Rx For Parenting Today

Another Dangerous Object Children are Swallowing

When Children Swallow Foreign Objects

A recent pediatric report stated that there has been a marked increase in ER visits for children who have swallowed foreign objects. Boys are being seen more often than girls.  When I had my pedaitric practice, I was amazed at what some of  the things my patients swallowed. One child swallowed a razor blade, another swallowed a safety pin that ended up in his trachea. A doctor friend's little grandchild swallowed a piece of raw carrot. (The mother didn't like to cook  and often gave the little boy chunks of raw carrot.) He had to be rushed to the hospital to have the chunk removed from his lung. Unbelievable. A child on an airplane tried to swallow a peanut which fortunately I was able to remove. Not only do children swallow common foods or objects, but toys and other things that contain magnets are causing terrible damage when a child swallows the magnets. One patient of mine swallowed dishwasher detergent and had to  have  part of his feeding tube or esophagus replaced.  Another child saw an open coke bottle in a neighbor's yard and swallowed some of the liquid. It was a caustic liquid to use in the garden. This child, too, had to have major surgery. 

There is a museum in Boston, I  have been told that contains objects children have swallowed. Medications found in bedside tables, medicine cabinets, or visitor's purses have and can cause a lot of problems.  I think the answer for parents is to teach their children that putting things in their mouths other than food the parents can supervise may lead to a lot of trouble. My children heard countless tales from me about the children whose stomachs I had to pump out because they had swallowed harmful substances. They both learned that was not something they ever wanted to happen to them!

Manners, Morals and Ethics

It must be hard these days to know how to raise a child who has good manners, moral, and ethical values.  Children usually mimic what their parents do. If they see their parents being rude to a sales clerk or someone else, they suppose that is O.K.  If parents are unkind to someone, that too is noticed by their children. I was in a store one early morning when one of the workers told me how she  had been treated by a father the day before. This particular woman was a temporary employee because she was waiting to move to  another city where her husband had been sent. I had been impressed by the  woman when she told me she had a master's degree and written two novels. Apparently, this father was taking his child to school, but had stopped at the store to get something. He said to his daughter, "See that woman behind the counter, that  is why you have to get good grades so you don't have to do what she is doing." I was appalled and wished I had been there to tell the father what I thought. How rude can someone be? 

I have had several parents of children with disabilities tell me about some of the things said to them. One lovely mother and her daughter were leaving church when a woman came up to her and said " You have offended God because you have a disabled child."  Unbelievable when the woman had also  just come from the church. One of my favorite teenagers told me that he would love to have a girl friend but he had heard  one girl tell another  one that " He is probably funny in the head since he has to walk with crutches."  

Kids also copy the way  parents obey the law. If you never stop at stop signs, cheat in other ways and assume the law does not apply to you, how do your children learn what is right and what is wrong? My father was not a warm,  hugging man but he certainly taught us what was right and what was wrong.  As a college professor, I am sure his students quickly learned that cheating was unacceptable. He would  have been appalled at the college admissions scandal we are seeing today. What were these  parents thinking?

 

 

 

Measles and Other Immunizations

It must be hard to be a parent these days and have concerns about all the immunizations  your children need to have. This is particularly true if you have friends who are refusing to  have their children immunized. Some states and cities are  not allowing children to attend school unless they are up to date with their immunizations. With several quite large measles epidemics recently in the U.S., I would certainly prefer to live in a state where children cannot go to school if the parents don't allow immunizations.

I took two weeks off from work when my daughter had measles. This was before there was an immunization for measles, as well as other bad communicable diseases. Measles can be very serious with bad complications, as can chicken pox, mumps, German measles etc.  Instead of worrying about all the shots a child has to be given, I wish parents could have  seen some of the children I had to care for when I had my pediatric training and in my early days of practice. Watching a child suffer, when he or she could  have been given a shot to prevent a disease, is very painful. I cared for one boy who had muscular dystrophy and then mumps that left him deaf. Not only did he have one serious disorder, but being deaf in addition was a terrible burden. I wonder how you could be the doctor for a child whose parents refuse immunizations. I hope these doctors will take time to explain some of the terrible problems that can occur with polio, measles, whooping cough etc. If you are a young doctor and being trained in a medical program that relies much on computer training, I'm not sure he or she will realize how important immunizations are for kdis. 

