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  • Letting go and allowing our kids to be themselves

    My family and I recently went to a water park and had a great day. We swam in the wave pool, floated in the lazy river, and played on the water slides in the kid area. The weather was great and the crowds were low - it was a perfect family fun day.

  • Pain management options to provide children comfort after surgery

    A pediatric anesthesia team is tasked with the job of bringing children into and out of anesthesia for surgery and other procedures. When your child is in the operating room, it’s the pediatric anesthesiologist and the rest of the pediatric anesthesia team who ensure that your child is given the right combination of medications in order for them to drift off to sleep for the procedure and have a smooth recovery once the procedure is complete.

  • Reading aloud to your kids affects literacy and school readiness

    Did you know that by the time your child reaches the 3rd grade, experts can reliably predict whether he will graduate high school?

  • Preparing your child for kindergarten?

    Kindergarten is a big step in the life of a little person. Children are expected to get through their day with greater independence and meet academic standards. As an occupational therapist, I’d like to shed a little light on one of the “other skills” needed to be a great student.

  • Spray sunscreen: is it safe for kids?

    Consumer Reports has recently updated their recommendations on sunscreen use in kids, saying that spray sunscreens should not be used in children.

  • The vaccine schedule is safe and effective

    Pediatricians often hear from parents that they are worried about giving too many vaccines at one time and “overloading the immune system” of their infant. As a result, parents ask to “spread the vaccines out more.” As pediatricians, we know that the vaccine schedule outlined by the Centers for Disease Control and Prevention (CDC) and recommended by nearly all pediatricians is safe and effective. We don’t understand how some rogue physicians and some well-meaning, but ignorant public figures can contradict good science and suggest that the vaccine schedule that we use is unsafe.

    All scientific evidence says that the vaccine schedule

    is indeed safe and very effective.

    Many people draw the conclusion that it must be dangerous to give vaccines all at once. But in fact, that could not be further from the truth. There are very specific reasons that we use each vaccine the way that we do, both when they are started, and how and when they are repeated. What I will give you in this post and in subsequent posts is hopefully a clear, understandable explanation of the design of the CDC’s recommended immunization schedule.

    The Hepatitis B Vaccine

    The hepatitis B vaccine is the one immunization that we routinely give as soon as a baby is born. This is for two reasons. First, it works that early. Newborns’ immune systems are already up and running and are able to respond to the hepatitis B vaccine and make antibodies right away. This is a very fortunate thing, as many of our vaccines don’t work in a newborn body. What we know about hepatitis B is that almost all cases in children are caused by spread from an infected mom during birth. Many moms who are carriers of hepatitis B are missed during pregnancy or in the hospital, either due to lack of prenatal care, lab error, or lack of communication. The amazing thing is that the one dose of hepatitis B vaccine, if given right after birth, is essentially perfect in preventing infection of the newborn. The birth dose of hepatitis B vaccine saves lives every day. The other nice thing about that vaccine is that there are essentially no relevant side effects, not even fever or discomfort.

    The Two-Month Wellness Visit

    We start our next routine vaccines at the two-month wellness visit. When we immunize we want to be sure that enough of mom’s antibodies are out of the newborn’s system and that the newborn’s immune system has matured enough to respond to our vaccines. We know that in the first month or more, some of the vaccines don’t work well yet. However, by six to eight weeks they work very well; this is why the DTaP, Polio, HIB, rotavirus, and pneumococcal vaccine series start when they do.

    This is NOT because the immunizations would

    “overwhelm” the immune system if given earlier.

    They just would not be effective.

    Of note, the most common and relevant side effects of the vaccines given to infants are a little bit of diarrhea or throw-up from the rotavirus vaccine, and maybe a little fever, fussiness, or local reaction in the thigh muscle for the others.

    The MMR Vaccine Controversy

    The MMR (measles, mumps and rubella) vaccine is one that has received a lot of attention since it was wrongly accused of causing autism.

    In fact, vaccines have clearly and repeatedly been shown

    not to cause autism or other developmental disabilities.

    And yet, many parents still believe that we wait to give the MMR until a year of age because it might be harmful if given earlier. They then wonder if waiting even longer might be even better. The problem is that the younger you are when you get the measles, the sicker you get and the more likely you are to die. Our goal with the MMR is to protect small children as young as we possibly can, and to reduce the spread of disease in our communities.

  • Postpartum depression in young fathers

    A recent study published in the journal Pediatrics showed that young fathers, those who became dads at an average age of 25 years, have a 68% increase in depression symptoms within the first five years of becoming dads. This applied to young dads who lived with their children and their wives or girlfriends. Dads who lived away from their children and older fathers did not show that same increase in rates of depression. So why might “postpartum depression” happen to dads? Isn’t that a “hormonal thing” that happens to new moms? But now that we know that this is an issue, can we and should we do something about it?

    What could cause postpartum depression in dads?

    The study carefully made clear that these results only show an association between becoming a dad and an increase in depression. The results do not show that becoming a father actually causes depression in young dads, but it makes sense that it might. They don’t suffer the same physical changes that are going on in new moms, but lots of aspects of parenthood are very stressful for a young dad. First, they are sleep deprived; exhaustion is a known cause of depression. Second, they suffer a kind of loss of their mate. Now mom is busy loving another person, often more than she loves her partner/spouse. Young dads may feel displaced, jealous, and guilty about that at the same time. The relationship between mother and baby is so intense and so culturally unique and special, that a young dad may really feel like a third wheel. Young dads, in particular, may have been enjoying a sort of fantasy new-love relationship with their beautiful partner, and now all of a sudden the rest of life has to do with spit up, dirty diapers, less sex, and a great deal of long-term responsibility. Young dads are also less likely to be secure in their jobs and their income. They may not feel strong in their ability to provide for their new family. All of this can certainly contribute to depression.

