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Daily Dose

Mom Judging

1:30 to read

This whole “mommy judging” is really becoming too much!  The latest involves Christy Teigen and her decision to go out to dinner 2 weeks after the birth of her daughter.  Why is she being judged about going out with her husband?  Even a new mother needs to eat!

When I am seeing a newborn for their first visit to the pediatrician I spend a great deal of time talking with the baby’s parents about the stress of having a newborn. While there are so many “highs” after bringing a new baby home, there are also the “lows” of feeling overwhelmed, sleep deprived, and feeling as if you aren’t prepared to be a parent (even after taking every class and reading every book).  For many parents just hearing that they are experiencing “normal” emotions is reassuring.  

During these discussions (while I am usually rocking that sweet newborn) I also inquire as to whether there are family or friends nearby,  or any other help in the home…knowing that “all hands on deck” can be a wonderful feeling when you just need a break, and yes, every parent, especially new parents need to have “a break”.  Whether that is a nap, or a long shower, or a quick trip to the store to pick up that special “sleep sack” you know will help your baby sleep…a break is healthy.  

A new mother also needs to eat and sleep to ensure that she is making milk in order to successfully breastfeed her newborn.  I remember being a new mother, even 30 years ago, and skipping meals because I was either “too tired”  to eat or “too busy” and my husband being wonderful and saying, “your Mom is going to keep the baby for an hour or two while we go out for a quick dinner!”.  While I am sure that I had a bit of trepidation about leaving our son,  and also figuring out how to nurse him just before we darted out the door,  I went!  The good news was that there were no cell phones or social media to interfere with our “new parent” quiet dinner out. i did not have to call home or text every 30 seconds to check on the baby, and my mother was quite capable of babysitting for an hour or two. No one was posting a picture of us leaving our baby, or commenting that I was “ a bad mother” for leaving my home….in fact, the whole event went unnoticed.  What I also remember is the feeling of re-connecting with my husband (who was also a new father), and having a quiet, nutritious dinner which re-energized us for another long day or night….

But now fast forward to 2016 and the CONSTANT connection with the world!!  Add in a celebrity who is being photographed day and night and whose every move is discussed and dissected. In this case being judged as a new mother for going out to dinner.  Christy did not take her new baby out to a crowded restaurant (you know how I feel about that), nor did she leave her baby home unattended.  She did not put her baby at risk at all. What she did do, was go out for dinner with her husband, albeit with lots of paparazzi following her. Going to dinner does not mean she “is an unfit mother”, it has nothing to do “with bonding with her baby” or “neglecting a newborn”.  So, she didn’t get to make a choice on her own, she didn’t put the issue out there for public comment either….she simply went out to dinner. Enough…leave her and other new mothers alone.

 

 

Daily Dose

2016 Goals

1:15 to read

Just finished cleaning up after the Christmas holidays and I resolved that I was going to “de-construct” the decorations before the next holiday…and not have to face the New Year with that task looming.  Now I can move on to some different resolutions!

The more and more that I realize how much time we all spend “hunched” over a screen of some sort, the more I think that this year should be about finding time to disconnect.  It used to be that you could just turn off your phone when you wanted to be “unavailable”.  That seemed so easy…people would just have to call back later, right?  But now we try text, email, g-chat, face time….all sorts of ways to try to connect.  It is much harder to be on the DL or unavailable. 

I continue to read new data on the need for personal communication via oral language, rather than a text or email. But the immediacy of communication these days makes it seem that we don’t talk any more, we just type!!  This is even becoming an issue for younger and younger children as they focus on their “baby”computers and screens that are given to them to watch…rather than on their parents and caregivers faces and interactive language.  There is already data to show that the interaction with a screen is not the same as that with a human….and that language may even be delayed.