What to do about Anger in Small Children

The mother of a three-year-old came to see me about her little boy. She said he always seemed angry and she didn't know what to do. I had never seen the child and said the first step would be for me to examine him. Anger can have many causes but three-year-olds are usually wonderful little people, one of my favorite ages. When the child came for an examination, there was no question that he seemed angry. He didn't want to play with any of the toys in my office or listen to any of my many music boxes. It took a while to examine him but first I gave him a crayon and paper.  He took the crayon and made deep, long lines. Then by having him sit on his mother's lap, I was able to do a fair examination. I knew my next step would be to get a blood count and urinalysis and then refer him to my favorite child psychologist. It took a while for her to finish testing him, but the report did not surprise me. The little boy was on the autism spectrum. I also had his hearing tested which showed he had a considerable hearing loss. This is not unusual for a child with autism and  a hearing test should always be done. 

We referred the little boy to the Regional Center where they have some good programs for children on the autism spectrum. They also usually have good social workers who work with the parents and make any needed referrals. A good social worker knows local resources and can be very helpful. Fortunately, the parents wanted to do everything possible to help the little boy. If one or both parents  deny a problem exists then the schools often have to be the ones to insist something be done. I  have seen this occur several times. Sometimes the parents resist but if they want their child in school, they usually decide to do what  the school personnel require.  

 

Raising Children in this Money/Celebrity Culture

It must be very difficult to raise children in these days when money and celebrities seem to rule. Now that we  have a TV celebrity president and billionaires running the country, how do  parents who care about raising caring, moral children make it from day to day? I was amazed and appalled at the accounts of parents who paid thousands of dollars to ensure their children were admitted to so-called elite colleges.

There is a wonderful non-profit in San Diego, A Bridge for Kids, that helps low income children with tutoring, computers, and even college tours to get into college. These are students that would never have a chance of going to college without this help. Just think of how many low-income students could have been helped with the thousands of dollars spent by parents on bribes to get their children into these rich, celebrity colleges. The daughter of one celebrity, whose parents paid an  enormous amount of money in  bribes for her to get into USC, said partying at college was her focus. Unbelievable! 

When I applied to Stanford it didn't occur to me that money would play such an important part for  so many of the students. I had worked as a waitress after school and weekends all through high school. I didn't  think about how I was going to pay the tuition at Stanford, but fortunately my college professor father had a colleague at Scripps College who started a scholarship for me and other women students who wanted to go to medical school. The Mary B Eyre scholarship is still active at Stanford. When I started Stanford I found I could wait on tables in the dining room of my dorm and I also worked in a small dorm store. In addition, I worked in the summers. I felt a strong disconnect between those of us who were "hashers" and the affluent women students we served. Most were there to find a rich husband, I heard.  I had never been exposed to wealth, being raised in a small college town where  most of my  friends were professors' children. 

I believe parents  do great harm to their children if money and only associating with rich  people is what they are taught.

The Devastating Effects of Measles

The New York Times on 2/12/19 had an excellent editorial on measles. They noted that the U.S. was measles free in 2000. Then Dr. Andrew Wakefield in England came up with the false claim that autism could result from vaccinations. He subsequently had his British license revoked and is now in Texas. He  met with Trump after the election.

Because so many parents have decided to not vaccinate their children, we now have had several new outbreaks of measles. So far 500 children have died from this disease. Many more have had bad problems with it. I do not understand how any parents could allow their children to possibly have measles encephalitis or other serious complications. When my daughter was in kindergarten in Rochester, New York, before we had a measles vaccine, a doctor's wife brought her ill son to Jennifer's classroom.  Of the 22 children in the class, only two escaped being infected by the virus he carried. Jennifer had a very bad time and I stayed with her the many days she was ill. The virus is very infectious and can cause great damage to a child. It  must be hard for a doctor to have parents who will not vaccinate their children. I would not be able to take care of children like this were I still in private  pediatric practice. Not only can measles cause great damage, but so can mumps, whooping cough, and other childhood diseases. One of my muscular dystrophy patients became deaf from mumps. It was before the vaccine was available and I know his parents would have had him vaccinated had the vaccine  been available. Polio still is found in a few countries and it hurts me terribly to know that polio could happen to U.S. children with  the rapid airplane travel from these countries and the decrease of immunizations in the U.S.

