Rx For Parenting Today

Having a Baby during the Corona Virus Pandemic

I was remembering tonight what I felt like when I was having my first baby and cannot imagine what parents must be feeling if their baby is due in the next few months. I don't see this terrible virus being controlled any time soon because of Trump's terrible and incompetent leadership. If a baby is due this month or in the next few months, I think parents need to check to be sure the doctor and hospital they choose is being strict about masks, social distancing, and proper protective equipment. If you are near a big city that is good because most big hospitals will hopefully be doing a good job of protecting their staff and patients.  I would do a lot of networking, ask a lot of questions, and be sure that you have a back-up plan if you need to change hospitals or have any sudden problem such as a premature birth, a placenta previa, or unusual bleeding. 

Most hospitals are not allowing partners or husbands to be in the hospital now when a baby is born, so it is important that you can connect with a cell phone or be able to text. I remember when my daughter was born on September 21st in Stockton, California  and my husband left for a while to visit with old friends. It was a scary time because I was in labor and badly needed support. That was before we had cell phones and other ways to connect electronically. I was lucky to have a caring, competent obstetrician, so I made it through O.K. Now that mothers and babies are sent home after a day or so, plans need to be made for some help at home and the refrigerator stocked. I was a navy doctor's wife at that time and we were being transferred to Pensacola, Florida. Jennifer was due August 29th but the delay in her birth meant I was never able to go back to our little house on the Navy base, but instead was taken to a friend's house and then had a long drive to my parents house in southern California while my husband went on to Pensacola for flight training.  I am relating this to show that the best laid plans can change and you need to be prepared for this. Having a good support system is a must and having things in order at your house or apartment is important. That is even more true now because of the  pandemic.   

Giving Children with Disabilities the Best Possible Life

Having cared for children with disabilities for many years, I have seen some marvelous parents and some who did not even try to be parents.  One mother whose daughter I was examining in a clinic said "The day she was born was the worst day of my life."  The little girl was sitting right there and heard what her  mother said. I wonder how she interpreted it. The child had spina bifida which is a multisystem disorder and one that can overwhelm any parent. A loving parent or parents can make the difference  in a child's life but watching the interaction between this mother and child I suspected rocky times were ahead. Children with spina bifida usually have to  have several surgeries and  also have problems with bladder, bowel and  learning. However, with good surgeries, good education, and loving supportive parents, they can do very well.  Their early years are important and if they can gradually learn how to become independent and have good schooling, that is important.  

I have found many children with disabilities become quite manipulative to get good care, so limits, firm discipline, and chores and not spoiling them can make a difference. They must know that they are loved and treated as normally as possible. Finding a physician or clinic where good care is available can be difficult, but possible. 

On wonderful mother who adopted several children with disabilities said to me "We have celebrations about even little things." How lucky those children were to have a parent like that.  Teaching  children how to make wise choices as they grow up is important. The children often face bullying in and out of school and  need to be taught how to handle this. Now with social media this can be even more of a problem. Each child is precious and should be give the best possible quality of life. 

Parenting During this Awful Pandemic

I was thinking today what I would do if I had small or teenage children during this terrible pandemic. It would depend on whether I was a stay-at-home parent or a parent who could go to work. Being a stay-at-home parent would mean that I would have to be very creative and find ways for the children to keep busy. Watching lots of TV would not be the answer, but books, games, cooking, chores, puzzles and other things would have to be tried. The most important thing for a stay-at-home parent is to have some time for yourself. If that means having to hire someone to watch the children while you read a book, work in the garage, took a bath, or did some work of your own, that must be part of your day. No parent should devote the entire day to the children. Kids also need to find creative ways to amuse themselves if the are old enough to do so. A playpen for the  little ones would be important to keep them safe for short periods.

Being a self-sacrificing parent  with no life of your own is not going to help your family or yourself. Because it looks as if the virus will not be under control for many more months due to the ineptitude of Trump, I think plans need to be made and discussed about how we can all survive this difficult time. People who lived through other awful times like the polio epidemic and wars had to become very creative. I have great respect for friends in other countries who have told me how they survived during some terrible times.