So the point of this is that my resolution is to take time everyday to just disconnect from a screen and enjoy a bit of old fashioned solitude and quiet time.  I am going to get up each day and not rush to the computer to check any “late breaking” emails from overnight.  I am also  going to turn off the I-phone which as they taught me early on at the Apple store, is not really a phone but rather a hand held computer!  I hope that there may be an hour every morning and another in the evening when I am totally disconnected….I’ll let you know how I do. Don’t worry if you can’t “find” me….I am just off the grid.

What are your resolutions?

Daily Dose

Early Talkers

1.15 to read

Is your child a precocious talker?  Most children start to acquire words around 12-15 months, but that means 5-10 words and building. By the time a child is 18 months old they are often mimicking when you ask them to say a word, and some are putting 2 words together. This is all very normal development. But there are few children who are just “early talkers” who are speaking in full sentences by the time they are 18-24 months! 

I think having such a verbal child during the early toddler years is both a “blessing and a curse”. I know that from raising my own children, where my oldest was quite verbal by 20 months, and was “bossing us around” before age 2!!  I also see this same dilemma in my little patients.  While some parents are worried that their 2 year old does not put 3-4 words together, others want to know how you can stop the chatter.  Parents.....we always have issues. 

Example:  When I come into the exam room for a 2 year old check up, the precocious talker looks up and says, “Hi Dr. Sue...what took you so long?”.  Or they may tell their parent that they “don’t need any help” as I ask them to climb on the exam table. Recently a little boy looked right at his mother and said, “I’ve got this”, when I asked him to take off his shoes.  

On another day a little girl was impatient to leave and kept asking her mother if they could go to the park after they left my office.  The mother kept telling the little girl, “maybe” . Finally, exasperated, the 2 year old said, “what’s the answer, yes or no?””  How do you keep a straight face? 

A verbal child can bring you to your knees, both laughing and sometimes wanting to cry.  How can a 2 year old know just what to say to make a parent feel inadequate?  Is it inborn? This seems to be especially true if you have had another child and the 2 year old is instructing you on how to parent “their baby”.   

So, if your child is a talker write down all of those clever sentences they blurt out......one day you will look back and laugh.  I often saw myself in my 2 year old as he told complete strangers , “my mommy says my baby brother cries all of the time, and he has colic!”  Out of the mouth of babes, and I still remember it.  Bittersweet.

Daily Dose

College Kids Get Sick!

1:30 to read

All of the students are back in college and many of them are now getting sick with a myriad of illnesses …college is almost like adult “day care”…you catch everything the first year you are there.  But, the difference is, many of these students are experiencing their first illness away from home and their parents!

This makes for many interesting phone calls and emails from patients who are somewhat “lost” as to how to care for themselves now that they are away from home.  For the most part, many of their illnesses are just upper respiratory coughs, colds and crud which just needs a little “TLC” (tender loving care), but unfortunately most roommates are really not into that.  Many of my patients did leave for college with their “college medical kit” that I had recommended they take, so they have most of the stuff they need to make it through their illness…even though they are wishing their parents were there to bring them hot tea or make their favorite soup, or just to offer empathy.

Several have called or sent me pictures of their rashes, or even bumps, bruises and “unknown injuries” etc. and need to see a doctor. In this case, they can use the college health center….but that means making their own appointment and dealing with their insurance.  This is a new experience for many students, and some have called to tell me they “can’t get in to see a doctor” when they need to go.  Now for an acute illness I am sure there is “urgent care” somewhere on the campus.  If not,  many college towns probably have some sort of “minute clinic” inside of a chain drugstore where you can see a nurse practitioner.  This is just the beginning of learning to navigate the health care system and deciding the level of care you need.  I discourage them from using the ER for non life-threatening illnesses, although some of the students assured me “that they felt like they were dying because their throat was sore”, followed by “I just need you to call me in an antibiotic”, which they probably knew I would not do. But, being a teen/young adult, it is always “worth asking”, right?

