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Daily Dose

Teaching Your Kids About Their Private Parts

Why do parents give their child's private parts nicknames instead of real names? If you have a child who is over the age of 15 months I know that you have played the game  "where’s your nose, where’s your eyes, where’s your ears?” It is a favorite for both parent and child as a toddler learns to point to various body parts. This game is also an important milestone in observing a child process language (receptive speech) and follow a command.  But, what happens after your child has learned the usual body parts?   In other words, what about the rest of their anatomy, specifically their “private parts”.

This topic came to mind the other day while I was seeing a little girl who was complaining of burning and itching with urination.  This is not an uncommon problem in the 3-6 year old little girl set, and part of the physical exam involves looking at the child’s “private parts”. As I begin talking to both the parent and child I always start off with the statement, “I am going to look at your vagina, and it will not hurt”. I also say “no one else should pull your underpants down and touch your vagina. The only people that can touch your vagina are you, your mother or father, and the doctor. These are your private parts, they are covered by your underwear and never let a stranger or even a friend pull down your underpants”. It is important that this age child understand who may or may not pull down their underpants. But, with that being said, it is always amazing to me how many parents say, “we don’t call it a vagina or penis”, and on this occasion the mother said, “Dr. Sue means your bunny hopper!!”  Okay, really? What in the world is a “bunny hopper?”  Why would a parent not name the body parts correctly and where do these names for vagina and penis find their derivation? Over the years I should have kept a list of “secret names” for vagina and penis as I have heard many. From the “princess patch” to “peanut” to “bo-hiney” you name it, there seem to be many parents who either are uncomfortable, or just cannot bring themselves to use the correct word for genitalia. Even Oprah has her word, “va-j-jay”. I submit that we go back to the correct anatomical name. It is so important to teach your children the appropriate words for penis and vagina. Just as they learn eyes, ear, nose, knee, foot, toe they need to know the names of their “private parts”. If you begin with the correct words it never seems awkward or uncomfortable and is no different than naming any other body part. You will be surprised at how easily your child accepts these words, but uses them appropriately too.  It is also important to name body parts correctly, especially if there is ever a question of inappropriate touching or abuse, in order that a child can correctly explain what happened. I still have to laugh when I hear all of the different names a child hears when a parent discusses genitalia, it must be confusing.  But regardless of what you name it, a penis and a vagina are private parts and need to be covered by our underpants, keep repeating that message to your child. What do you think? Would love to hear from you!

Daily Dose

Childhood Headaches

A child complaining of headaches also causes a lot of parental concern, as we often jump to the worst conclusions.Headaches are a very common complaint during childhood. A child complaining of headaches also causes a lot of parental concern, as we often jump to the worst conclusions (something about human nature?). The prevalence of any type of headache ranges from 37

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Daily Dose

Should your child get their MMR ahead of schedule?

1:30

Most of the discussion about the current measles outbreak revolves around those who choose NOT to vaccinate. But on the other side of the story anxious parents have called me and are wanting to make sure their children’s MMR vaccine is up to date. In fact some are so anxious they want to vaccinate their children “ahead of schedule”.  

One mother has an almost 4 year old, who had their first MMR on schedule when her son was 1 year.  She called and asked if she could bring him in 3 months before his 4th birthday, “just to make sure he is okay”. I assured here that there was not an indication to vaccinate him early and that I would see him later this spring for his routine check up.  She was relieved...as was he.  (he is not looking forward to that 4 year old visit!)

Several other parents have called and asked if they should bring their 6, 7 or 8 month old child in to have their MMR even before their 1 year check up. The current recommendations have not changed and the MMR vaccine is still being given at 12 months of age and then a “booster” dose at 4-6 years of age. There are recommendations to immunize children between 6-12 months of age who are traveling internationally. Many countries have far more measles cases than what we currently seeing in the United States.  For information on travel and measles vaccine go to www.cdc.gov.

I do remember being a young physician in the late 80’s when there was an epidemic of measles. The first time I saw a case of measles was in 1990 and I myself had a young baby at the time. There were over 55,000 cases of measles in the U.S. and over 120 deaths. Due to the extent of this measles “epidemic” a recommendation was then made to give any infant over 6 months of age a measles vaccine, knowing that they were not getting fabulous protection, but better than none. This group, including my now 25 year old son, then received MMR vaccine between 12-15 months, and again at 4-6 years.  