Teens Concern About Depression and Anxiety

I worry that so many parents these days seem more concerned about how their kids perform and look rather than about how the young people are feeling. There was a startling article by Karen Zraick in the 2/26/19 New York Times. She discusses a survey from the Pew Research Center finding that 70% of teenagers were concerned about mental health issues. These included depression and anxiety. The article noted that social media, academic pressure, terror attacks, and school shootings were causing  a lot of anxiety. An important statement in the article was that "A study in 2017 found admissions for children and teens to hospitals for suicide and self-harm had more than doubled from 2008 to 2015." This is frightening. So what can  parents do to watch out for their teens and make a difference in their lives?

I  found in my many years of practicing pediatrics that teens need someone they can talk to who really listens. I had many patients who pretended to have a sore throat or not feel well come to my office, They just wanted and needed an adult to  talk to who listened and was not judgmental. They also want guidelines and advice about how to handle problems they were facing. I still hear from quite a few of these teenagers and am always glad to know what is going on in their lives.  It was a compliment that many of my two children's friends liked coming to our house rather than going home to their often quite elegant, affluent homes.  Children of the wealthy face a lot of burdens and often find the pressure is just too much. I was fortunate to be able to have both a good psychologist and a good psychiatrist to help with some of the most desperate kids. I felt the best gift I could give my children was to let them be the person they wanted to be, support their various activities and  establish boundaries. I was able to say "No" when it was needed and loved having them. 

 

Colleges and Students' Mental Health

I was delighted to see an article in today's New York Times  saying several colleges, including UCLA, are adding personnel to care for their students' mental health problems. This is long overdue. I hope some of the prestigious Eastern colleges will follow suit. Many parents these days are putting so much emphasis on their children going to prestigious colleges that I worry. I remember in my Stanford medical school class of 62 students that two of our class committed suicide. This is becoming more and more common in both undergraduate and medical school classes. What a tragedy to see the life  of bright, capable students end when mental health counselors should have been available. Sadly, as in the New York University case of suicide, the student was seen by a nurse practitioner in the health service and given medicine, but not referred to a physician, a psychologis, or a psychiatrist. 

Public schools in the past had a nurse on staff and some even had social workers. Now when a student is having  or creating problems, many schools simply get rid of the  student with no follow-up and no help. This is unforgivable. Several of the recent school and college  shootings have been by former students expelled from school with no help for their mental health problems. I have a long list of these. I wish we could  have an R.N. and social worker in every school, including charter and private schools. I think we would save many lives.

Toys for Children with Special Needs

In a recent pediatric newsletter I found an article about buying toys for children with special needs. I was puzzled by one statement that said " Parents should chose toys that they can use to play together with their child". I disagree with that statement  because caring for a child with special needs often doesn't leave a lot of time to "play." Also, many parents don't enjoy games.  My first child loved big wood puzzles and I don't see how my helping her would have been  much fun for either of us. I  never enjoyed playing  games with my two children, but did when I could make the time. My granddaughter liked to play store and I did this occasionally, but I would have enjoyed reading to her much more. Children need  time to play on their own, be creative, and a parent's involvement may not make this possible. 

Some good points the article made were to "Choose toys for the child's developmental, not chronological age." It was also mentioned that the toy should be adjusted to fit the child.  Electronic toys can interfere with a child's creativity and traditional toys are the best. 

One of the most important points made in the article was that all toys should be checked for parts that could be removed  and put in the mouth. Little children will try to swallow unbelievable things and choking can be a hazard. So if you enjoy games and have the time to play with your little children, that is great.  I raised two very creative children, so I don't think either of them suffered by my not being a game-playing mother!