On the other hand some of these students have chronic conditions and need ongoing care. The most common reason is the need for someone to follow them for their ADHD now that they have moved out of state.  Their college health center is equipped to do this, but it does mean you will need to schedule an appointment.  If the students have not planned ahead they are finding that they cannot get an appointment in the next day or two, and it may actually be weeks before they can be seen. Even though I discussed this with them prior to their departure for college (as I am sure their parents did as well) they are “surprised” to find that they may have to wait!!  In the interim they are having to do without their medication….which is difficult for them and a hard way to learn the necessity for planning ahead.

So…if this is your son or daughter or yourself (college patients of mine), plan ahead…get set up with the health center now…before the winter months and more illness. While you are there, get your flu vaccine!

Daily Dose

Diaper Dermatitis

1:30 to read

Newborn babies have the softest little bottoms and they also have a lot of poop! The combination often leads to a raw red bottom and a diaper rash. A newborn often poops every time they eat and sometimes in between....and you don’t even realize they have pooped again.

Even with the constant diaper changing (would you have believed you would use 8-12 diapers a day) it is very common for that newborn to develop their first diaper rash.  Not only will the skin be red and raw....it may even sometimes be so chapped that it may bleed a bit.  This diaper rash is causes a lot of parental concern and will often result in the new parent’s first of many calls to their pediatrician.

A new baby is supposed to poop a lot, so you can’t change that fact,  but you can try all sorts of things to protect that precious bottom and treat the diaper rash.  After using a diaper wipe ( non perfumed, hypo-allergenic) I sometimes bring out the blow dryer and turn it to cool and dry the baby’s bottom a bit. Then I apply a mixture of a zinc based diaper cream (examples:  Desitin, Dr. Smith’s, Triple Paste cream), which I mix in the palm of my hand with a tiny bit of liquid over the counter antacid.  (I don’t measure it:  just a lot of diaper cream and small amount of antacid so it won’t be runny).  I put a really heavy layer of this on the baby’s bottom.

If after several days rash is still not improving it may have become secondarily infected with yeast so I add a yeast cream (Lotrimin AF, Triple Paste AF) to the concoction. If it has yeast this should do the trick to treat all of the problems.

I will also sometimes alternate using Aquaphor on the bottom with the above diaper cream concoction.  It will take some time for it to totally go away but you are trying to get a barrier between the poop and the skin on the baby’s bottom. She keep something on there after each diaper change.

After a few weeks of constant pooping the number of stools do slow down and bit and that will help heal that new baby’s bottom as well. 

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Daily Dose

Teen Driving

1:30 to read

 It’s funny that I often find myself reading articles in the newspaper or online, or even watching a TV segment, only to find that an “issue” that I have thought was important for years is “newsworthy” again.  The most recent example being on the topic of teenage drivers and the importance of parental involvement.

I feel like it was not too long ago that I was talking to my own sons about driving….and at that time Texas did not have a lot of rules around getting your driver’s license, besides being 16 an enrolled in school. (thankfully the laws in Texas have changed since then).  So after much discussion about the perils of teenage driving and knowing that the death rate due to an automobile accident topped the list for teens,  my husband and I  came up with a driving contract (which I have shared with too many to count), which clearly outlined the rules and expectations for our sons when they began to drive. I can also remember the oldest looking at the 3 page typed contract and announcing, “ I am not going to sign that!”.  If I remember correctly my husband’s calm reply was, “OK - then don’t drive”. He is a man of few words..but very convincing. 

Fortunately for us, all of our sons did sign the contract, knew the consequences and started off driving our family Suburban…and never had a serious accident (so many prayers as they pulled out of the driveway).  One son did back into a fence, and another hit a car in a parking lot….but I felt fortunate that that was the extent of their accident history.  

According to a recent article in the NY Times there is a time to be a helicopter parent, and that is when your “child” begins to drive.  “In 2013, just under a million teenage drivers were involved in police reported crashes, which resulted in 373,645 injuries and 2,927 deaths”.  These statistics are probably under-reported, and it is estimated that “one in four teens are going to be in a crash in their first six months of driving,” and one would hope that these would be minor “fender benders”, which as we told our sons, do count as an accident.