So...stay tuned, with new cases now cropping up in infants in a day care center in Chicago, and several more suspected cases in other areas...this story is unfortunately not over.

If you do NOT know you or child’s vaccination status.....it doesn’t “hurt” to get another MMR.  

Daily Dose

Teaching A Child Boundaries & Limits

1.15 to read

"Boundaries" and "limits" are two words that every parent needs to have in their vocabulary, just the same way that every child knows the words "no" and "mine".

It comes naturally to a toddler to learn the word NO, and to shake their heads when they don't want to eat the peas or take a bath or go to bed. Right after NO, they somehow magically learn the word MINE, and life really changes for parents. Now that sweet, precious toddler is empowered and has the world on a string, or at least their string. Very soon after your toddler learns their important jargon, it is important that parents start enforcing age appropriate limits and boundaries. A toddler running off from their parent who is standing line at Starbucks looks very cute with that impish smile of "are they going to get me?" But a three or four year old who darts in and out of line, and not paying any attention to others around them is not as cute. Where are their parents who need to put them back in line with a firm, "NO", and stop them from tearing up the store? Boundaries and limits must begin at a young age, but should be age appropriate. You cannot expect a three year old to sit through a two-hour dinner at a fancy restaurant, or a six year old to sit still through an entire opera (despite the fact that their grandmother thinks they should) or even a 12 year old to go to five family holiday parties in a day (maybe two?) But without teaching your children the lessons of limits, boundaries and consequences when they first venture out into the real world, you cannot expect them to listen later on as they continue to test both their limits and yours. That's your daily dose, we'll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

A Little TLC Goes A Long Way

Just what is TLC and how can it help your child feel better quicker?I can tell that I am aging!!  Not by the new “character lines” I see popping up (hate that), but rather by the way that language and jargon continues to change. I really have tried to stay up with new acronyms such as LOL, or POS, or even “keep it on the DL”.

But while we “mature” adults feel the need to keep up with the younger generation’s “language”, some of the older acronyms seem to be fading away.  I realized this today when I was seeing a young patient and his mother. The cute little 5 year old boy had one of those nasty winter time viruses with a fever and a cough. After finishing his exam and doing an influenza test on him (it was negative) I told the mom that the best way to treat his virus was with fever control and a little TLC.  She gave me this blank look and said, “is that a brand of cough syrup?”  I didn’t know whether to laugh or to cry. I thought that TLC was a universal acronym for all mothers (or maybe better put for parents) as even my own parents and grandparents would say, “you just need a little TLC”. For those of you who have read this far and still don’t know what I am talking about, TLC is the acronym for “tender loving care”.  What better way to treat your feverish, coughing, uncomfortable child, than with a little TLC. When my own children are sick, even now that they don’t all live at home, they still all want some TLC.  As much of a rule follower that I am, when your child is sick, the rules get broken for a while. That means that children get to sleep in their parent’s beds (I often moved after a few wild kicks and thrashing), but one parent remained with the feverish child sleeping next to mom or dad. There were all sorts of “forbidden fruits” given to a child who was sick, such as “slurpees”, ice cream and popsicles in bed, favorite foods all day long and even television without a  time limit. The homework might not get finished due to a fever and general “feel bads”, and the list of things to do just went away for a few days while a child was sick.  It was one of those lovely parenting moments when you could just “turn off the time” and snuggle with a sick child. In other words, lots of TLC. TLC has nursed many a child through numerous illnesses over the years.  I don’t think the directions for TLC have changed.  Just do anything that makes your child feel better. Games in bed, making cookies and jello to eat after an afternoon nap, and even getting to have a special TV tray to use while eating chicken noodle soup.  These “comfort foods” and pampering do make anyone who is sick feel a little bit better.  There are even studies to confirm this. So, remember TLC is not a new fancy cough syrup. It is the “tender loving care” a parent gives to a sick child. Some things never change with time and TLC is one of them.  Best of all, no need for a prescription or a copay! That’s your daily dose for today.  What’s your favorite TLC remedy for your kids? Comment below to share with all of us!