Children Diagnosed with the Virus and What Needs to Be Done

Several sources today have noted that a half million children have been diagnosed with the corona virus. I could not find the ages involved and if these were children who had gone back to school. Yes, school is important but a child's health is more important. Unless a school is checking temperatures each day on entry, has a nurse on site, and has followed the strict requirements to reopen safely, I would be very hesitant about sending a child to school at this time. Sadly, only 40% of schools have a nurse on site and 35% of schools have a part-time nurse.

Nicholas Kristof had an excellent article on the editorial page of the New York Times about what is happening in low-income areas where children are being told that classes will be on-line. Yes, the children will perhaps be safer at home, but the problem is that the majority of these low-income children will not have computers and will lose a lot of teaching. Mr. Kristof noted that if these children miss just 10% of class days, this is associated with a seven-fold increase risk of dropping out. Special needs children must have the services law required by law in their IEPs but how these will be provided at this time is a problem. Creative ways must be found, so the children can receive what is needed outside of their schools. Schools need more federal aid, low income children must have computers if their schools will be online, and masks, social distancing, out-door classes when possible, and checking the ventilation systems must all be done or we will have more infected kids.

Additional Tips about Finding a Good Pediatrician

There was a good article today in the online version of the New York Times about finding a pediatrician. I agreed with most of it, but some crucial facts were missing. If your child has an after hours or weekend medical problem you want to be sure  the pediatrician will meet you in a hospital emergency room. ER doctors are fine for cuts, burns, trauma, or broken bones, but not for high fevers, ear infections, pneumonia or any of the other common problems a child may have. If a pediatrician sends parents to an ER for after hours or weekend care, I would find another doctor.

Another really important point is: will you be able to talk to the M.D. or just to the secretary or nurse if you have a problem you need to discuss?  One nurse told a former patient of mine when she called to speak to the doctor, "He won't tell you anything that I cannot tell you." It took a call to her mother and then to me and then my call to the doctor for the doctor to take the mother's call. Her child had had a small seizure!

Also if a child is old enough to answer questions or is a teenager, does the doctor talk to the child or just to the parents?  Kids should  be able to ask and answer questions and a good relationship between the doctor and child or teen is very important. 

Another really important tip is, does the doctor see all his or her patients or does a nurse practitioner see some of them? Unless the doctor sees all the children, that is not acceptable pediatric care. You can always change doctors if you are not satisfied with one you have seen.

Dr. Spock and Parenting Today

Dr. Benjamin Spock, a much loved pediatrician, wrote  Baby and Child Care, a book that has helped countless parents raise their children. I was very fortunate to hear him speak many years ago at U.C. San Francisco Medical School. He was also extremely kind to write a wonderful endorsement for my first book, Raising a Handicapped Child. Sometime ago I came across another book of his in a used bookstore. In re-reading parts of the book, I found some words of wisdom that are even more applicable today. He wrote about American Permissiveness stating that "When parents try too hard to be tolerant and patient, children miss the guidance they need. -----They are apt to provoke their parents with worse and worse behavior in order to force their parents to assume control_and to get the air cleared." I think Dr. Spock would be amazed at some of the parenting I see today. So many parents want to be their children's friends and are afraid to ever say "No". Children want and need boundaries. Then they know the rules and feel safe. When I was a small child, I always felt I was the parent and not my mother. Fortunately, my father set the rules and so I was O. K.

Dr. Spock also discussed how children are raised in other countries and how different parenting in some countries is so different from it is in America. I wonder what Dr. Spock would say if he were alive today. I wish more pediatricians and family doctors would teach parenting or hold parenting classes as I did when I was in pediatric practice. Our children are our future and they need to learn how to act and cope in this strange world we  live in today. 