The biggest risk for a new teenage driver occurs when you add passengers to the car.  According to Dr. Nicole Morris at the University of Minnesota  “adding one non family passenger to a teenager’s car increased the rate of crashes by 44%, and that risk doubles with a second passenger and quadruples with 3 or more”. If your teen is not distracted by their passengers they are likely to be using their phones to stay in touch with their friends….either by text, talking or by checking their various social media sites….all while driving. Although teens state, “ I barely take my eyes off the road”, anything more than 2 seconds can be deadly. Better to turn off the phone and all notifications before your teen hits the road.

Teens should be reminded that driving is a privilege, and parents of teenage drivers need to have ongoing discussions surrounding expectations for obtaining the privilege of driving. Parents need to be knowledgable about teenage driving and their states’ laws - and enforce those, (too many parents of my patients seem to ignore some of the laws - such as limiting passengers in the car). Even if your state does not have laws regulating a step wise progression to full driving privileges (so called graduated driver’s licenses), parents may adopt their own to help ensure their teens safety. Earning more and more independence can be proven with time and a good driving record and the adage, “nothing good happens after midnight still stands”.  

If ever there is a time to be a hovering involved parent it when your child begins to drive - it has been proven to save lives.

 

     

Daily Dose

Too Much Pressure to Play Sports?

1:30 to read

Does your child play a sport “after school”?  It seems children as young as 3-4 years of age are now involved in soccer and even football.  Some children are barely walking before they are signed up for a team.  Parents tell me various reasons for this including, “if they don’t start young they will be at a disadvantage athletically”, “if we don’t get on a team now, there will not be room for our child once they start kindergarten or first grade”,  and “our child wants to play and wear a uniform”. I just see lots of issues with burn out.

It seems awfully early to start “team sports” to me. I am a huge advocate of families and children playing together and learning all sorts of games and sporting skills. Kicking a soccer ball in the yard, or hitting the wiffle ball off of the tee, or having Dad throw a pass with the football all seems pretty “normal” to me. But organized sports with a 3 year old who is still in diapers….really?  Maybe one of the “guidelines” should be you have to be potty trained.  Yes, this is true, I see children in diapers who “will not pee or poop in the potty” according to their parents, but they go to soccer practice?  What is wrong with this picture?

So, while some of these well intentioned parents have told me that they are having fun being the coach, or attending games with other friends, their pre-school children “don’t have time to be potty trained”. They are too busy going to school, followed by organized activities that “it is just easier to let them stay in diapers”. I was even with a 4 year old at a football game and she was still in diapers?

At some point these children and parents will need to skip a practice or two and stay home long enough to get potty trained.  I am noticing that children are getting older and older before they are potty trained. I know there are books written on this topic with the philosophy that “the child will ultimately train themselves”, or “ how to potty train in 3 days, with a child who shows no interest”…or something along those lines.  But really, in my experience, if you watch your child’s cues, spend the time to “talk bathroom habits” and have the “time” to be home to potty train most children are potty trained between 24-36 months of age.  Yes, there are occasional children (none of my own) that just show interest earlier and say things like “I go potty now” and really do it on their own. There are also some who are more difficult to get interested and may be harder to potty train…but again, which is probably a more important life time skill…..getting out of a diaper or trying to figure out how to line up for a soccer game? I’m just saying.

Daily Dose

Tragic Accidents

1:30 to read

There have been several recent tragic accidents in the national news involving young children one of whom was injured while another died. Just the other day there was a death in our community of a young child who had been forgotten in the family car during the summer heat. I am heartsick for the families that have been involved in all of these situations.  But, I am even more sickened by the fact that there has been such a backlash against these parents and “shaming” rather than compassion.

I have practiced pediatrics long enough to have known several children who died in tragic accidents. Yes, accidents!   For my parenting “peer” group,  these accidents occurred long before social media, and the constant barrage of iPhone footage being shown on a news loop across the country 24 hours a day.  Fortunately, for my friends who lost a child, or for a child I cared for in my practice, the out pouring of sadness and compassion came from their family, friends and neighbors.  I cannot remember anyone “judging” these parents as we too all had small children and our whispered sentiments were often, “there but for the grace of God go I”.

