you can.
  • Once you've blotted up as much of the urine as you can, saturate the entire area of urine stain with hydrogen peroxide. Let it stand for 5 minutes, and then use towels again to blot the area dry.
  • Once the mattress is dry, sprinkle baking soda over the entire area and let it stand for 24 hours. The next day, vacuum the baking soda away. It should be clean and odor free.

Bedwetting is one of those stages that kids go through that some day will just be a memory. Until then, reassure your little one that this too shall pass. Praise your child when they make it through the night without wetting the bed and let them know that if an accident happens, it’s OK – we’ll try again tonight.

Story sources: http://www.webmd.com/sleep-disorders/guide/bedwetting-causes#2

http://www.webmd.com/parenting/ss/slideshow-bedwetting

 

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