 

 

Keeping Children Happy and Busy During the Pandemic

I was thinking today what I would do if I had small children and teens during this pandemic. Having survived 3 very hard years in Rochester, New York during long, long winters and short springs and summers, I  had to be very creative to keep  our two children busy. My daughter, even as a small child, loved puzzles and her brother loved building things. I found large paper blocks that were great and puzzles made out of wood. I did a lot of reading to the children, playing games with them and they helped me with cooking. Even small children like to help make cookies and a favorite was a cake you make all in one pan. Even as adults I think the two children made this cake. Little ones can help with chores and this gives them a feeling of being important and learning a new task.  I think all children and teens need chores. It makes them feel they are contributing  to the family and gives them a sense of pride. As children get older they can put on plays or skits and a dress-up box is a must for every household. I still have one my  grandchildren used. TV was never on in our house, except for programs like Captain Kangeroo and a few other children's programs. How lucky I was that we did not have computers then and social media. 

Keeping Small Children Safe

When small children begin to crawl there are lots of ways they can hurt themselves. Open wires or frayed cords, electric outlets and fireplaces can all be sources of trouble. You can buy covers for electrical outlets or it may be possible to order them from the Internet. Fire screens are essential and any plants that are poisonous should be put up and out of the way. If you have stairs, I would put a gate  at the top and bottom. A playpen can be a life-saver if the door bell or telephone rings. Also if someone is in the kitchen cooking, pot handles should be out of reach and nothing should be under the kitchen sink  a child can get into. The little cubes for dishwashers have caused injuries in children who  put them in their mouths. Kids will put almost anything in their mouths, so you need to anticipate that this can happen. 

Toy chest lids can fall on a child and the garage must be off-limit, as should the washing machine and dryer. Kids love to crawl into small spaces that may not always be safe. If a visitor has a big purse it should be put up high and not down where a child can get into it. It could contain medicine or several things of interest to a child. In my book, Your Personal Parenting Guide I list even more things and places that can be problems. There are many ways a child can be put in danger, so please check your house and yard carefully if you have a toddler or small children.

Parenting a Child to Prevent Allergies

Many parents of small babies have told me that their pediatricians and family doctors don't talk to them these days about what they should and should not feed their babies. I guess if you have to see a patient every 8-15 minutes that this is not on their minds. Sadly, if you have a baby and are from a family that has lots of allergies, food is a very important subject. We had some excellent professors when I was a medical student at the old  Stanford Medical School and I certainly followed their advice when I had my two children. My husband had quite severe asthma when he was stressed and I tried to be very careful about what I fed the babies, when I started a new food, and how long I tried a new food before I started another. I also checked labels on baby food jars and didn't give the babies mixtures of food. I was delighted to see that neither child grew up with allergies. I was also careful about what I ate when I was breastfeeding which is something we were also taught. Many babies and children are allergic to cows milk and a colicky baby may be an allergic baby. Constipation can be a sign of wheat intolerance and eczema can be on an allergic basis. 

 If your baby or child starts showing signs of allergy,  a pediatric allergist would be important to see. Foods that can cause problems are: chocolate, eggs, wheat, fish, nuts, citrus, and even soybean milk. There are now some other milks that can be given. I disagree with doctors who say small amounts of peanuts  are O.K. to try. I don't think we have adequate long-term studies. 

Resources for Parents of Twins

Learning to care for one baby is not easy but having twins can be very difficult though fun.  A  friend who is a twin and  comes from a family with several sets of twins has always been a great resource for me to help parents of twins. She recently told me that there is a town called Twinsburg in Ohio where they have an annual twins convention. In checking the Internet I discovered it will be cancelled this year. However, there is a Twins magazine that can be accessed either digitally or in print. Information is available about the magazine on the internet. There are also 200 chapters of twins clubs across the U.S. They offer a great deal of support. Twin births are slowly increasing, so now one of every thirty babies is a twin. 

There is a National Organization of Mothers of Twins Clubs that also offers a lot of information. Their number is 877-540-2200 and their website is www.nomotc.org. Another resource is www.twinsadvice.com.  One of most important thing I have always stressed to parents of twins is that the twins should be treated as separate individuals. They should not be dressed alike  and if possible be in different classes in school. Twins often have their own special language and it is important that they have playmates as they get older, so they don't just play with each other.

I have cared for many sets of twins and it has been fun to see  them  grow. I still hear from a favorite family who had twins and their first child is now a pediatrician who keeps in touch with me.