If you are in the throes of raising your children, I would expect that you can remember and now   understand what your parents told you and mine told me, “accidents happen”. Fortunately for most of us these accidents involve bumps, bruises, stitches or even broken bones.  When that happens, I would heave a big sigh of relief that all of these “accidents” and injuries were “fixable”, even if they left a few scars.  (My boys were great at soothing my tears as they said, “scars are cool Mom”).

Fast forward to today and the sentiments seem to have changed.  Over the last weeks, I have watched TV and read different sites on the internet only to see and hear too many terribly mean and downright hurtful comments regarding the parents of the children involved in the accidents. Whether it was the child who fell into the gorilla enclosure who thankfully survived, or the toddler who was pulled into the lagoon by an alligator and drowned, or the child who died in a hot car….these are just unspeakable, tragic accidents. It doesn’t matter how many children you have, it is not possible to keep your child within arms reach, or to have constant eye contact with them from birth-21 years of age (and accidents happen after that as well). I just had an friend who lost her 29 year old son in a tragic accident on their ranch….I am heartsick for them. 

The definition of an accident is “an unfortunate incident that happens unexpectedly and unintentionally, that typically results in damage or injury”.  So, it is not a planned event, or even something that is preventable, despite all of the latest gizmos and safety features we wrap around our children. But when the tragic unforeseen accident occurs and a child is harmed, who are we to judge that parent or family. These were not cases of child abuse, or of a child being left unattended , or not riding in a car seat…these were all accidents that occurred within a few feet of the parents. Horrible, terrible, unfair and all accidental.

So, as both a parent and pediatrician I wonder what has happened to empathy in today’s society? Would it not be more appropriate for the parenting public to be saying ( or posting or texting or whatever)  “there but for the grace of God go I ”? These are the times you hug your child a bit tighter or call them to just check in and hope and pray that you never find yourself on the other side of an accident, because accidents can happen - even to great parents and happy children. 

Daily Dose

Play Together As A Family

1.15 to read

A report just published in Pediatrics emphasizes the importance of “play in promoting healthy child development”. This article serves as a reminder that children need free play time to help them learn resilience and creativity and is important in helping a child to develop physically, emotionally and intellectually.

The New Year is the perfect time to resolve to spend time together just playing! I have noticed that the weather has been pretty mild across the country and I imagine there are plenty of children who may have been lucky enough to have received a bike, scooter, skates, a swing set, basketball hoop, soccer goal etc. for Christmas.  Now is the time to gather the family and go outside and enjoy some of these gifts.

There really is not a better time to bond than during a game of basketball with dad, or flag football with siblings, or to have mom go outside and swing!   I was lucky enough to have received a new bike (big tires, few gears and a bell) as well as a new helmet and I am already enjoying some bike riding with all of my adult children and husband. We are trying to make a commitment to ride together every weekend.  (More about New Year’s resolutions later)

Studies have shown that as recess has been taken out of schools and with cuts to park budgets as well, our children are not getting as many opportunities for free play. Just that good “ole” unstructured time on the playground for a game of tag, or hopscotch or four square, as well as time to climb and jump on the playground equipment. All of the experiences help a child to be creative and imaginative with their play which helps them build confidence and resilience as well.

I know parents are busy and many are working harder with the economy being the way that it is. But, if a family will just try to take 15 – 30 minutes a day to turn off the computer or TV after school or on the weekends and go outside for a walk, run, or some  free-play it might become a good habit!  There are many inexpensive ways to enjoying playtime which may only require a ball, sidewalk chalk or a jump rope. Being a creative parent who values playtime will help to encourage your child as well.

So, make the commitment to PLAY more!  Sounds like fun to me.

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DR SUE'S DAILY DOSE

Enjoy your celebrations but PLEASE be safe!

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