Daily Dose

Bug Spray & Bug Bites!

1:15 to read

 It’s that time of year again when the bugs start to return from their “off season vacations” and pediatricians start to see children who are suffering from uncomfortable bug bites.

The best way to prevent bites from the myriad of insects including mosquitoes, mites, chiggers, flies and fleas is by using an insect repellent. Insect repellents do not prevent bites from stinging insects such as bees, hornets and wasps. The AAP recommends using bug sprays in children who are older than 2 months of age when necessary for preventing insect bites during outdoor activities. The most common insect repellent is DEET, a chemical that has been studied for over 50 years. Most of the OTC bug sprays contain DEET in different strengths. The higher the concentration of DEET, which typically ranges from 5 – 30 %, the greater the protection and length of effectiveness. I usually recommend starting with the lowest concentration of DEET, which typically provides protection for 1-2 hours, and use a higher concentration as needed for longer protection.

The number of bites a child receives and their reaction to bites are different in all children, so each child may need a different concentration of DEET to be effective. With concentrations of DEET above 50% (not recommended for children), the effectiveness and duration of protection actually plateaus, so there is really no benefit from higher concentrations.

Another product approved for use in the U.S. about 5 years ago is picardin. Picardin provides similar protection in both duration and effect to DEET. Cutter, Skin So Soft and Off all have some products containing 7-10% picardin. The advantage to picardin containing products is that they are odorless (unlike DEET) and do not feel as greasy on the skin and are less likely to cause skin irritation and damage to fabrics . With all products you must read the labels to see what you are getting. There has been some recent data on the use of natural products such as oil of eucalyptus which the CDC has found to be comparable in its duration of effectiveness in preventing mosquito bites, to lower concentrations of DEET. It may also work well against ticks (Repel).

Eucalyptus oil may be poisonous if ingested in large quantities and should not be used in children younger than 3 years of age. Other studies have found that 2% soybean oil (Bite Blocker for Kids) has similar levels of protection to products containing 5-15% DEET, and may provide up to 90 minutes of protection from mosquitoes. This may be a useful product for short term exposures. Chemical repellents containing permethrin kill ticks on contact but should never be applied to the skin, but may be applied to clothing. Insect repellents should not be reapplied throughout the day, as is sunscreen. Parents should be instructed to spray the insect repellent on their hands first and then apply to their child and do not apply to the areas around the nose and mouth. 

It is a good idea to wash the repellents off with soap and water at the end of the day. That’s your daily dose for today. We’ll chat again tomorrow.

Daily Dose

Common Newborn Questions Answered!

Dr. Sue answers common questions about newborn babies.Well, it seems like it takes more than one column to discuss the first days home with a newborn baby.  After discussing the nuances of breast feeding, there are also many questions regarding all of the noises that babies make.