    Why does this matter?

    Depressed fathers “read and interact less with their kids, are more likely to use corporal punishment, and are more likely to neglect their kids. Compared to the children of non-depressed dads, these children are at risk for having poor language and reading development and more behavior problems and conduct disorders.” According to lead study author Dr. Craig Garfield, an associate professor in pediatrics and medical social sciences at Northwestern University’s Feinberg School of Medicine, “Parental depression has a detrimental effect on kids, especially during those first key years of parent-infant attachment. We need to do a better job of helping young dads transition through that time period.”

    What can we all do about this?

    Just being more aware of how dads might feel when their babies are born is a start. So much of our focus is on the baby and on how mommy is doing. Dads are usually assumed to be fine, and to be there to help mom. The solution can start with the family and friends. Grandparents, aunts and uncles can offer to change a poopy diaper or two so that dads are not the only ones doing that. It may be a proud role for some new dads to be the diaper guy, but some may really hate it. Friends can take mom out for a walk so that dads can have some quiet, loving, alone time with the new baby if they want that. Or, if dad just needs to get out of the house for a while, friends can offer to watch over mom and the baby so that dad can get a break. Nights can be tough too, especially if dads have to go to work every day. Many young dads cannot afford to take leave from work when a baby is born, so they work all day and then try to spell mom during the night. Family and friends can spend a night here or there filling in for dad so that he can get a few full nights of sleep if that is an issue.

  • Are juice cleanses harmful to kids?

    Juice cleanses are widely popular among adults, especially women, as they are strategically marketed as a powerful way to detoxify the body and “reboot” metabolism, as well as provide a “jump start” in weight loss. As these juice products are showing up in more and more family-shared refrigerators, kids are starting to take notice and want to join in on the juice craze, too. Several recent news articles even highlight stories of young juice devotees, ranging in ages from 6 years old to 18 years old. One story even includes a mother-daughter duo that share a love for organic cleanses, who recently when on a five-day cleansing program because dad was out of town (because of course, I don’t think dad would approve!).

  • Does your child struggle with messy handwriting?

    Writing should be about the art of putting down your thoughts on paper. Whether a child is learning to write their name for the first time, draw a picture to share a story, or compose an essay for class, the most important part of any writing is the message itself. Handwriting that is difficult to read distracts and becomes the focus. So what happens when the mechanics of writing become such a struggle that the child is focusing all their energy on how to write rather than the writing itself? Where do parents go for help when their child just can’t seem to write neatly and every attempt ends up with tears? I’ve got a solution.

  • Emotional Eating: Parenting and its effect on our children’s eating behaviors

    I was asked to speak on TV recently about an article entitled “Eating Your Feelings? Your Mom Might Be to Blame.” Of course, for TV, the story had to sound catchy, so the TV host really played up the blaming mother and grandmother aspect. That made me sad; parenting is really a hard job and it is rough to be blamed for errors we make while doing our best. The data, though, really does suggest that how we were parented may affect eating behaviors and those of our children. The issue is important, since at least a quarter of preschool children in the United States are overweight. Obesity at the age of five is a very strong predictor of whether or not someone will be obese as an adult. So how we feed our young children and how we teach them to eat really matters for their whole lives. My take is that this information is not an opportunity to point fingers, but an opportunity to learn and to do better as parents.

    What the study has to say

    The article was based on a study done by researchers at the University of Illinois and published in the Journal of Developmental and Behavioral Pediatrics. It showed that primary caregivers (usually moms) who had an insecure attachment to their own mothers are more likely to have young children with unhealthy eating habits who are overweight or obese. “Insecure attachment” is a term from psychology that has to do with how we feel about parents who don’t respond consistently to our needs. Parents who grew up insecure tend to have more trouble dealing with their own children’s needs, especially when it has to do with negative things like distress, anger, or sadness. That in turn is connected with some unhealthy behaviors surrounding food and eating.

    Real life examples

    The study clearly showed that homes where children’s sadness or anger are dismissed are also homes where there are fewer family mealtimes, more television viewing time, and more “comfort feeding.” These behaviors are known to lead to obesity in even the youngest of children. For example, an overwhelmed mother might respond to a temper tantrum by feeding her toddler snacks to make him stop crying instead of using appropriate parenting techniques to deal with the tantrum. Another example might be the parent who puts her four-year-old in front of the TV to eat dinner instead of having a family mealtime, since the TV keeps the child quiet and makes her sit still longer than sitting at the table for dinner. Sadly, this also leads to overeating in the whole family.

    So, what do we do with this?

    Well, if you have a two-year-old who is already overweight, maybe there is room to work with your parenting behaviors around food. Look at how you respond to your child’s negative behaviors. Do you tell your child, “that’s nothing to be angry about?” Or do you find yourself saying, “don’t be sad?” Instead you could say, “I hear that you are angry” or “you seem to be sad.” It’s hard to do. If you need to, ask your pediatrician for suggestions to deal with (and to help your child to deal with) those negative feelings. Could you tolerate a little tantrum or some tears instead of abandoning the family table for a meal in front of the TV (we call it the brain sucker in my house)? Could you give up feeding your child snack foods or treats to console them when they are angry or sad? Could you let go of the expectation that your small child will sit still to eat and will clean her plate? Could you serve a healthy, well-balanced meal and deal with it if your “picky” toddler gives you a hard time about it or refuses to eat?