Everyone thinks that infants are pretty quiet, that is until you sleep with a newborn in the bassinet right next to your bed.  Newborns are noisy!!  They not only cry (that is a whole other topic) but they squeak, grunt, stretch, yawn, have weird breathing noises, hiccup and pass tons of gas. (Dad’s are so cute when they say, “there is something wrong with my baby girl as she FARTS and it stinks, this can’t be normal?”) The first thing that many parents will notice is that their infant has “weird” breathing patterns. The baby seems to take some rapid breaths and then pauses and it looks like “they have stopped breathing” for a few seconds, and then resumes their more normal breathing.   This is called periodic breathing and is quite normal for the first few weeks of a baby’s life.  I swear only first time parents notice this, as you have the time to watch your precious baby and count their breaths. Every subsequent baby in the family is equally loved, but is typically not under the microscope like a first born and we only notice that they are ‘’’breathing”.  As an infant matures so does the breathing pattern and the respiratory rate becomes more rhythmic. If your baby has any color changes, i.e  turns dusky, or blue with their breathing that is a cause for immediate concern and a call to the doctor or 911. Another common concern is often how many times a day a baby will hiccup. If you remember, the baby often hiccupped in utero, and this too continues after they are born. Babies seem to hiccup for an inordinate amount of time, which bothers parents, but usually seems not to faze the baby at all. It is fine to try and give your newborn water if they are hiccupping and it is really bothering either you or them, but is not necessary.  Just like an infant’s startle (Moro) reflex, babies seem to get the hiccups when they are younger and they slow down as the baby’s nervous system matures.  A baby may hiccup for minutes to an hour and then just stop and fall asleep, oblivious to the concern that this event has caused their parents. Babies also make a lot of stretching and grunting and groaning noises, and are perfectly comfortable.  But these noises will awaken a sleeping parent.  If your baby is not crying during all of these noises, I would not pick he/she up, but would wait to see if they then go back to sleep. Some of these noises occur even while a baby is sound asleep. In this case the adage, “never wake a sleeping baby” is good advice.  These noises do not necessarily mean a baby needs to eat, especially if you think they may have just eaten an hour ago. Again, your baby should not appear in any distress or have color changes, they are just noisy! Lastly, GAS!  All babies have gas, and no one knows that until they have cared for a newborn.  It does not matter if a baby is breast or bottle fed, they produce gas, and it is loud and may be stinky. I think that infants produce more gas in the first 3-4 months of life than they will again until they are old (grandparents age, ask them). It seems like so many things occur both early and later in life, and gas is just one example. As a newborn’s GI tract matures, they seem to produce less gas, and are also often more comfortable after a feeding. When a baby is “gassy” they often like to have movement, so they like to be rocked, or put on their tummy and patted (only if awake, never to sleep), and they may enjoy the swing, or the motion of riding in a car, or putting the infant seat on top or a vibrating washing machine or dryer.  There are many “home remedies” but maturation of the GI tract just takes time. In most cases, changing an infant’s formula or a mother’s diet will not change the gas, but many people will try it. Remember, this too shall pass! 
(no pun intended) That's your daily dose for today.  We'll chat again tomorrow. Send your question or comment to Dr. Sue!

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 year....as a parent I think that is a great idea.

 

Daily Dose

Teen Drivers

1:30 to read

As you know, when teens start to drive, I am a huge advocate for parent - teen driving contracts. I wrote my own contracts for my boys but I recently found a website that all parents who are getting ready to have teen drivers need to be aware of.

Injuries from motor vehicle crashes are the #1 cause of death for teens in the United States.  Studies have shown that having limits and boundaries in place for new drivers reduces the number of motor vehicle accidents that new drivers experience. Although not all states have “graduated driver’s licenses”, all parents can have discussions about the privilege and responsibility of driving and set their own guidelines for their new teen driver.

The website www.youngdriverparenting.org was developed by the National Institute of Child Health and Human Development and is an interactive site for both parent and teen.  The program is entitled “Checkpoints”.  The website includes teen driving statistics to help parents keep their teen drivers safe as well as giving information about state-specific teen driving laws.

The site has a great interactive component to help parents create their own parent-teen driving “contract” that addresses such things as teen driving hours, number of passengers allowed, and boundaries for driving. These parameters can be modified as the teen becomes more experienced and meets the “checkpoints” that were agreed to.  It is a great site as it not only gives you a template for the agreement, but sends emails as the allotted amount of time has passed for each step of the contract.  You don’t have to remember what you and your teen agreed to, they email you and then you and your child can revisit the agreement and expand it over time as your driver becomes more experienced.

Instead of handing out my “dog eared” old driving contracts that I wrote for my boys, I am now going to send my patients to this site (which is also being sustained by the American Academy of Pediatrics).  

Teen drivers whose parents are actively involved in monitoring their driving are not only less risky drivers but know ahead of time what their parent’s expectations are. Having a teen involved proactively with driving rules is far preferable to regretting that limits, boundaries and parental rules were not discussed prior to allowing your new driver on the road.

The website is not only free it is also evidence based, and within 5 - 10 minutes of reviewing the site a family is set to go with their own checkpoint agreement.  Here’s to teen driver safety!

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Can essential oils boost your child's immune system and fend off colds and flu?

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Can essential oils boost your child's immune system and fend off colds and flu?

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